My research interests are shaped by resistance to a culture of complacency, oppression, objectification, and dehumanization - in everyday practices. Through my research, I aim to reduce inequities that are sustained by colonized attitudes and processes. I apply my expert knowledge of theories of cognition, behaviour, and measurement to advance a view of clinical practice and learning as dynamic, context-dependent, and fundamentally shaped by human judgment, social interaction, and the values embedded within our institutions.
Resistance, in this sense, is not just critique; it is intervention — a commitment to evidence-informed change that confronts attitudes and structures that enable exclusion while claiming fairness.
I have challenged the assumption that more simulation, higher fidelity, or more resource-intensive design inherently leads to better learning.
Across this work, we showed that educational value depends on alignment with purpose and thoughtful use of resources, and that technical optimization cannot be separated from educational intent. We reframed efficiency and effectiveness as value-driven decisions that reveal how educational practices can either reinforce or resist waste, excess, and unexamined norms.
Monteiro, Sandra; Sibbald, Matthew. Choosing Wisely - Clinician Educators' Guide to High-Value Simulation-Based Education. Archives of Medicine and Health Sciences 8(2):p 302-305, Jul–Dec 2020. | DOI: 10.4103/amhs.amhs_323_20
Monteiro, S., Sibbald, M., Beecroft, J. et al. Choosing Wisely for Simulation-Based Learning in Health Professions Education. Med.Sci.Educ. 35, 2541–2554 (2025). https://doi.org/10.1007/s40670-025-02471-z
Monteiro S, Sibbald M. Aha! Taking on the myth that simulation-derived surprise enhances learning. Med Educ. 2020;54:510–516. https://doi.org/10.1111/medu.14141
Wang A, de Sa D, Darie S, Zhang B, Rockarts J, Palombella A, Nguyen L, Downer N, Wainman B, Monteiro S. Development of the McMaster Embalming Scale (MES) to assess embalming solutions for surgical skills training. Clinical Anatomy. 2023 Jul;36(5):754-63.
I have challenged the assumption that survey-based research is neutral.
Across this work, we show how standardized approaches can reduce people to categories, variables, and averages, obscuring context, voice, and relational meaning. I highlight how these methods can objectify participants and reinforce systems of knowledge that prioritize control, efficiency, and generalizability over humanity and lived experience.
I have challenged the assumption that aligning medical education with societal needs can be achieved by adding more competencies, content, or expectations onto individual learners.
In this work, I argue that this “everything, all at once” approach overburdens individuals while obscuring the structural and institutional conditions that shape practice. I highlight how the pursuit of comprehensiveness can become a harmful myth that shifts responsibility away from systems and onto learners.
Monteiro SD. Everything alone: Is medical education chasing a harmful myth in its effort to embrace societal need?. Medical Education. 2024 Apr 1;58(4).
I have challenged the assumption that improving healthcare and education is primarily a matter of refining individual skills or reasoning processes.
Across this work, we show how inequities are produced and sustained by collective, structural, and cultural conditions, and how dominant models of reasoning privilege certain ways of knowing while excluding others. I advance a shift from individual correction to collective responsibility, positioning change as a structural, relational, and justice-oriented effort.
Monteiro S, Acai A, Kahlke R, Chan TM, Sukhera J. Shifting paradigms: a collective and structural strategy for addressing healthcare inequity. J Eval Clin Pract. 2024;30:887-893. doi:10.1111/jep.14013
Monteiro S, Keuhl A, Lee M, Chan TM. ReThinking clinical reasoning: a paradigm shift. J Eval Clin Pract. 2024;30:766-773. doi:10.1111/jep.13986
Alvarez AA, Monteiro S, Chen R, Cohen K, Fofana M, Powell C, Tago A, Martin L. Re‐THINK: Use of narratives to explore social justice in clinical practice and education. Journal of Evaluation in Clinical Practice. 2024 Apr 1;30(3).
I have challenged the assumption that women decline academic opportunities due to lack of interest, confidence, or ambition.
Across this work, we show how these decisions are shaped by unequal distributions of labor, expectation, and consequence within gendered institutional structures. I reveal how narratives of choice obscure systemic inequities and shift responsibility away from the conditions that produce them.
Monteiro S, Chan TM, Kahlke R. His opportunity, her burden: A narrative critical review of why women decline academic opportunities. Med Educ. 2023;57(10):958-970. doi:10.1111/medu.15141
I have challenged the assumption that clinical reasoning can be understood as a context-free cognitive skill.
Across this work, we show that reasoning is inseparable from the cultural, social, and situational conditions in which it occurs, shaping what is noticed, interpreted, and acted upon. I argue that attempts to isolate or standardize reasoning risk misrepresenting expertise and overlooking the conditions that give it meaning.
Cameron E, Fleming H, Mose R, Monteiro S. Exploring context and culture in clinical reasoning medical education: a qualitative exploratory study. J Eval Clin Pract. 2025;31:e14126. doi:10.1111/jep.14126
Olson A, Kämmer JE, Taher A, et al. The inseparability of context and clinical reasoning. J Eval Clin Pract. 2024;30:533-538. doi:10.1111/jep.13969
Precision is not the same as understanding.
I have challenged the assumption that statistical methods provide straightforward, objective answers independent of context.
Across this work, we show how decisions about sample size, reliability, and analytic approach depend on purpose, design, and judgment. I emphasize that methodological rigor is not about following rules, but about aligning analytic choices with the questions, contexts, and values that shape the work.
Norman G, Monteiro S, Salama S. Sample size calculations: should the emperor’s clothes be off the peg or made to measure?. Bmj. 2012 Aug 23;345.
McConnell MM, Monteiro S, Bryson GL. Sample size calculations for educational interventions: principles and methods. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2019 Aug 15;66(8):864-73.
Monteiro S, Sullivan GM, Chan TM. Generalizability theory made simple (r): an introductory primer to G-studies. Journal of graduate medical education. 2019 Aug 1;11(4):365-70.