Capstone research projects database
The Capstone research project is where students work on real-world issues.
See the Capstone projects TRP students have worked on over the years.
The ADAPTS Project: Advancing Diabetes Care for Adolescents preparing for healthcare transition in Saskatchewan
This study explores the transition needs of adolescents with type 1 diabetes in Saskatchewan, highlighting key support gaps and priorities to inform the development of a formal transition care program.
Background
The transition from pediatric to adult care for adolescents with type 1 diabetes mellitus is a particularly challenging and vulnerable period, leaving adolescents at high risk for deterioration of their physical and mental health. Transition programs have been shown to support adolescents, improve their quality of care, and minimize negative health consequences related to transition. Currently, however, no formal transition support program exists in Saskatchewan for adolescents with diabetes. This survey-based exploratory study examined perspectives, anticipated challenges, and needs for transition of adolescents with type 1 diabetes followed in the LiveWell Pediatric Diabetes Program in Saskatoon, Saskatchewan and their caregivers. Respondents identified the need for supports to facilitate increasing adolescent independence and negotiation of responsibility for diabetes-related tasks between adolescents and their caregivers. Education regarding smoking, substance use, and sexual health needs to be improved. Adolescents and their caregivers also conveyed the need for information about their future adult diabetes care provider, wanting to meet them in advance, and their preference of in-person individual meetings to facilitate transition readiness. These findings, which better our understanding of transition challenges and needs, will be instrumental in guiding further transition care initiatives to minimize gaps in care, reduce patient and family anxiety related to transition, and improve adolescent health and independence.
Project team
- Katherine Backman
TRP supervisors
Project advisory committee
- Mark Inman, MD
- Ryzel Shulman, MD
See our community directory for more on committee members.
The Effects of the Recent COVID-19 Pandemic on Solid Organ Transplantation: An Essential Medical Service
This qualitative study explores how stakeholders at the Multi-Organ Transplant Program (MOTP) at Toronto General Hospital adapted to disruptions in care during the COVID-19 pandemic.
Background
The saturation of healthcare services during the COVID-19 pandemic has imposed multiple challenges on healthcare delivery, with disruption across all essential medical services. One such service that has been impacted at-large is organ transplantation.[1] The COVID-19 pandemic has affected not only processes related to donors or recipients, but also the administration of resources in the healthcare systems, mental health of different stakeholders, safety of healthcare professionals (HCPs), ways of communicating, and research activities, amongst others.[2] This project aimed to understand how various stakeholders at the MOTP at TGH in Toronto, Canada, were affected by and responded to the COVID-19 pandemic. These findings may be used to inform and contribute to improved healthcare delivery responses and strategies during times of systemic strain on the healthcare system. This project employed a qualitative approach to understand and compare organ transplantation processes at the MOTP before and during the COVID-19 pandemic. A modified Journey Mapping Method – Organ Mapping – was employed to describe and visualize regulatory, institutional, and individual tasks and responsibilities along the organ transplant pathway, from donor to recipient. An initial draft of the Organ Map was designed using publicly available MOTP data, and then complemented after discussions with key stakeholders.
To further investigate the institutional, professional, and individual experiences of healthcare delivery among MOTP stakeholders, 1-hour-long semi-structured interviews were conducted. This project recruited a sample size of 16 participants from three cohorts: healthcare professionals (HCPs); administrative staff; and patients and families. Interviews were transcribed and analyzed by the TRP Capstone Team using thematic content analysis[3] to uncover key barriers and facilitators to organ transplantation during COVID-19. The interviews focused on changes to practices during the COVID-19 pandemic, including workflow, protocols, methods of communication, education and training, decision-making processes and priorities, and the use of clinical and administrative resources. The TRP Capstone Team synthesized and analyzed these data to learn from the experiences of participants in healthcare delivery during systemic strain, such as in a pandemic. We expect that our findings will help to identify areas (systemic, professional, and personal) that can be improved while enhancing best-practices and future optimization for the MOTP and healthcare delivery. The next steps of this project include the dissemination of the results through a publication in a peer-reviewed journal, report for all stakeholders, Capstone defense presentation, and presentation at an upcoming transplant conference.
Project team
- Fabricio Batistella Zasso
- Atina Boonchit
- Katherine Puerto Nino
- Sabrin Salim
TRP supervisors
Project advisory committee
- Alex Jadad
- Heather Boon
- Gary Levy
See our community directory for more on committee members.
The MEND (Meaningfully Empowering the Neurodiverse) Initiative: Helping Autistic Adults in the GTA Express their Mental Health Needs
The MEND Initiative is a student-led Capstone project within the TRP. Our goal is to collaborate with autistic adults (18 years of age and older) in the Greater Toronto Area (GTA) to develop an intervention that empowers them to express their mental health needs to their chosen healthcare provider(s).
