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BACKGROUND: Health human resources are scarce worldwide. In occupational therapy (OT), physical therapy (PT), and speech-language pathology (S-LP), attrition and retention issues amplify this situation and contribute to the precarity of health systems. OBJECTIVE: To investigate the phenomena of attrition and retention with OTs, PTs and S-LPs who stayed in, or left their profession. METHODS: Cultural-historical activity theory provided the theoretical scaffolding for this interpretive description study. We used purposeful sampling (maximum variation approach) to recruit OTs, PTs, and S-LPs from Quebec, Canada. Individual interviews were conducted with 51 OTs, PTs, and S-LPs from Quebec, Canada, in English or French (2019–2020). Inductive and deductive approaches, and constant comparative techniques were used for data analysis. RESULTS: Six themes were developed: 1) characteristics of work that made it meaningful; 2) aspects of work that practitioners appreciate; 3) factors of daily work that weigh on a practitioner; 4) factors that contribute to managing work; 5) relationships with different stakeholders that shape daily work; and 6) perceptions of the profession. Meaningfulness was tied to participants' sense that their values were reflected in their work. Factors outside work shaped participants' work experiences. Recurrent negative experiences led some to leave their profession. CONCLUSION: Findings underscore a critical need to address contributing factors to attrition and retention which are essential to ensuring the availability of OTs, PTs and SLPs for present and future rehabilitation needs. [ABSTRACT FROM AUTHOR]

BACKGROUND: Health human resources are scarce worldwide. In occupational therapy (OT), physical therapy (PT), and speech-language pathology (S-LP), attrition and retention issues amplify this situation and contribute to the precarity of health systems. OBJECTIVE: To investigate the phenomena of attrition and retention with OTs, PTs and S-LPs who stayed in, or left their profession. METHODS: Cultural-historical activity theory provided the theoretical scaffolding for this interpretive description study. We used purposeful sampling (maximum variation approach) to recruit OTs, PTs, and S-LPs from Quebec, Canada. Individual interviews were conducted with 51 OTs, PTs, and S-LPs from Quebec, Canada, in English or French (2019–2020). Inductive and deductive approaches, and constant comparative techniques were used for data analysis. RESULTS: Six themes were developed: 1) characteristics of work that made it meaningful; 2) aspects of work that practitioners appreciate; 3) factors of daily work that weigh on a practitioner; 4) factors that contribute to managing work; 5) relationships with different stakeholders that shape daily work; and 6) perceptions of the profession. Meaningfulness was tied to participants' sense that their values were reflected in their work. Factors outside work shaped participants' work experiences. Recurrent negative experiences led some to leave their profession. CONCLUSION: Findings underscore a critical need to address contributing factors to attrition and retention which are essential to ensuring the availability of OTs, PTs and SLPs for present and future rehabilitation needs. [ABSTRACT FROM AUTHOR]

Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors—education/research, practice, and policy/regulation—that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector's individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants' conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners' effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders. [ABSTRACT FROM AUTHOR]

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included. Data were analyzed using numerical and qualitative content analyses. Of the 4859 articles screened, 37 were eligible for inclusion. Social media may facilitate knowledge sharing in HPE, but there is a lack of conceptual clarity on what is meant by 'dissemination' and 'KT'. Who is responsible for sharing knowledge, what knowledge is being shared, and the target audiences are not always clear. Multiple factors (e.g., affordances, opportunity costs) influence how social media is used as a mechanism of dissemination, and it remains unclear whether and how it is used as a mechanism of KT. Concepts like KT and dissemination, which are often borrowed from other disciplines, must be critically evaluated for their relevance and suitability if they are to be appropriately applied to HPE and in particular to social media. Educators looking to use social media to teach students about KT should consider whether this use of technology truly aligns with their stated learning outcomes. [ABSTRACT FROM AUTHOR]

Clinically integrated teaching (CIT) is an effective approach for promoting evidence-based practice (EBP) competencies among medical students. Challenges towards the implementation of CIT in rehabilitation curricula include educators' different conceptualizations of EBP, the perceived complexity of EBP and the boundaries between the academic and the clinical setting. This study aimed to identify tailored strategies to implement in rehabilitation programs and their affiliated clinical sites to support the development of EBP competencies among students in occupational therapy (OT), physical therapy (PT) and speech-language pathology (S-LP). Nominal group technique (NGT) with stakeholders from three rehabilitation programs in Canada, offering the professional master's in OT and PT (n = 35 participants) and in S-LP (n = 8). The top two strategies identified in the OT/PT NGT were: 1) Developing a flexible definition of EBP that recognizes its complexity; 2) Providing clinicians with more access to the teaching content by pairing faculty with preceptors. The top two strategies identified in the S-LP NGT were: 1) Providing students with opportunities for decision-making with experienced clinicians; 2) Increasing interactions between faculty and preceptors using formal group meetings. Findings laid foundations for future integrated knowledge translation projects to collaboratively implement, and test identified strategies. Rehabilitation professions including occupational therapy, physical therapy and speech-language pathology acknowledge the importance of evidence-based practice (EBP). Current challenges in the teaching of EBP among rehabilitation students include educators' different conceptualizations of EBP, the perceived complexity of EBP, and the boundaries between the academic and the clinical setting. This study shows that increasing interactions between faculty and preceptors, for instance through an online community of practice, constitutes a stakeholder-endorsed priority to advance EBP education in rehabilitation. [ABSTRACT FROM AUTHOR]

Following a longitudinal study to understand how evidence-based practice evolves during the initial years of occupational therapy (OT) and physiotherapy (PT) practice, we held an end-of-grant symposium with representatives from education, practice, research, and policy. The objectives were to: (1) elicit feedback on the implications of the study results; and (2) co-develop a list of actionable recommendations for each sector. Qualitative participatory approach. The symposium was held over two half days and consisted of a presentation of study findings, a discussion on the implications of the research for each sector and future recommendations. Discussions were audio recorded, transcribed verbatim and analyzed using qualitative thematic analysis. The themes related to implications of the longitudinal study included: (1) A need to rethink what evidence-based practice (EBP) really is; (2) How to practice EBP; and (3) The continuing challenge of measuring EBP. The co-development of actionable recommendations resulted in nine strategies. This study highlighted how we may collectively promote EBP competencies in future OTs and PTs. We generated sector-specific avenues that may be pursued to promote EBP and argued for the importance of pooling efforts from the four sectors so that we may achieve the intended ethos of EBP. There is a need to revisit the definition of evidence-based practice (EBP) and the traditional 3-circle model in rehabilitation to include a broader conceptualization of what constitutes evidence. We recommend using EBP measures as tools for self-reflection and professional development that can support practitioners to be reflective and accountable evidence-based practitioners. Optimal promotion of EBP competencies in occupational therapists and physiotherapists should rest upon collaborative efforts from the education, practice, research, and policy sectors. [ABSTRACT FROM AUTHOR]

