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Interdisciplinary rounds are a new care coordination strategy in several healthcare settings. This article describes the process used by clinical nurse specialists in one institution to broaden existing discharge planning rounds to interdisciplinary rounds. In addition, a survey queried advanced practice nurse subscribers to two listserves, the ANPACC and CNS-L, to determine how other institutions conducted interdisciplinary rounds, including structure, membership, and leadership. As a result of the changed focus in rounds, the target institution noted greater participation by all disciplines in achieving patient and family outcomes, increased early recognition of patients at risk, and improved communication among members of the healthcare team. These findings were supported by participants in the Internet survey. It was determined that interdisciplinary rounds are a valuable mechanism for improved patient outcomes and increased staff professionalism. [ABSTRACT FROM AUTHOR]

This malignancy, with about 185,000 diagnoses annually, claims nearly 40,000 lives each year. [ABSTRACT FROM AUTHOR]

Background and Need for Innovation: Teaching and learning approaches can support medical students in developing the research skills necessary to be adept consumers of scientific research. Despite various influencing factors, existing literature on effective strategies in undergraduate medical education remains limited., Goal of Innovation: Using a spiraled curriculum, we created and evaluated a longitudinal course to enhance medical students' research abilities., Steps Taken for Development and Implementation of Innovation: During a recent curriculum renewal at one medical school, a three-year longitudinal course on the principles of research was developed and implemented. The innovation of this course includes the sequential nature and deliberate redundancy of curriculum content, how new knowledge is linked to prior learning, and the progressive level of difficulty in knowledge application and skill development., Evaluation of Innovation: The authors analysed faculty members' and students' satisfaction and their perceptions of each session of the course using program evaluation data collected between 2019 and 2021. Both faculty members and students recognized the benefits of revisiting concepts and highlighted learning outcomes like improved synthesis of information, explaining findings to patients, and enhanced critical thinking., Critical Reflection: The adoption of a spiraled curriculum in undergraduate medical education offers a systematic approach for developing students' research skills. The positive reception of this innovation underscores its potential to help future health professionals form a professional identity as adept researchers. However, its implications demand careful consideration and ongoing evaluation to ensure that the desired outcomes are sustained., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Purpose: The purpose of this Special Article is to document the evolution of the anesthesia assistant (AA) profession in Canada and summarize AA practice at Canadian institutions as it exists today, five decades after Quebec and 15 years after most other provinces formalized AA practice., Source: Through the Management Committee of the Association of Canadian University Departments of Anesthesia (ACUDA), we conducted a purposeful sampling of all ACUDA chairs or their delegates. We requested the following data: history of AAs becoming a reality in their particular province or region; potential recruitment pools; training programs and curricula; pathway to credentialing; funding, pay, retention, recruitment, and status of union representation; and metrics., Principal Findings: Data were provided by 19 institutions in 8 provinces: Newfoundland and Labrador, Nova Scotia, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, and British Columbia. Given the different health care governance structures across the provinces, AA roles vary in terms of its associated technical, clinical, and educational responsibilities. The role of AAs in supporting anesthesia care through equipment maintenance and assistance with airway management, resuscitation, and administration of regional anesthesia seems to be well established, as is their role in providing brief intraoperative relief for anesthesiologists during a stable period of anesthesia. Anesthesia assistant duties continue to evolve, becoming more aligned with the specific institution and less dependent on the supervising anesthesiologist. Apart from the initial metrics collected during the Ontario ACT implementation pilot projects, we are not aware of any formal metrics, current or ongoing, being collected across Canada, related to either patient safety events or perioperative efficiency., Conclusions: This compilation of pan-Canadian AA data shows diverse models of practice and highlights the value to patients and the health care system as a whole of incorporating these allied professionals into the anesthesia care team (ACT). The present findings allow us to offer suggestions for consideration during discussions of retention, recruitment, program expansion, and cross-country collection of metrics and other data. We conclude by making six recommendations: 1. recognize that implementation of ACTs is a key element in solving the challenge of an increasing surgical backlog; 2. develop, or facilitate the development of, metrics and increase data-sharing nationally to enable health care authorities to better understand the importance of AAs in patient safety and perioperative efficiency; 3. develop and implement funding strategies to lower the barriers to AA training such as hospital-sponsored positions, ongoing salary support, and return-of-service arrangements; 4. ensure that salaries appropriately reflect the increased level of training and added levels of responsibility of certified AAs; 5. develop long-term strategies to ensure stable funding, recruitment and retention, and a better match between the number of AA training positions and the need for newly certified AAs; and 6. engage all stakeholders to acknowledge that AAs, as knowledgeable and specifically trained assistants, not only fulfill their defined clinical role but also contribute significantly to patient safety and clinical efficiency by assuming nondirect patient care tasks., (© 2024. Canadian Anesthesiologists' Society.)

