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Introduction: Post-secondary institutions are increasingly promoting equity, diversity and inclusion (EDI) in health professions education. Yet, institutions continue to be spaces of exclusion and marginalization for health professional students from marginalized groups. Purpose: To explore the education experiences of health professionals from marginalized groups in Canada. Methods: We draw on a subset of data from a larger qualitative study examining experiences of health professionals who self-identify as disabled, working-class origin, racialized, ethnic minority, and/or minority sexual/gender identity (LGBTQ+). This analysis includes 35 participants from medicine, nursing, and occupational therapy. Results: We identified five main themes: 1) isolation, being the "only one"; 2) normative curricula; 3) marginalization by classmates and instructors; 4) exclusionary social and cultural capital; and 5) coping strategies. Conclusion: Learners from marginalized groups are still experiencing marginalization in health professional education, despite institutional commitments to EDI. An overhaul of professional education is needed to address exclusionary processes.

The hospital setting may be especially difficult for pediatric patients on the autism spectrum and their families compared to those not on the spectrum. Child life specialists are healthcare professionals specifically trained to support parents and their children and help prepare them for hospital procedures. Because of this specialized skill set, these professionals likely have a wealth of expertise to share relevant to caring for autistic patients. This study aimed to understand 21 child life specialists' experiences working with patients on the spectrum. Our findings highlighted the following themes: Parents are the Experts, Proactive and Individualized Care, Disclosure, and Hospital-Wide Suggestions to Improve Patient Care. We discuss the practice implications of these findings on the healthcare experiences of pediatric patients on the spectrum.

This article explores the experiences of the use of the "Regional Health and Social Care Hospital Passport" ("Regional Hospital Passport") in Northern Ireland from the perspectives of adults with intellectual disabilities, family carers and health professionals. From semi-structured interviews three themes emerged: usefulness; facilitators; and barriers to the use of the "Regional Hospital Passport". There were clear benefits of the Hospital Passport when used across hospital services and clinical practice settings such as dental and General Practices. There was participant agreement that communication and the person-centred care experiences were enhanced. Findings suggest that providers of health and social care services need to take greater responsibility and accountability for ensuring "Regional Hospital Passports" are promoted and used across all settings. There is a requirement to develop the wider use and uptake of hospital passports to support adults with intellectual disabilities, with potential for use with other patient groups.

This study is an attempt to bridge the gap between the understanding of strengths and challenges of people with autism to operationalize a strength-based approach to serve people with autism effectively. By virtue of being based on firsthand accounts by parents and practitioners the people who spend prolonged periods with people with autism in natural settings, and are privy to direct observation of abilities and challenges, the study yields in-depth information that addresses a continued gap in the existing literature on the subject. Twenty participants (13 parents and seven practitioners) took part in the study through a semi-structured questionnaire and face-to-face interviews. Data were analyzed following qualitative thematic analysis methodology. Strengths and related challenges experienced were extracted as the broad themes, based on which support needs were derived and future directions recommended. The paper recommends strategic home-school collaborations with crucial, concurrent roles played by parents and practitioners.

Continuing education offers healthcare professionals the opportunity to adapt to the many changes in society and to improve their skills and knowledge to provide optimal care for patients. As technology evolves, healthcare workers can benefit from virtual peer-to-peer and mentor interactions with digital technology as a platform for continuing professional development (CPD). Nevertheless, healthcare professionals' experiences in CPD in online learning settings have not been tackled clearly. The aim of our systematic scoping review is to investigate the effects of distance and hybrid learning settings in continuing education on learning outcomes and perceptions among healthcare professionals. A quantitative literature search was conducted following the preferred reporting items for systematic reviews and meta-analyses scoping research, allowing data collection of healthcare study scores from previous articles tackling the subject. A total of 17 articles met the inclusion criteria and were reviewed. We identified four main categories of learning outcomes: knowledge acquisition, skills and performance, participants' attitudes toward training, satisfaction, confidence, and self-efficacy. This systematic scoping review highlights that continuing distance education improves health professional learning outcomes. Continuing education in online learning setting allow more learning accessibility for healthcare professionals, as it was found to be a solution for temporal and physical constraints.

There is a rising recognition of the crucial role self-care plays in managing heart failure (HF). Yet patients often have difficulties implementing ongoing self-care recommendations into their daily lives. There is also recognition of the importance of theory for successful intervention design, and understanding of key factors for implementation so interventions fit a given context. Local key stakeholders can provide valuable insights to help understand relevant context-specific factors for intervention implementation. This study sought to engage stakeholders to explore and determine relevant contextual factors needed to design and facilitate successful implementation of an HF self-care intervention in the German health care system. A ranking-type Delphi approach was used to establish consensus from stakeholders (i.e., clinicians, patients, policymakers/potential funders) regarding eight factors (content, interventionist, target group, location, mode of delivery, intensity, duration, and format) to adequately define the components and implementation strategy of the intervention. Seventeen participants were invited to participate in the first Delphi round. A response rate of 94% (16/17) was achieved and maintained for all three Delphi rounds. Stakeholder consensus determined that nurses specializing in HF are the most appropriate interventionists, target groups should include patients and carers, and the intervention should occur in an outpatient HF clinic, be a mixture of group and individual training sessions, and last for 30 minutes. Sessions should take place more frequently in the beginning and less often over time. Local stakeholders can help determine contextual factors that must be taken into account for successful delivery of an intervention. This enables the intervention to be developed and applied based on these factors, to make it suitable for the target context and to enhance participation to achieve the desired outcomes.