Rationale: Only half of newly implemented evidence‐based practices are sustained. Though poor sustainment can lead to negative consequences for clinical teams, organizations and patients, the causal explanations of sustainment are largely unknown. Aims and Objectives: We aimed to ascertain how (mechanisms) and in what circumstances (context) a newly implemented outcome measure in rehabilitation was sustained or not (outcome). Methodology: Informed by an integrated knowledge translation approach, we conducted a realist evaluation using a mixed method, embedded single case study design with data collection up to 18 months following the implementation of the Mayo‐Portland Adaptability Inventory ‐ version 4 (MPAI‐4), a rehabilitation outcome measure. Quantitative data (survey and patient charts) was analysed using descriptive statistics, then integrated with qualitative data (interviews with 10 key informants) and analysed using inductive and deductive retroduction. We integrated the data to develop a case description and ultimately, to refine the programme theory to better understand the sustainability of the MPAI‐4. Results: We linked context, mechanisms and outcomes, and also emphasized sustainability strategies in 18 explanations of how sustainability works. These explanations provide evidence for four overarching patterns: (1) implementation and sustainability phases are interconnected, (2) outcomes build on each other recursively, with patient benefits as the keystone outcome, (3) sustainment is achieved to varying levels across different sustainability outcomes [e.g., high level (e.g., rate of MPAI‐4 scoring: 77.7%) to low level (e.g., rate of MPAI‐4 application to clinical decision‐making: 3.7%)] and (4) the work of sustaining the MPAI‐4 is shared amongst different stakeholders. Conclusion: Implementation teams can draw from this programme theory to improve the sustainment of outcomes measures while researchers could continue to refine the theory. Continued investigation of sustainability, including diverse and continuous sustainability outcomes, is needed to understand how to maintain improvements in quality of care and patient outcomes. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Introduction: In continuing professional development (CPD), educators face the need to develop and implement innovative assessment strategies to adhere to accreditation standards and support lifelong learning. However, little is known about the development and validation of these assessment practices. We aimed to document the breadth and depth of what is known about the development and implementation of assessment practices within CPD activities. Methods: We conducted a scoping review using the framework proposed by Arksey and O'Malley (2005) and updated in 2020. We examined five databases and identified 1733 abstracts. Two team members screened titles and abstracts for inclusion/exclusion. After data extraction, we conducted a descriptive analysis of quantitative data and a thematic analysis of qualitative data. Results: A total of 130 studies were retained for the full review. Most reported assessments are written assessments (n = 100), such as multiple-choice items (n = 79). In 99 studies, authors developed an assessment for research purpose rather than for the CPD activity itself. The assessment validation process was detailed in 105 articles. In most cases, the authors examined the content with experts (n = 57) or pilot-tested the assessment (n = 50). We identified three themes: 1-satisfaction with assessment choices; 2-difficulties experienced during the administration of the assessment; and 3-complexity of the validation process. Discussion: Building on the adage "assessment drives learning," it is imperative that the CPD practices contribute to the intended learning and limit the unintended negative consequences of assessment. Our results suggest that validation processes must be considered and adapted within CPD contexts. [ABSTRACT FROM AUTHOR]

Rationale: Evidence suggests that sustainability planning and the use of a collaborative approach to planning result in better sustainability outcomes and more relevant knowledge. Yet, both approaches appear to be underutilized. A detailed description of collaborative sustainability planning may encourage the use of these two impactful strategies. Aims and Objectives: To explore the collaborative sustainability planning process for a single outcome measure in three rehabilitation sites. Methodology: Within the Mayo‐Portland Adaptability Inventory—version 4 (MPAI‐4) implementation project, we conducted a qualitative description study. We used data from 12 core sustainability planning meetings and 108 follow‐up meetings that included a total of 31 clinical and research team participants. Sustainability planning was informed by an MPAI‐4‐specific implementation guide, and by the results from a realist review of the sustainability of rehabilitation practices and the Clinical Sustainability Assessment Tool. We analyzed qualitative data using thematic content analysis. Results: Three themes describe the collaborative sustainability planning process: (1) "collaboration as a driver for sustainability" which captures the active collaboration underpinning sustainability planning; (2) "co‐creation of a sustainability plan to achieve shared objectives" which captures the identified barriers and facilitators, and selected sustainability strategies linked to one of six collaboratively identified shared objectives; and (3) "the iterative nature of sustainability planning" which captures the necessity of an agile and responsive sustainability planning process. Conclusion: Identified strategies may be useful to support (collaborative) sustainment. Future research could investigate the effect of collaborative sustainability planning on sustainability objectives, and the relationship between these objectives. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of reliable and valid evidence-based practice (EBP) measures for physiotherapy students. This study validated EBP-student (EBP-S) measures for physiotherapy students. Methods: EBP measures developed from previous research were cross-culturally validated for use by physiotherapy students. The adapted EBP-S consisted of six measures: use of EBP, EBP activities, EBP knowledge, self-efficacy for EBP, attitudes towards EBP, and perceptions of the teaching and assessment of EBP in the curriculum. The final version was completed by physiotherapy students (n = 335). The psychometric properties for each EBP-S measure were estimated, including construct validity using Rasch model, internal consistency reliability using person separation index (PSI), test-retest reliability using intraclass correlation coefficient (ICC), and differential item functioning (DIF). Results: Two formative measures (use of EBP and EBP activities) were only linguistically modified for use with students. A Rasch model was applied to the other four reflective measures. For knowledge, 55% (6/11) items fit the Rasch model with chi-square fit statistic (χ2) = 34.46, p = 0.08; PSI = 0.85. For self-efficacy, 89% (8/9) items fit the Rasch model with χ2 = 25.11, p = 0.80; PSI = 0.89. For attitudes, 62% (8/13) items fit the Rasch model with χ2 = 61.49, p = 0.00; PSI = 0.71. For perception of the teaching and assessment of EBP in the curriculum, 62% (8/13) items fit the Rasch model with χ2 = 80.99, p = 0.45; PSI = 0.92. perception of the teaching and assessment of EBP in the curriculum showed DIF in three items. The ICCs ranged between 0.80 and 0.98. Conclusions: The EBP-S measures were validated for physiotherapy students, including the testing of psychometric properties, which were not tested in the original studies. Further refinements should be considered for the use of the EBP-S with other groups of students or if changes are applied to the current curriculum. [ABSTRACT FROM AUTHOR]

Many of the important research advances in understanding and treating Parkinson's disease never leave the academic sphere, as communication barriers limit accessibility for, and engagement with, broader audiences. To increase meaningful dialogue between academic researchers and community stakeholders, Piece of Mind: Parkinson's brought together neuroscientists, people with Parkinson's disease (PD), and artists to co-create a knowledge translation performance based on scientific research and lived experience. The filmed, feature-length performance engages the viewer emotionally and intellectually using circus, dance, music, poetry, and patient testimonials. We provide an overview of our participatory process and a scene-by-scene description of the performance. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Introduction: Contextual factors can influence healthcare professionals' (HCPs) competencies, yet there is a scarcity of research on how to optimally measure these factors. The aim of this study was to develop and validate a comprehensive tool for HCPs to document the contextual factors likely to influence the maintenance, development, and deployment of professional competencies. Methods: We used DeVellis' 8-step process for scale development and Messick's unified theory of validity to inform the development and validation of the context tool. Building on results from a scoping review, we generated an item pool of contextual factors articulated around five themes: Leadership and Agency, Values, Policies, Supports, and Demands. A first version of the tool was pilot tested with 127 HCPs and analyzed using the classical test theory. A second version was tested on a larger sample (n = 581) and analyzed using the Rasch rating scale model. Results: First version of the tool: we piloted 117 items that were grouped as per the themes related to contextual factors and rated on a 5-point Likert scale. Cronbach alpha for the set of 12 retained items per scale ranged from 0.75 to 0.94. Second version of the tool included 60 items: Rasch analysis showed that four of the five scales (ie, Leadership and Agency, Values, Policies, Supports) can be used as unidimensional scales, whereas the fifth scale (Demands) had to be split into two unidimensional scales (Demands and Overdemands). Discussion: Validity evidence documented for content and internal structure is encouraging and supports the use of the McGill context tool. Future research will provide additional validity evidence and cross-cultural translation. [ABSTRACT FROM AUTHOR]

