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23. Overconfidence among physicians and nurses: the 'microcertainty' phenomenon

Author

Baumann, Andrea O., Deber, Raisa B., and Thompson, Gail G.

Subjects
Physicians -- Practice, Clinical competence -- Evaluation, Breast cancer -- Care and treatment, Decision-making -- Usage, Nurses -- Practice, Medical personnel -- Practice, Health, Social sciences
Abstract

Overconfidence in clinicians was examined in two independently designed studies, each using a different research approach. The first study examined treatment choices of physicians in treating breast cancer, and the second rapid decision making among nurses working in Intensive Care Units. In both studies, individual respondents were highly confident they had made the right choice ('micro-certainty'), although there was no consensus across respondents as to what the optimal treatment would be ('macro-uncertainty'). The difference between micro-certainty of individuals and macro-uncertainty within the clinical community may cast some light on the persistence of practice variation. The implications of overconfidence in clinical treatment for patients, practitioners, and professional regulation are discussed.

Published
1991

25. Attractiveness of employment sectors for physical therapists in Ontario, Canada (1999-2007): implication for the long term care sector

Author

Landry Michel D, Hastie Robyn, Oñate Känecy, Gamble Brenda, Deber Raisa B, and Verrier Molly C

Subjects
Physical therapy, Health human resources, Workforce, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Recruiting and retaining health professions remains a high priority for health system planners. Different employment sectors may vary in their appeal to providers. We used the concepts of inflow and stickiness to assess the relative attractiveness of sectors for physical therapists (PTs) in Ontario, Canada. Inflow was defined as the percentage of PTs working in a sector who were not there the previous year. Stickiness was defined as the transition probability that a physical therapist will remain in a given employment sector year-to-year. Methods A longitudinal dataset of registered PTs in Ontario (1999-2007) was created, and primary employment sector was categorized as ‘hospital’, ‘community’, ‘long term care’ (LTC) or ‘other.’ Inflow and stickiness values were then calculated for each sector, and trends were analyzed. Results There were 5003 PTs in 1999, which grew to 6064 by 2007, representing a 21.2% absolute growth. Inflow grew across all sectors, but the LTC sector had the highest inflow of 32.0%. PTs practicing in hospitals had the highest stickiness, with 87.4% of those who worked in this sector remaining year-to-year. The community and other employment sectors had stickiness values of 78.2% and 86.8% respectively, while the LTC sector had the lowest stickiness of 73.4%. Conclusion Among all employment sectors, LTC had highest inflow but lowest stickiness. Given expected increases in demand for services, understanding provider transitional probabilities and employment preferences may provide a useful policy and planning tool in developing a sustainable health human resource base across all employment sectors.

Published
2012
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36. Canadian Medicare: can it work in the United States? Will it survive in Canada?

Author

Deber, Raisa B.

Subjects
Health care reform -- Models -- Comparative analysis, Medical policy -- Comparative analysis -- Models, Canada -- Social policy
Abstract

I. INTRODUCTION Canada's system of universal health insurance, which, in a probable effort to confuse Americans, we call Medicare, is both popular and, in general, highly successful.(1) It combines relatively [...]