This study aimed to analyse how school health team professionals in geographical areas with a long tradition of neo-Nazi activism discursively conceptualise the problem of racism. The participants do not consider racism or neo-Nazi mobilisation to be a central problem at their schools. At the same time, they cited several examples of obvious expressions of neo-Nazi convictions among students. This discrepancy is explained in different capacities. Firstly, as the students are understood to have a mill-town mentality, certain behaviours are expected and excused. Secondly, to be seen as a problem, racist expression is also expected to be visual. A third factor is that the problem is individualised, focusing on one incident at a time.

The all-encompassing term "Medical Spanish" references the Spanish used by healthcare professionals. Medical Spanish courses have gained traction as the Spanish-speaking population in the U.S. continues to grow. Consequently, demand for courses in Medical Spanish and other areas of Spanish for Specific Purposes (SSP), a subfield of Languages for Specific Purposes (LSP), has grown. As SSP discipline grows, there is a need to understand curricular decisions and implementation, assessment, and learning activities for Medical Spanish courses. One area of Medical Spanish that has not been widely explored is that of assessment. This article discusses assessment challenges in teaching Medical Spanish and offers tips for instructors of these courses, including two learning activities--community service-learning and role playing--that can serve as useful assessment tools.

This study was an initial step toward planning tele-practice in a South Indian state's public-sector services for childhood hearing and speech-language problems. The aim was to understand the perceptions public-sector health care professionals (HCPs) regarding their willingness and need for tele-practice-based diagnostics and rehabilitation services. Focus group discussions (FGD), semi-structured interviews (SSI), and geo-spatial analysis were employed in a cross-sectional study. Different public-sector HCPs participated in the qualitative study. Data sufficiency was assessed using theoretical saturation and cross-case variance. Data was analyzed using hybrid deductive-inductive thematic analysis. Geo-tags and geo-locations of all children with disabilities and all the public-sector service providers were used to generate geospatial maps. HCPs felt that childhood hearing and speech-language disorder services were inadequate and lacked sufficient qualified professionals. There was inconsistent equipment and professional availability in district-level facilities. HCPs were comfortable using technology, and were willing to investigate tele-practice, but they required training in tele-practice.

Purpose: This study aims to examine the influence of perceived supervisor support (PSS) for strengths use on knowledge sharing (KS) intentions, mediated through work engagement and knowledge self-efficacy, based on the job demand-resources theory and the broaden and build theory. Design/methodology/approach: Structural equation modeling and bootstrap analyses were performed to examine the research model using data derived from a two-wave questionnaire survey of 162 employees from five health-care organizations. Findings: The results indicate that PSS for strengths use promoted KS intentions fully mediated through work engagement and subsequently through knowledge self-efficacy. However, there was no direct relationship between PSS for strengths use and KS intention. Originality/value: The contribution of this research to the literature on KS is to find the effectiveness of a strengths-based approach in promoting KS intentions across boundaries and identifying mediating factors that link PSS for strengths use to KS intentions.

The child perspective, i.e. an adult understanding and viewing of a child, is frequently being discussed. However, it is open to individual interpretation as the concept is only vaguely defined. This paper focuses on factors characterising the child perspective held by adults in an organisation which treats and supports adults and children who endure mental illness as a result of war, torture, and/or life as refugees. A cross-sectional descriptive design involving qualitative data was used. Data were gathered at the Health and care department, Swedish Red Cross, through open-ended questions in a web-based questionnaire answered by 69 employees. Additionally, ten semi-structured interviews were conducted with key individuals who represented a variety of professional functions within the department. The data were combined to form a united data set used for analysis. A thematic analysis was undertaken, based on the descriptions by Braun and Clarke, and three major themes emerged. Two of these described the professionals' perceptions in terms of a child perspective. The first, "Considering the child as an individual", focused on how a child perspective encouraged the employees to create a friendly atmosphere and to seek out children's perspectives. The second, "Acknowledging the child's rights", highlighted a view of the child perspective as involving the safeguarding of children and the provision of "voice". The third theme, "Ambiguity in implementation", described the operationalisation of the child perspective in daily work, illustrating both favourable and problematic factors. To conclude, the understanding gained by this paper could be used to raise awareness of, concretise and operationalise a child perspective in other organisations in which adults encounter children. Likewise, this understanding could be used for ongoing research, knowledge development and further discussions in terms of child-focused work and rights-related initiatives involving children.

The purpose of this article is to describe the creation and implementation of a faculty student mentoring program at an accelerated school of pharmacy, and to review 'best practices' relating to mentoring programs.

The COVID-19 pandemic has disproportionately impacted people of color, underscoring the importance of equity in the public health response. The Duquesne University Center for Integrative Health (DUCIH) is a university-wide center focused on training future practitioners and improving health equity in the Pittsburgh region. DUCIH's initial pandemic response included a virtual adaptation of community health programs and supporting partners' testing and vaccination efforts. In March 2021, the Allegheny County Health Department (ACHD) asked DUCIH to establish a vaccine Point of Dispensing (POD) at Central Baptist Church in Pittsburgh's Hill District, to reach underrepresented populations. DUCIH engaged the Schools of Health Sciences, Nursing, and Pharmacy and multiple university offices to recruit an interprofessional team of 263 volunteers. From March to June 2021, the POD administered 5,652 vaccines in an underserved neighborhood, with a majority of doses administered to people of color, meeting the POD's aim. This university-church partnership has continued with vaccine clinics and health screenings. This case study shares lessons for rapid response to public health emergencies through university-wide collaboration with community partners. Universities with health science schools should cultivate relationships with local health departments to promote awareness of these capabilities.