Introduction: Community-based spinal cord injury (SCI) organizations deliver peer mentorship programs in rehabilitation settings. Little is known on how these programs are delivered through the collaboration between community-based SCI organizations and rehabilitation institutions. This study aimed to identify barriers, facilitators, and collaboration processes within a SCI peer mentorship program provided by a community-based organization at a rehabilitation center. Methods: A qualitative case study design was applied. Seven participants were recruited, including two mentees, two mentors, one program director of the community-based SCI organization, and two healthcare professionals of the rehabilitation center. Each participant completed a one-on-one interview. Data were analyzed inductively and deductively based on the Consolidated Framework for Implementation Research (CFIR). Results: Ten factors were identified to influence the delivery of the peer mentorship program, including nine CFIR constructs. Successful delivery of the program required strong, collaborative inter-professional relationships between health professionals and community organizational staff (e.g., peer mentors) as facilitators; whereas potential cost, minimal patient needs, and limited mentor resources were found to be barriers. Engaging health professionals by initiating communications, reflecting and evaluating the program collectively with health professionals were important collaboration processes for the community-based organization to maintain effective partnership with the rehabilitation center. Discussion: The collaboration processes and strategies to addressing/leveraging the barriers and facilitators may inform evidence-based practice to establish and optimize the delivery of SCI peer mentorship programs in various rehabilitation settings. [ABSTRACT FROM AUTHOR]

Rationale: Engagement in scholarly practice has been associated with professional empowerment, role satisfaction and improvements in care delivery and patient outcomes across many healthcare professions. However, in evolving professions like respiratory therapy, scholarly practice is excluded from competency frameworks, resulting in a gap in education and subsequent application of this competency in practice. An exploration of scholarly practice in respiratory therapy may provide insights into evolving professions that face tensions between meeting competency requirements as outlined in frameworks and providing quality healthcare to the populations they serve. Aims and Objectives: The aim of the study was to explore what scholarly practice means, and how it manifests in practice from respiratory therapists' (RTs) perspectives. Methods: We used interpretive description methodology. We purposively sampled participants to obtain varied perspectives of scholarly practice in respiratory therapy. We conducted 26 semistructured interviews with RTs in different roles (clinicians, educators, researchers, leaders and managers) across Canada and analysed the data using inductive analysis. Data collection and analysis proceeded concurrently. Results: We developed five main themes: (i) the identity of a scholarly practitioner in RTs; (ii) factors influencing scholarly practice; (iii) one's impression of their professional self‐image; (iv) scholarly practice as a vehicle for changing practice and (v) the complex interconnections between knowledges and practices. Conclusion: Scholarly practice appears to be a multifaceted phenomenon encompassing a wide range of activities and skills including conducting research, reflective practice, application of research to practice, and contributing to the advancement of the profession and healthcare. Scholarly practice is influenced by organisational context and culture, available resources, intrinsic motivation and external political context. We identified similarities between professional identity and the description of the scholarly practitioner, suggesting that these two phenomena may be interconnected. Furthermore, participants believed that scholarly practice could enhance the image, credibility, legitimacy and professionalisation of the profession. [ABSTRACT FROM AUTHOR]

While peer-reviewed articles and conferences are appropriate for disseminating research findings within academia, they are less effective for translating scientific knowledge into meaningful and practical applications. Moreover, exchanging knowledge with nonacademic stakeholders is a crucial yet often overlooked step in ensuring that research aligns with the needs and reality of knowledge users. This is particularly problematic in dementia and Alzheimer's disease research, where social stigma and the reliance on quantitative and self-report methods hamper meaningful dialogue between academic researchers, nonacademic stakeholders, and the broader community. The authors' project Piece of Mind uses performing arts to create common ground for knowledge exchange, facilitate empathy through creative collaboration, and improve public awareness of dementia. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Introduction: Health care professionals work in different contexts, which can influence professional competencies. Despite existing literature on the impact of context on practice, the nature and influence of contextual characteristics, and how context is defined and measured, remain poorly understood. The aim of this study was to map the breadth and depth of the literature on how context is defined and measured and the contextual characteristics that may influence professional competencies. Methods: A scoping review using Arksey and O'Malley's framework. We searched MEDLINE (Ovid) and CINAHL (EBSCO). Our inclusion criteria were studies that reported on context or relationships between contextual characteristics and professional competencies or that measured context. We extracted data on context definitions, context measures and their psychometric properties, and contextual characteristics influencing professional competencies. We performed numerical and qualitative analyses. Results: After duplicate removal, 9106 citations were screened and 283 were retained. We compiled a list of 67 context definitions and 112 available measures, with or without psychometric properties. We identified 60 contextual factors and organized them into five themes: Leadership and Agency, Values, Policies, Supports, and Demands. Discussion: Context is a complex construct that covers a wide array of dimensions. Measures are available, but none include the five dimensions in one single measure or focus on items targeting the likelihood of context influencing several competencies. Given that the practice context plays a critical role in health care professionals' competencies, stakeholders from all sectors (education, practice, and policy) should work together to address those contextual characteristics that can adversely influence practice. [ABSTRACT FROM AUTHOR]

This study aimed to better understand the factors influencing the provision of sexuality-related post-stroke rehabilitation services by clinicians on different sites and to explore strategies to improve post-stroke rehabilitation services with stakeholders. A qualitative study with co-design methods was conducted with 20 clinicians from five post-stroke rehabilitation centers in Canada, 1 manager and 1 patient-partner. Participants either took part in a focus group or in sessions of an adapted version of the LEGO Serious Play method to explore influencing factors and strategies of improvement in relation to post-stroke sexual rehabilitation services. Thematic analysis was conducted semi-deductively using the Theoretical Domains Framework (TDF), the Capability, Opportunity, Motivation and Behaviour (COM-B) system and the Behaviour Change Wheel (BCW). A total of twenty factors pertaining either to the categories of Capability (n = 8; e.g., Sexual rehabilitation procedural knowledge), Motivation (n = 4; e.g., Professional boundaries) or Opportunity (n = 8; e.g., Workload) were perceived as influencing provision of sexual rehabilitation services by participants. A theoretical model was conceptualized. Strategies (n = 10) were categorized in concordance with the BCW as Training (n = 1), Enablement (n = 5) or Environmental restructuring (n = 4). This study showed that factors influencing provision of post-stroke rehabilitation services were numerous and interrelated, and that various strategies aiming either clinicians or the rehabilitation environment would be relevant to improve services. This study will help guide the design and implementation of future interventions studies aiming at improving post-stroke sexual rehabilitation services. [ABSTRACT FROM AUTHOR]