Project team
- Katie Boddison
- Alena Moya
- Abitha Suthakaran
- Mouzhan Varshoueitabrizi
TRP supervisors
TransCoRe: Translational Success in Corneal Regenerative Medicine
Globally, 12.7 million people await corneal transplantation. Since only 1 in 70 are treated due donor tissue shortage, researchers have turned to regenerative cell-, tissue-engineering-, gene- and drug-based alternatives. However, despite decades of research, few have crossed the “valley of death” of translation to assume a well-defined role in the corneal blindness treatment paradigm. Today, corneal transplantation remains the gold standard therapy. The need to accelerate the translation of emerging regenerative therapies to overcome the burden of corneal blindness is clear. The problems is that there is no objective way to determine the translational potential of emerging therapies.
Background
Determining the translational potential of emerging therapies is essential both for deciding whether their development is worth pursuing and for building customized strategies to accelerate their translational progress. Our aim is therefore to develop a translational potential assessment tool for emerging cornea regenerative therapies. In this project, we will:
- Map the current rate of translation of corneal regenerative therapies, process bottlenecks, and factors predictive of translational success.
- Design a low-fidelity prototype of a translational potential assessment tool.
- And test the prototype to collect feedback from cornea researchers on concept, content, design and utility.
This tool would be the first of its kind and would directly impact cornea researchers, funding entities, and industry who must make resource allocation and directional decisions early in technology development. The ambition is to make safe and effective alternatives available to cornea-blind patients faster.
Project video
Watch Cristina's video about her Capstone Project:
Watch Christina's video on YouTube
Project team
- Cristina Bostan
TRP supervisors
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Transforming mental health in anesthesia education
Anesthesia residents have been reported to be at very high risk for developing mental health problems. There is a need to address mental health concerns in anesthesia residents.
Background
Anesthesia trainees are unique in that they work with a faculty member intimately one-to-one on a daily basis and this makes faculty key persons that can recognize those trainees in trouble. With the implementation of the new competency-based curriculum in 2017, this will entail a greater number of one-to-one assessments placing even more emphasis on the importance of faculty in maintaining resident wellness.
Project team
- Fahad Alam
- Clyde Matava
TRP supervisors
Project advisory committee
- Dr. Lisa Bahrey, Education Director, Department of Anesthesiology UHN-SHS
See our community directory for more on committee members.
Transitioning Cancer Follow-Up Care from Specialized Oncology Teams to Primary Care Providers
Oncology units at Princess Margaret are overburdened, and the integration of PCPs could ease the burden on the hospital. There is a need to test the validity and usability of an End-of-Treatment letter prototype, which aims to improve the communication barriers faced by oncology teams and PCPs. This project involves the iterative refinement of a tool for clinics at PM by embedding specific PCP feedback. In doing so, this project builds on existing literature to gather first-hand experiences, translated into a refined communication tool for use by PM to effectively optimize the communication between providers during this transition.
Background
Integrating cancer survivorship care with primary care providers (PCPs), specifically family physicians, may ease the burden on hospitals and allow cancer care specialists to focus on patients receiving primary treatment. This project aimed to examine the overall views of PCPs regarding their role in cancer survivorship care and identify the resources they require to effectively manage this responsibility.
The Toronto Translational Framework was used to guide the approach, identify the problem and need, verify the need, and test a prototype. This project employed a multi-method approach, including a survey distributed to family physicians for general perspectives on providing cancer survivorship care and semi-structured interviews to gather feedback on the end-of-treatment letter. Overall, 28 surveys and 9 interviews were conducted with family physicians. Findings from the surveys and interviews indicated a clear disparity in the communications between family physicians and oncology teams, with a need for a better definition of roles and improved information formatting of the end-of-treatment letter. A primary barrier towards optimizing the transition of patients is the lack of clinician buy-in and clinical support (e.g. human resources) to facilitate projects that address the communication barriers. To better understand the specific communication barriers, updating and validating a tool that could facilitate better communication, such as the end-of-treatment letter, could help optimize the transition of patients from specialized care teams back to their primary care providers and support better coordination of care.
Project team
TRP supervisors
See our community directory for more on committee members.
Trust Through Transparency: Developing a Stakeholder-Informed Explainability Framework for Clinician-Facing Medical Imaging AI Outputs
Artificial intelligence is increasingly being used to support healthcare decision-making, but its predictions can be difficult for healthcare professionals to interpret and trust. There is a need for clear, clinically meaningful explanations that help users understand how an AI system reached its conclusions without causing information overload. This project aimed to identify how AI-generated predictions and explanations can be presented to strengthen transparency, informed trust, and usefulness in clinical practice.