Published
1993

43. A032 – Health, lifestyle and aging with Multiple Sclerosis: A qualitative study

Author

Arnold, Catherine M., Faulkner, Robert A., Ploughman, Michelle, Austin, Mark, Kearney, Anne, Murdoch, Michelle, Stefanelli, Mark, Godwin, Marshall, Muir, Susan W, Speechley, Mark, Borrie, Michael, Montero-Odasso, Manuel, MacKay-Lyons, M, Creaser, G, Macdonald, A, McKenna, J, Murphy, S, O'Neill, VR, Nilsson, T, Begley, L, Ikert, Kathy M., Long, Kristin M., Bittner, Darren R., Birmingham, Trevor B., Bryant, Dianne M., Richardson, Julie, Letts, Lori, Chan, David, Stratford, Paul, Hand, Carri, Price, David, Hilts, Linda, Coman, Liliana, Edwards, Mary, Baptiste, Sue, Law, Mary, Alexander, Elliot, Rosenthal, Stephanie, Guilcher, Sara, Evans, Cathy, Gattey, M, Hydomako, R, McLean, B, O'Leary, J, Shkopich, K, Klassen, L, Laprade, Judi, Roy, Marla, Laing, M, Di Nicolantonio, L, Goncharova, K, Pui, M, Vas, H, House, R, Switzer-McIntyre, S, Cheifetz, O, Serediuk, F, Park Dorsay, J, Hladysh, G, Woodhouse, L, Dalzell, MA, Shallwani, S, Preuss, RA, Patterson, Debbie, Ptak, Janice, Howe, JA, Brunton, K, Salisbury, K, Sharma, SK, Childerhose, DE, Sharma, S, WalkerJohnston, JA, Barnes, JL, Fisher, Megan E., Aristone, Martha N., Young, Katrina K., Waechter, Laurie E., Landry, Michel D., Taylor, Leslie A., Cooper, Nicole S., Wong, S, Hébert, Luc J., Rowe, Peter, Debouter, Kelly, Lai, Denise, Winn, CS, Chisholm, BA, Hummelbrunner, JA, Wasson, Pamela, Passalent, L, Soever, L, Kennedy, C, Warmington, K, Shupak, R, Thomas, R, Linekar, S, Lundon, K, Morgan, Dale, Kelly, Larry, Hastie, Robyn, Deber, Raisa B., Verrier, Molly C., O'Callaghan, L, Alexander, E, Titus, D, MacDougall, P, Hoens, AM, Garland, SJ, Tunnacliffe, R, Lineker, S, Varatharasan, N, Schneider, R, MacKay, C, Murphy, SM, Wu, Kenneth, Fox, Patricia, Tullis, Elizabeth, Stephenson, Anne L., Davis, AM, Mahomed, N, Badley, EM, Scott, Lisa, Carpenter, Christine, Brander, Rosemary R., Paterson, Margo L., Chan, Yolande E., Reinikka, KJE, French, E, Huijbregts, M, Cleaver, SR, Paulenko, T, Hebert, D, Creaser, GA, MacKenzie, D, Barkhouse-McKeen, C, Shrier, Ian, Freeman, K, Davidson, L, Pelland, L, Wilson, Nicole, Hopkins-Rosseel, Diana, Fraser, M, Wainwright, G, MacCormack, B, Basque Godin, C, Mori, B, Evans, C, Gibson, BE, Thornton, M, Dutton, T, King, J, Lawrence, PJ, Duggan, M, Hoens, A, Geddes, E Lynne, Gill, Caroline, Fong-Lee, Dianna, Lindsay, Jane, McPhail, Stacey, McIntosh, Karen, Marken, Suri L., Dutton, Tanya, Hopkins-Rosseel, DH, Kasdan, P, Fong-Lee, D., Marken, Siri, Moreside, JM, McGill, SM, Juma, S, Winter Di Cola, JL, Kennedy, DM, Dickson, P, Denis, S, Robarts, S, Gollish, J, Salbach, NM, Veinot, P, Jaglal, SB, Bayley, M, Rolfe, D, Dogra, M, Woodhouse, LJ, Spadoni, GF, Stratford, PW, Fox, P, Sessford, J, Beaton, D, Harniman, E, Inrig, T, Baxter, K, Portanova, A, Smuck, L, Connelly, DM, Shaw, J, Adkin, A, Jog, M, Hollway, D, Earl, M, Murphy, A, MacDonald, E, Overend, TJ, Brooks, D, Anderson, CM, Cicutto, L, Keim, M, McAuslan, D, Nonoyama, M, Levac, D., Pierrynowski, M., MacPherson, M, Glassman, L, Jadan, P, MacArthur, L, Landry, M, Frenette, J, Dumont, N, Moreland, JD, DePaul, VG, DeHueck, AL, Musselman, KE, Yang, JF, Tousignant, M, Moffet, H, Boissy, P, Corriveau, H, Cabana, F, Marquis, F, Towns, Megan, Barrett, Lauren, Darling, Catherine, Lee, Michelle, Aganon, Isabel, Hill, Kylie, Brooks, Dina, Robbins, Shawn, Alcock, Greg, Maly, Monica, Jones, Gareth, Birmingham, Trevor, Glazebrook, Cheryl