Introduction: The growing interest in knowledge translation and implementation science, both in clinical practice and in health professions education (HPE), is reflected in the number of studies that have sought to address what are believed to be evidence‐practice gaps. Though this effort may be intended to ensure practice improvements are better aligned with research evidence, there is a common assumption that the problems researchers explore and the answers they generate are meaningful and applicable to practitioner needs. Methods: This Mythology paper considers the nature of problems from HPE as the focus of HPE research and the ways in which they may or may not be aligned. The authors argue that, in an applied field such as HPE, it is vital that researchers better understand how their research problems relate to practitioner needs and what the limitations on evidence uptake might be. Not only can this establish clearer paths between evidence and action, but it also requires a rethink of much of knowledge translation and implementation science thinking and practice. Results: The authors explore five myths: whether everything in HPE is a problem; whether practitioner needs involve problem solving; whether practitioner problems are resolvable with sufficient evidence; whether researchers effectively target practitioner problems; and whether studies that focus on solving practitioner problems make significant contributions to the literature. Conclusions: To advance the conversation on the connections between problems and HPE research, the authors propose ways in which knowledge translation and implementation science might be approached differently. In the latest instalment of Medical Education Mythology, Thomas and Ellaway explore five myths surrounding "problems" in health professional education research and their impact on using research to guide practice. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Introduction: Knowledge translation experts advocate for employing knowledge brokers (KBs) to promote the uptake of research evidence in health care settings. Yet, no previous research has identified potential barriers for KBs to promote the uptake of research evidence in rehabilitation settings. This study aimed to identify the barriers and facilitators for KBs in Canadian rehabilitation settings as perceived by individuals serving as KBs. Methods: Qualitative study using semistructured telephone interviews with individuals performing KB activities in rehabilitation settings across Canada. The interview topic guide was informed by the Consolidated Framework for Implementation Research (CFIR) and consisted of 20 questions covering three domains (characteristics of individuals, inner setting, and outer settings). We conducted qualitative descriptive analysis combining deductive coding guided by the CFIR. Results: Characteristics of individuals included having communication skills, clinical experience, research skills, and interpersonal features, in addition to being confident and motivated and receiving training. The inner setting domain included having constant networking with stakeholders and being aware of stakeholders' needs, in addition to resources availability, leadership engagement, knowledge accessibility, prioritizing brokering activities, and monitoring KBs' performance. Finally, the outer setting domain showed that KBs need to be connected to a community of practice to promote information exchange and avoid work duplications. Discussion: Factors likely to hinder or promote the optimal use of KBs within Canadian rehabilitation settings include skill sets and networking abilities; organizational culture, resources, and leadership engagement; and the need for specific training for KBs and for evaluation tools to monitor their performance. [ABSTRACT FROM AUTHOR]

Background: Occupational therapists (OTs) and physiotherapists (PTs) are expected to provide evidence-based services to individuals living with disabilities. Despite the emphasis on evidence-based practice (EBP) by professional entry-level programs and professional bodies, little is known about their EBP competencies upon entry to practice and over time or what factors impact EBP use. The aim of the study was to measure and understand how EBP evolves over the first three years after graduation among Canadian OTs and PTs, and how individual and organizational factors impact the continuous use of EBP. Methods: A longitudinal, mixed methods sequential explanatory study. We administered a survey questionnaire measuring six EBP constructs (knowledge, attitudes, confidence, resources, use of EBP and evidence-based activities) annually, followed by focus group discussions with a subset of survey participants. We performed group-based trajectory modeling to identify trajectories of EBP over time, and a content analysis of qualitative data guided by the Theoretical Domains Framework. Results: Of 1700 graduates in 2016–2017, 257 (response rate = 15%) responded at baseline (T0) (i.e., at graduation), and 83 (retention rate = 32%), 75 (retention rate = 29%), and 74 (retention rate = 29%) participated at time point 1 (T1: one year into practice), time point 2 (T2: two years into practice, and time point 3 (T3: three years into practice) respectively. Group-based trajectory modeling showed four unique group trajectories for the use of EBP. Over 64% of participants (two trajectories) showed a decline in the use of EBP over time. Fifteen practitioners (7 OTs and 8 PTs) participated in the focus group discussions. Personal and peer experiences, client needs and expectations, and availability of resources were perceived to influence EBP the most. Conclusions: Though a decline in EBP may be concerning, it is unclear if this decline is clinically meaningful and whether professional expertise can offset such declines. Stakeholder-concerted efforts towards the common goal of promoting EBP in education, practice and policy are needed. [ABSTRACT FROM AUTHOR]

Rationale, Aims and Objectives: An important aspect of scholarly discussions about evidence‐based practice (EBP) is how EBP is measured. Given the conceptual and empirical developments in the study of EBP over the last 3 decades, there is a need to better understand how to best measure EBP in educational and clinical contexts. The aim of this study was to identify and describe the main challenges, recommendations for practice, and areas of future research in the measurement of EBP across the health professions as reported by systematic reviews (SRs). Methods: We conducted a secondary analysis of qualitative data obtained in the context of a previously published umbrella review that aimed to compare SRs on EBP measures. Two reviewers independently extracted excerpts from the results and discussion/conclusion sections of the 10 included SRs that aligned with the three research aims. An iterative six‐phase reflexive thematic analysis according to Braun and Clarke was conducted. Results: Our thematic analysis produced five themes describing the main challenges associated with measuring EBP, four themes outlining main recommendations for practice, and four themes representing areas of future research. Challenges include limited psychometric testing and validity evidence for existing EBP measures; limitations with the self‐report format; lack of construct clarity of EBP measures; inability to capture the complexity of the EBP process and outcomes; and the context‐specific nature of EBP measures. Reported recommendations for practice include acknowledging the multidimensionality of EBP; adapting EBP measures to the context and re‐examining the validity argument; and considering the feasibility and acceptability of measures. Areas of future research included the development of comprehensive, multidimensional EBP measures and the need for expert consensus on the operationalization of EBP. Conclusions: This study suggests that existing measures may be insufficient in capturing the multidimensional, contextual and dynamic nature of EBP. There is a need for a clear operationalization of EBP and an improved understanding and application of validity theory. [ABSTRACT FROM AUTHOR]

Introduction: Implementation of evidence-informed educational interventions (EEI) involves applying and adapting theoretical and scientific knowledge to a specific context. Knowledge translation (KT) approaches can both facilitate and structure the process. The purpose of this paper is to describe lessons learned from applying a KT approach to help implement an EEI for clinical reasoning in medical students. Methods: Using the Knowledge to Action framework, we designed and implemented an EEI intended to support the development of students' clinical reasoning skills in a renewed medical curriculum. Using mixed-methods design, we monitored students' engagement with the EEI longitudinally through a platform log; we conducted focus groups with students and stakeholders, and observed the unfolding of the implementation and its continuation. Data are reported according to six implementation outcomes: Fidelity, Feasibility, Appropriateness, Acceptability, Adoption, and Penetration. Results: Students spent a mean of 24 min on the activity (fidelity outcome) with a high completion rate (between 75% and 95%; feasibility outcome) of the entire activity each time it was done. Focus group data from students and stakeholders suggest that the activity was acceptable, appropriate, feasible, adopted and well-integrated into the curriculum. Discussion: Through the process we observed the importance of having a structuring framework, of working closely and deliberatively with stakeholders and students, of building upon concurrent evaluations in order to adapt iteratively the EEI to the local context and, while taking students' needs into consideration, of upholding the EEI's core educational principles. [ABSTRACT FROM AUTHOR]