Introduction: Respiratory therapists (RTs) are expected to provide high-quality care for patients with chronic and acute cardiopulmonary conditions across the lifespan by staying abreast of emerging scientific evidence and effectively integrating it into clinical practice. This integration of evidence is encompassed within the competency of scholarly practice. However, there is currently a limited understanding of RTs' scholarly practice. Furthermore, despite RTs' widespread presence in the Canadian healthcare system, comprehensive studies describing the profiles of RTs are lacking. This study aimed to describe the demographic characteristics, scholarly and practice profiles of the respiratory therapy profession in Canada., Methods: A cross-sectional survey was distributed via the national professional association and regulatory bodies. The survey contained seven sections with 52 items. We calculated means and standard deviations, or medians and interquartile ranges for continuous variables and frequencies and proportions for categorical variables. Open-ended questions were analyzed using summative content analysis., Results: We analyzed data from 832 participants (6.8% response rate) from Ontario (17.8%), Québec (15.7%), and Alberta (13.3%), and across other provinces. Nearly 40% had completed an undergraduate degree beyond their respiratory therapy diploma. Few participants had authored or co-authored peer-reviewed publications. RTs reported reading approximately 2.2 peer-reviewed publications monthly. Most participants agreed on the importance of critical reflection in practice (93.1%) and that having a supportive work environment was vital. Almost three-quarters of participants (73.4%) reported that they believe that RTs are valued members of interprofessional teams, and 78% agreed that understanding research enables them to engage in patient advocacy., Conclusion: This survey provides a portrait of the practice and scholarly profile of the respiratory therapy profession in Canada. While the profession shows potential for growth, concerns persist regarding limited engagement in activities related to scholarly practice. Addressing these challenges and nurturing a culture of scholarly practice are likely necessary to support the development of scholarly practice in the profession. Creating supportive environments, providing access to resources, and encouraging professional development activities may advance the scholarly practice of RTs. Future national surveys could employ random sampling strategies to achieve a more representative sample of the profession., Competing Interests: MZ is deputy editor of the Canadian Journal of Respiratory Therapy, AW is an associate editor of the Canadian Journal of Respiratory Therapy, neither were involved in any decision regarding this manuscript. AB, PN, AT have no conflicts to disclose.

Competing Interests: TD and MZ are on the editorial board for the Canadian Medical Education Journal. Neither were involved in any decision regarding this manuscript. All other authors report no conflicts of interest.

Background: Respiratory therapists (RTs) are expected to stay updated on technology, treatments, research, and best practices to provide high-quality patient care. They must possess the skills to interpret, evaluate, and contribute to evidence-based practices. However, RTs often rely on research from other professions that may not fully address their specific needs, leading to insufficient guidance for their practice. Additionally, there has been no exploration of knowledge gaps and research needs from RTs' perspectives to enhance their practice and patient outcomes. The research questions guiding this study were: ( i ) what are the perceived practice-oriented knowledge gaps? and ( ii ) what are the necessary research priorities across the respiratory therapy profession according to experts in respiratory therapy?, Methods: A qualitative description study was conducted using semi-structured focus groups with 40 expert RTs from seven areas of practice across Canada. Data was analyzed using qualitative content analysis., Results: We identified four major themes relating to what these experts perceive as the practice-oriented gaps and necessary research priorities across the respiratory therapy profession: 1) system-level impact of RTs, 2) optimizing respiratory therapy practices, 3) scholarship on the respiratory therapy profession and 4) respiratory therapy education., Discussion: The findings establish a fundamental understanding of the current gaps and the specific needs of RTs that require further investigation. Participants strongly emphasized the significance of research priorities that consider the breadth and depth of the respiratory therapy profession, which underscores the complex nature of respiratory therapy and its application in practice., Conclusion: The unique insights garnered from this study highlight the knowledge gaps and research needs specific to RTs. These findings pave the way for further exploration, discourse, and research aimed at understanding the specific contributions and requirements of RTs., Competing Interests: MZ is deputy editor of the Canadian Journal of Respiratory Therapy, AW is an associate editor of the Canadian Journal of Respiratory Therapy, SQ and MLN are on the editorial board for the Canadian Journal of Respiratory Therapy. None were involved in any decision regarding this manuscript. EK has no conflicts to disclose. All authors have completed the ICMJE uniform disclosure form.