Primary care providers (PCPs) are increasingly called upon to screen for and treat depression. However, PCPs often lack the training to diagnose and treat depression. We designed an innovative 12-month evidence and mentorship-based primary care psychiatric training program entitled the University of California, Irvine (UCI) School of Medicine Train New Trainers Primary Care Psychiatry (TNT PCP) Fellowship and examined whether this training impacted clinician prescription rates for antidepressants. We retrieved information on 18,844 patients and 192 PCPs from a publicly insured health program in Southern California receiving care between 2017 and 2021. Of the 192 PCPs, 42 received TNT training and 150 did not. We considered a patient as exposed to the provider's TNT treatment if they received care from a provider after the provider completed the 1-year fellowship. We utilized the number of antidepressant prescriptions per patient, per quarter-year as the dependent variable. Linear regression models controlled for provider characteristics and time trends. Robustness checks included clustering patients by provider identification. After PCPs completed TNT training, "exposed" patients received 0.154 more antidepressant prescriptions per quarter-year relative to expected levels (p < 0.01). Clustering of standard errors by provider characteristics reduced precision of the estimate (p < 0.10) but the direction and magnitude of the results were unchanged. Early results from the UCI TNT PCP Fellowship demonstrate enhanced antidepressant prescription behavior in PCPs who have undergone TNT training. A novel, and relatively low-cost, clinician training program holds the potential to empower PCPs to optimally deliver depression treatment.

Background: From a range of perspectives, scholars have demonstrated the value of school-based health centers (SBHCs) in recent decades, but few studies have examined the logistics of establishing SBHCs. Methods: Semi-structured interviews were conducted with 9 hospital and 6 school employees involved in a network of SBHCs. After common themes were identified, cluster analysis was performed. Finally, quotes were identified within each thematic cluster for further qualitative analysis. Results: The most prominent themes were (1) differences in physical space (between schools and clinical settings), (2) collaboration and communication, and (3) privacy and compliance. Implications For School Health Policy, Practice, and Equity: This study points to several high yield considerations for the practice of SBHCs. First, we identified three distinct needs: (1) clear funding streams for construction costs for health services on school grounds, (2) improved understanding of SBHC space needs, and (3) blueprints for collaborating within SBHCs. Second, this study points to a future in which new-build and renovated schools should include space for SBHCs. Conclusions: This qualitative thematic analysis provides a picture of health and educational professionals engaged in creative, collaborative, and adaptive work to meet children's health care needs within SBHCs, but also highlights the challenges of navigating physical space, compliance, and collaboration within SBHCs.

Background: Narrative exposure therapy (NET) is a trauma-focused cognitive behavioural therapy, recommended by the National Institute for Health and Care Excellence in 2018, to treat posttraumatic stress disorder in adults. There is a lack of research exploring the effectiveness of NET with adults with intellectual disabilities. The aim of this study is to develop an adapted version of the NET protocol (IDNET) for use with adults with mild intellectual disability. Methods: A qualitative research design was employed. Stage one involved systematically adapting the NET protocol for adults with mild intellectual disabilities in collaboration with a service user group comprising eight consultants. Stage two involved gaining professionals' views on the adapted protocol and on the use of NET in intellectual disability services. This comprised a focus group of eight clinical psychologists specialising in intellectual disabilities and an expert panel of three NET clinicians. The framework approach was conducted on the focus group data only following guidance from a previous study. Findings: An adapted NET protocol and collection of 'easy read' therapy materials were developed (IDNET), which incorporated feedback from the three stakeholder groups. Key concepts of 'Optimism and motivation to adapt NET for people with mild intellectual disabilities' and 'Factors related to NET in practice' were developed to describe the views of clinical psychologists. A number of issues were raised by professionals regarding the delivery of IDNET. Conclusions: Professionals were optimistic about IDNET; however, issues raised regarding the delivery of IDNET require exploration when IDNET is trialled in practice. Specific implications for clinical practice and future research are discussed.

Competent clinical reasoning skills are necessary for providing safe and effective health care. Professional level health science education programs are keenly interested in fostering effective clinical reasoning skills. As such, many programs expect students to engage in complex clinical reasoning tasks early in their education. However, early novice students may not be entering programs with the requisite skills to meet those expectations. Pre-professional undergraduate anatomy curricula are prerequisites for professional education programs across the health sciences and could be an appropriate context for developing initial clinical reasoning skills, providing a "cognitive head start" for students matriculating into professional health science education programs. This article describes an evidence-based pedagogical approach for teaching initial clinical reasoning skills within an undergraduate anatomy curriculum. While an undergraduate anatomy curriculum is the context in this case, this approach is based on high-level pedagogical concepts and could be modified and adopted across the spectrum of disciplines that prepare students for professional level health science education programs.

This research aims to design and develop a mobile-learning training kit for assessing the depression risk of elderly Muslims using the spiritual dimension of human security. In this research, we compare the achievements before and after the training of village health volunteers using mobile-learning training kits in a simple, random way. The sample is divided into two groups: a sample of 30 individuals is used to determine the performance and the academic achievement of the mobile-learning training kit. In addition, 33 other people are used to assess user satisfaction with the mobile learning training kit. The research indicates that the design and development of the training kits involving digital storytelling are characterized by two languages: Thai and Malay, consisting of 4 modules, with an efficiency of 81.56. In terms of achievement in a series of training sessions using the mobile-learning training kit, it was found that after training, the results were statistically significantly higher than before training at 0.05 and that the users' satisfaction with the training kit was extremely high.

