A Call to Disrupt Heteronormativity and Cisnormativity in Physical Therapy: Perspectives of 2SLGBTQIPA+ Participants on Future Directions for PT Curricula.

Purpose: To explore the perspectives of individuals with self-reported expertise and/or lived experiences regarding aspects of 2SLGBTQIPA+ health that should be included in pre-licensure physical therapy (PT) curricula across Canada, including how, when, and by whom this content should be delivered. Method: We conducted a critical qualitative, cross-sectional study with semi-structured virtual interviews. We analyzed participants' perspectives thematically using the DEPICT method. Results: Thirteen participants across Canada with a variety of gender identities and sexual orientations were interviewed. Participants described how transformative change on 2SLGBTQIPA+ issues in PT requires an approach that is based on interrupting heteronormativity and cisnormativity in PT curricula. Participants explained how this could be achieved by (1) emphasizing both historical inequities and present-day considerations for safe and inclusive practice, (2) introducing the content early and integrating it throughout the programme using a variety of large- and small-group sessions, and (3) including 2SLGBTQIPA+ individuals in content delivery and creation. Conclusions: This study brings attention to the need for the PT profession to understand how the pervasive social structures of heteronormativity and cisnormativity shape education and practice, and offer strategies for disrupting complicity with these systems of inequality.

Objectif: explorer les points de vue des personnes qui déclarent avoir des compétences ou des expériences de vie relativement à des aspects de la santé des LGBTQIPA2+ qui pourraient être inclus dans le programme de physiothérapie avant l'obtention du permis au Canada, y compris la manière de transmettre la matière, ainsi que le moment où la transmettre et par qui elle doit être transmise. Méthodologie: étude qualitative transversale critique comprenant des entrevues virtuelles semi-structurées. Les chercheurs ont analysé les points de vue des participants par thèmes, à l'aide de la méthode DEPICT. Résultats: au total, 13 participants du Canada de diverses identités de genre et orientations sexuelles ont participé à une entrevue. Ils ont décrit que, pour parvenir à un changement transformatif des enjeux LGBTQIPA2+ en physiothérapie, il faut adopter une approche reposant sur l'interruption de l'hétéronormativité et de la cisnormativité au sein du programme de physiothérapie. Les participants expliquent comment y parvenir : 1) en soulignant à la fois les iniquités historiques et les considérations actuelles en matière de pratique inclusive sécuritaire, 2) en présentant la matière tôt et en l'intégrant à tout le programme dans le cadre de séances en grands et en petits groupes 3) en faisant participer les personnes LGBTQIPA2+ à la présentation et à la création de la matière. Conclusions: la présente étude fait ressortir toute l'importance de faire comprendre à la profession comment les structures sociales d'hétéronormativité et de cisnormativité omniprésentes modèlent l'éducation et la pratique, et comment offrir des stratégies pour enrayer la complicité avec ces systèmes d'inégalité.

Digital Interventions to Understand and Mitigate Stress Response: Protocol for Process and Content Evaluation of a Cohort Study.

