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Staley B, Hickey E, Rule D, Barrett H, Salter C, Gibson R, Rochus D. Speech-language pathology and ethical practice in global contexts. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:15-25. [PMID: 32308047 DOI: 10.1080/17549507.2020.1743358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Given the growing professional interest of speech-language pathologists (SLP) in global development work and the opportunities for minority world health providers to use their skills internationally, conversations about what SLPs do when working in majority world settings, and how they do it are imperative. This paper presents case studies of speech-language pathology work in global settings examined within the context of ethical frameworks developed by: The American Speech-Language-Hearing Association, Speech-Language and Audiology Canada, and Speech Pathology Australia. These case studies drawn from personal experiences working as SLPs in majority world contexts are used to discuss the following issues: (1) the need for honest and reflective conversations about SLPs' motivations for engagement in global work; (2) the need to consider how funds are used to have the biggest and most sustainable impact on emerging professional contexts; (3) the necessity of long-term mutually beneficial global partnerships; (4) critical examination of culturally appropriate speech-language pathology services and recommendations; (5) learning to listen to majority world colleagues; (6) creating opportunities for majority world colleagues to represent themselves at conferences, meetings and in the literature, and; (7) the crucial role university staff play in fostering ethical and sustainable speech-language pathology practices.
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Affiliation(s)
- Bea Staley
- School of Education, Charles Darwin University, Casuarina, Australia
| | - Ellen Hickey
- School of Communication Sciences & Disorders, Dalhousie University, Halifax, Canada
| | - David Rule
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | | | | | - David Rochus
- Yellow House Health and Outreach Service, Kisumu, Kenya
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Alias A, Rideout M, You R, Lencucha R. Global health and rehabilitation education in Canada: a qualitative analysis of experiences and perspectives of educators. Disabil Rehabil 2020; 44:2537-2547. [PMID: 33073629 DOI: 10.1080/09638288.2020.1834627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Rehabilitation practice is increasingly tied to global trends. First, healthcare services are increasingly tailored to be patient-centered, requiring knowledge of sociocultural contexts and experiences of a diverse patient population. Second, non-communicable diseases and morbidity stemming from infectious diseases are creating greater needs for rehabilitation services in countries facing this double burden of disease. Third, globalization continues to shape the risk factors for disease and disability and influences the type of services accessible and the financing and management of such services. Given this context, there is a critical need to examine how global health (GH) is approached in rehabilitation curricula. How students learn about these various dynamics will impact their ability to practice in this environment and best meet the needs of the patients and populations they are caring for. OBJECTIVES This study explores how university-level Canadian occupational and physical therapy educators understand GH within their academic and clinical practices. METHODS The project followed a qualitative design. Semi-structured interviews were conducted with participants (n = 12; randomized purposive sampling was used). A deductive and inductive thematic analysis was performed to describe the participants perspectives on and practices of GH education in rehabilitation education programs. FINDINGS There was an overall coherence between the literature and the participant's views of the constituent elements of GH. Participants viewed GH as a framework to broaden the clinical training of students by encouraging a critical "clinical toolbox" via themes of structural competency, cultural sensitivity, and a sense of global citizenship and stewardship. However, GH was also described by participants as being implicitly present in the curriculum due to ambiguities regarding the scope of GH, seen as a key obstacle in the integration of GH education in rehabilitation programs. INTERPRETATION Despite the growing interest and relevance of GH, there is a noteworthy absence of GH education guidelines. There is a need to uncover the scope and underpinnings of GH and to outline rehabilitation-oriented GH competencies as per the positive value of GH attributed by the educators to the training of our healthcare workforce.IMPLICATIONS FOR REHABILITATIONGlobal health is seen by a sample of educators to provide rehabilitation students with a critical and holistic "clinical toolkit" by introducing themes of structural competency, cultural sensitivity and awareness, and global stewardship, enabling them to become good global clinicians and global citizens;The increased interest in global health throughout academic curricula presents new challenges for educators and students, specifically relating to understanding the mission and aims of this field. There is a need to clarify the notion and field of global health and how it complements clinical training within rehabilitation programs;There is a need to advance the literature on global health in rehabilitation by exploring what competencies are seen to be relevant to the field and practice of rehabilitation.