Health literacy is critical for individual empowerment because it affects how people obtain health information and use it in ways that benefit their health. Healthcare practitioners frequently lack adequate training in health literacy principles. The present study evaluated the psychometric properties of the Health Literacy Measure for Adolescents (HELMA) instrument to assess the health literacy and the predictors of health literacy among youth from Malaysia and Sri Lanka studying at a medical institution. Following ethics clearance, students aged between 18-24 years enrolled in semesters I through V were approached. Following informed consent, using convenience sampling/complete enumeration, i.e., all students were invited to participate. Overall, 315 participants provided complete data. Cronbach's alpha for the HELMA instrument was 0.74. Based on factor loading, Access, Reading, and Self-efficacy were combined under the sub-domain 'Approach.' Health literacy was highest in the domain of 'Numeracy' followed by 'Understanding' and 'Approach'. Lower health literacy was observed among younger students and those in lower semesters while having a health worker in the family significantly improved health literacy among participants. Our findings support the use of the HELMA instrument to assess youth health literacy.

This article looks at ways schools can address the problem of increased mental health concerns among students in the school setting. Insufficient training of school staff, lack of mental health professionals in schools, inconsistent programming, and teacher mental health concerns make supporting students mental health difficult. Addressing these concerns is possible through teacher training, mental health professionals in all schools, school programming, and support for teacher mental health. These changes would have a positive influence on student academic success and children's future emotional well-being.

Numerous studies have documented the transition difficulties that health care students experience when they move into paid professional practice. Addressed in this paper are three questions that challenge post-secondary educators. (1) What might a successful transition look like for a "new" health care professional? (2) What individual actions could we, as educators, initiate to promote successful transitions for our students? Should we accept mentoring as an effective strategy to support students' transition, and if so (3) What might demonstrate effective mentorship? The evidence suggests that the process of transition into professional life for health care workers may be facilitated when post-secondary education experiences include the development of strong professional networks, the provision of supportive learning opportunities, supports for developing self-confidence in their new roles are provided and mentoring continues after graduation. [Articles in this journal were presented at the University of Calgary Conference on Postsecondary Learning and Teaching.]

In the last two decades, India has seen a massive rise in the number of medical schools. As a result, numerous issues, including the availability of qualified teachers, have made medical education in India challenging. Faculty development (FD) has gained significant attention because of its importance in educational capacity building. FD programs help faculty become more aware of their professional responsibilities. Medical education units can play a vital role in FD and thus improve the quality of medical training by training the teachers. The National Teacher Training Centre (NTTC), Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, was the first center established by the Ministry of Health and Family Welfare, Government of India in 1975, with the assistance of the World Health Organization, to promote the training of health professionals in educational science and technology, including educational planning and research. This article describes the profile of activities of NTTC, which is functioning under the aegis of the Department of Medical Education (DME), JIPMER, and lists the outcomes that contributed to the success of DME with particular reference to the last decade. The establishment of DME is seen to affect the medical school positively.

Contemporary design education seeks to prepare students for the workplace through studiobased learning that replicates real world practice. Design problems in the workplace have become increasingly complex and one example of this is within the area of design for healthcare, which requires multidisciplinary collaboration between various stakeholders to build knowledge in order to create new products, services systems and spaces. The complexity of these roles creates challenges for design educators in preparing students for the workplace. This paper presents a hybrid approach to address this challenge by presenting a real-world approach to design education. This entails a bottom-up approach to facilitate design research in a clinical setting to gather rich insights and needs of the clinical setting along with a top-down industry collaboration with sponsored briefs to guide students through the requirements of developing solutions in a heavily regulated field. The paper outlines examples of this process and how it was achieved in a blended model that was predominantly online in response to the changed environment caused by the COVID-19 pandemic. The advantages of this model are threefold, students gain deep knowledge and skills through collaborating with a variety of stakeholders within health care, they gain the opportunity to validate their designs through testing and feedback with these partners and lastly students develop the connections to create opportunities for further partnerships and employment.

There is an increasing interest in design and creative thinking processes in the Sciences, Technology, Engineering, and Mathematics (STEM) and health education disciplines. Many new degree programs are integrating design thinking into their syllabi, with the intention of bringing creative problem-solving methods to these disciplines. In reality, the exposure these students get is minimal, and it does not provide enough foundation for them to use the knowledge and apply the process(es) in real-life situations. There is an increased awareness of the importance of design thinking in the innovative process. More and more STEM, business, and health establishments are embedding trained designers into their research teams -- yet many designers are not equipped to work on interdisciplinary teams. Design students tend to approach problems more intuitively, opportunistically, and build on creative leaps of imagination whereas, STEM and health disciplines are often more algorithmic, systematic, and rationale. This can often generate tension in interdisciplinary teams, especially when traditional disciplines (e.g., Engineering, Sciences) are integrating relatively newer thinking (e.g., design thinking). In this paper, we share the outcome of a phenomenological study on a high-functioning interdisciplinary team working on a health innovation project focused on aging with a disability. This case study illustrates the skill set needed for designers, health and technology professionals to make a significant contribution to its overall outcome. We identified key attributes that contribute towards being an effective member of interdisciplinary teams. Based on this study, we propose a pedagogical approach to better equip design, STEM, and Health students to be more competitive in changing economic expectations and ensure more impactful design outcomes.