M., Wright, F. Virginia, Martin, MBA, Norton, B, Ramsaran, KD, Street, ME, Syed, SN, Dang, MT, Barclay-Goddard, R, Stratford, P, Miller, P, Karam, J., Zettel, M., Green, K., Carter, D., Lam, F., Evans, C., Yeung, E., Lindquist, NJ, Magis, TF, Rispin, JE, Walton, PE, Kirby, RL, Manns, PJ, Haller, MK, Marler, K, Lore, S, Sottana, B, Crowley, A, Beaudin, V, Sloan, C, Landry, SC, Nigg, BM, Tecante, KE, Albers, Pamela, Devon, Heidi, Nairn, Lacey, Olenick, Betsy, Roach, Stephanie, Arnold, Cathy, Watts, Cathy, Wieler, M, Jones, CA, Allen, J, Haennel, R, Shaw, JA, Zecevic, A, Dal Bello-Haas, V, Harrision, L, Kanthan, R, Lawson, S, Zaluski, N, Petrie, A, Rohs, J, Parker, R, Roy, JS, MacDermid, JC, Roth, JH, Grewal, R, Officer, Alexis, DePaul, Vincent, Bosch, Jackie, Wilkins, Seanne, Wishart, Laurie, Inness, EL, Mansfield, A, Biasin, L, Prajapati, S, Lakhani, B, Mileris, R, McIlroy, WE, Henderson, RJ, Vanik, J, Alyoshkina, N, Diamond, C, Lee, J, Martinov, K, O'Brien, KK, Alexander, R, King, K, Murray, J, Tebeje, M, Bayoumi, AM, Bereket, T, Swinton, M, Norman, G, Solomon, P, Anstey, S, Bethune, M, Thomas, A, Wood-Salomon, E, Curwin, S, D'Amboise, SN, Héroux, ME, Pari, G, Norman, KE, Lee, Linda-Joy, Coppieters, Michel W., Hodges, Paul W., Perreault, Audrey, Tremblay, Louis E., Thibault-Gagnon, S, Gentilcore-Saulnier, E, McLean, L, Kay, JL, McNeely, ML, Campbell, KL, Peddle, CJ, Courneya, KS, Subramanian, SK, Levin, MF, Dechman, G, Tupper, SM, Levesque, L, Reese, H, Nailer, T, Walton, D, Schachter, CL, Stalker, CA, Teram, E, Lasiuk, G, Bartlett, Doreen, Chiarello, Lisa, Jacobs, Diane, Busch, Angela, Novak, Christine B., Anastakis, Dimitri J., Beaton, Dorcas E., Mackinnon, Susan E., Katz, Joel, Figueiredo, S, Finch, L, Jiali, M, Ahmed, S, Huang, A, Mayo, NE, Lochhead, Lois, MacMillan, Peter, DePaul, V, Burridge, H, Kwok, C, Rosario, J, Stogios, C, McKay, E, Moyer, E, Wishart, L, Holly, J, DYER, Joseph-Omer, MAUPAS, Éric, de ANDRADE MELO, Sibele, BOURBONNAIS, Daniel, FORGET, Robert, Shrier, I, Boudier-Reveret, M, Feldman, D, Mazer, B, Rege, SS, Soever, LJ, Fenety, Anne, Hoens, Alison, Harman, Katherine, Bassett, Raewyn, Byrne, Jeannette M., Prentice, Stephen D., Carlesso, Lisa, Cairney, John, Hoogenes, Jennifer, Gabison, S, Nussbaum, EL, Taillon-Hobson, A., McLean, L., Aaron, S., Bilodeau, M., Taillon-Hobson, Anne, McLean, Linda, Aaron, Shawn, Bilodeau, Martin, Zbarsky, Kathryn, Parsley, Dana, Clegg, Heather, Welch, Tyler, Fernandes, Catherine, Jaglal, Susan, Inness, Liz, Williams, Josh, McIlroy, William, Howe, Jo-Anne, Yardley, D, Benoit, M, Blake, T, Gillies, G, Ho, R, MacKinnon, M, Chesworth, BM, Busch, AJ, Dooley, A, Coons, S, Crockett, K, Mucha, J, Kean, CO, Birmingham, TB, King, LK, Giffin, JR, Lourenço, Christiane B., Subramanian, Sandeep, Sveistrup, Heidi, Levin, Mindy F., DESMEULES, FRANÇOIS, DIONNE, CLERMONT E., BELZILE, ÉTIENNE L., BOURBONNAIS, RENÉE, FRÉMONT, PIERRE, Richards, CL, Schneider, GM, Smith, AD, Bath, B, Bourassa, R, Lovo Grona, S, Schneider, KJ, Emery, Carolyn, Norman, Kathleen, Pearson, Neil, Woodhouse, Linda, Pelland, Lucie, Werstine, Rob, and Schneider, Kathryn

