By Meagan Ryan, RN, PhD (c)
Assistant Professor, Rankin School of Nursing, St. Francis Xavier University
Corresponding author

Patti Hansen-Ketchum, RN, PhD
Associate Professor, Rankin School of Nursing, St. Francis Xavier University

Ryan E.R. Reid, PhD
Associate Professor, Department of Human Kinetics, St. Francis Xavier University

Brittany A. MacDonald-MacAulay, P.Eng, PhD
Assistant Professor, Department of Engineering, St. Francis Xavier University

James A. Hughes, PhD
Associate Professor, Department of Computer Science, St. Francis Xavier University

Aidan Murdock, BScN Student
Research Assistant, St. Francis Xavier University

Citation: Ryan, M., Hansen-Ketchum, P., Reid, R. E.R., MacDonald-MacAulay, B. A., Hughes, J. A. & Murdock, A. (2025). RN-led platform for collaborative patient care: A digital innovation pilot study. Canadian Journal of Nursing Informatics, 20(4). https://cjni.net/journal/?p=15670

Abstract

Effective coordination and real-time communication are essential for delivering high-quality, person, and family-centered care among various health providers. Registered Nurses, as leaders of intra and interprofessional care teams, play a pivotal role in the oversight of evidence-informed care, ensuring accountability of all providers in the implementation of quality care. Challenges in communication, coordination, and follow-up can hinder the effectiveness of collaborative care in many health systems and are exacerbated by ongoing staffing shortages, increased patient acuity, and complex demands of patient and family-centered care. An evolving digital technology solution is central to Registered Nurses to help lead and document interaction and decision-making among care providers, including check-ins, post-care reviews, and continuity of care, transforming how care teams can work together to meet the needs of patients and families. A digital platform is currently under design, tailored to a rural health setting, and optimized through a multi-phased research program facilitated by a collaborative team of interdisciplinary researchers. This article captures the first phase, a fundamental pilot study of the software functionality in a simulated health care environment.

Keywords: Collaboration, Teamwork, Accountability, Digital Augmentation, Pilot Study, collaborative care, nurse-led teams

Introduction

Leadership in nursing practice involves critical questioning, evidence-informed decision-making, and collaboration among health providers in the implementation, documentation, and evaluation of interventions for quality care. Effective coordination and real-time communication are essential for delivering high-quality, person, and family-centered care among various health providers in hospital and long-term care settings. Registered Nurses (RNs), as leaders of intra and interprofessional care teams, play a pivotal role in the oversight of evidence-informed care plans, ensuring accountability of all providers in the implementation of quality care for patients and families. However, many RNs and other health providers continue to struggle managing the significant gaps in communication, coordination, and follow-up in their practice, which hinder the effectiveness of collaborative care required across health systems.

Registered nurses often face fragmented communication among care providers, relying on delayed documentation and informal hallway conversations. These challenges are exacerbated by ongoing staffing shortages, increased patient acuity, and the complex demands of patient and family-centered care across health systems. RNs are accountable for ensuring that interventions are implemented, documented, and evaluated within designated timeframes but team members and the absence of seamless communications and follow-up can undermine their ability to do so. Across Canada, there are gaps in technological solutions that could help support real-time collaboration, accountability to care, and improve patient outcomes. An innovative technological solution designed specifically for RNs to help facilitate real-time communication, collaborative care planning, and follow-up can transform how care teams work together to meet the needs of patients and families.

A solution-focused platform is currently under design via multi-phased research trials, led by a team of interdisciplinary researchers from nursing, engineering, computer science, and kinesiology. This initial pilot study aims to conceptualize and acquire input on the functionality of the early design and application of the real-time collaborative care platform in a simulated healthcare environment. The stakes remain high since care delivery and accountability affect the health of all.