In recent years, health professions researchers have suggested that a dual identity that includes both a professional and interprofessional identity is essential to interprofessionality. This scoping review sought to describe the learning experiences that may support the development of an interprofessional identity, providing direction for future research. A scoping review was conducted to identify papers published between 2000 and 2020 that provided empiric evidence to support the impact of planned or spontaneous learning experiences involving two or more healthcare professions that fostered the development of an "interprofessional identity," or a sense of belonging to an interprofessional community. Twelve papers were identified for inclusion. Articles varied regarding both the professional groups studied and the developmental levels of their participants. A wide variety of learning experiences were described in the identified studies, including designed activities and programs, as well as those occurring spontaneously in authentic clinical environments. Examples of longitudinal and integrated programs were also identified. The construct of an interprofessional identity and its potential impact on interprofessional practice has yet to be sufficiently studied. The results of this scoping review suggest that a variety of experiences that occur throughout the professional development trajectory may foster an interprofessional identity. Longitudinal, integrated interprofessional learning programs may result in a more long-lasting impact on interprofessional identity and these types of programs should be the focus of future research.

To transition successfully into independent practice, newly graduated independent physicians (new "attendings") undergo a process of professional identity formation (PIF) as a clinician within a new community of practice (CoP). PIF is crafted by socialization within a CoP including transfer of tacit knowledge. While certain tacit knowledge is critical for professional identity, we understand little how it shapes PIF. We set out to describe the tacit knowledge acquired by new attendings within a CoP and how it contributes to PIF. Informed by constructivist grounded theory, we interviewed 23 new attendings about the tacit knowledge they acquired in early practice. Data collection and analysis occurred iteratively. We identified themes using constant comparative analysis and generated a theory that underwent member checking and feedback. Implicit standards from group culture imparted high expectations on new attendings and led to internal stress. New attendings also encountered a tacit code of conduct as behavioral elements of group culture. These elements created external conflict between new attendings and group members such as departmental colleagues, consulting physicians, and other health professionals. Depending on the support they received, new attendings responded to the stress and conflict in three ways: they doubted, adjusted, or avoided. These strategies molded their professional identity, and moved them towards or away from the CoP as they navigated their transition and PIF. We describe a novel theory of how tacit group culture shaped new attending physicians' professional identity in a new community of practice. Internal stress and external conflict occurred due to high expectations and tacit culture elements. New attendings' doubt, adjust, or avoid responses, shaped by support they received, in turn crafted their professional identity. Education leaders should prepare graduating trainees to navigate aspects of transition to independent practice successfully.

Scholarly practitioners are broadly defined as healthcare professionals that address critical practice problems using theory, scientific evidence, and practice-based knowledge. Though scholarly practice is included in most competency frameworks, it is unclear what scholarly practice "is," how it "develops" and how it is "operationalized" in clinical practice. The aim of this review was to determine what is known about scholarly practice in healthcare professionals. We conducted a scoping review and searched MEDLINE, EMBASE, CINAHL from inception to May 2020. We included papers that explored, described, or defined scholarly practice, scholar or scholarly practitioner, and/or related concepts in healthcare professionals. We included a total of 90 papers. Thirty percent of papers contained an explicit definition of scholarly practice. Conceptualizations of scholarly practice were organized into three themes: the interdependent relationship between scholarship and practice; advancing the profession's field; and core to being a healthcare practitioner. Attributes of scholarly practitioners clustered around five themes: commitment to excellence in practice; collaborative nature; presence of virtuous characteristics; effective communication skills; and adaptive change ethos. No single unified definition of scholarly practice exists within the literature. The variability in terms used to describe scholarly practice suggests that it is an overarching concept rather than a definable entity. There are similarities between scholarly practitioners and knowledge brokers regarding attributes and how scholarly practice is operationalized. Individuals engaged in the teaching, research and/or assessment of scholarly practice should make explicit their definitions and expectations for healthcare professionals.

Background: Government restrictions enforced globally in response to COVID-19 necessitated changes to the delivery of mental health services, with many psychology professionals (PPs) forced to transfer their face-to-face practice to virtual means (telephone/video therapy) overnight. This review explores what is known about the experiences of PPs providing psychological support to people with intellectual disabilities (PWID) during the pandemic. Method: Literature was systematically searched and 11 papers were identified, critically appraised and thematically synthesised. Results: Four themes were synthesised from findings: (1) 'Impact at Service Level', (2) 'The Emotional Impact on PPs', (3) 'The Limitations of Virtual Support', (4) 'Unexpected Gains'. Conclusions: This review highlights the challenges and positives in experiences of PPs, whilst acknowledging the inequalities experienced by PWID. It is hoped that the findings can be used to aid education and training, and inform future practice and policy. Future research is recommended.

Background: The use of virtual reality (VR) in medical education allows learners to make mistakes safely without risk to patients and to refine a range of clinical skills by repetition. However, there is still wide variability both between, and within countries regarding the amount of training delivered using VR, particularly in relation to intensive care medicine Objectives: To identify the range of uses, phase of development and effectiveness of VR for intensive care unit (ICU) staff training. Methods: The review followed the scoping review framework set out by Levac et al. (2010). A multi-database search was undertaken. All study types were included if they explored the use of VR for intensive care staff (ICU) staff training. Full paper screening, data extraction and assessment of bias was carried out by a single reviewer with verification by a second reviewer. A narrative synthesis was chosen to summarize the data. Results: The search strategy identified 647 records. Following the removal of duplicates, screening of titles, abstracts and full texts, five studies were included. VR for ICU training has primarily focused on skill acquisition for surgical procedures. The majority of studies in this area were classified to be at an early stage of assessing acceptability, tolerability and efficacy. There was very low-quality evidence that VR for ICU training is effective. Conclusions: Studies have explored the use of VR for a small number of surgical procedures and emergency patient scenarios. VR for ICU training demonstrates some potential, however further development and high-quality research is required. Research relating to virtual reality for ICU staff training is currently of weak methodological quality and as such, no recommendations to clinical practise can be made. Wherever possible when using VR for ICU staff training it should be utilized as part of a high-quality study.