Background: The widespread implementation of longitudinal assessment (LA) to document trainees' progression to independent practice rests more on speculative rather than evidence-based benefits. We aimed to document stakeholders' knowledge of- and attitudes towards LA, and identify how the supports and barriers can help or hinder the uptake and sustainable use of LA. Methods: We interviewed representatives from four stakeholder groups involved in LA. The interview protocols were based on the Theoretical Domains Framework (TDF), which contains a total of 14 behaviour change determinants. Two team members coded the interviews deductively to the TDF, with a third resolving differences in coding. The qualitative data analysis was completed with iterative consultations and discussions with team members until consensus was achieved. Saliency analysis was used to identify dominant domains. Results: Forty-one individuals participated in the study. Three dominant domains were identified. Participants perceive that LA has more positive than negative consequences and requires substantial ressources. All the elements and characteristics of LA are present in our data, with differences between stakeholders. Conclusion: Going forward, we could develop and implement tailored and theory driven interventions to promote a shared understanding of LA, and maintain potential positive outcomes while reducing negative ones. Furthermore, ressources to support LA implementation need to be addressed to facilitate its uptake. [ABSTRACT FROM AUTHOR]

Professional identity is believed to foster self-confidence and resilience in health care professionals. While literature exists describing professional identity in medicine, the relevance of this evidence to rehabilitation professionals (occupational therapy (OT), physical therapy (PT) and speech-language pathology (S-LP)) is limited due to differences between professions in decision-making authority (patient care), professional autonomy and understanding of their scope of practice. The objective was to determine the extent, range and nature of the literature on professional identity/professional identity formation in rehabilitation professionals. Findings from the scoping review based on Arksey and O'Malley's methodological framework are presented. A search was conducted on MEDLINE (Ovid), Embase (Ovid), AMED, CINAHL, and ProQuest Dissertations and Theses from 1996 to October 2020 for empirical and conceptual studies on OT, PT, and S-LP clinicians or students. Of 4983 retrieved records, 53 papers were selected for data extraction. Data were organised into themes for professional identity/professional identity formation: conceptual descriptors (dynamic state, multiple identities); influences (person, professional education/environments, profession-at-large). Findings are consistent with the professional identity literature in medicine. However, they point to gaps for further empirical inquiry in the role of symbols and rituals in the professional identity/professional identity formation of rehabilitation professionals, profession-specific differences between OT, PT and S-LP, and influences related to the profession-at-large on the professional identity/professional identity formation of rehabilitation professionals. These findings may help to inform professional education programs and health care and professional systems in developing resources to support professional identity formation of rehabilitation professionals. [ABSTRACT FROM AUTHOR]

Rationale: Knowledge brokers (KBs) can help promote the uptake of the latest research evidence into clinical practice. Little is known about who they are, the types of roles they perform, and the training they receive. Establishing a portrait of Canadian KBs working in the rehabilitation sector may inform health care organizations and knowledge translation specialists on how best to advance KBs practices. The overall goal was to describe the profile of KBs working to promote the uptake of evidence within rehabilitation settings in Canada. Specifically, this study aimed to describe the sociodemographic and professional characteristics, work activities, and training of KBs. Methods: A cross‐sectional online survey was administered to KBs working in rehabilitation settings across Canada. The survey included 20 questions covering sociodemographic and professional characteristics, work activities, and training opportunities. Response frequency and percentage were calculated for all categorical variables, and the weighted average (WA) for each role was calculated across participants. Descriptive analysis was conducted for all open‐ended questions. Results: Of 475 participants accessing the website, 198 completed the survey questionnaire, including 99 clinicians, 35 researchers, and 26 managers. While over two‐thirds of respondents had completed a graduate degree, only 38% reported receiving KBs‐related training. The respondents' primary roles corresponded to a linking agent (WA = 1.84), followed by capacity builder (WA = 1.76), information manager (WA = 1.71), facilitator (WA = 1.41), and evaluator (WA = 1.32). Conclusions: KBs are mostly expert clinicians who tend to perform brokering activities part‐time targeting their peers. Participants mostly perform the linking agent, capacity builder, and information roles. Moreover, only a few participants received formal training to perform brokering activities. [ABSTRACT FROM AUTHOR]

The importance of clinical reasoning in patient care is well-recognized across all health professions. Validity evidence supporting high quality clinical reasoning assessment is essential to ensure health professional schools are graduating learners competent in this domain. However, through the course of a large scoping review, we encountered inconsistent terminology for clinical reasoning and inconsistent reporting of methodology, reflecting a somewhat fractured body of literature on clinical reasoning assessment. These inconsistencies impeded our ability to synthesize across studies and appropriately compare assessment tools. More specifically, we encountered: 1) a wide array of clinical reasoning-like terms that were rarely defined or informed by a conceptual framework, 2) limited details of assessment methodology, and 3) inconsistent reporting of the steps taken to establish validity evidence for clinical reasoning assessments. Consolidating our experience in conducting this review, we provide recommendations on key definitional and methodologic elements to better support the development, description, study, and reporting of clinical reasoning assessments. [ABSTRACT FROM AUTHOR]

