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Developing a grounded theory for interprofessional collaboration acquisition using facilitator and actor perspectives in simulated wilderness medical emergencies

Submitted: 16 January 2016
Revised: 5 December 2016
Accepted: 4 December 2016
Published: 28 March 2017

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Author(s) : Smith HA, Reade M, Maar M, Jeeves N.

Marion Maar

Citation: Smith HA, Reade M, Maar M, Jeeves N.  Developing a grounded theory for interprofessional collaboration acquisition using facilitator and actor perspectives in simulated wilderness medical emergencies. Rural and Remote Health (Internet) 2017; 17: 3880. Available: (Accessed 24 October 2017). DOI:


Context:††Interprofessional collaboration is a complex process that has the potential to transform patient care for the better in urban, rural and remote healthcare settings. Simulation has been found to improve participantsí interprofessional competencies, but the mechanisms by which interprofessionalism is learned have yet to be understood. A rural wilderness medicine conference (WildER Med) in northern Ontario, Canada with simulated medical scenarios has been demonstrated to be effective in improving participantsí collaboration without formal interprofessional education (IPE) curriculum.
Issues:††Interprofessionalism may be taught through rural and remote medical simulation, as done in WildER Med where participantsí interprofessional competencies improved without any formal IPE curriculum. This learning may be attributed to the informal and hidden curriculum. Understanding the mechanism by which this rural educational experience contributed to participantsí learning to collaborate requires insight into the events before, during and after the simulations. The authors drew upon feedback from facilitators and patient actors in one-on-one interviews to develop a grounded theory for how collaboration is taught and learned.†
Lessons learned:††Sharing emerged as the core concept of a grounded theory to explain how team members acquired interprofessional collaboration competencies. Sharing was enacted through the strategies of developing common goals, sharing leadership, and developing mutual respect and understanding. Further analysis of the data and literature suggests that the social wilderness environment was foundational in enabling sharing to occur.†Medical simulations in other rural and remote settings may offer an environment conducive to collaboration and be effective in teaching collaboration. When designing interprofessional education, health educators should consider using emergency response teams or rural community health teams to optimize the informal and hidden curriculum contributing to interprofessional learning.

Key words: Canada, grounded theory, health personnel/education, interprofessional relations, patient care team, patient simulation, qualitative research, shared decision making, wilderness.

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