Background

Various digital tools and platforms are adopted to improve communication and collaboration in healthcare settings across North America. For instance, communication platforms like Telmediq and Vocera (Vocera, 2020) are adopted in parts of Canada (British Columbia and Ontario) to enhance connectivity between care providers through secure messaging, alerts, and virtual visits among other features. These tools allow healthcare providers, particularly physicians, to bypass traditional barriers, such as paging systems or delayed information sharing. Barriers to the widespread use of communication technologies tend to include a lack of interoperability, insufficient training, and resistance to change among healthcare providers (Zakerabasall et al., 2021). Staffing shortages and increasing workloads further intensify these challenges, as healthcare providers may perceive new technologies as an additional burden rather than a solution. Further, many existing tools are designed with a focus on administrative efficiency rather than real-time clinical collaboration, which limits their utility for RNs leading care teams. In Canada, digital tools in health systems tend to be used in the transition of patient information between healthcare facilities or between units rather than in the delivery of moment-to-moment care at the bedside. RN-led apps have not yet been designed for use in collaborative delivery and evaluation of real-time care within health facilities.

Across Canada and in Nova Scotia particularly, many healthcare providers rely on informal communication methods, such as hallway conversations or fragmented paper-based systems, which fail to ensure accountability and real-time decision-making. While platforms, like Meditech Expanse, have been used to enhance electronic health record (EHR) integration, they do not adequately support the real-time interprofessional collaboration required of the RN leadership role in coordinating care. There is a need for innovative, nurse-driven solutions that address gaps in communication, documentation, and collaboration among care teams (Canadian Nurses Association [CNA], 2024). Research on real-time collaborative platforms suggest they can significantly improve care coordination, reduce errors, and enhance accountability (Foronda, et al, 2016; Middleton et al. 2013). Various mobile apps tailored to the needs of RNs and care teams, as captured in a scoping review (Nezamdoust et al., 2022), have shown promise in pilot studies across the globe.

Nursing has extensive, yet still unleashed potential for leading digital innovation (Booth et al., 2023). RNs gain frontline, evidence-informed insight into digital and other innovative solutions for leading patient and family care. By leveraging insights from existing technologies and addressing identified gaps, the development of a tailored platform for RNs in Nova Scotia could help revolutionize collaborative care in healthcare settings. For RNs, who are accountable for leading care teams and ensuring quality care, such tools can help support and enhance their leadership capacity, leading to improved outcomes for patients and families (Nezamdoust et al., 2022). On-going research is critical to further design, pilot (i.e., simulated environment), and evaluate these tools across various health care settings. As a starting point, the research design for this pilot originates from the following related research questions:   

How does the implementation of the collaborative care platform influence the coordination of care, including the real-time communication and accountability among health providers in the care of patients and families?

What are the strengths and challenges to the implementation of the RN-led collaborative care platform in simulated patient care scenarios?

Methods

The methodological assumptions of this study were informed by critical realism, socio-ecological perspectives, and design thinking (Bhaskar et al.; 2016; Archer, 2017; Brown, 2019). Critical realism highlighted the importance of diverse perspectives to help critically examine the complex interplay of social and systemic factors within the case. Socio-ecological thinking provided a framework for understanding individual-level experiences as dynamically situated within and influenced by organizational and policy-level contexts (Bronfenbrenner & Evans, 2000). Design thinking emphasized iterative, human-centered problem-solving approaches that integrated empathy, creativity, and systems thinking to address complex challenges (Brown, 2019; Carlgren et al., 2016).

The research design for this pilot study employed a case study approach using qualitative analysis. The case study design aligned with real-life contexts (Yin, 2014), and the pilot approach enabled in-depth examination of the interactions and learning processes during simulated scenarios (Cowperthwait, 2020). Data collection methods included semi-structured focus groups with participants involved in the simulated care scenarios, to acquire qualitative insights.

Setting

The case study involved the role play of four simultaneous patient care scenarios using high-fidelity manikins and one human actor as patients, with nursing educators as participants who simulated the roles of healthcare providers in a state-of-the-art hospital-based simulation centre on a university campus. The simulation involved clinical decision-making scenarios where participants used an interactive digital platform to communicate and collaborate with one another as health care providers in the provision of patient care. The patient care process required prioritization, communication, collaborative decisions, and follow-up using the digital platform.