Objective: Strategic storytelling can be used to reframe dominant cultural narratives and improve community health outcomes. This pilot study assessed the impact of an original, online 3-week e-course, delivered from November to December 2021, in increasing learners' knowledge of and concern for the seriousness of skin-shade discrimination and the use of skin-lightening products in India, increasing learners' understanding of storytelling-based communication techniques for public health promotion, and increasing learners' intentions to use strategic storytelling for social change. Design, Setting and Method: The course used case-method pedagogy to address colourism and cosmetic skin lightening. Learners (N = 25) completed a pre-course baseline survey on their knowledge and concerns regarding colourism and the use of skin-lightening products, as well as their expectations and interests in taking the course. Following course completion, learners completed a post-webinar survey. The Wilcoxon Signed-Rank test was used to assess differences from pre- to post-course surveys on quantitative items. Open-ended responses were also analysed using qualitative content analysis for recurring themes on learner interest and experience. Results: From pre- to post-course surveys, there were significant improvements in learners' knowledge of skin shade discrimination and the use of skin-lightening products (p < 0.05). Learners indicated being more concerned about the seriousness of skin shade discrimination post-course compared to pre-course. Learners also described a positive learning experience and indicated that the e-course enhanced their understanding of strategic storytelling. Conclusion: Findings highlight the importance of an original e-course that uses case-method pedagogy to build knowledge and skills that addresses the impacts of colourism on the health of Indian adolescents and provides new directions for future research on health education interventions that aim to tackle colourism.

Professional identity impacts the workforce at personal, interpersonal and profession levels however there is a lack of reviews of professional identity research across practising health professionals. To summarise professional identity research in the health professions literature and explore how professional identity is described a scoping review was conducted by searching Medline, Psycinfo, Embase, Scopus, CINAHL, and Business Source Complete using "professional identity" and related terms for 32 health professions. Empirical studies of professional identity in post-registration health professionals were examined with health profession, career stage, background to research, theoretical underpinnings and constructs of professional identity being extracted, charted and analysed using content analysis where relevant. From 9941 studies, 160 studies across 17 health professions were identified, with nursing and medicine most common. Twenty studies focussed on professional identity in the five years post-entry to the workforce and 56 studies did not state career stage. The most common background for the research was the impact of political, social and healthcare reforms and advances. Thirty five percent of studies (n = 57) stated the use of a theory or framework of identity, the most common being classified as social theories. Individual constructs of professional identity across the research were categorised into five themes--"The Lived Experience of Professional Identity"; "The World Around Me"; "Belonging"; "Me"; and "Learning and Qualifications." Descriptions of professional identity are broad, varied, rich and multi-layered however the literature is under theorised with current theories potentially inadequate to capture its complexity and make meaningful contributions to the allied health professions.

Social support is vital in promoting the health, well-being, and performance of students and clinicians in health professions. Health settings' demanding and competitive nature imposes unique challenges on students and clinicians with disabilities. This paper aims to explore the trajectories and experiences of social support interactions amongst students and clinicians with disabilities in health professions. In a qualitative longitudinal study, 124 in-depth semi-structured interviews were conducted with 27 health students and 29 health clinicians with disabilities. Data analysis was informed by grounded theory as an adapted analytic approach involving constant comparisons. A few main characteristics of social support and trajectories in which social support is negotiated emerged from the data: (1) The need to be accepted and not questioned when asking for support, (2) Support interactions that do not heighten otherness, (3) Failure to acknowledge the challenges, (4) Interactions that support the process of disclosure (5) Interactions that allow mobilization of social support without strain or an extra effort. These findings have important implications for designing more supportive health professions, educational programs, and workplaces for people living with disabilities.

Background: For students with traumatic brain injury (TBI), the COVID-19 pandemic exacerbated challenges they were already experiencing at school. Methods: This qualitative study employed focus groups and interviews with students, parents, school, and medical personnel to explore the school experiences of students with TBI. Thematic qualitative analyses were used. Results: Key themes from the analysis include (a) incidence of brain injuries decreased; (b) screen time for students with TBI exacerbated symptoms; (c) COVID protocols at school made it difficult for educators to identify and provide accommodations for students with TBI; (d) COVID protocols at school could inadvertently exacerbate mental health difficulties after a TBI; and (e) COVID-related logistics increased the time between an injury and return to school or return to play. Implications for School Health Policy, Practice, and Equity: The results from this study suggest that professional development for teachers supporting students with TBI is needed, especially for online learning environments. Additionally, because mental/behavioral health concerns may arise for students with TBI in online learning environments, school health care providers can work with families to assess a student's mental health, making referrals to appropriate supports. Conclusions: There is a significant need for professional development and school-wide infrastructure supportive of students with TBI.

While Extended Reality (XR) autism research, ranging from Augmented to Virtual Reality, focuses on socio-emotional abilities and autistic children requiring low support, common interventions address the entire spectrum and focus on other abilities, including perceptual abilities. Based on these observations, this paper first addresses common practitioners' interventions, and then suggests XR use cases and guidelines to better support them. To do so, 34 interviews were conducted with stakeholders, mainly including practitioners, and then analyzed. Emerging XR use cases were compared with the findings from two former systematic literature reviews, and emerging design guidelines were compared with the findings from a literature survey that we conducted. Findings suggest that collaborative XR sensory-based and mediation approaches could benefit the entire spectrum.