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., (© 2023 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Introduction: Competency-based medical education (CBME) offers perceived advantages and benefits for postgraduate medical education (PGME) and the training of competent physicians. The purpose of our study was to gain insights from those involved in implementing CBME in two residency programs to inform ongoing implementation practices., Methods: We conducted a qualitative descriptive study to explore the perspectives of multiple stakeholders involved in the implementation of CBME in two residency programs (the first cohort) to launch the Royal College's Competence by Design model at one Canadian university. Semi-structured interviews were conducted with 17 participants across six stakeholder groups including residents, department chairs, program directors, faculty, medical educators, and program administrators. Data collection and analysis were iterative and reflexive to enhance the authenticity of the results., Results: The participants' perspectives organized around three key themes including: a) contextualizing curriculum and assessment practices with educational goals of CBME, b) coordinating new administrative requirements to support implementation, and c) adaptability toward a competency-based program structure, each with sub-themes., Conclusion: By eliciting the perspectives of different stakeholder groups who experienced the implementation processes, we developed a common understanding regarding facilitators and challenges for program directors, program administrators and educational leaders across PGME. Results from our study contribute to the scholarly conversation regarding the key aspects related to CBME implementation and serve to inform its ongoing development and application in various educational contexts., Competing Interests: None, (© 2023 Dubé, Wagner, Zaccagnini, Gomez-Garibello; licensee Synergies Partners.)

Evidence-based practice relies on using research evidence to guide clinical decision-making. However, staying current with all published research can be challenging. Many clinicians use review articles that apply predefined methods to locate, identify, and summarize all available evidence on a topic to guide clinical decision-making. This paper discusses the role of review articles, including narrative, scoping, and systematic reviews, to synthesize existing evidence and generate new knowledge. It provides a step-by-step guide to conducting a systematic review and meta-analysis, covering key steps such as formulating a research question, selecting studies, evaluating evidence quality, and reporting results. This paper is intended as a resource for clinicians looking to learn how to conduct systematic reviews and advance evidence-based practice in the field., (Copyright © 2023 by Daedalus Enterprises.)

Background: Respiratory therapists (RTs) are in a unique position to positively impact patient outcomes through respiratory care research. Research plays a key role in evidence-based medicine; however, few RTs perform and publish research. Identification of barriers experienced by RTs may help increase RT-driven research. Thus, we aimed to identify barriers and research interests for RTs., Methods: American Association for Respiratory Care (AARC) members were invited to anonymously complete a survey via an electronic link posted on AARC Connect. Survey domains included research training, experience, reasons for doing research, important respiratory topics, and barriers to conduct research., Results: Responses from 82 surveys were analyzed. The majority were female (56%), and most had a graduate degree (61%), with a mean working experience of 25.3 ± 13.6 y. Fifty-seven percent of respondents reported at least one publication in a peer-reviewed journal. The desire to improve patient outcomes was the top-ranked reason for doing research. Most received research training through a graduate-level program (56%), but few had a formal research mentor (26%). Clinical research (67%) and quality improvement (63%) were the most common types of research. Data collection was the most common research role (51%). Invasive ventilation, advanced monitoring, and airway clearance were identified as the most important research topics. The primary barriers for RTs to conduct research were lack of protected time for research, opportunities to participate, training, departmental support, and mentorship., Conclusions: Lack of time, resources, and opportunities were identified as the primary barriers to RT research, and many RTs have not received formal research training. Resources such as formal mentorship, funding, and protected time may help increase RT participation in research., Competing Interests: Ms Willis, Mr Miller, and Dr Li are section editors for Respiratory Care. Mr Miller discloses relationships with Saxe Communications and S2N Health. Dr Li discloses relationships with Fisher & Paykel Healthcare, Aerogen, the Rice Foundation, American Association for Respiratory Care, and Heyer. The remaining authors have no conflicts of interest to disclose., (Copyright © 2023 by Daedalus Enterprises.)