The digital platform used for this pilot study was Microsoft (MS) Teams, specifically programmed for participants to create, delegate, and follow-up on care plan interventions, documenting and communicating in real-time among providers in the process. This platform was selected because it can perform the rudimentary communication features to be used in this pilot study. This allowed the research team to evaluate the basic communication features to optimize in the next phases of this research project. The platform was a cost-effective choice for the pilot and is accessible to use by application or webpage on varying devices, iPads in this case. iPads were chosen because they were adaptable and readily available within the university for in-kind use in the simulation lab.

The simulation was designed to mimic real-time interactions and communication options during simulated patient care, accessible through a tablet interface, in this instance, an iPad; the core requirement for this stage was access to MS Teams The patient scenarios involved the care of four acutely ill and recovering adult patients among three providers, namely a Registered Nurse, Licensed Practical Nurse, and a Continuing Care Assistant in a rural health care context. The patients had evolving health conditions that required the providers to collaborate, assign, delegate, and report on care interventions and communicate outcomes over time using the digital platform.

The participants were pre-briefed on the patient scenarios, their individual and collective roles, and the use of the digital platform. The pre-brief included an overview of the MS Teams application on the iPads by the research team. Participants had the opportunity to explore the features of MS Teams and ask questions as needed to the research team. A video that demonstrated how to navigate through the screens and required functions was provided before the pre-brief and again during the pre-brief time. Once the participants reported feeling comfortable with using MS Teams, they were then provided with the simulated patient scenarios and provided time to ask questions about each patient. The researchers showed the participants each simulated patient room and oriented participants to the equipment that was in place to enhance the realistic experience.

Those who participated in the study took part in the simulation scenarios, followed by a focus group discussion for their input. The duration of the simulation was approximately 60 minutes, as was the focus group discussion.

Participant Sample

Nurse educators who were employed within a School of Nursing and who had at least five years of RN experience with acute patient and family care were recruited for the study. Participants were recruited from a population of 10 eligible nurse educators within a university nursing department. Purposive sampling was used and six participants were recruited. The simulated case scenario and associated focus group discussions were facilitated twice with two separate groups of participants.

There were no known power differentials, nor were there any known or anticipated risks or harms in the participation of the simulated scenarios or in the focus groups. The pilot study was approved through the university’s research ethics board (Romeo #27782). The aggregate data, including themes and related quotes, emerged from de-identified participants.

Data Collection

Focus groups, which were used to collect data on participants’ experiences, often prove to be an effective method of data collection for case studies. Focus groups provide an opportunity for participants to share experiences, which can expand critical thinking capacity and contribute to the synthesis of ideas among the group (Krueger & Casey, 2000). Focus groups offer a synergistic environment for participants, building on the responses of others in the discussion.

The focus groups were in-person and facilitated by the researchers, whose roles were to ask questions, listen, keep the conversation on track, and ensure that all participants had an equal opportunity to participate in the discussion. A semi-structured approach was used to guide the focus group questions and discussions. The information collected from these focus groups included the barriers and facilitators of the collaborative care software platform in the provision of patient care. The focus group conversations were audio-recorded and transcribed by Microsoft Teams. Additional notes were taken in real-time by the researchers present.

Data Analysis

Qualitative data were analyzed using thematic analysis. This method of data analysis was focused on identifying common patterns that emerged from the focus group discussions. Such themes were substantiated by the data and conceptualized collectively by the researchers. The audio-recorded discussions from the focus groups were transcribed and coded to “detect reoccurring patterns” (Miles, et al., 2014, p. 73). Data with corresponding patterns were grouped together to develop a thematic structure that helped to relate and connect meaningful portions of the discussions.  