Project Extension for Community Healthcare Outcomes (ECHO) Nevada applied the ECHO virtual hub-and-spoke telementoring model over nine 6-week cohorts (between November 2019 and November 2021) supporting community health workers (CHWs) who advise clients with diabetes or pre-diabetes. This study describes the program implementation, including evaluation data collection efforts. Didactic topics included 'Intro to Healthy Eating and Easy Wins' to 'Grocery Shopping, Cooking Tips, Reading Labels, Meal Plans' and 'Reducing Bias and Being a Good Role Model'. Spoke participants signed up to review cases. Seventy-three of the enrolled participants (n = 100) attended three or more of the six sessions. Spoke participants completed 42 case presentations. The average self-efficacy increased from 2.7 [standard deviation (SD): 1.1] before completing the program to 4.1 (SD: 0.8) after completing the program. Average knowledge scores increased from 71 (SD: 16) before completing the program to 83 (SD: 14) after completing the program. Five group interviews drew actionable feedback that was incorporated into the program. Key elements of the ECHO model were successfully incorporated to support educational goals of a cohort of CHWs in nutritional coaching. Our program evaluation data tracking system shows non-significant but encouraging results regarding self-efficacy improvement and knowledge retention.

Background: Patient navigation programs have shown promise for improving health but are not widely used in obstetric care. Our objective was to understand obstetric provider perspectives on how to implement patient navigation to optimize care during the postpartum period for low-income patients. Method: Focus groups were conducted with obstetric physicians, nurses, and social workers who care for low-income pregnant and postpartum patients in an academic medical center. Semistructured interview guides were developed to elicit conversations about the potential value of patient navigators, recommendations for navigator training, and how navigators could be most effective in improving postpartum care. Analysis of themes was based on the constant comparative method. Results: Twenty-six obstetric providers (six focus groups) discussed elements for a successful obstetric navigation program. Successful implementation themes included selecting navigators with appropriate interpersonal attributes, arranging navigator training, and identifying the most valuable services navigators could render. Desirable navigator attributes included persistence in patient advocacy, consistency, relatability, and a supportive manner. Training recommendations included learning the health care system, identifying where to obtain health system and community resources, and learning how be effective health educators. Suggested services were broad, ranging from traditional care coordination to specific educational and resource-driven tasks. Conclusions: Obstetric providers perceive patient navigation to be a potentially beneficial resource to support low-income patients and offered recommendations for navigation implementation. These included suggestions for patient-centered navigators, with specific training and services focused on promoting care continuity and coordination.

Background: The experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ) parents of children with developmental disabilities (DDs) in health and early learning systems are largely understudied. Inclusive, affirming services are critical to timely identification and intervention for DDs. This literature review aimed to establish whether LGBTQ parents experience structural bias and discrimination when accessing care for their children in health and early learning systems. Methods: PubMed, ERIC, and Scopus were searched for empirical research from 1990 to 2020 on: LGBTQ; parents, children, families; bias, disparities, discrimination; and health and early learning services. Themes were analyzed by conceptual model bias levels, participant type, and setting. Results: The search yielded 1,872 unduplicated records (three through hand search). Twenty-nine articles representing 26 studies in health and early learning in eight countries met the inclusion criteria. Biases common across sectors included challenges surrounding LGBTQ status disclosures; lack of acknowledgment of non-biological parents; and heterosexist forms. Knowledge gaps and negative attitudes about LGBTQ families were found among some professionals and students. Conclusion: Some LGBTQ parents experienced bias and discrimination while accessing care for their children in health and early learning systems. Policies and programs to implement and monitor LGBTQ-inclusive health education and evaluate practice changes are recommended to improve professionals' knowledge, attitudes, and behavior. Multilevel workforce development (e.g., accreditation standards, organizational audits, and training) is needed to create and sustain LGBTQ-affirming health and education environments. Honoring LGBTQ family diversity and reducing health and early learning inequities are critical for improving children's health and education outcomes.

An autism diagnosis in adulthood can increase women's self-compassion and inform appropriate supports. This study explored what helped and hindered autistic women when accessing an adulthood autism diagnosis in Australia. Ten autistic women diagnosed as adults within the past 5 years participated in a semi-structured interview about their experiences of accessing a diagnosis. Framework analysis was used to identify barriers and facilitators on person, provider and system levels. Person-level factors included women's recognition of their autism, motivation, preparation, social support and approach during the assessment. Provider-level factors related to providers' level of knowledge and skill in working with autistic women, as well as the women's experience of being dismissed or misdiagnosed. Interactions between person- and provider-level factors highlighted that the diagnostic process is relational. System-level factors included the requirements of the diagnostic process (time, financial costs, and technology) and the nature of diagnostic criteria and assessment tools used. These factors provided the context in which person-level and provider-level factors operated. The experiences of participants highlight improvements that could be made to accessing an adulthood autism diagnosis for women in Australia, including provider knowledge of the heterogeneity of autism and the development of resources to help autistic women prepare for their diagnostic assessment.