Evidence based medicine (EBM) has been synonymous to delivery of quality care for almost thirty years. Since the movement's inception, the assumption has been that decisions based on high quality evidence would translate to better care for patients. Despite EBM's many attractive features and the substantive attention it has received in the contemporary clinical and medical education literature, how it is defined and operationalized as a component of training is often unclear and problematic. How to practice EBM is not well articulated in the literature; therefore, it becomes difficult to teach and equally challenging to assess. In this paper, we put forward a call for deeper consideration of how EBM is taught, and for clarification on how it is defined and operationalized in medical education. In preparing this paper, we considered questions such as what it means to practice EBM, the role that medical education plays in helping realize EBM, how the teaching of EBM can change to reflect recent developments in clinical practice and education, and whether transformations in the practice of medicine necessitate a change in how we teach EBM. We end with four avenues that may be pursued to advance the teaching of EBM in medical education: (1) consensus on what we mean by EBM; (2) clear articulation of EBM-associated competencies; (3) empirically and theoretically supported means of promoting EBM competencies; (4) ways to assess both skill acquisition and use of EBM. We discuss implications for educators of EBM. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The uptake of Self-Management Support (SMS) among clinicians is suboptimal. To date, few studies have tested knowledge translation (KT) interventions to increase the application of SMS in chiropractic teaching clinics. Study objective: Evaluate the feasibility of implementing a KT intervention to promote the use of a SMS strategy among chiropractic interns, their supervisors, and individuals with spine pain compared to controls. Methods: Mixed methods pilot clustered-clinical trial. Clusters of 16 Patient Management Teams were allocated to a complex KT intervention (online and workshop training). Primary feasibility outcomes for clinicians, interns and patients were rates of recruitment, retention, and adherence to protocol. A nominal group technique and interviews were used to seek end-users' views on the implementation process, and generate possible solutions. Results: In total, 16 (84%) clinicians, 65 (26%) interns and 42 patients agreed to participate. All clinicians in the intervention group completed all KT intervention components, 23 interns (85%) completed the online training and 14 interns (51.8%) attended the workshop training. All clinicians in the intervention and seven (78%) in the control group completed all outcome measures at baseline and 6-month follow-up, while 15 (55.6%) and 23 (60.5%) interns in the intervention and control groups completed the questionnaires at baseline and 6-month follow-up, respectively. Among patients, 10 (52.6%) and 12 (52.2%) in the intervention and control groups respectively completed the questionnaires at the end of the study. Based on interview findings, solutions to improve the feasibility of conducting a full trial include: making SMS a part of the internship, changing the time of introducing the study to the interns, and having more training on SMS. Conclusion: Recruitment and retention of chiropractic interns and patients for a larger implementation trial in a single outpatient teaching clinic may be challenging. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Pain is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Pain is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Knowledge brokers (KBs) can promote the uptake of best practice guidelines in rehabilitation. Although many institutions offer training opportunities to health care professionals who wish to undertake KBs roles, the characteristics and content of those educational training opportunities (ETOs) are currently unknown. This study aimed to describe the ETOs available to rehabilitation professionals in Canada and determine whether the ETOs meet the competencies expected of the KBs roles. Methods: We conducted a Canada-wide environmental scan to identify ETOs using three strategies: online search, phone calls, and snowball. To be included in the study, ETOs had to be offered to rehabilitation professionals in Canada and be targeting KBs competencies and/or roles. We mapped each of the content to the KBs competencies (knowledge and skills) within the five roles of KBs: information manager, linking agent, capacity builder, facilitator, and evaluator. Results: A total of 51 ETOs offered in three Canadian provinces, British Columbia, Ontario, and Quebec, were included in the analysis. For KBs competencies, 76% of ETOs equipped attendees with research skills, 55% with knowledge brokering skills, and 53% with knowledge on implementation science. For KBs roles, over 60% of ETOs supported attendees to in performing the capacity builder role and 39% the evaluator role. Discussion: Findings suggest that ETOs focused primarily on preparing participants with the research and knowledge brokering skills required to perform the capacity builder and evaluator roles. Comprehensive educational training covering all KBs roles and competencies are needed. [ABSTRACT FROM AUTHOR]

This project aimed to develop, implement and evaluate a train-the-trainer initiative for community rehabilitation workers (CRWs) and rehabilitation specialists within a community rehabilitation program for children with delayed development in Tamil Nadu, India. Guided by the Knowledge to Action framework, non-governmental and academic partners collaboratively developed two 2-day workshops for (1) rehabilitation specialists and (2) CRWs. Outcomes were evaluated using mixed methods, with pre and 2.5-months post surveys (59 participants) and three focus groups (17 participants) involving trainers and trainees (including rehabilitation specialists and CRWs). There were significant increases in the CRWs' self-perception of their capacity to assess comprehension, provide explanations, respond to questions, adjust teaching, motivate learners, communicate effectively, and provide feedback. Significant changes were noted for rehabilitation specialists in five of seven domains, and for rehabilitation specialist leads in six of seven domains. Participants appreciated the interactive training style, and the use of immersive methods such as role play, though noted challenges when instructions were unclear or when they felt that material was more theoretical. This collaboratively developed train-the-trainer project demonstrates the value of such an intervention, provides an example of how a tailored program can be developed, and suggests the importance of stakeholder-driven design processes. The ability to provide effective training is a core skill set for people engaged in community-based rehabilitation (CBR) programs, yet examples of initiatives to train trainers are lacking, as is their evaluation. This project demonstrates the value of a collaborative and tailored train-the-trainer program to support community rehabilitation workers and rehabilitation specialists in their training roles within a CBR program in India. A stakeholder-driven design process supported by a collaboration between non-governmental organization and academic partners enhanced the capacity to develop, implement and evaluate the train-the-trainer program. [ABSTRACT FROM AUTHOR]

Implementation science approaches the challenges of translating evidence into practice as a matter of scientific inquiry. This conceptual paper uses an implementation science lens to examine the ways in which evidence from health professions education research is brought to bear on decision-making. The authors describe different decision-making contexts and the kinds of evidence they consider, and from this, they outline ways in which research findings might be better presented to support their translation into policy and practice. Reflecting on the nature of decision-making in health professions education and how decisions are made and then implemented in different health professions education contexts, the authors argue that researchers should align their work with the decision-making contexts that are most likely to make use of them. These recommendations reflect implementation science principles of packaging and disseminating evidence in ways that are meaningful for key stakeholders, that stem from co-creation of knowledge, that require or result in meaningful partnerships, and that are context specific and relevant. [ABSTRACT FROM AUTHOR]

Aim: Integrated knowledge translation (IKT) is an increasingly recommended collaborative approach to minimize knowledge translation gap. Still, few studies have documented the impact of IKT to optimize knowledge uptake in healthcare settings. An IKT-based clinical algorithm (Algo) was deployed in Quebec (Canada) homecare services to support skill mix for selecting bathing equipment for community-dwelling adults. The objective of this study was to document the characteristics related to Algo's IKT process. Methods: A multiple-case study with a nested concurrent mixed design was conducted in provincial homecare services. Based on Knott and Wildavsky's seven-stage classification and the integrated- Promoting Action on Research Implementation in Health Services model, Innovation , Recipients , and Context , characteristics related to Algo's levels of utilization were documented. Quantitative (electronic questionnaire) and qualitative (semistructured interviews and focus groups) data were collected for each case (i.e. homecare service). Descriptive statistics and thematic analysis were performed to describe each case through a mixed methods matrix, for intra/intercase analyses. Results: Knowledge translation characteristics of five Algo's levels of utilization were documented: reception, cognition, reference, effort, and impact. Innovation characteristics (e.g. underlying knowledge) were found to facilitate its dissemination and its use. However, the Recipients (e.g. unclear mechanisms to implement change) and Context (e.g. organizational mandates nonaligned with skill mix) characteristics hampered its application through intermediate and advanced levels of utilization. Conclusion: The knowledge translation analysis of Algo allowed for documenting the IKT-based benefits in terms of utilization in healthcare settings. Although an IKT approach appears to be a strong facilitator for initiating the implementation process, additional characteristics should be considered for promoting and sustaining its use on local, organizational, and external levels of context. Facilitation strategies should document the administrative benefits related to Algo's utilization and contextualize it according to homecare services' characteristics. Key points * The IKT approach used for developing Algo facilitated the initiation of its application but seems insufficient in its actual form to support its implementation accordingly to contextual characteristics (e.g. policies). * Ulterior IKT initiatives should embrace additional stakeholders and contextual characteristics to better align the codevelopment of scientific knowledge with priorities and mandates of the healthcare system. [ABSTRACT FROM AUTHOR]