Results

Thematic analysis of the data yielded six distinct themes: (1) communication and collaboration; (2) professional development and relational care; (3) coordination of care and team-based visibility; (4) contextual fit and clinical appropriateness; (5) workflow integration and system optimization; and (6) accountability, responsibility, and legal considerations. As illustrated in Figure 1, these themes encompass the complexity of the health system and vary in system integration.

Figure 1

Core Themes

Theme One: Communication & Collaboration

This theme encompasses the use of verbal and digital communication strategies, appropriateness of communication methods (i.e., synchronous versus asynchronous), and utility in collaboration across disciplines. Verbal strategies of communication were largely preferred by participants when acute patient conditions occurred. The instinct to relay information verbally instead of on the platform is shown:

“We keep running into each other, so naturally your instinct is to say in person “Go do this”. So then it made it like, OK. I have to put it in here”.

However, value was recognized in the use of asynchronous communication on the digital platform, despite reporting that it can be “awkward” and “slower” at times. Participants cited that when it comes to team collaboration, use of the digital application to organize, document, and plan care during team huddles was helpful in bridging the communication and collaboration gap in their practice experiences. As the patient case scenarios continued to evolve and become more complex, participants noted that collaboration became increasingly difficult to maintain, particularly in the follow-up from care providers on the interventions for patient care. One of the participants stated:

 “In my mind when you think about your code management like that closed loop communication. I feel like you get that face-to-face and I didn’t feel like I got it from here”.

Another participant suggested that:

“It (the technology) should have a way to capture closed loop communication. So that when task is assigned or delegated or collaborated between disciplines it’s acknowledged…”.

Participants perceived a need for a closed-loop communication feature, such as read-receipts, to ensure that assigned interventions were received, followed-up on and accounted for within the software.

Theme Two: Professional Development and Relational Care

This theme captures the reported concerns about the critical balance between the use of digital technology and the professional verbal communication required in the development of therapeutic relationships with patients, particularly among early-career health professionals. The participants suggested the potential for technology to impede establishing a therapeutic relationship with patients especially for new graduate nurses. One participant indicated that:

“Giving them more digital because they have a hard time with the communication could be a detriment. To be honest, I think that we are already seeing such a lack of communication skills and you really can’t take that empathetic, compassionate piece out of nursing”.

At the same time, participants also contradicted this notion and shared that the digital platform might help build confidence among health providers and augment verbal communication and collaboration. Participants noted that the generational differences within the nursing workforce may alter preferences for communication and showed how a technological medium may ease the anxiety among the team. As one participant suggested:

“It’s hard to say that it would be because I know if like for me, like I’d rather talk face to face but I know that in some younger generations they don’t want to talk to face to face. Especially like with physicians or talk over the phone because they’re scared to talk to them”.

It is important to note there is potential for atrophied verbal skills in the over-reliance on digital technologies. Further, participants cited concerns that more technology integration in health systems could result in decreased quality of patient interactions, including degraded empathy, compassion, and human presence.

Theme Three: Coordination of Care & Team-Based Visibility

Participants reported that the platform has the potential to improve continuity of care, track progress in care planning, and facilitate role clarification and assignment, enhancing team collaboration. The ability to view the intervention allocation and monitor the distribution and follow-up of task management was reported as a strength in using the digital platform. Participants highlighted the importance of transparency amongst healthcare providers on care interventions when noting:

 “It just makes it more available at kind of you know, everyone on the multidisciplinary team can also see what’s going on, which is nice”.

The monitoring and coordination of care was reported to be streamlined and efficient when using this platform.  Participants viewed this as a helpful strategy for RNs as leaders of care teams, improving the overall unit flow. Participants noted that the aligned documentation on the platform also helped to provide accountability among the care providers within their roles. One participant stated:

“…coordination, it kind of keeps the health care providers accountable, more or less everyone could be able to see and even like continuous updates and kind of like there be like a living track”.