Background: Although the literature in medical anthropology and transcultural psychiatry has documented how cultural representations shape individual experiences and perceptions of psychosocial distress and its management, less attention has been given to what is actually meant when the concept of culture is used in professional practice, and how this may influence experience of care. Objective: The objective of this article is to explore what understandings of culture circulate in youth mental health practitioners' and families' narratives, and to analyse how different operationalizations of the concept may affect experience of services. Methods: This article draws upon the qualitative components of a larger mixed-methods research program on collaborative care in youth mental health. Semi-structured interviews were conducted in Montréal (Québec, Canada) with 39 parents, 48 youths and 29 practitioners about their experience of services, and with 26 practitioners about their experience of intercultural training. Data was analyzed using thematic and narrative approaches. Results: Results show that families and practitioners use a multiplicity of understandings of the concept of culture in their discourses as a narrative strategy to mediate dialogue in clinical encounters, either by engaging in it, avoiding it, or refusing it. Conclusions: The concept of culture and its use in the clinical realm can be seen a double-edged sword, both as a tool to reify stereotypes and inequalities, and as a means to mobilize representations towards cultural safety and transformative practices. Minority families' experiences of services may be improved by providing intercultural training and a supportive work environment to clinicians.

Objective: The impact of social media on public health has been examined in various studies. However, none have explored user engagement based on the type of Facebook posts related to renal disease. Therefore, the present study sought to determine which type of nephrology-related posts have greater user engagement. Setting: Facebook pages. Methods: The posts on a specific Facebook page curated by a team of nephrologists in Malaysia were examined in this cross-sectional study. The type of post, likes, comments, shares of a post and reach of a post were used for data analysis. Analysis of variance was used to quantify the relative contribution of each independent variable to the odds of the post being highly liked or shared. The Kruskal-Wallis test was used to compare links, photos, shared videos, status and videos for parameters such as reach, the number of times a specific piece of content has been displayed on a screen (impressions), and user engagement. Results: Shared videos and photos received the highest median reach of 5,862 and 5,880, respectively. People who 'liked' the page in 2019, 2020 and 2021 numbered 193, 4,196 and 2,835, respectively. Among the types of content on the Facebook page, photos and shared videos received the highest median lifetime reach of the post compared to links, status and videos in terms of 'people who liked the page'. Conclusion: The study findings suggest that posting a video or photo maximises the chance of engagement and meaningfully impacts public health outcomes.

Healthcare providers play a key role in early identification of eating disorders (EDs), especially in underserved states where ED treatment resources are lacking. Currently, there is little known about ED screening and treatment practices in underserved states. The current study assessed current ED screening and treatment practices among healthcare providers in an underserved state using data collected by a government-formed state ED council. Healthcare providers (N = 242; n = 209 behavioral health providers; n = 33 medical providers) practicing in Kentucky completed a brief, anonymous survey on ED screening and treatment practices, comfort with screening for EDs, and interest in continued education. Over half of healthcare providers indicated screening for EDs, with the majority using a clinical interview. After identification of ED symptoms, providers reported a combination of treating in-house, referring out, or seeking consultation. In bivariate analyses, medical providers were significantly more likely than behavioral health providers to use a screening tool specifically designed for EDs. The majority of medical providers indicated that they received education about EDs and feel knowledgeable about ED screening tools, though most reported infrequent use of these screening tools in their practice. Nearly all behavioral health and medical providers expressed interest in continuing education on ED screening and treatment. These findings indicate a need for, and interest in, education on evidence-based ED screening and treatment resources in underserved states and demonstrate the utility of a state ED council to collect these data to inform future education and treatment strategies.

Barriers to access and delivery of effective healthcare for autistic individuals have received attention in the social science literature. Less understood is why and how these barriers exist. The purpose of this qualitative review was to explore and interpret salient findings and characteristics of qualitative research that has examined the experiences of healthcare providers providing care to autistic individuals. A systematic information retrieval of electronic databases resulted in 15 qualitative research studies that met the inclusion criteria. Analysis of thematic findings and characteristics across studies was conducted, and a deeper interpretation highlighted an emphasis and reinforcement of the complexities of supporting autistic individuals in the healthcare context. Considerations are offered for diversifying and strengthening future research in this area.

Background: The COVID-19 pandemic has placed enormous strain on health systems around the world, undermining the mental health and wellbeing of healthcare workers. Supporting people with intellectual disabilities may be particularly challenging for workers, as some people with intellectual disabilities may have a limited understanding of the pandemic, and find it challenging to adhere to the restrictions imposed by public health guidelines such as social distancing, lockdowns and change in usual routine and activities. In addition, many people with intellectual disabilities have increased vulnerability to more negative effects of COVID-19, with significantly higher mortality rates. Although there is emerging research on the mental health of healthcare staff during this time, there has been little specific work on the mental health of staff working with people with intellectual disability, particularly a lack of qualitative research. Methods: The current study employed semi-structured interviews with 13 healthcare workers (12 women and 1 man) who were working with people with intellectual disability during the COVID-19 pandemic. The interview data were analysed using thematic content analysis. Findings: The participants spoke in depth about the challenges of the working environment, the impact of providing care during the pandemic on staff mental health, supporting staff mental health and wellbeing and learning for the future. Conclusions: Systematic efforts are required to protect the mental health of this staff cohort, as well as encouraging resilience and successful coping among staff themselves.

Background: Many children with intellectual developmental disorders are insufficiently physically active and do not reach recommendations for physical activity. Pediatric healthcare providers play a key role in addressing these children's needs, including promoting interventions for physical activity. Aim: To explore pediatric healthcare providers' perceived needs, barriers, and facilitators for promoting physical activity for children with intellectual developmental disorders. Methods: Semi-structured focus groups, analyzed using qualitative content analysis. Sixteen healthcare providers participated. Results: Main findings are the importance of parental support and engagement, need for structure, and stakeholder collaboration to bridge the gap between pediatric organizations and external stakeholders. Conclusion: The study highlights the need for developing and implementing strategies to promote physical activity for children with intellectual developmental disorders in pediatric health care, and for producing guidelines regarding physical activity interventions for this vulnerable group.