BACKGROUND: Staffing and resource shortages, especially during the COVID-19 pandemic, have increased stress levels among health care workers. Many health care workers have reported feeling unable to maintain the quality of care expected within their profession, which, at times, may lead to moral distress and moral injury. Currently, interventions for moral distress and moral injury are limited. OBJECTIVE: This study has the following aims: (1) to characterize and reduce stress and moral distress related to decision-making in morally complex situations using a virtual reality (VR) scenario and a didactic intervention; (2) to identify features contributing to mental health outcomes using wearable, physiological, and self-reported questionnaire data; and (3) to create a personal digital phenotype profile that characterizes stress and moral distress at the individual level. METHODS: This will be a single cohort, pre- and posttest study of 100 nursing professionals in Ontario, Canada. Participants will undergo a VR simulation that requires them to make morally complex decisions related to patient care, which will be administered before and after an educational video on techniques to mitigate distress. During the VR session, participants will complete questionnaires measuring their distress and moral distress, and physiological data (electrocardiogram, electrodermal activity, plethysmography, and respiration) will be collected to assess their stress response. In a subsequent 12-week follow-up period, participants will complete regular assessments measuring clinical outcomes, including distress, moral distress, anxiety, depression, and loneliness. A wearable device will also be used to collect continuous data for 2 weeks before, throughout, and for 12 weeks after the VR session. A pre-post comparison will be conducted to analyze the effects of the VR intervention, and machine learning will be used to create a personal digital phenotype profile for each participant using the physiological, wearable, and self-reported data. Finally, thematic analysis of post-VR debriefing sessions and exit interviews will examine reoccurring codes and overarching themes expressed across participants' experiences. RESULTS: The study was funded in 2022 and received research ethics board approval in April 2023. The study is ongoing. CONCLUSIONS: It is expected that the VR scenario will elicit stress and moral distress. Additionally, the didactic intervention is anticipated to improve understanding of and decrease feelings of stress and moral distress. Models of digital phenotypes developed and integrated with wearables could allow for the prediction of risk and the assessment of treatment responses in individuals experiencing moral distress in real-time and naturalistic contexts. This paradigm could also be used in other populations prone to moral distress and injury, such as military and public safety personnel. TRIAL REGISTRATION: ClinicalTrials.gov NCT05923398; https://clinicaltrials.gov/study/NCT05923398. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54180.

Development and Implementation of a Stress Monitoring Paradigm Using Virtual Reality Simulation During the COVID-19 Pandemic.

Healthcare providers, particularly during the COVID-19 crisis, have been forced to make difficult decisions and have reported acting in ways that are contrary to their moral values, integrity, and professional commitments, given the constraints in their work environments. Those actions and decisions may lead to healthcare providers' moral suffering and distress. This work outlines the development of the Moral Distress Virtual Reality Simulator (Moral Distress VRS) to research stress and moral distress among healthcare workers during the COVID-19 pandemic. The Moral Distress VRS was developed based on the agile methodology framework, with three simultaneous development streams. It followed a two-week sprint cycle, ending with meetings with stakeholders and subject matter experts, whereby the project requirements, scope, and features were revised, and feedback was provided on the prototypes until reaching the final prototype that was deployed for in-person study sessions. The final prototype had two user interfaces (UIs), one for the participant and one for the researcher, with voice narration and customizable character models wearing medical personal protective equipment, and followed a tree-based dialogue scenario, outputting a video recording of the session. The virtual environment replicated an ICU nursing station and a fully equipped patient room. We present the development process that guided this project, how different teams worked together and in parallel, and detail the decisions and outcomes in creating each major component within a limited deadline. Finally, we list the most significant challenges and difficulties faced and recommendations on how to solve them.

Digital Interventions for Stress Among Frontline Health Care Workers: Results From a Pilot Feasibility Cohort Trial.