Subjects
active transfer strategies for informing clinical practice through information technologies, injury prevention, health human resources management strategies, Merging Research and Practice, implementation and management strategies, Abstracts, clinical experience, clinical skills and clinical reasoning modules in orthopaedic practice, Special Sessions, evolving physiotherapist roles, chronic disease prevention, neurological, basic science or clinically focused research on targeted physiotherapy interventions, Scientific sessions, fundamental scientific research, mobility, Newfoundland, Canadian Physiotherapy Association Congress 2010, population health services, advances in research related to neuromusculoskeletal practice, health system reform, patient and client preference, clinical research and the reciprocal transfer of knowledge between clinical practice and research, innovative service delivery models, post-operative management of acute care patients, promotion of research, practice and patient/client care in the neuromusculoskeletal area, Canada, assessment and treatment of disability that arises from both spinal and peripheral pathologies, Abstracts, CPA Congress 2010, role of physiotherapists in primary health care, exercise prescription, Physical Therapy, Sports Therapy and Rehabilitation, Health Promotion, clinical decision making, St. John's, evidence based practice model, informing the development of clinical research questions, determinants of health, innovative models of practice, physiotherapy leadership development, Physio10, Leadership in Action, public and patient education, musculoskeletal, benchmarking areas of practice, inter-professional collaboration and education strategies, Neuromusculoskeletal Practice, public, private and independent practice management of physiotherapy services, Merging Research with Practice, cardio-respiratory
Published
2010

45. Accountability through Regulation in Ontario's Medical Laboratory Sector

Author

Gamble, Brenda, Bourne, Lavern, and Deber, Raisa B.

Subjects
Interviews as Topic, Male, Ontario, Financing, Government, Social Responsibility, Quality Assurance, Health Care, Organizational Case Studies, Humans, Female, Documentation, Clinical Laboratory Services, Licensure, Research Paper
Abstract

Although the use of performance indicators for the analytical (and highly measurable) phase of the medical laboratory process has had a long and successful history, it is now recognized that the value of a laboratory test is embedded in a system of care. This case study, using both documents and interview data, examines the approaches to accountability in the Ontario Medical Laboratory Sector, noting both the challenges and benefits. This sector relies heavily on the regulation instrument, including a requirement that all medical laboratories licensed by the provincial government must follow the guidelines set out by the Quality Management Program - Laboratory Services. We found the greatest challenges exist in the pre-analytical phase (where a large portion of total laboratory errors occur), particularly the interface between the laboratory and other providers.

Published
2014

47. Communications

Author

Corsi, Jerome R., Bruell, Christopher, Deber, Raisa B., Gray, Virginia, Diggins, John P., Gregor, A. James, Tullock, Gordon, Riker, William H., Brams, Steven J., Bernholz, Peter, Riker, William H., and Harsanyi, John C.

Published
1974

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