Background
This project focused on improving the communication of AI-generated predictions to healthcare professionals. Two web-based prototype interfaces were developed and compared, presenting predictions from a previously trained glioma classification model through different formats and levels of explainability. The interfaces were designed to explore whether presenting model outputs more clearly and in a clinically relevant manner could improve understanding and support informed trust.
The prototypes were evaluated through user-testing interviews in which participants reviewed representative glioma cases, rated each interface for clarity and trust, and provided feedback on clinical usefulness, information overload, and workflow integration. Quantitative ratings and qualitative feedback were analyzed to identify preferred features, refine the prototype, and develop recommendations for designing transparent and user-centred clinical AI interfaces.
Project team
- Fardin Islam
TRP supervisors
See our community directory for more on committee members.
UC-ON
UC-ON is a multi-site data collaborative focused on clinics that serve uninsured and undocumented patients across Ontario. The goal is pretty simple: right now, these clinics are doing critical work, but the data is fragmented and often not usable across sites. We’re building a standardized, de-identified dataset so we can describe service use patterns, patient needs, barriers to access, and resource intensity — and ultimately support better planning and stronger funding advocacy with real evidence.
Background
Ontario’s healthcare system is frequently characterized as universal; however, a substantial and poorly measured population remains excluded from consistent access to publicly funded care. Existing literature suggests that between 200,000 and 500,000 people in Ontario alone are medically uninsured at any given time, largely due to immigration-related barriers, including undocumented status, expired or precarious immigration status, temporary resident categories, and mandatory waiting periods for provincial coverage such as the Ontario Health Insurance Plan (OHIP) (Garasia et al., 2023).
The gaps within this space are not theoretical. For example, the OHIP three-month waiting period (which was temporarily lifted during the COVID-19 pandemic) historically left many newcomers without coverage during their initial settlement period, contributing to delayed or forgone care (Niraula et al., 2023). Contrary to being often described as universal, this dynamic creates a de facto uninsured population that relies on a patchwork of services, including community health centres (CHCs), dedicated uninsured walk-in clinics, volunteer-run clinics, and informal referral networks (Health Network for Uninsured Clients, n.d.).
Despite the critical role these clinics play, there is a striking lack of Canadian, Ontario-specific quantitative literature that systematically describes who these patients are, what care they receive, the barriers they face, and the resources required to meet demand. A recent systematic review of evidence on uninsured migrant populations in Canada identified only 10 quantitative studies, and importantly, no quantitative research capturing economic costs associated with uninsured care (Garasia et al., 2023). Existing work is often qualitative, geographically limited, or aggregated in ways that obscure operational realities at the clinic level. Even foundational estimates of the uninsured population are broad and imprecise, reflecting substantial measurement challenges rather than definitive counts (Garasia et al., 2023).
The absence of robust data is resulting in concrete consequences where both patients and the Canadian healthcare system are suffering. Clinics serving uninsured and undocumented populations frequently operate with limited resources, variable funding streams, and chronic demand-capacity mismatches, yet they lack the empirical evidence needed to justify staffing models, service structures, or stable funding. Clinics, funders and policymakers, in turn, lack data that quantifies unmet need, service utilization patterns, and resource intensity, making it difficult to design targeted investments, system-level supports, or efficient workflow maps that could improve access and outcomes (Health Network for Uninsured Clients, n.d.).
This project aims to respond directly to the gap in the literature through the creation of a multi-clinic, standardized, de-identified dataset drawn from clinics already providing care to uninsured and undocumented patients across the GTA and Ontario. By leveraging existing partnerships and routinely collected clinical data, this project will generate actionable evidence that supports:
- More efficient and equitable resource allocation within clinics
- Stronger funding and policy advocacy grounded in real service utilization data
- A foundational empirical literature base for uninsured care in Ontario
Project team
- Ayyah Elayan
- Rukana Ragutharan
TRP supervisors
See our community directory for more on committee members.
Understanding Partners’ Biggest Challenge in Postpartum Mental Health: Early Recognition or Reciprocal Support?
Postpartum Depression (PPD), postpartum anxiety, and postpartum OCD affect up to one in five birthing parents, yet the role of partners in early symptom recognition and support remains significantly underexamined. Many partners describe feeling unprepared, isolated, and unsure how to respond when early signs of distress emerge. The goal of this study is to determine which barrier most significantly affects couples’ ability to navigate postpartum mental health challenges: difficulty recognizing clinically significant symptoms or a lack of concrete reciprocal support skills once symptoms are noticed.
