Collaboration is neither the ethos, nor the experience, of most professionals in health care. Nevertheless, the concept of collaboration has become increasingly popular in recent years, promising to enhance all aspects of work, academic, and political life. And while collaboration is a significant and complex phenomenon, it has not been clearly understood for its impact on health care professionals and their work, or for the factors that influence its success or failure. The purpose of the study was to explore the meaning of collaboration, as conveyed by the lived experience of health care professionals, as well as the interpersonal and interactional determinants and their impact on the outcomes of their collaboration. The conceptual paradigm of phenomenology and hermeneutic phenomenological methods guided the research. In-depth interviews were conducted with 10 health care professionals engaged in interprofessional practice in a novel community-based geriatric care program. The interviews were audiotaped and transcribed verbatim. Ricoeur’s procedural steps were used to analyze the transcripts. Acquiring the ‘real world’ experiences of health care professionals enabled the emergence of six themes: engaging in collective thinking and action to produce best outcomes and optimize clients’ health; responding to collaboration for self and other members as a continued work in progress; experiencing the personal and professional rewards as markers of success with collaboration; existing challenges create barriers that impede collaboration; experiencing the interactional dynamics of collaboration and their influences requires the interpersonal attributes of quality communication, openness, trust, and respect; and forming a common vision is necessary for collaboration but difficult to achieve. The findings of this study suggest that collaboration is a genuinely experiential phenomenon: it is a human process that requires leadership on the part of all health care professionals to negotiate and agree upon the processes that will enhance their relationships and are necessary for collaboration to unfold. This study produced a number of recommendations that can be offered to multiple stakeholders in the geriatric care setting, as well as extended to those in the other domains of health care.

Collaboration is neither the ethos, nor the experience, of most professionals in health care. Nevertheless, the concept of collaboration has become increasingly popular in recent years, promising to enhance all aspects of work, academic, and political life. And while collaboration is a significant and complex phenomenon, it has not been clearly understood for its impact on health care professionals and their work, or for the factors that influence its success or failure. The purpose of the study was to explore the meaning of collaboration, as conveyed by the lived experience of health care professionals, as well as the interpersonal and interactional determinants and their impact on the outcomes of their collaboration. The conceptual paradigm of phenomenology and hermeneutic phenomenological methods guided the research. In-depth interviews were conducted with 10 health care professionals engaged in interprofessional practice in a novel community-based geriatric care program. The interviews were audiotaped and transcribed verbatim. Ricoeur’s procedural steps were used to analyze the transcripts. Acquiring the ‘real world’ experiences of health care professionals enabled the emergence of six themes: engaging in collective thinking and action to produce best outcomes and optimize clients’ health; responding to collaboration for self and other members as a continued work in progress; experiencing the personal and professional rewards as markers of success with collaboration; existing challenges create barriers that impede collaboration; experiencing the interactional dynamics of collaboration and their influences requires the interpersonal attributes of quality communication, openness, trust, and respect; and forming a common vision is necessary for collaboration but difficult to achieve. The findings of this study suggest that collaboration is a genuinely experiential phenomenon: it is a human process that requires leadership on the part of all health care professionals to negotiate and agree upon the processes that will enhance their relationships and are necessary for collaboration to unfold. This study produced a number of recommendations that can be offered to multiple stakeholders in the geriatric care setting, as well as extended to those in the other domains of health care.