BACKGROUND: The COVID-19 pandemic has challenged the mental health of health care workers, increasing the rates of stress, moral distress (MD), and moral injury (MI). Virtual reality (VR) is a useful tool for studying MD and MI because it can effectively elicit psychophysiological responses, is customizable, and permits the controlled study of participants in real time. OBJECTIVE: This study aims to investigate the feasibility of using an intervention comprising a VR scenario and an educational video to examine MD among health care workers during the COVID-19 pandemic and to use our mobile app for longitudinal monitoring of stress, MD, and MI after the intervention. METHODS: We recruited 15 participants for a compound intervention consisting of a VR scenario followed by an educational video and a repetition of the VR scenario. The scenario portrayed a morally challenging situation related to a shortage of life-saving equipment. Physiological signals and scores of the Moral Injury Outcome Scale (MIOS) and Perceived Stress Scale (PSS) were collected. Participants underwent a debriefing session to provide their impressions of the intervention, and content analysis was performed on the sessions. Participants were also instructed to use a mobile app for 8 weeks after the intervention to monitor stress, MD, and mental health symptoms. We conducted Wilcoxon signed rank tests on the PSS and MIOS scores to investigate whether the VR scenario could induce stress and MD. We also evaluated user experience and the sense of presence after the intervention through semi-open-ended feedback and the Igroup Presence Questionnaire, respectively. Qualitative feedback was summarized and categorized to offer an experiential perspective. RESULTS: All participants completed the intervention. Mean pre- and postintervention scores were respectively 10.4 (SD 9.9) and 13.5 (SD 9.1) for the MIOS and 17.3 (SD 7.5) and 19.1 (SD 8.1) for the PSS. Statistical analyses revealed no significant pre- to postintervention difference in the MIOS and PSS scores (P=.11 and P=.22, respectively), suggesting that the experiment did not acutely induce significant levels of stress or MD. However, content analysis revealed feelings of guilt, shame, and betrayal, which relate to the experience of MD. On the basis of the Igroup Presence Questionnaire results, the VR scenario achieved an above-average degree of overall presence, spatial presence, and involvement, and slightly below-average realism. Of the 15 participants, 8 (53%) did not answer symptom surveys on the mobile app. CONCLUSIONS: Our study demonstrated VR to be a feasible method to simulate morally challenging situations and elicit genuine responses associated with MD with high acceptability and tolerability. Future research could better define the efficacy of VR in examining stress, MD, and MI both acutely and in the longer term. An improved participant strategy for mobile data capture is needed for future studies. TRIAL REGISTRATION: ClinicalTrails.gov NCT05001542; https://clinicaltrials.gov/study/NCT05001542. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/32240.

Digital Interventions to Reduce Distress Among Frontline Health Care Providers: Analysis of Self-Perceived Stress.

Due to the constraints of the COVID-19 pandemic, healthcare workers have reported behaving in ways that are contrary to their values, which may result in distress and injury. This work is the first of its kind to evaluate the presence of stress in the COVID-19 VR Healthcare Simulation for Distress dataset. The dataset collected passive physiological signals and active mental health questionnaires. This paper focuses on correlating electrocardiogram, respiration, photoplethysmography, and galvanic skin response with the Perceived Stress Scale (PSS)-10 questionnaire. The analysis involved data-driven techniques for a robust evaluation of stress among participants. Low-complexity pre-processing and feature extraction techniques were applied and support vector machine and decision tree models were created to predict the PSS-10 scores of users. Imbalanced data classification techniques were used to further enhance our understanding of the results. Decision tree with oversampling through Synthetic Minority Oversampling Technique achieved an accuracy, precision, recall, and F1 of 93.50%, 93.41%, 93.31%, and 93.35%, respectively. Our findings offer novel results and clinically valuable insights for stress detection and potential for translation to edge computing applications to enhance privacy, longitudinal monitoring, and simplify device requirements.

Development of a data-driven digital phenotype profile of distress experience of healthcare workers during COVID-19 pandemic.

BACKGROUND AND OBJECTIVE: Due to the constraints of the COVID-19 pandemic, healthcare workers have reported acting in ways that are contrary to their moral values, and this may result in moral distress. This paper proposes the novel digital phenotype profile (DPP) tool, developed specifically to evaluate stress experiences within participants. The DPP tool was evaluated using the COVID-19 VR Healthcare Simulation of Stress Experience (HSSE) dataset (NCT05001542), which is composed of passive physiological signals and active mental health questionnaires. The DPP tool focuses on correlating electrocardiogram, respiration, photoplethysmography, and galvanic skin response with moral injury outcome scale (Brief MIOS). METHODS: Data-driven techniques are encompassed to develop a tool for robust evaluation of distress among participants. To accomplish this, we applied pre-processing techniques which involved normalization, data sanitation, segmentation, and windowing. During feature analysis, we extracted domain-specific features, followed by feature selection techniques to rank the importance of the feature set. Prior to classification, we employed k-means clustering to group the Brief MIOS scores to low, moderate, and high moral distress as the Brief MIOS lacks established severity cut-off scores. Support vector machine and decision tree models were used to create machine learning models to predict moral distress severities. RESULTS: Weighted support vector machine with leave-one-subject-out-cross-validation evaluated the separation of the Brief MIOS scores and achieved an average accuracy, precision, sensitivity, and F1 of 98.67%, 98.83%, 99.44%, and 99.13%, respectively. Various machine learning ablation tests were performed to support our results and further enhance the understanding of the predictive model. CONCLUSION: Our findings demonstrate the feasibility to develop a DPP tool to predict distress experiences using a combination of mental health questionnaires and passive signals. The DPP tool is the first of its kind developed from the analysis of the HSSE dataset. Additional validation is needed for the DPP tool through replication in larger sample sizes.