Background
The importance of our work is underscored by two recurring gaps identified in the literature. The first is a recognition gap, in which partners struggle to distinguish typical postpartum adjustment from symptoms of PPD or anxiety, particularly intrusive thoughts and anxiety‑based presentations that are less widely understood. The second is a reciprocal support gap, where couples lack evidence‑based guidance on how to provide mutual emotional and practical support during periods of distress. Both gaps have been identified as barriers to timely help‑seeking and recovery, yet it remains unclear which poses the greater challenge for most families. Addressing this uncertainty is essential for developing targeted, partner‑inclusive interventions that reflect the lived experiences of those most affected.
To explore these questions, the study uses a three‑phase qualitative design grounded in interpretive description and participatory co‑design. In the first phase, semi‑structured interviews will be conducted with couples in which the birthing parent has experienced PPD and/or postpartum anxiety. These interviews will capture dyadic perspectives on symptom recognition, barriers to early identification, and challenges in providing reciprocal emotional and practical support. In the second phase, couples returning from phase 1, along with perinatal clinicians, will come together for a participatory co‑design session. This session will refine preliminary themes, identify which barrier couples perceive as most significant, and collaboratively prototype components of a practical resource such as a recognition guide, micro‑skills toolkit, or hybrid tool. In the final phase, the prototype will be validated with new couples to assess usability, relevance, and cultural appropriateness, with feedback informing the final iteration.
The study is expected to reveal clear patterns in how couples interpret early postpartum mental health symptoms, including common misunderstandings surrounding anxiety and intrusive thoughts, and uncertainty about how to provide mutual support. It is anticipated that couples will identify one barrier as the primary bottleneck, offering direction for targeted intervention. The co‑designed resource is expected to be perceived as practical, validating, and applicable to real‑world postpartum contexts.
Project team
- Amanda De Guzman
- Mansimran Kaur
- Katarina Sinilaite
TRP supervisors
See our community directory for more on committee members.
Understanding Peer Support Needs of Adolescents and Young Adults with Cancer in Pediatrics
This project explores how to design meaningful peer support for adolescents and young adults (AYA) with cancer, evolving from an initial idea into a translational, mixed-methods approach grounded in stakeholder input and system understanding.
Background
This project started with three colleagues in the same program who had an idea – to help teens with cancer in pediatrics. We had very different backgrounds and experiences; one geriatrician with subspecialty training in cognitive neurology, one mental health research project manager with experience transitioning youth from pediatric to adult mental health services, and one pediatric hematologist/oncologist with an interest in AYA oncology. The idea was born after a brainstorming session in which we discussed the results of an informal needs assessment study previously conducted at SickKids. Our initial plan was to design a solution to help teens with cancer connect to each other. The early phases of our project involved brainstorming ideas for solutions, and we were quite focused on social media as a platform and designing a physical space or “teen lounge”. However, from learning about translational research, we realized that: A) we needed to better understand this problem space and the needs of our population, and B) that we were jumping to solutions without actually knowing what patients want. From the literature, we also learned about the vastness of peer support possibilities. The initial informal interviews conducted did not contain nearly enough information or data on which to base our project, as it was too broad and not adequate to properly understand a specific patient need. We went back to the drawing board. We decided to focus on one area that was a suspected need based on the literature, first-hand experience, an environmental scan of existing programs, and trends from the results of the informal needs assessment. Our goal had evolved – to connect teens with cancer to each other: peer support for AYA in pediatrics. As academic clinicians, scientific rigor was important to us; however, we are grateful for the constant reminders that conducting a single-component scientific study is unlikely to provide sufficient information on which to base a successful patient intervention. Brainstorming the design of the mixed methods study came rather naturally to us, and this was initially our entire plan. However, the Translational ThinkingTM Framework introduced to us at the Translational Research Program (TRP) stresses the importance of understanding the current landscape by speaking to a wide variety of stakeholders, which we realized would be critical to ensure future success. We learned that there are several obstacles and required steps before an idea can become a solution and before that solution can be successfully implemented and sustained. Hence, we developed the two-component translational approach and decided to informally explore the perceived value of peer support among key stakeholders in AYA oncology in parallel to the formal study. In addition, we came to realize the importance of knowledge translation (KT) in the process of ultimately implementing a successful and sustainable intervention. Of course the process of this project did not go as we anticipated; many people we met along the way helped to guide us, and our project, in various directions. Each step of the way, we re-grouped, made decisions, changed our plans, and learned about flexibility, ambiguity, and health care system, and research intricacies. We have learned more than we ever thought possible.
Project team
- Philippe Desmarais
- Katye Stevens
- Danielle Weidman
TRP supervisors
Project advisory committee
- Abha Gupta, MD, Sick Kids;
- Jackie Bender, MSc, PhD, UHN research;
- Christopher Klinger, PhD, University of Toronto
- Heather Colquhoun, PhD, OT Reg, University of Toronto
See our community directory for more on committee members.