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., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

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., (© 2022 John Wiley & Sons Ltd.)

Introduction: Adolescents and young adults require age-appropriate healthcare services delivered by clinicians with expertise in adolescent medicine. However, resident family physicians report a low perceived self-efficacy and under-preparedness to deliver adolescent medical care. We conducted a scoping review to map the breadth and depth of the current evidence about adolescent medicine training for family medicine residents., Content: We followed Arksey and O'Malley's framework and searched seven electronic databases and key organizations' webpages from inception to September 2020. Informed by the CanMEDS-FM, we analyzed the extracted data concerning basic document characteristics, competencies and medical topics using numerical and qualitative content analysis., Summary: We included 41 peer-reviewed articles and six adolescent health competency frameworks (n=47). Most competencies taught in family medicine programs were organized under the roles of family medicine expert (75%), communicator (11.8%), and professional roles (7.9%). Health advocate and leader were rarely included (1.3%), and never scholar ., Outlook: The omission of multiple competency roles in family medicine resident education on adolescents is insufficient for family physicians to deliver optimal care to adolescents. The combined efforts of family medicine stakeholders to address adolescent medicine competency gaps may positively impact the perceived competence reported by family medicine residents., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Delphi survey techniques are a common consensus method used to collect feedback from an expert panel to inform practices, establish guidelines, and identify research priorities. Collecting respiratory therapists' (RT) expertise and experiences as part of consensus-building methodologies is one way to ensure that they align with RT practices and to better influence respiratory care practice. This narrative review aimed to report the RT representation in expert panels of Delphi studies focused on respiratory therapy practices and research priorities. The research question that guided this review is: to what extent are RTs included as expert participants among published Delphi studies relate to respiratory therapy and research topics? We conducted a structured search of the literature and identified 23 papers that reported Delphi studies related to respiratory care practices and 15 that reported on respiratory-related research priorities. Delphi studies that focused on reporting consensus on respiratory care practices included the following: (1) mechanical ventilation, (2) high-flow nasal cannula therapy, (3) COVID-19 respiratory management, (4) home oxygen therapy, (5) cardiopulmonary monitoring, and (6) disease-specific guidelines. Delphi studies that focused on establishing respiratory research priorities included the following: (1) theory and practice-orientated knowledge gaps, and (2) priority research topics for empirical investigation. The results of this review suggest that RTs were rarely included as expert participants and, when involved, were minimally represented (5% to 33%). Given RTs' diverse and relevant experience in respiratory care, incorporating their perspectives to inform future education, respiratory care practices, and research priorities would allow evidence to better align with knowledge gaps deemed important for the respiratory therapy profession., Competing Interests: Mr. Zaccagnini is an editorial board member of RESPIRATORY CARE and was not involved in any decision regarding this manuscript. There are no conflicts of interest from any authors to disclose., (Copyright © 2022 by Daedalus Enterprises.)