Assessing the inter-rater and intra-rater reliability of the Physical Therapy Competence Assessment for Airway Suctioning (PT-CAAS).

BACKGROUND AND PURPOSE: The Physical Therapy Competence Assessment for Airway Suctioning (PT-CAAS) is a recently developed measure to assess the clinical competence of physiotherapists who perform airway suctioning with adults. The purpose of this study was to assess the inter-rater and intra-rater reliability of the PT-CAAS. METHODS: Scoring rules were developed through expert consultation. Reliability was then assessed using nine videos of suctioning performed in a simulated learning environment. A repeated measures design was used, with two replicate sets of measurements made by each participant for all videos. Data were analyzed using a repeated measures model for the concurrent assessment of inter-rater and intra-rater reliability. Participants were physiotherapists with suctioning experience. RESULTS: Twenty physiotherapists completed initial scoring and re-scoring for all nine videos; their data were included in the analysis. Intraclass correlation coefficients (ICCs) for inter-rater reliability ranged from 0.569 [lower one-sided 95% confidence interval (CI): 0.395; standard error of measurement (SEM): 0.963] for infection control to 0.759 (lower one-sided 95% CI: 0.612; SEM: 0.722) for post-suctioning assessment and care. The inter-rater ICC for overall performance was 0.752 (lower one-sided 95% CI: 0.602; SEM: 0.660). ICCs for intra-rater reliability ranged from 0.759 (lower one-sided 95% CI: 0.197; SEM 0.721) for infection control to 0.860 (lower one-sided 95% CI: 0.544; SEM: 0.550) for post-suctioning assessment and care. The intra-rater ICC for overall performance was 0.867 (lower one-sided 95% CI: 0.559; SEM: 0.483). DISCUSSION: Evidence of moderate to good inter-rater and good intra-rater reliability was found; however, the results should be interpreted with caution given the wide CIs and relatively large SEMs. Improved assessor training and assessments of reliability using a larger sample size are recommended.

Digital Interventions to Reduce Distress Among Health Care Providers at the Frontline: Protocol for a Feasibility Trial.

BACKGROUND: Stress, anxiety, distress, and depression are high among health care workers during the COVID-19 pandemic, and they have reported acting in ways that are contrary to their moral values and professional commitments that degrade their integrity. This creates moral distress and injury due to constraints they have encountered, such as limited resources. OBJECTIVE: The purpose of this study is to develop and show the feasibility of digital platforms (a virtual reality and a mobile platform) to understand the causes and ultimately reduce the moral distress of health care providers during the COVID-19 pandemic. METHODS: This will be a prospective, single cohort, pre- and posttest study examining the effect of a brief informative video describing moral distress on perceptual, psychological, and physiological indicators of stress and decision-making during a scenario known to potentially elicit moral distress. To accomplish this, we have developed a virtual reality simulation that will be used before and after the digital intervention for monitoring short-term impacts. The simulation involves an intensive care unit setting during the COVID-19 pandemic, and participants will be placed in morally challenging situations. The participants will be engaged in an educational intervention at the individual, team, and organizational levels. During each test, data will be collected for (1) physiological measures of stress and after each test, data will be collected regarding (2) thoughts, feelings and behaviors during a morally challenging situation, and (3) perceptual estimates of psychological stress. In addition, participants will continue to be monitored for moral distress and other psychological stresses for 8 weeks through our Digital intervention/intelligence Group mobile platform. Finally, a comparison will be conducted using machine learning and biostatistical techniques to analyze the short- and long-term impacts of the virtual reality intervention. RESULTS: The study was funded in November 2020 and received research ethics board approval in March 2021. The study is ongoing. CONCLUSIONS: This project is a proof-of-concept integration to demonstrate viability over 6 months and guide future studies to develop these state-of-the-art technologies to help frontline health care workers work in complex moral contexts. In addition, the project will develop innovations that can be used for future pandemics and in other contexts prone to producing moral distress and injury. This project aims to demonstrate the feasibility of using digital platforms to understand the continuum of moral distress that can lead to moral injury. Demonstration of feasibility will lead to future studies to examine the efficacy of digital platforms to reduce moral distress. TRIAL REGISTRATION: ClinicalTrials.gov NCT05001542; https://clinicaltrials.gov/ct2/show/NCT05001542. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/32240.

