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The feminist approach in the decision-making process for treatment of women with breast cancer.

https://arctichealth.org/en/permalink/ahliterature166972
Source
Ann Acad Med Singapore. 2006 Sep;35(9):655-61
Publication Type
Article
Date
Sep-2006
Author
Ewa Szumacher
Author Affiliation
Education, Radiation Program, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada. ewa.szumacher@sw.ca
Source
Ann Acad Med Singapore. 2006 Sep;35(9):655-61
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Breast Neoplasms - therapy
Decision Making
Evidence-Based Medicine - methods
Female
Feminism
Humans
Abstract
The principal aim of this review was to investigate a feminist approach to the decision-making process for women with breast cancer. Empirical research into patient preferences for being informed about and participating in healthcare decisions has some limitations because it is mostly quantitative and designed within the dominant medical culture. Indigenous medical knowledge and alternative medical treatments are not widely accepted because of the lack of confirmed efficacy of such treatments in evidence-based literature. While discussing their treatment options with oncologists, women with breast cancer frequently express many concerns regarding treatment side effects, and sometimes decline conventional treatment when the risks are too high.
A search of all relevant literary sources, including Pub-Med, ERIC, Medline, and the Ontario Institute for Studies in Education at the University of Toronto was conducted. The key words for selection of the articles were "feminism," "decision-making," "patients preferences for treatment," and "breast cancer."
Fifty-one literary sources were selected. The review was divided into the following themes: (1) limitations of the patient decision-making process in conventional medicine; (2) participation of native North American patients in healthcare decisions; (3) towards a feminist approach to breast cancer; and (4) towards a feminist theory of breast cancer.
This article discusses the importance of a feminist approach to the decision-making process for treatment of patients with breast cancer. As the literature suggests, the needs of minority patients are not completely fulfilled in Western medical culture. Introducing feminist theory into evidence-based medicine will help patients to be better informed about treatment choices and will assist them to select treatment according to their own beliefs and values.
PubMed ID
17051283 View in PubMed
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Helping learners in difficulty--the incidence and effectiveness of remedial programmes of the Medical Radiation Sciences Programme at University of Toronto and the Michener Institute for Applied Sciences, Toronto, Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature160929
Source
Ann Acad Med Singapore. 2007 Sep;36(9):725-34
Publication Type
Article
Date
Sep-2007
Author
Ewa Szumacher
Pamela Catton
Glen A Jones
Renate Bradley
Jeremy Kwan
Fiona Cherryman
Cathryne Palmer
Joyce Nyhof-Young
Author Affiliation
Department of Radiation Oncology, Toronto Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada.
Source
Ann Acad Med Singapore. 2007 Sep;36(9):725-34
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Education, Medical - standards
Educational Measurement
Female
Humans
Male
Ontario
Radiation Oncology - education
Remedial Teaching - methods
Retrospective Studies
Students, Medical - psychology
Universities
Abstract
Academic difficulty can often be a significant problem for students in health professional programmes. Students in difficulty are often identified late in their training and run the risk of dismissal if remediation is not successful. Since the inception of the Medical Radiation Sciences Program (MRSP) at the University of Toronto, Faculty of Medicine, and the Michener Institute (MI) in 1999, a number of students have required remediation due to problems in the didactic or clinical component of their training. Not all remediation was successful, and a number of students have been dismissed. There is relatively sparse evidence in the educational literature regarding the nature of academic difficulties that health professional students encounter, and what constitutes appropriate remedial education. The purpose of this research was to evaluate the incidence and prevalence of remediation in the MRSP and the nature of the academic problems. In addition, this study looked at the type of remedial instruction that the Radiation Sciences Board of Examiners (BOE) recommended for these students as well as the effectiveness of these recommendations.
This study consisted of a review of the academic records of students who failed one or more courses and underwent pre-clinical or clinical remediation, and who were presented at the Medical Radiation Sciences Board of Examiners at the University of Toronto between September 1999 and December 2004. Data extraction forms were developed to obtain demographic information, the nature of the academic problems, the remedial recommendation, and their outcomes.
This study identified 69 students who were presented to the BOE 95 times. Forty-four students (44/69, 64%) were from the Radiation Therapy stream, 16 students (16/69, 23%) were from the Nuclear Medicine stream and 9 students (9/69, 13%) were from the Radiographic Technology stream. Most of the remediation occurred due to pre-clinical 50 (50/69, 72%), clinical 15 (15/69, 22%) and both preclinical and clinical problems 4 students (4/69, 6%). Out of 54 students who required pre-clinical remediation, 40 (74%) were promoted. Out of 19 students who required clinical remediation, 10 (10/19, 53%) passed their remediation. Six students (6/69, 9%) were dismissed from the programme due to unsuccessful remediation; 2 due to pre-clinical and 4 due to clinical problems. Based on these results, the remediation process at the MRSP was successful; however, 6 students (6/69, 9%) were dismissed from the programme during the last 4 years despite lengthy unsuccessful remediation.
Our study provided an important perspective about the remediation process at the MRSP at the Michener Institute for Applied Health Sciences. Despite its retrospective methodology, it attempted to identify the magnitude of learning problems that lead to remediation, and identified the efficacy of the remedial programmes.
PubMed ID
17925980 View in PubMed
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Multidisciplinary radiation oncology palliative care rounds as a continuing educational activity implementing the rapid response radiotherapy program at the toronto sunnybrook regional cancer centre.

