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Introduction: Simulation has been identified as a key training modality to enhance interprofessional care for patients with co-occurring physical and mental illnesses. Fidelity is an important instructional design consideration for interprofessional simulation; however, research examining the contribution of physical, psychological, and sociological fidelity in achieving learning outcomes remains limited. This qualitative study explored the relationship between fidelity and learning from the perspective of interprofessional simulation course participants., Methods: Semistructured interviews were conducted with participants from the Interprofessional Simulations of Patient Experiences Across the Care Continuum - Child and Youth course. Consistent with grounded theory, data collection and analysis proceeded in an iterative fashion and emergent themes were identified by the research team through a process of constant comparative analysis., Results: Data saturation was reached after 10 interviews. High psychological fidelity allowed participants to engage in the simulation scenarios in ways that were congruent with their professional roles, which supported individual practice change. Tasks that were too closely aligned with their clinical experiences sometimes, however, limited new learning opportunities. Selective manipulations of sociological fidelity seemed to support learning outcomes related to understanding and appreciating the roles and responsibilities of other health professionals. Physical fidelity was less essential., Conclusions: Psychological and sociological fidelity were perceived by participants as being most critical to learning in interprofessional mental health simulation. Improving our understanding of how simulation works in this context is important to effectively direct the efforts of learners, instructors, and designers toward maximizing the benefit of simulation-based learning in a cost-efficient manner.

There is a growing interest in interprofessional care (IPC) as a way to provide better healthcare. However, it is difficult to evaluate this mode of healthcare delivery because identifying the appropriate measurement tool is a challenge, given the wide diversity in team composition and settings. Adding to this complexity is a key gap in the IPC evaluation research: the client/patient perspective. This perspective has generally not been included in the development of IPC healthcare team evaluations. The authors received a Canadian Institute for Health Research Planning Grant to host a one-day forum with 24 participants from across Canada representing health professions such as social work, medicine, occupational therapy, and physical therapy, in addition to researchers, client/patient advocates, and hospital administrators. The overarching goal of the forum was to create a demonstration project that supports the development of an IPC assessment tool for healthcare teams that includes clients/patients. Using a concept mapping methodology, participants discussed client/patient inclusion in IPC assessments, and through a consensus process, chose a demonstration project for further development.

Introduction: Co-workers can play an important role after a work-related injury. They can provide details about the circumstances of an accident, offer emotional support to the injured worker and help with job tasks upon a co-worker's return to work (RTW). Working with an injured co-worker, however, can also strain work relationships and increase workload. The purpose of this study was to determine the role that co-workers play after a work-related injury and during the RTW process in the unionized, electrical construction sector., Methods: We conducted two focus groups with injured electricians and union representatives. We also interviewed co-workers who had worked with someone who had been injured in the course of employment. We examined the role that co-workers can play after a work-related injury and some of the factors facilitating and hindering co-worker support., Results: The structure of work in the electrical sector-a focus on cost-cutting and competition, job insecurity, perceptions of "different camps" among co-workers, little modified work and poor formal communication-can impede co-worker support and contribute to making injured workers' experiences difficult. Management can play an important role in setting an example for how injured workers are regarded and treated., Conclusions: Future research should explore how workers can better be supported after a work-related injury and during the RTW process.

Introduction: This research explored the experience of clinicians during the transition from working as an interdisciplinary team to providing a transdisciplinary model of care in a functional restoration program (FRP) for clients with chronic disabling musculoskeletal pain., Methods: This qualitative study used a grounded theory approach to data collection and analysis. In depth interviews were conducted to gather data and analysis was performed by the coding of emergent themes., Results: Three major themes were identified that contributed towards building a successful transdisciplinary team: the client population; opportunities for communication with colleagues; and an organizational structure that supports transdisciplinary teamwork., Conclusions: Transdisciplinary teams with multiple health care providers are suitable for treating patients with complex needs and with injuries that are chronic in nature. However, transdisciplinary teamwork requires input from an organizational level and from a communication level to effectively contribute to both clinician satisfaction and to improved coordination in patient care.

Objective: To learn what educators across the health professions involved in primary health care think about the use and development of academic family health teams to provide, teach, and model interprofessional collaboration and about the introduction of interprofessional education (IPE) within structured academic primary care., Design: Qualitative study using focus groups., Setting: Higher education institutions across Ontario., Participants: Purposeful sample of 36 participants from nursing, pharmacy, speech language pathology, occupational and physical therapy, social work, and family medicine., Method: Participants were invited to join focus groups of 6 to 8 health professionals. Themes were derived from qualitative analysis of data gathered using a grounded-theory approach., Main Findings: Three major themes were identified: the lack of consensus on opportunities for future academic family health teams to teach IPE, the lack of formalized teaching of interprofessional collaboration and the fact that what little has been developed is primarily for family physicians and hardly at all for other health professionals, and the confusion around the definition of IPE across health professions., Conclusion: The future role of family health teams in academic primary care settings as a place for learners to see teamwork in action and to learn collaboration needs to be examined. Unless academic settings are developed to provide the necessary training for primary health care professionals to work in teams, a new generation of health care professionals will continue to work in status quo environments, and reform initiatives are unlikely to become sustainable over time.

In this Foundations article, the authors reflect on the meaning of time through their past work creating novel roles for psychiatric service users to be involved in the education of health professions trainees and faculty. Inspired by music composer Hector Berlioz, the authors explore and critique the ableist, chrononormative temporalities of academia, and medical education. The authors introduce the conception of crip time from critical disability studies and use it to reflect on their experiences of the different temporalities that people bring to service user engagement and other collaborative projects. "Crip time" can help challenge notions of pace and productivity to create a more inclusive space for teachers and learners in health professions education. [ABSTRACT FROM AUTHOR]

Research in the area of collaboration between complementary and alternative medicine (CAM) and biomedical practitioners often describes their relationships as fraught with power struggles. This paper explores communication among the various stakeholders at an integrative health clinic for artists located in a university hospital. Qualitative research methods were used, in-depth interviews and semi-structured focus groups, to facilitate the gathering of information about patterns of communication among stakeholders involved at the clinic. The findings describe the challenges to communication and integration at the clinic. The lack of communication is described as a scheduling issue, or lack of consistent presence of CAM practitioners, and a lack of formal methods of communication (patient charting). The consequences of these gaps were felt mostly by the CAM practitioners, as their scope of practice was not well understood by other practitioners. CAM practitioners stated that this had a direct effect on their confidence levels. CAM practitioners were relegated to the periphery of the hospital in their role as part-time, contract employees. Their lack of consistent presence at the clinic lead to a lack of understanding of their scope of practice, hence, a lack of referrals from other health-care practitioners, particularly those who were biomedically-oriented. [ABSTRACT FROM AUTHOR]