Background: Low back pain (LBP) and low back related disorders are highly prevalent and associated with a considerable burden of pain, disability and work loss. People with a variety of low back-related complaints comprise a large proportion of referrals made to orthopedic surgeons and many of these patients are not considered to be surgical candidates or have not maximized their non-surgical options for managing their low back-related complaints. Objectives: We sought to evaluate the impact of a triage assessment program delivered by physiotherapists using a variety of approaches. Informed by a biopsychosocial model, the objectives of this dissertation were: 1) To determine the short term impact of a physiotherapy triage assessment for people with low back-related disorders on participant self-reported pain, function and quality of life and patient and referring practitioner satisfaction. 2) To determine which demographic, clinical, psychosocial and environmental factors are predictive of improved self-reported pain, function, quality of life and participant and referring practitioner satisfaction. 3) To determine the diagnostic and treatment recommendation concordance between physiotherapists and orthopaedic surgeons, using a newly developed clinical classification tool, for people presenting to a spinal triage assessment service with low back complaints. Methods: Two approaches were used to achieve the aforementioned objectives: a prospective observational study (n=115) to address the first two objectives and a sub-group reliability study (n=45) to address the third objective. Results: There was a mean overall significant improvement in the SF-36 Physical Component Summary at the 4-6 week post-test time point and relatively high satisfaction reported by participants and referring care providers. Qualitative analysis of comments revealed a variety of positive, negative and other contextual factors that may impact outcomes. A variety of different sociodemographic, psychological, clinical and other variables were associated with success or improvement in each respective outcome. There may be a potential mechanism of reassurance that occurs during the spinal triage assessment process as those with higher psychological distress were more likely to improve on certain outcomes. There was high diagnostic concordance between physiotherapists and an orthopaedic surgeon; however, there were more differences in management recommendations between the surgeon and a solo physiotherapist versus physiotherapists working in a collaborative team. Conclusions: A spinal triage assessment program delivered by physiotherapists has the potential to positively impact a variety of patient-related short term outcomes including satisfaction. Further study is needed to examine longer-term outcomes and which biopsychosocial factors may impact these outcomes.

The purpose of this study is to learn about the professional development practices of physiotherapists working in long-term care homes in Ontario. A survey was created based on relevant literature and piloted for this study. The survey included both quantitative and open-ended questions. 44 Physiotherapist responded, which represents approximately 10% of physiotherapists working in long-term care in Ontario. The results indicate that physiotherapists are isolated from their physiotherapist peers and lack access to communities of practice, professional socialisation, professional culture and social regulation. Although physiotherapists’ interactions with interprofessional teams added breadth to their knowledge, these interactions did not enhance their profession-specific skills. Many physiotherapists are seeking professional community and social supports in healthcare settings outside of the long-term care context. The implications of this study are that physiotherapists, their professional associations, and their college must understand the importance of professional socialization in learning, and ensure that physiotherapists working in long-term care have access to and seek such social support. Physiotherapy service providers in long-term care should provide mentoring, support and opportunities for social learning for their clinicians. Finally, long-term care homes and the Ministry of Health and Long-term care need to ensure that policies provide a better definition of the role of physiotherapists in long-term care.

No description available.

The purpose of this study is to learn about the professional development practices of physiotherapists working in long-term care homes in Ontario. A survey was created based on relevant literature and piloted for this study. The survey included both quantitative and open-ended questions. 44 Physiotherapist responded, which represents approximately 10% of physiotherapists working in long-term care in Ontario. The results indicate that physiotherapists are isolated from their physiotherapist peers and lack access to communities of practice, professional socialisation, professional culture and social regulation. Although physiotherapists’ interactions with interprofessional teams added breadth to their knowledge, these interactions did not enhance their profession-specific skills. Many physiotherapists are seeking professional community and social supports in healthcare settings outside of the long-term care context. The implications of this study are that physiotherapists, their professional associations, and their college must understand the importance of professional socialization in learning, and ensure that physiotherapists working in long-term care have access to and seek such social support. Physiotherapy service providers in long-term care should provide mentoring, support and opportunities for social learning for their clinicians. Finally, long-term care homes and the Ministry of Health and Long-term care need to ensure that policies provide a better definition of the role of physiotherapists in long-term care.

The purpose of this study is to learn about the professional development practices of physiotherapists working in long-term care homes in Ontario. A survey was created based on relevant literature and piloted for this study. The survey included both quantitative and open-ended questions. 44 Physiotherapist responded, which represents approximately 10% of physiotherapists working in long-term care in Ontario. The results indicate that physiotherapists are isolated from their physiotherapist peers and lack access to communities of practice, professional socialisation, professional culture and social regulation. Although physiotherapists’ interactions with interprofessional teams added breadth to their knowledge, these interactions did not enhance their profession-specific skills. Many physiotherapists are seeking professional community and social supports in healthcare settings outside of the long-term care context. The implications of this study are that physiotherapists, their professional associations, and their college must understand the importance of professional socialization in learning, and ensure that physiotherapists working in long-term care have access to and seek such social support. Physiotherapy service providers in long-term care should provide mentoring, support and opportunities for social learning for their clinicians. Finally, long-term care homes and the Ministry of Health and Long-term care need to ensure that policies provide a better definition of the role of physiotherapists in long-term care.

No description available.

No description available.

No description available.