Even ensuring appropriate staffing, bed management and other unit flow requirements can be monitored with more precision on the platform. The coordination of care on the platform assisted the team members in identifying barriers for patient care flow and the redistribution of interventions among providers when changes occurred in the acuity of care. For instance, one participant stated:

“What I’d be doing is looking at the LPN’s load and saying there are certain things within your patient’s scenario size I should be probably overseeing as an RN. Like so I should be talking to myself, more so because maybe the acuity is really high”.

The enhanced visibility and tracking options in the platform were viewed as a strategy that improves patient care and health outcomes for patients, including discharge planning.

Theme Four: Contextual Fit & Clinical Appropriateness

Participants found that this platform could have more utility in specific health care settings, such as long-term care, home and community care, and general medical/surgical units. Settings with higher traffic, such as the emergency department, or critically unstable, such as the intensive care unit, would be less appropriate because providers are often co-located in nearby physical spaces, and immediate in-person verbal communication and coordination is needed for the acuity of care. While reflecting on the simulated unstable patient scenario, a participant noted:

“I personally found it challenging because I was dealing with an acute situation and so without you coming to tell me to come look at this. I didn’t look to it”.

Participants suggested that when patients are on more long-term medical or surgical units, the platform could aid the continuity of communication and collaboration that can be otherwise challenging due to the potential physical distance, and lack of interaction and follow-up between care providers in separate rooms. When highlighting the settings where the platform flourished, a participant stated:

“It’s great for coordination purposes in a non-acute situation setting because I think that is a huge strong suite of it. Everyone being able to see all of the tasks for the patients, that are for each professional”.

Additionally, participants reported that this platform could be helpful for RN leadership and coordination of larger teams, specifically when teams include many unregulated health providers, such as Certified Care Assistants who are often hired in long-term care. Participants suggested that the platform could even prevent harm for patients due to its ability to strengthen RN leadership ensuring accountability with a large interprofessional team by using an example stating:

“Even like if you think of say you removed a Foley Catheter and you know you didn’t realize someone took your patient to the bathroom because they didn’t really capture that anyway, right? And they voided. Maybe you unnecessarily reinserted a catheter”.

Theme Five: Workflow Integration & System Optimization

This theme focuses on the need for interoperability between this platform and existing digital health technologies to improve workflow, reduce administrative burden, and integrate in real time. Participants reported that a key facilitator to nurses adopting this technology would be for it to reduce the substantial burden of documentation. It was noted that to achieve this, ensuring that the technology is well integrated into the current electronic health record (EHR) and other clinical systems would be necessary. The importance of the interoperability between the platform and EHR was noted by a participant:

“You know, it would be nice to kind of see that captured if it flowed over to the charting system somehow that would be a benefit. So that you didn’t feel like you were necessarily maybe double charting on things”.

It was recommended by participants that the platform be simple with customizable screen layouts. A customizable layout with drop-down menus for frequently used features would allow each worker to bring the components of the platform that they most often use to their home page on the device, accommodating workflows with fewer “clicks”. A participant outlined this need:

“I think having things all visible on that homepage would be more helpful rather than having to go to like different clients and click into different aspects. Yeah, it’s the same. I found it was like simple to get used to. Just if there was a little less clicking into things”.

Infection control and ergonomic concerns were cited in reference to the hardware, with participants reporting that the iPads were cumbersome at times and could be an infection control hazard if transported from bedside to bedside. Furthermore, a participant explored ways to minimize the cumbersome and infection-control aspect of iPad inter-room transport by having a stationary iPad or similar device at the bedside.

“It would certainly be better for patient care. It would be spending more time at the bedside. I don’t think it’s a bad thing, so having technology, there and available, stationary that we use I would see that as a facilitator. If it stayed at the bedside now”.

Theme Six: Accountability, Responsibility & Legal Considerations

Professional and legal accountability, platform reliability, and responsibility for duties associated with the platform were cited by the participants as points of concern. One example of this was whether the data from the platform could be used in a legal proceeding, or by the employer to audit or monitor health professionals.