https://arctichealth.org/en/permalink/ahliterature184259
Source
J Cancer Educ. 2003;18(2):86-90
Publication Type
Article
Date
2003
Author
Ewa Szumacher
Edmee Franssen
Charles Hayter
Cyril Danjoux
Edward Chow
Lourdes Andersson
Rebecca Wong
Andrew Loblaw
Author Affiliation
Department of Radiation Oncology, University of Toronto, Ontario, Canada. ewa.szumacher@tsrcc.on.ca
Source
J Cancer Educ. 2003;18(2):86-90
Date
2003
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Cancer Care Facilities
Education, Medical, Continuing - methods
Humans
Neoplasms - radiotherapy
Ontario
Palliative Care
Patient care team
Physicians
Program Evaluation
Radiation Oncology - education - methods
Abstract
This paper describes the development of the Rapid Response Radiotherapy Program and evaluates the continuing medical education (CME) series, in the form of multidisciplinary monthly Radiation Oncology Palliative Care Rounds at the Toronto Sunnybrook Regional Cancer Centre.
Palliative care rounds were initiated by the multidisciplinary committee in September, 1998. From January, 2000, to June, 2002, attendees used a standard 5- point Likert rating scale to conduct formal evaluations.
A total of 203 evaluation forms examining 20 rounds have been collected. Findings indicated that 86.8, 96.0, 87.1, and 90.8% of participants thought the material of the presentation was relevant to their practice, interesting, and instructional. Overall 90.1% of the respondents highly rated the grand rounds (rating of 4 or 5).
The grand rounds are an effective CME activity at our hospital.
PubMed ID
12888382 View in PubMed
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Ontario radiation oncology residents' needs in the first postgraduate year-residents' perspective survey.

https://arctichealth.org/en/permalink/ahliterature163735
Source
Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):512-7
Publication Type
Article
Date
Oct-1-2007
Author
Ewa Szumacher
Eiran Warner
Liying Zhang
Gabrielle Kane
Ida Ackerman
Joyce Nyhof-Young
Olusegun Agboola
Catherine de Metz
George Rodrigues
Sachi Voruganti
Susan Rappolt
Author Affiliation
Department of Radiation Oncology, Toronto Regional Cancer Centre, Toronto, Ontario, Canada. Ewa.Szumacher@sunnybrook.ca
Source
Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):512-7
Date
Oct-1-2007
Language
English
Publication Type
Article
Keywords
Adult
Faculty, Medical - standards
Female
Humans
Internship and Residency - standards
Male
Middle Aged
Ontario
Personal Satisfaction
Program Evaluation
Questionnaires
Radiation Oncology - education - standards
Stress, Psychological - prevention & control
Abstract
To assess radiation oncology residents' needs and satisfaction in their first postgraduate year (PGY-1) in the province of Ontario.
Of 62 radiation oncology residents, 58 who had completed their PGY-1 and were either enrolled or had graduated in 2006 were invited to participate in a 31-item survey. The questionnaire explored PGY-1 residents' needs and satisfaction in four domains: clinical workload, faculty/learning environment, stress level, and discrimination/harassment. The Fisher's exact and Wilcoxon nonparametric tests were used to determine relationships between covariate items and summary scores.
Of 58 eligible residents, 44 (75%) responded. Eighty-four percent of residents felt that their ward and call duties were appropriate. More than 50% of respondents indicated that they often felt isolated from their radiation oncology program. Only 77% agreed that they received adequate feedback, and 40% received sufficient counseling regarding career planning. More than 93% of respondents thought that faculty members had contributed significantly to their learning experience. Approximately 50% of residents experienced excessive stress and inadequate time for leisure or for reading the medical literature. Less than 10% of residents indicated that they had been harassed or experienced discrimination. Eighty-three percent agreed or strongly agreed that their PGY-1 experience had been outstanding.
Most Ontario residents were satisfied with their PGY-1 training program. More counseling by radiation oncology faculty members should be offered to help residents with career planning. The residents might also benefit from more exposure to "radiation oncology" and an introduction to stress management strategies.
Notes
Comment In: Int J Radiat Oncol Biol Phys. 2008 Mar 1;70(3):963-418262111
PubMed ID
17482769 View in PubMed
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