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., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Objectives: The objective of the review was to estimate the quality of systematic reviews on evidence-based practice measures across health care professions and identify differences between systematic reviews regarding approaches used to assess the adequacy of evidence-based practice measures and recommended measures., Introduction: Systematic reviews on the psychometric properties of evidence-based practice measures guide researchers, clinical managers, and educators in selecting an appropriate measure for use. The lack of psychometric standards specific to evidence-based practice measures, in addition to recent findings suggesting the low methodological quality of psychometric systematic reviews, calls into question the quality and methods of systematic reviews examining evidence-based practice measures., Inclusion Criteria: We included systematic reviews that identified measures that assessed evidence-based practice as a whole or of constituent parts (eg, knowledge, attitudes, skills, behaviors), and described the psychometric evidence for any health care professional group irrespective of assessment context (education or clinical practice)., Methods: We searched five databases (MEDLINE, Embase, CINAHL, PsycINFO, and ERIC) on January 18, 2021. Two independent reviewers conducted screening, data extraction, and quality appraisal following the JBI approach. A narrative synthesis was performed., Results: Ten systematic reviews, published between 2006 and 2020, were included and focused on the following groups: all health care professionals (n = 3), nurses (n = 2), occupational therapists (n = 2), physical therapists (n = 1), medical students (n = 1), and family medicine residents (n = 1). The overall quality of the systematic reviews was low: none of the reviews assessed the quality of primary studies or adhered to methodological guidelines, and only one registered a protocol. Reporting of psychometric evidence and measurement characteristics differed. While all the systematic reviews discussed internal consistency, feasibility was only addressed by three. Many approaches were used to assess the adequacy of measures, and five systematic reviews referenced tools. Criteria for the adequacy of individual properties and measures varied, but mainly followed standards for patient-reported outcome measures or the Standards of Educational and Psychological Testing. There were 204 unique measures identified across 10 reviews. One review explicitly recommended measures for occupational therapists, three reviews identified adequate measures for all health care professionals, and one review identified measures for medical students. The 27 measures deemed adequate by these five systematic reviews are described., Conclusions: Our results suggest a need to improve the overall methodological quality and reporting of systematic reviews on evidence-based practice measures to increase the trustworthiness of recommendations and allow comprehensive interpretation by end users. Risk of bias is common to all the included systematic reviews, as the quality of primary studies was not assessed. The diversity of tools and approaches used to evaluate the adequacy of evidence-based practice measures reflects tensions regarding the conceptualization of validity, suggesting a need to reflect on the most appropriate application of validity theory to evidence-based practice measures., Systematic Review Registration Number: PROSPERO CRD42020160874., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 JBI.)

Objective: Communication is a core competency for all physicians in training. In Canada, the importance of communication during residency is recognized through the CanMEDS framework. Although literature exists around teaching communication skills to residents, research in psychiatry residents is lacking. The purpose of this study was to explore how faculty members conceptualize the development of communication skills in psychiatry residents and develop a model reflecting this., Methods: The authors used a constructivist grounded theory approach. Purposive sampling was used to select 14 faculty educators who regularly supervise psychiatry residents in a single university-based residency training program. Semi-structured interviews were conducted to explore educators' perceptions of how communication skills develop during residency. Constant comparative analysis occurred concurrently with data collection until thematic theoretical sufficiency was reached and relationships between themes determined., Results: Five themes underlie the McMaster Advanced Communication Competencies model, describing the progressive development of communication abilities in residents. Three themes identify foundational sets of abilities including: refining common foundational relational abilities, developing foundational specific psychiatric communication abilities, and learning to reflect upon and manage internal reactions. These foundational pillars then allow residents to develop a personalized art of flexible psychiatric interviewing, and skillfully partner with patients in co-creating care plans., Conclusions: This research describes a preliminary communication competency model for teaching and assessing psychiatry residents. It defines the core communication abilities required for residents to progress to independent practice. Future research could explore and test the model's validity and transferability., (© 2021. Academic Psychiatry.)

The novel coronavirus disease 2019 (COVID-19) created a shortage of mechanical ventilators in the healthcare sector, resulting in rationed distribution, ethical dilemmas, and high mortalities. This technical report outlines the design and product outcome of a mechanical ventilator based on readily available off-the-shelf components, minimizing the dependence on manufacturing facilities. The ventilator was designed to operate in both hospitals and remote locations, having the ability to operate off various gas pressures and low voltage supplies. Due to the COVID-19 restrictions, the challenges of developing a device in an online setting with minimal manufacturing assistance were explored. Within a 10-day period, the team designed, prototyped, and conducted preliminary feasibility testing on the mechanical ventilator. The proposed design was not intended to replace, or be used as a medically approved ventilator, but demonstrates the ability to exploit off-the-shelf components to enable fast development and assembly., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, DeBoer et al.)