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Affiliation(s)
- Ali Alias
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada
| | - Maria Rideout
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada
| | - Raymond You
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada
| | - Raphael Lencucha
- School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Canada
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Abstract
Background: The interest in Global Health (GH) as an academic discipline has increased in the last decade. This article reports the findings of a scoping review of studies about Global Health education in the Americas. Objective: To analyse educational programs on global health in the Americas. Method: Five electronic databases were used in a scoping review: PubMed, Scopus, Web of Knowledge, CINAHL, and Lilacs. Data collection happened in November 2017–March 2018. The following stages were rigorously observed: identification, selection, charting, and summarizing the studies that were included. To process the data, we used IRaMuTeQ software. Findings: Forty-six studies were identified and organized in categories: 1) diversity of the topics addressed in GH; 2) models of teaching; 3) emotional, cultural, and collaborative aspects in teaching GH; 4) student preparation for GH experiences; and 5) structures required for a GH course. Conclusions: The existing global health curriculum in the Americas is diffuse and limited, with a greater focus on clinical aspects. Thus, a minimum curriculum for students from different areas is needed. Results evidenced that the teaching of global health in the Americas is still incipient, although it is promising. The lack of a common curriculum for the courses in the region makes it difficult to train sensitive and capable professionals to achieve the 2030 Sustainable Development Goals.
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Kalbarczyk A, Nagourney E, Martin NA, Chen V, Hansoti B. Are you ready? A systematic review of pre-departure resources for global health electives. BMC MEDICAL EDUCATION 2019; 19:166. [PMID: 31118015 PMCID: PMC6532266 DOI: 10.1186/s12909-019-1586-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 04/30/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND There has been an exponential increase in the offering of short-term international field experiences in recent years in response to student demands for global health opportunities. Pre-departure preparation is an essential component to equip trainees with the adequate safety, wellness, and cultural competence needed to engage in a meaningful and mutually beneficial elective. This review seeks to quantify the plethora of pre-departure preparation training available to public health, clinical, and undergraduate trainees across the continuum of education for short-term experiences in low-and middle-income countries (LMICs). METHODS We performed a systematic review of Pubmed, Embase, Web of Science, Scopus, and Ovid Global Health in February, 2018. A three-concept search was employed and included "global or international health"; "education or preparation of personnel/students"; and "field programs or travel." The study teamed used PRISMA reporting guidelines to conduct title and full-text reviews and conduct data extraction and analysis. RESULTS The search returned 2506 unique articles. Of these, 55 met inclusion criteria and were included in the final review. Ninety one percent (91%) of articles focused on pre-departure trainings for medical students and residents. Nine thematic domains for short-term international field experiences emerged; culture, safety, and project-specific knowledge were the most frequently covered domains while mentorship, professionalism, and emotional wellness and culture shock were least common. Approximately half (53.3%) of studies specifically evaluated the pre-departure component of the international experience using a survey or evaluation form. Recommendations emerged from these evaluations including early engagement with international partners, inclusion of self-reflection exercises and site-specific content, and utilization of interactive approaches in learning. Some institutions face barriers to conducting pre-departure preparation such as lack of dedicated faculty, finances, and institutional support. CONCLUSIONS Interest in pre-departure training for international experiences is growing but few programs conduct and publish evaluations of these trainings. Pre-departure trainings should be developed in partnership with receiving institutions and faculty and incorporate critical self- reflection throughout the experience. In addition to the experience itself, institutions need to evaluate these curricula to better understand how they influence trainees' capacity to effectively engage in LMIC settings.
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Affiliation(s)
- Anna Kalbarczyk
- Johns Hopkins Center for Global Health, Baltimore, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Emily Nagourney
- Johns Hopkins Center for Global Health, Baltimore, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Nina A. Martin
- Johns Hopkins Center for Global Health, Baltimore, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Victoria Chen
- Johns Hopkins Center for Global Health, Baltimore, USA
| | - Bhakti Hansoti
- Johns Hopkins Center for Global Health, Baltimore, USA
- Johns Hopkins School of Medicine, Baltimore, USA
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Storr C, MacLachlan J, Krishna D, Ponnusamy R, Drynan D, Moliner C, McLaughlin K, Murphy S, Edgelow M, Campbell-Rempel MA, Bossers A, Lauckner H, Cameron D. Building sustainable fieldwork partnerships between Canada and India: Finding common goals through evaluation. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2018. [DOI: 10.1080/14473828.2018.1432312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Caroline Storr
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Janna MacLachlan
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Handi-Care Intl., Toronto, Canada
- Amar Seva Sangam, Ayikudy, India
| | - Dinesh Krishna
- Handi-Care Intl., Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - Donna Drynan
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Carmen Moliner
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
| | - Kristina McLaughlin
- Handi-Care Intl., Toronto, Canada
- School of Graduate and Postdoctoral Studies, Western University, London, Canada
| | - Susanne Murphy
- Faculty of Health Sciences, School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
| | - Megan Edgelow
- Faculty of Health Sciences, School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
| | - Margaret Anne Campbell-Rempel
- Occupational Therapy Department, Rady Faculty of Health Sciences, College of Rehabilitation Sciences, Winnipeg, Canada
| | - Ann Bossers
- Faculty of Health Sciences, School of Occupational Therapy, The University of Western Ontario, London, Canada
| | - Heidi Lauckner
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Debra Cameron
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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Khan R, Hodges B, Martimianakis MAT, Cole D. Twelve tips for undertaking reflexive global health experiences in medicine. MEDICAL TEACHER 2017; 39:1023-1028. [PMID: 28598707 DOI: 10.1080/0142159x.2017.1333589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND While interest and opportunities for global health experiences (GHE) continue to grow, the preparation of students and health professionals alike to engage in these GHEs remains limited. AIMS This article provides tips for reflexivity prior to undertaking a GHE and suggests ways to debrief the experience in order to ensure that trainees and professionals that engage in GHEs can both help their intended communities and also get the most out of the experience. METHODS The authors conducted a scoping review using Medline, PubMed and Google scholar using searching the terms: global health, global health experience, global health research, and international medical elective. We supplemented this search with our own experiences working with international partners. CONCLUSIONS GHEs should be undertaken with reflexivity prior to, during and subsequent to the experience in order to ensure that all collaborators in the partnership meet their intended goals.