Participants discussed the potential for use of voice notes (reducing time typing), but again, wondered how these could be used beyond immediate use in the healthcare setting. Participants explored the suggested time-saving benefits of voice messages.

“Like if I could hit record and send a voice message versus the typing would be a very good way to do that. Like to catch that. Like not wasting the time of typing it out and just verbally saying it and sending her own voice recording.”

However, participants voiced their concerns about legal liability around any technological discrepancies in transcription documentation:

“So, if you were taken to court, say on a situation that happened and it was like, OK. Well, you know, you documented that you did this 5P rounding at you know 4:00 AM and actually there was no one in that room until 5:30”.

If technology was utilized to transcribe, an issue may arise from transcription incongruities that would require additional review. However, participants stated that the use of the platform would enhance the overall documented accountability for assigned duties, reflecting on this as a positive outcome.

System integration is represented across the themes in Figure 1. The arrow represents a sliding scale of complexity around the system integration that connects each theme. Systems integration in this case, refers to the complex coordinated processes that occur between people and among varied digital technologies in health settings. These connections help to exchange data, enable interoperability among data platforms, and increase efficiency in communication, collaboration, and accountability in the provision of care, all the while moving forward together like spokes in a wheel. While some themes represent greater system integration complexity, the themes do not exist in silos. The themes work in synergy and overlap when moving through the bi-directional arrow. Creating cohesion and alignment with clinical needs requires action applied to each theme, and each theme is fundamentally important to another.

Discussion

The results from this pilot study have elucidated the barriers and facilitators of this technology, with particular focus on the feasibility of implementation. These results are instrumental in the proceeding phases of this project as the software evolves, and further trials are conducted. Exploring the catalysts alongside the challenges to the implementation of this digital technology are instrumental in optimizing the software and enhancing outcomes for patients and care providers.

Facilitators

Data from the pilot indicates that the software platform aids communication and care coordination. As key competencies for RNs, communication and care coordination are vital to ensure effective collaboration among health care teams (Canadian Interprofessional Health Collaborative, 2024). A Canadian survey found that 42% of the total participants (n = 10,130) experienced at least one gap in care coordination and communication, commonly resulting in frustration by having to repeat information to several providers (Canada Health Infoway, 2022). This signals the importance of ensuring care coordination and communication by health providers to improve patient health outcomes.

Collaboration among team members could be improved by enhanced team-based visibility and care coordination. Ensuring that there are clear and well-articulated roles among team members allows teams to work effectively and enhances collaboration in health settings (Canadian Interprofessional Health Collaborative, 2024). As a primary competency of the RN, ensuring collaboration among health teams is vital to quality patient care. The use of this technology to provide role clarity and therefore, effective teamwork and enhance collaboration, is a key finding from this pilot study.

Barriers

A key barrier identified related to the legal aspects of integrating technology in clinical areas. This was a concern both from a professional perspective for RNs, and a patient privacy issue. Ensuring safeguards to protect patient information must be considered in the design of clinical technology. This is not a new concern when it comes to digital technology in nursing. Ensuring legal clarity is an area of digital health and nursing research that requires further exploration (Pepito et al., 2025). Factors such as ensuring adequate policy development, education and governance of digital technologies will aid in achieving ethical integration of digital health technologies in nursing care settings.

Another important barrier involves the ability of RNs to establish and maintain therapeutic relationships with patients and families when technology is involved in care. While participants in this pilot reported fears that technology could threaten the nursing-patient relationship, digital health technology, when used efficiently by health providers, has potential to ensure that holistic person-centred care and compassion are part of the process (Wiljer et al., 2024). Consideration of person-centred, compassionate care and the patient-nurse relationship is vital to the evolving development of technology design, including the appropriateness of digital interventions for varied settings.

Implications for Practice and Further Research

Importantly, this research demonstrates the value of RN input on digital health technologies as they are designed and tested. Critical strategies to inform the early and evolving design and integration of digital innovations and technology in clinical areas are well elucidated by the themes in this study. The findings point to the unique and valued positioning of the RN in health systems that makes their contribution to digital health technology, and other innovative advancements, instrumental in the development process from both a user perspective and leader across health settings.