Purpose: Regulatory bodies impose continuing professional development (CPD) requirements on health care professionals (HCPs) as a condition for license revalidation. Many regulatory bodies require annual evidence of CPD activities that are informed by reflective practices, guided by learning plans, and compiled into a portfolio. The purpose of this integrative review is to summarize the literature discussing how regulatory bodies use portfolios with evidence of reflection for licensure renewal. Method: We reviewed English-language articles published until May 2020 discussing evidence of CPD and reflective practice in portfolios in the context of licensure renewal. Results: We located 17 articles for the review. None reported or measured outcomes beyond submission of reflective evidence. Sixteen articles (93%) included information about passive learning resources that regulatory bodies provided to help guide HCPs' reflective learning activities. HCPs' feedback about using reflective learning activities indicated mixed opinions about their utility. Conclusions: Few publications reported how jurisdictions expected HCPs to provide evidence of reflective practices for licensure renewal. None of the regulatory bodies required evidence regarding the impact of reflective practice on patient or organizational outcomes. HCPs reported both benefits and challenges of a mandated reflective process., (© Canadian Physiotherapy Association.)

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., Competing Interests: MZ and AW are members of CJRT’s editorial board and were not involved with any decisions about the manuscript. All other authors declare no conflict of interest.

Rationale, Aims and Objectives: The Withdrawal Assessment Tool (WAT-1) is one of the most widely used clinician-reported outcome measures to evaluate iatrogenic withdrawal symptoms (IWS) in critically ill children. However, the WAT-1's measurement properties have not been aggregated. Aggregating psychometric research on the WAT-1 will enhance appropriate use, and outline gaps for future empirical research. The aim of this systematic review is to critically appraise, compare, and summarize the measurement properties and evidence quality, and describe the interpretability and feasibility of the WAT-1 for identifying IWS symptoms in critically ill children., Methods: A systematic search of Medline, Embase and CINAHL was conducted from inception to 15 April 2020. Study inclusion/exclusion, data extraction, and measurement property evidence and the modified GRADE quality scoring were applied according to the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines., Results: Six studies were included in the review. There was sufficient, high-quality evidence for reliability, structural validity, criterion validity, measurement error, construct validity, and feasibility. More information is required to support the WAT-1's content validity, responsiveness, internal consistency, cross-cultural validity, and interpretability according to COSMIN guidelines., Conclusion: The results of this review indicate that the WAT-1 is a precise, easy to use measure of IWS in critically ill children despite some measurement property inconsistencies and gaps in the publication record. More information is required to support its content validity, responsiveness, internal consistency, cross-cultural validity, and interpretability., (© 2021 John Wiley & Sons, Ltd.)

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., Competing Interests: MZ and AW are members of CJRT ’s editorial board and were not involved with any decisions about the manuscript. All other authors declare no conflict of interest.

Cell-mediated immunity to CMV, if known, could improve antiviral drug therapy in at-risk children and young adults with LT and IT. Host immunity has been measured with CMV-specific T cells, which express IFNγ, but not those which express CD154, a possible substitute for IFNγ. CMV-specific CD154+ T cells and their subsets were measured with flow cytometry after stimulating PBL from recipient blood samples with an overlapping peptide mix of CMV-pp65 antigen for up to 6 hours. CMV-specific CD154+ T cells co-expressed IFNγ in PBL from three healthy adults and averaged 3.8% (95% CI 3.2%-4.4%) in 40 healthy adults. CMV-specific T cells were significantly lower in 19 CMV DNAemic LT or IT recipients, compared with 126 non-DNAemic recipients, 1.3% (95% CI 0.8-1.7) vs 4.1 (95% CI 3.6-4.6, P < .001). All T-cell subsets demonstrated similar between-group differences. In logistic regression analysis of 46 training set samples, 12 with DNAemia, all obtained between days 0 and 60 from transplant, CMV-specific T-cell frequencies ≥1.7% predicted freedom from DNAemia with NPV of 93%. Sensitivity, specificity, and PPV were 83%, 74%, and 53%, respectively. Test performance was replicated in 99 validation samples. In 32 of 46 training set samples, all from seronegative recipients, one of 19 recipients with CMV-specific T-cell frequencies ≥1.7% experienced DNAemia, compared with 8 of 13 recipients with frequencies <1.7% (P = .001). CMV-specific CD154+ T cells are associated with freedom from DNAemia after LT and IT. Among seronegative recipients, CMV-specific T cells may protect against the development of CMV DNAemia., (© 2019 The Authors. Pediatric Transplantation published by Wiley Periodicals, Inc.)