Medical education literature suggests clinically-integrated teaching may be the most effective approach to teach evidence-based practice (EBP). Before implementing this educational best practice in rehabilitation curricula, it is imperative to better understand the current context, barriers and facilitators to teach EBP in rehabilitation from the academic to the clinical setting. The aim of this study was to explore faculty and preceptors' experiences and perceptions of teaching EBP in rehabilitation professions, namely occupational therapy, physical therapy and speech-language pathology. We gathered data from seven focus groups and an individual interview with a sample of 24 faculty and 15 preceptors, i.e., clinical supervisors. Data collected were subjected to inductive thematic content analysis. We identified three overarching themes and corresponding strategies. First, "Recognizing EBP as a multifaceted concept" denoted participants' lack of consensus regarding the meaning and scope of EBP, and their awareness of such discrepancies. Second, "Complexity of EBP is at the core of teaching practices and experiences" referred to participants' perception of EBP as a complex process involving high-level cognitive skills, which influenced their teaching practices and challenged students and themselves. Third, "Connections and divides between research and practice" represented the limited and delicate connection between faculty and preceptors, the factors either bridging or maintaining the gap between them, and the impacts of such connections and divides on teaching. Improving collaboration between faculty and preceptors constitutes an essential first step towards more effective EBP training programs in rehabilitation that could be facilitated through online communities of practice or integrated knowledge translation research projects. [ABSTRACT FROM AUTHOR]

Background: Occupational therapy (OT) and physical therapy (PT) programs in Canada have moved to graduate‐level entry education to address graduates' readiness for evidence‐based practice (EBP). Whether rehabilitation professionals with advanced training in EBP are meeting their responsibilities as evidence‐based professionals upon entry into practice and the factors that influence the use of evidence is unclear. The aim of this study was to examine the individual and organizational factors associated with the use of EBP and supporting evidence‐based activities among graduates of professional OT and PT master's programs. Methods: A cross‐sectional design using a survey of recent graduates of the 29 OT and PT programs in Canada. The survey measured six constructs supportive of EBP (ie, knowledge, attitudes, confidence, organizational resources, actual use of EBP, and evidence‐based activities). Analyses consisted of descriptive statistics to characterize the sample and the different variables and ordinal multivariate regression analysis. Results: 257 graduates (15%) completed the survey. Attitudes towards EBP was positively associated both with evidence‐based activities (odds ratio = 1.36 with a 95% CI: 1.22 to 1.52) and use of EBP (odds ratio = 1.23 with a 95% CI: 1.12 to 1.36); greater confidence was related to greater use of EBP (OR = 1.12, 95% CI: 1.01 to 1.24); and working in a private practice setting was found to be related to performing more evidence‐based activities (odds ratio = 3.15, 95% CI: 1.40 to 7.12). Conclusions: Despite a greater focus on EBP knowledge in these curricula across Canada, knowledge was not related to EBP use nor evidence‐based activities upon entry into practice. On the other hand, attitudes, confidence and working in private practice were. University programs should consider curricular strategies that increase the use of EBP, provide opportunities to engage in evidence‐based activities with an emphasis on promoting the development of positive attitudes towards EBP and increasing learners' confidence in their ability to be evidence‐based professionals. [ABSTRACT FROM AUTHOR]

Evidence informed approaches to health professions education can ensure accountability to learners and society in providing meaningful and effective education and helping resource strained systems via streamlined and cost-efficient practices. Knowledge translation and implementation science are two areas of study originally developed in clinical medicine in response to concerns that health care practices were incongruent with the scientific evidence. Two decades of research have led to important advances in our understanding of the nature and magnitude of research-practice gaps, the factors that support or impede adoption of evidence in clinical decision-making, and in the design and evaluation of theory driven interventions to reduce gaps. This paper borrows concepts from knowledge translation and implementation science to further our thinking about how health professions education can 'truly' be evidence informed. The article is organised in four sections: a discussion of the impetus for the evidence informed health professions education movement; a description of the origins of knowledge translation and implementation science; a discussion on how knowledge translation and implementation science can be leveraged to advance the evidence informed health professions education agenda; and suggestions for future discussion and research. An example is used to illustrate the application of the underpinning principles of knowledge translation and implementation science. The authors suggest a theory driven, staged and systematic approach that integrates knowledge translation principles and processes and involves key stakeholders interested in promoting the application of educational research of evidence. [ABSTRACT FROM AUTHOR]

Rationale: Despite the available evidence to support optimal practices in rehabilitation, significant knowledge practice gaps persist. Opinion leaders (OLs) and knowledge brokers (KBs) can enhance the success of knowledge translation (KT) interventions and improve uptake of best practices among clinicians. However, the literature on the mechanisms underpinning OLs'/KBs' activities, and guidance on the type of support needed for successful implementation of these roles in rehabilitation contexts is scarce. This research aimed to highlight the differences and similarities between OLs and KBs with respect to context, mechanism, and outcomes as well as describe the common patterns of OLs and KBs by creating a context‐mechanism‐outcomes configuration. Methods: We conducted a realist review to synthesize the available evidence on OLs/KBs as active KT strategies. A search was conducted across five databases up to November 2019. Two independent reviewers extracted the data using a structured form. A context‐mechanism‐outcome configuration was used to conceptualize a cumulative portrait of the features of OLs/KBs roles. Results: The search identified 3282 titles after removing duplicates. Seventeen studies (reported in 20 articles) were included in the review. Findings suggest a number of desirable features of OLs/KBs roles that may maximize the achievement of targeted outcomes namely being (a) embedded within their organization as "insiders"; (b) adequately skilled to perform their role; (c) identified as able to fulfil the role; (d) appropriately trained; and (e) able to use different KT interventions. Conclusion: Findings of this realist review converge to create a context‐mechanism‐outcomes configuration with suggestions to optimally utilize OLs/KBs in rehabilitation. The configurations suggest desirable features that can lead to a greater potential to achieve targeted goals. It is preferable that OLs/KBs be embedded in the organization and that they are adequately skilful and well‐trained. Also, OLs/KBs should perform the required roles using KT interventions adapted to the local context. [ABSTRACT FROM AUTHOR]

Objectives: Over the last two decades, the number of scoping reviews in core medical education journals has increased by 4200%. Despite this growth, research on scoping reviews provides limited information about their nature, including how they are conducted or why medical educators undertake this knowledge synthesis type. This gap makes it difficult to know where the field stands and may hamper attempts to improve the conduct, reporting and utility of scoping reviews. Thus, this review characterises the nature of medical education scoping reviews to identify areas for improvement and highlight future research opportunities. Method: The authors searched PubMed for scoping reviews published between 1/1999 and 4/2020 in 14 medical education journals. The authors extracted and summarised key bibliometric data, the rationales given for conducting a scoping review, the research questions and key reporting elements as described in the PRISMA‐ScR. Rationales and research questions were mapped to Arksey and O'Malley's reasons for conducting a scoping review. Results: One hundred and one scoping reviews were included. On average, 10.1 scoping reviews (SD = 13.1, median = 4) were published annually with the most reviews published in 2019 (n = 42). Authors described multiple reasons for undertaking scoping reviews; the most prevalent being to summarise and disseminate research findings (n = 77). In 11 reviews, the rationales for the scoping review and the research questions aligned. No review addressed all elements of the PRISMA‐ScR, with few authors publishing a protocol (n = 2) or including stakeholders (n = 20). Authors identified shortcomings of scoping reviews, including lack of critical appraisal. Conclusions: Scoping reviews are increasingly conducted in medical education and published by most core journals. Scoping reviews aim to map the depth and breadth of emerging topics; as such, they have the potential to play a critical role in the practice, policy and research of medical education. However, these results suggest improvements are needed for this role to be fully realised. Over the last 20 years, the number of #MedEd reviews has grown >2600% (4200% for scoping reviews). To explore this growth, Maggio et al. conducted a scoping review of 101 scoping reviews across 14 journals. [ABSTRACT FROM AUTHOR]