Study Limitations

This pilot occurred in a simulated health environment, outside of real-world contexts. The software is in the early stages of development, which is limiting in that some of the noted barriers were the result of the infancy of the software platform. However, the study provided an opportunity for the research team to gain further insight into application of the early phase platform as well as participant input for the evolving software design.

Conclusion

This pilot study was the first phase of a multi-phased research study dedicated to the investigation and development of an RN-led collaborative care software platform. The pilot enabled the team to trial an innovative collaborative care digital platform in a safe simulated environment and collect data on user (i.e., health provider) needs and functional requirements. The data provided by participants, as both facilitators and barriers, will inform the next phase of the research. As a next step, the research team plans to collaborate with a student engineering group for their expertise alongside the pilot data to further develop and optimize the architectural design of the software.  Once relevant changes are made to the software application, the next research trial phase will be conducted with health provider partners in rural long-term care and acute health care settings. Further data will be collected for continued input from providers as well as for the determination of any pre and post quality patient care improvement outcomes over time. This will enable this team to tailor the technology further to address the unique challenges and workflows of healthcare organizations and ultimately improve the quality of care for patients and families.

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Author Biographies

Meagan Ryan, RN, PhD (c), Assistant Professor

Meagan Ryan is a Registered Nurse, Assistant Professor, and the Director of Nursing Student Affairs and Educational Initiatives at the Rankin School of Nursing, St. Francis Xavier University.  Her research focuses on the transition from student to professional nurse and the role of digital health technologies in nursing education and practice. 

Patti Hansen-Ketchum, RN, PhD, Associate Professor

Patti Hansen-Ketchum is a Registered Nurse, Associate Professor, and the Director of Programs for the AO and LPN streams at the Rankin School of Nursing, St. Francis Xavier University.   Her research focuses on complex health systems, including the vital relations between people and their environments, and how these connections influence health.

Ryan E.R. Reid, PhD, Associate Professor

Ryan Reid is an Associate Professor in the Department of Human Kinetics at St. Francis Xavier University. His research focuses on creating tools to integrate wearable technologies into the daily lives of at-risk groups to improve personal health and health care.

Brittany MacDonald-MacAulay, P.Eng, PhD, Assistant Professor

Brittany MacDonald-MacAulay is a Professional Engineer and Chemist, a LEED® Green Associate™, CSSC-CSSBB, CSSC-CLSSWB, ProCert AMP, and an Assistant Professor in the Department of Engineering at St. Francis Xavier University. Her research focuses on advancing industry efficiency through waste valorization and symbiotic relationships, improving petroleum modeling and viscosity reduction, enhancing engineering education, and promoting safety.

James A. Hughes, PhD, Associate Professor

James Hughes is an Associate Professor in the Department of Computer Science at St. Francis Xavier University. His research focuses on the development of machine learning algorithms for real world applications.

Aidan Murdock, BScN Student

Aidan Murdock is a Research Assistant and BScN Student at St. Francis Xavier University. He will graduate this year and plans to work as a Registered Nurse in rural areas of Nova Scotia.

Acknowledgments

We would like to express our gratitude to the participants of this study for their time and commitment to furthering improvements in healthcare. We would also like to acknowledge Michelle MacNeil for her time and knowledge, ensuring that we could conduct this research successfully in the Clinical Simulation Laboratory at St. Francis Xavier University.

Funding Information

This research received funding from the University Council on Research at St. Francis Xavier University (Grant # FY26 Spring 08).

Authors Contributions

PHK – Study design; Data collection; Writing (original draft; review & editing)

MR – Study design; Data collection; Writing (original draft; review & editing)

RERR – Study design; Data collection; Writing (review & editing)

BMM – Study design; Data collection; Writing (review & editing)

JAH – Study design; Data collection; Writing (review & editing)

AM – Study design; Data collection; Writing (review & editing)