Updating the Evidence: Suctioning Practices of Physiotherapists in Ontario.

Purpose: The purpose of this article is to describe current tracheal suctioning practices of physiotherapists in the province of Ontario and to determine what factors influence these practices. Method: A cross-sectional online survey was conducted. An online survey link and quick response code were mailed to Ontario physiotherapists who were actively providing patient care and were authorized to perform tracheal suctioning as identified by the College of Physiotherapists of Ontario. Results: Ninety physiotherapists participated in the survey (23% response rate). Most (66%) suctioned in an intensive care setting, and many (41%) reported frequently using a closed endotracheal suctioning system. Hyperoxygenation was frequently performed before suctioning by 48% of participants, and only 18% frequently hyperoxygenated after suctioning. Most participants reported infrequently performing saline instillation (52%) and infrequently hyperinflating before suctioning (79%). Clean gloves were reported as the personal protective equipment most frequently worn across all suctioning approaches, and goggles and sterile gloves were least often worn while suctioning. Previous suctioning experience had the most influence on suctioning practices, and limited access to equipment had the least influence. Conclusions: Some of the tracheal suctioning practices of physiotherapists in Ontario vary from evidence-based clinical guidelines.

Objectif : décrire les pratiques actuelles d'aspiration de la trachée utilisées par les physiothérapeutes de la province de l'Ontario et déterminer les facteurs qui influencent ces pratiques. Méthodologie : sondage transversal en ligne. Les physiothérapeutes de l'Ontario qui donnaient des soins aux patients et étaient autorisés à effectuer des aspirations trachéales conformément aux données de l'Ordre des physiothérapeutes de l'Ontario ont reçu le lien vers un sondage en ligne et vers un code de réponse rapide. Résultats : au total, 90 physiothérapeutes ont participé au sondage (taux de réponse de 23 %). La plupart (66 %) procédaient à l'aspiration en soins intensifs, et bon nombre (41 %) déclaraient souvent utiliser un système d'aspiration trachéale fermé. De plus, 48 % des répondants utilisaient souvent l'hyperoxygénation avant l'aspiration, mais seulement 18 % y avaient souvent recours après l'aspiration. La plupart des participants ont déclaré instiller rarement du sérum physiologique (52 %) et procéder rarement à l'hyperinflation avant l'aspiration (79 %). Pour toutes les méthodes d'aspiration, les gants propres étaient l'équipement de protection individuelle le plus porté, mais les lunettes et les gants stériles étaient les moins utilisés. Les expériences d'aspiration antérieures avaient le plus d'influence sur les pratiques d'aspiration, et l'accès limité à l'équipement en avait le moins. Conclusion : On constate une variabilité entre les pratiques d'aspiration trachéale des physiothérapeutes de l'Ontario et les directives cliniques fondées sur des données probantes.

Perceptions of preparedness: How hospital-based orientation can enhance the transition from academic to clinical learning.