The article explores ways on how medical educators can deliver quality education primarily through online media amidst the COVID-19 pandemic. Topics covered include the techniques and strategies that educators can employ to help ensure the success of virtual learning, educational reform needed to meet the learning needs of future students, and principles of learning sciences and cognitive psychology that online educational innovations have in common

Introduction: A recurrent challenge facing respiratory therapists (RTs) is their legitimacy as professionals. RTs are often referred to as technologists, vocationalists, or technicians and must often justify their status as full professionals rather than "professional technicians". There is currently little exploration of what it means to be a profession and the process of professionalization in respiratory therapy. Approach: Drawing from sociological theory, the purpose of this paper is to discuss the professionalization of respiratory therapy in Canada using Andrew Abbott's theory, the "system of professions". We will use this theory as a lens to propose areas of consideration for professional development regarding two pervasive themes in the respiratory therapy community, RTs' specialized body of knowledge and professional autonomy. Findings: Abstract knowledge is believed to be essential in the evolution from occupation to profession and is valuable to a profession in three ways: it can influence the profession's legitimacy, it can be used for conducting research, and it promotes higher education. RTs possess jurisdictional professional autonomy within Canada. The privilege of self-regulation allows RTs to act according to their knowledge and judgement without direct oversight from other professions. Conclusion: Based on Abbott's theoretical position, RTs can rightly justify their position as professionals. However, RTs need to acknowledge that professionalization is a dynamic and continuous process that requires creative changes to innovate within the profession and support future efforts to reinforce their position as professionals. Throughout this paper, we offer suggestions for how RTs can contribute to the ongoing professionalization of respiratory therapy. [ABSTRACT FROM AUTHOR]

Objectives: Educators and researchers recently implemented developmental progress assessment (DPA) in the context of competency‐based education. To reap its anticipated benefits, much still remains to be understood about its implementation. In this study, we aimed to determine the nature and extent of the current evidence on DPA, in an effort to broaden our understanding of the major goals and intended outcomes of DPA as well as the lessons learned from how it has been executed in, or applied across, educational contexts. Methods: We conducted a scoping study based on the methodology of Arksey and O'Malley. Our search strategy yielded 2494 articles. These articles were screened for inclusion and exclusion (90% agreement), and numerical and qualitative data were extracted from 56 articles based on a pre‐defined set of charting categories. The thematic analysis of the qualitative data was completed with iterative consultations and discussions until consensus was achieved for the interpretation of the results. Results: Tools used to document DPA include scales, milestones and portfolios. Performances were observed in clinical or standardised contexts. We identified seven major themes in our qualitative thematic analysis: (a) underlying aims of DPA; (b) sources of information; (c) barriers; (d) contextual factors that can act as barriers or facilitators to the implementation of DPA; (e) facilitators; (f) observed outcomes, and (g) documented validity evidences. Conclusions: Developmental progress assessment seems to fill a need in the training of future competent health professionals. However, moving forward with a widespread implementation of DPA, factors such as lack of access to user‐friendly technology and time to observe performance may render its operationalisation burdensome in the context of competency‐based medical education. Adding to the Cross‐cutting edge series, Johnston et al. introduce readers to the postmodern concept of the simulacrum, explore its relevance to the growing field of simulation education. [ABSTRACT FROM AUTHOR]

Scoping reviews are increasingly used in health professions education to synthesize research and scholarship, and to report on the depth and breadth of the literature on a given topic. In this Perspective, we argue that the philosophical stance scholars adopt during the execution of a scoping review, including the meaning they attribute to fundamental concepts such as knowledge and evidence, influences how they gather, analyze, and interpret information obtained from a heterogeneous body of literature. We highlight the principles informing scoping reviews and outline how epistemology-the aspect of philosophy that "deals with questions involving the nature of knowledge, the justification of beliefs, and rationality"-should guide methodological considerations, toward the aim of ensuring the production of a high-quality review with defensible and appropriate conclusions. To contextualize our claims, we illustrate some of the methodological challenges we have personally encountered while executing a scoping review on clinical reasoning and reflect on how these challenges could have been reconciled through a broader understanding of the methodology's philosophical foundation. We conclude with a description of lessons we have learned that might usefully inform other scholars who are considering undertaking a scoping review in their own domains of inquiry. [ABSTRACT FROM AUTHOR]

Rehabilitation post-stroke is critical for maximizing patient outcomes. This study assessed the feasibility of implementing and evaluating a continuing professional development (CPD) intervention aimed at increasing the uptake of stroke best practice guidelines among physiotherapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) in six university-affiliated stroke rehabilitation centers in Quebec, Canada. Twelve stroke best practice recommendations with reflective tools were sent weekly by e-mail. Participants' eligibility criteria included: a) profession; b) practicing more than 1 year in a stroke rehabilitation program; c) fluency in French or English; and d) basic computer literacy. Feasibility (operationalized via participation, satisfaction and relevance), cognitive impact, perceived application in practice and expected patient outcomes were measured over 24 weeks using three questionnaires and analyzed using descriptive statistics. The sample totaled 62 of 133 eligible (47%) clinicians. Satisfaction, relevance and cognitive impact of delivered information varied across disciplines and recommendations. Agreement with the recommendations was high across disciplines. On average, three-interdisciplinary recommendations (related to post-stoke depression, post-stoke fatigue and patients' and caregivers' learning needs) were rated as the most relevant for at least one patient. The majority of clinicians would use the recommendations for a specific patient and expected health benefits by applying those recommendations. This study demonstrated the feasibility of assessing the impact of a CPD intervention in stroke rehabilitation uptake and informed the design of a research program aimed at increasing the use of stroke evidence-based rehabilitation interventions. [ABSTRACT FROM AUTHOR]

Introduction: Health care professionals are expected to embrace and enact the scholarly practitioner role. Scholarly practitioners demonstrate a lifelong commitment to excellence in practice through continuous learning, engagement in evidence-informed decision-making, contributions to scholarship, and knowledge translation. However, the specific features and requirements associated with this role are not uniform. The absence of well-defined and delineated conceptualizations of scholarly practice and the scarcity of empirical research on how scholarly practice is operationalized contribute to a lack of a shared understanding of this complex role. Aim: The purpose of this scoping review is to map the breadth and depth of the literature on what is known about scholarly practice in licensed health care professionals. Methods: Arksey and O'Malley's 6-stage scoping review framework will be used to examine the breadth and depth of the literature on the definitions and conceptualizations of the scholar role in health care professionals. We will conduct a comprehensive search from inception to present in MEDLINE (Ovid), EMBASE (Ovid), and CINAHL using scholarly practitioner terms and related synonyms, including a grey literature search. Following a calibration exercise, two independent reviewers will screen retrieved papers for inclusion and extract relevant data. Included papers will: (i) explore, describe, or define scholarly practice, scholar or scholarly practitioner, and/or related concepts in the licensed health care professionals; (ii) be conceptual and/or theoretical in nature; (iii) use quantitative, qualitative, or mixed methodologies; and (iv) be published in English or French. Numeric and thematic analysis will characterize the data and address the research objectives. [ABSTRACT FROM AUTHOR]