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Affiliation(s)
- Rabia Khan
- a The Wilson Center, Faculty of Medicine, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - Brian Hodges
- a The Wilson Center, Faculty of Medicine, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | | | - Donald Cole
- a The Wilson Center, Faculty of Medicine, Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
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Jesus TS, Landry MD, Dussault G, Fronteira I. Human resources for health (and rehabilitation): Six Rehab-Workforce Challenges for the century. HUMAN RESOURCES FOR HEALTH 2017; 15:8. [PMID: 28114960 PMCID: PMC5259954 DOI: 10.1186/s12960-017-0182-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 01/12/2017] [Indexed: 05/26/2023]
Abstract
BACKGROUND People with disabilities face challenges accessing basic rehabilitation health care. In 2006, the United Nations Convention on the Rights of Persons with Disabilities (CRPD) outlined the global necessity to meet the rehabilitation needs of people with disabilities, but this goal is often challenged by the undersupply and inequitable distribution of rehabilitation workers. While the aggregate study and monitoring of the physical rehabilitation workforce has been mostly ignored by researchers or policy-makers, this paper aims to present the 'challenges and opportunities' for guiding further long-term research and policies on developing the relatively neglected, highly heterogeneous physical rehabilitation workforce. METHODS The challenges were identified through a two-phased investigation. Phase 1: critical review of the rehabilitation workforce literature, organized by the availability, accessibility, acceptability and quality (AAAQ) framework. Phase 2: integrate reviewed data into a SWOT framework to identify the strengths and opportunities to be maximized and the weaknesses and threats to be overcome. RESULTS The critical review and SWOT analysis have identified the following global situation: (i) needs-based shortages and lack of access to rehabilitation workers, particularly in lower income countries and in rural/remote areas; (ii) deficiencies in the data sources and monitoring structures; and (iii) few exemplary innovations, of both national and international scope, that may help reduce supply-side shortages in underserved areas. DISCUSSION Based on the results, we have prioritized the following 'Six Rehab-Workforce Challenges': (1) monitoring supply requirements: accounting for rehabilitation needs and demand; (2) supply data sources: the need for structural improvements; (3) ensuring the study of a whole rehabilitation workforce (i.e. not focused on single professions), including across service levels; (4) staffing underserved locations: the rising of education, attractiveness and tele-service; (5) adapt policy options to different contexts (e.g. rural vs urban), even within a country; and (6) develop international solutions, within an interdependent world. CONCLUSIONS Concrete examples of feasible local, global and research action toward meeting the Six Rehab-Workforce Challenges are provided. Altogether, these may help advance a policy and research agenda for ensuring that an adequate rehabilitation workforce can meet the current and future rehabilitation health needs.