BACKGROUND: Clinical placements are essential for applied learning experiences in health professions education. Unfortunately, there is little consensus on how best to prepare learners for the transition between academic and clinical learning. We explored learners' perceptions of hospital-based orientation and resulting preparedness for clinical placement. METHODS: Sixty-three learners participated in a total of 18 semi-structured focus groups, during their clinical placements. Data were analyzed thematically. RESULTS: We organized learners' perceptions of hospital-based orientation that support their preparedness for placement into three themes: (1) adequate site orientation for learner acquisition of organization acumen and (2) clinical preceptor training to support unit/service and (3) individual components. CONCLUSION: Thoughtful attention to hospital-based orientation can support learners in transitioning from academic to clinical learning. Hospital organizations should attend to all three components during orientation to better support learners' preparedness for clinical learning.

CONTEXTE: Les stages cliniques sont essentiels aux expériences d'apprentissage appliquées dans l'enseignement médical. Malheureusement, il n'existe pas de consensus sur la meilleure manière de préparer les étudiants à la transition entre l'apprentissage académique et l'apprentissage clinique. Nous avons exploré la perception des étudiants de l'orientation en milieu hospitalier et de l'état de préparation qui en résulte pour les stages cliniques. MÉTHODES: Au total, 63 étudiants ont participé 'à travers 18 groupes de discussion semi-structurés lors de leurs stages cliniques. Les données ont été analysées de manière thématique. RÉSULTATS: Nous avons classé les perceptions des étudiants relativement à l'orientation en milieu hospitalier qui soutient leur état de préparation pour un stage en trois thèmes différents : (1) une orientation adéquate du site pour l'acquisition par l'étudiant de l'expertise de l'organisation et (2) la formation du précepteur clinique pour soutenir l'unité/le service et (3) les composantes individuelles. CONCLUSION: Une attention particulière centrée sur l'orientation en milieu hospitalier peut soutenir les étudiants dans leur transition de l'apprentissage académique à l'apprentissage clinique. Les organismes hospitaliers doivent inclure les trois composantes pendant l'orientation pour mieux soutenir l'état de préparation des étudiants pour leur apprentissage clinique.

Lessons learned in preparing for and responding to the early stages of the COVID-19 pandemic: one simulation's program experience adapting to the new normal.

Use of simulation to ensure an organization is ready for significant events, like COVID-19 pandemic, has shifted from a "backburner" training tool to a "first choice" strategy for ensuring individual, team, and system readiness. In this report, we summarize our simulation program's response during the COVID-19 pandemic, including the associated challenges and lessons learned. We also reflect on anticipated changes within our program as we adapt to a "new normal" following this pandemic. We intend for this report to function as a guide for other simulation programs to consult as this COVID-19 crisis continues to unfold, and during future challenges within global healthcare systems. We argue that this pandemic has cemented simulation programs as fundamental for any healthcare organization interested in ensuring its workforce can adapt in times of crisis. With the right team and set of partners, we believe that sustained investments in a simulation program will amplify into immeasurable impacts across a healthcare system.

Assessing the Clinical Competence of Health Care Professionals Who Perform Airway Suctioning in Adults.

Airway suctioning is an important health care intervention that can be associated with serious adverse effects. Given the risks involved with suctioning, it is important to ensure the clinical competence of health care professionals who perform it. A scoping review was conducted to identify the nature and extent of research related to the assessment of airway-suctioning competence for health care professionals working with adults. This included an examination of the assessment context, the type of suctioning and health care professionals being assessed, and the methods used to assess competence. Four scientific electronic databases (MEDLINE, EMBASE, CINAHL, and the Cochrane Library) were searched from inception to March 9, 2018. A gray literature search was also performed. Two reviewers independently screened articles and resources for inclusion, and data were extracted using a form created by the authors. Seventy full text articles and resources were screened for eligibility, with 36 included in the review. Endotracheal suctioning was the most common type, and intensive or critical care units were the primary setting of interest (28 of 36, 78%). Competence or a component of competence for nurses, nursing students, nursing assistants, or nurse technicians was specifically addressed in 97% (35 of 36) of the included articles and resources; 4 of 36 (11%) also included physical therapists, 1 of 36 (3%) included respiratory therapists, and 1 of 36 (3%) was aimed toward all clinicians who perform suctioning. Nine (25%) used questionnaire-based assessments, 11 (31%) used checklists, audit forms, or other observational tools, and 16 (44%) used both. Directed content analysis revealed 3 major themes: consistency across overarching evaluation frameworks, inconsistency across detailed components, and inconsistency in the evaluation or reporting of assessment tool measurement properties. Additional gaps in the literature included limited consideration of health care professionals beyond nursing, limited consideration of settings beyond intensive and critical care, a lack of tools to assess nasotracheal and orotracheal suctioning, and limited detail regarding assessment tool development.

Simulation Experiences in Canadian Physiotherapy Programmes: A Description of Current Practices.

Purpose: Although health care professional education programmes around the world are increasingly using sophisticated simulation technology, the scope of simulation use in Canadian physiotherapy programmes is currently undefined. The current study explores the definitions of simulation, its current use, and the perceived benefits and barriers in Canadian entry-to-practice physiotherapy programmes. Method: Using a qualitative, descriptive study approach, we contacted Canadian physiotherapy programmes to identify faculty members with simulation experience. Using a semi-structured interview format, we asked participants to discuss their perspectives of simulation in their physiotherapy programmes. Interviews were audio recorded, transcribed, and analyzed for themes. Results: Of 13 eligible Canadian physiotherapy programmes, participants from 8 were interviewed. The interviews revealed three major themes: (1) variability in the definition of fidelity in simulation, (2) variability in simulation use, and (3) the benefits of and barriers to the use of simulation. Conclusions: Variability in the definition of fidelity in simulation among Canadian physiotherapy programmes is consistent with the current literature, highlighting a spectrum of complexity from low fidelity to high fidelity. Physiotherapy programmes are using a variety of simulations, with the aim of creating a bridge from theoretical knowledge to clinical practice. This study describes the starting point for characterizing simulation implementation in Canadian physiotherapy programmes and reflects the diversity that exists across the country.

Objectif : autour du monde, les programmes de formation des professionnels de la santé font de plus en plus appel à une technologie de simulation raffinée. On ne connaît pas l'ampleur de l'utilisation de la simulation dans les programmes canadiens de physiothérapie. La présente étude porte sur les définitions de la simulation, son utilisation actuelle et les avantages et obstacles perçus à son utilisation dans les programmes canadiens de physiothérapie de base. Méthodologie : les chercheurs ont utilisé une approche descriptive et qualitative. Ils ont pris contact avec les programmes canadiens de physiothérapie pour savoir quels professeurs avaient de l'expérience en simulation. Au moyen d'entrevues semi-structurées, ils ont demandé aux participants de parler de leurs perspectives de la simulation au sein de leurs programmes de physiothérapie. Ils ont enregistré les entrevues sur bande sonore, les ont transcrites et analysées pour en dégager les thèmes. Résultats : au sein des treize programmes canadiens de physiothérapie admissibles, les participants de huit d'entre eux ont été interviewés. Les entrevues ont fait ressortir trois thèmes majeurs : 1) la variabilité de la définition de fidélité de la simulation, 2) la variabilité dans l'utilisation de la simulation et 3) les bienfaits et les obstacles liés à l'utilisation de la simulation. Conclusions : la variabilité de la définition de fidélité de la simulation dans les programmes canadiens de physiothérapie correspond aux constatations des publications actuelles, ce qui fait ressortir un spectre de complexité qui passe de la faible fidélité à la haute fidélité. Les programmes de physiothérapie font appel à diverses simulations afin de créer un pont entre les connaissances théoriques et la pratique clinique. La présente étude décrit le point de départ pour caractériser l'adoption de la simulation dans les programmes canadiens de la physiothérapie et reflète la diversité au pays.