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Affiliation(s)
- Tiago S. Jesus
- Portuguese Ministry of Education, Aggregation of Schools of Escariz, 4540-320 Escariz, Portugal
| | - Michel D. Landry
- Doctor of Physical Therapy Division, Duke University Medical Center, Duke University, Box 104002, 27710 Durham, NC United States of America
- Duke Global Health Institute, Duke University, Durham, NC United States of America
| | - Gilles Dussault
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Inês Fronteira
- Global Health and Tropical Medicine (GHTM) & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon (IHMT-UNL), Rua da Junqueira 100, 1349-008 Lisbon, Portugal
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Bessette J, Camden C. Pre-Departure Training for Student Global Health Experiences: A Scoping Review. Physiother Can 2017; 69:343-350. [PMID: 30369702 DOI: 10.3138/ptc.2015-86gh] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: The authors identify the recommended pre-departure training (PDT) practices for physiotherapy students participating in a global health experience (GHE): both the content to be covered and the preferred learning methods to be used. They also discuss the implications of these recommendations for the physiotherapy field. Method: A scoping review of scientific and grey literature was performed to identify the recommended PDT practices. A thematic analysis was then performed to identify emerging themes. Results: The recommended PDT content broke down into the following areas: global health knowledge; ethics, introspection, and critical thinking; cultural competency; cross-cultural communication; placement-specific knowledge; and personal health and safety. The recommended learning methods were a combination of didactic, reflective, and experiential components that would enhance knowledge, develop cross-cultural skills, and address attitudinal changes. Conclusion: The growing participation of Canadian physiotherapy students in GHEs requires universities to adequately prepare their students before they leave to mitigate moral hazards. Given that little empirical research has been published on the effectiveness of PDT, the authors encourage collaborative efforts to develop PDT and evaluate its effectiveness for students and its impact on host communities.
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Affiliation(s)
| | - Chantal Camden
- School of Rehabilitation, Faculty of Medicine and Health Sciences.,Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Que
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Flinkenflögel M, Ogunbanjo G, Cubaka VK, De Maeseneer J. Rwandan family medicine residents expanding their training into South Africa: the use of South-South medical electives in enhancing learning experiences. BMC MEDICAL EDUCATION 2015; 15:124. [PMID: 26231997 PMCID: PMC4522112 DOI: 10.1186/s12909-015-0405-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 07/06/2015] [Indexed: 06/01/2023]
Abstract
BACKGROUND International medical electives are well-accepted in medical education, with the flow of students generally being North-South. In this article we explore the learning outcomes of Rwandan family medicine residents who completed their final year elective in South Africa. We compare the learning outcomes of this South-South elective to those of North-South electives from the literature. METHODS In-depth interviews were conducted with Rwandan postgraduate family medicine residents who completed a 4-week elective in South Africa during their final year of training. The interviews were thematically analysed in an inductive way. RESULTS The residents reported important learning outcomes in four overarching domains namely: medical, organisational, educational, and personal. CONCLUSIONS The learning outcomes of the residents in this South-South elective had substantial similarities to findings in literature on learning outcomes of students from the North undertaking electives in the Southern hemisphere. Electives are a useful learning tool, both for Northern students, and students from universities in the South. A reciprocity-framework is needed to increase mutual benefits for Southern universities when students from the North come for electives. We suggest further research on the possibility of supporting South-South electives by Northern colleagues.
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Affiliation(s)
- Maaike Flinkenflögel
- Discipline Primary Health Care, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
- Partners in Health, Rwinkwavu, Rwanda.
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium.
| | - Gboyega Ogunbanjo
- Department of Family Medicine & Primary Health Care, Sefako Makgatho Health Sciences University, South Africa (previously known as University of Limpopo - Medunsa Campus, South Africa), Limpopo, South Africa.
| | - Vincent Kalumire Cubaka
- Discipline Primary Health Care, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
- Center for Global Health, Department of Public Health, Aarhus, Denmark.
| | - Jan De Maeseneer
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium.
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Mesaroli G, Bourgeois AM, McCurry E, Condren A, Petropanagos P, Fraser M, Nixon SA. Enhanced Patient-Centred Care: Physiotherapists' Perspectives on the Impact of International Clinical Internships on Canadian Practice. Physiother Can 2015; 67:385-92. [PMID: 27504039 PMCID: PMC4962655 DOI: 10.3138/ptc.2014-57gh] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To explore the perspectives of physiotherapists who participated in an international clinical internship (ICI) in low- or middle-income countries (LMICs) during their physiotherapy (PT) training in a Canadian PT programme regarding the ICI's impact on their PT practice in Canada. METHODS This qualitative descriptive study used in-depth semi-structured interviews. Data were organized using NVivo; inductive and deductive coding were used to analyze data and develop broader themes. RESULTS The 13 practising Canadian physiotherapists interviewed described three enhanced capacities: (1) critical reflection on culture, values and practice; (2) communication skills; and (3) creativity and resourcefulness. These capacities were perceived to transfer to Canadian practice by enhancing participants' ability to deliver patient-centred care, specifically through an enhanced understanding of patients' values and social determinants of health, regardless of the Canadian setting or patient population. CONCLUSIONS For PT students considering an ICI, the study findings provide insight into the perceived impact of ICIs on Canadian practice. For PT academic programmes, the findings can guide decisions on the extent of investment in ICIs as learning opportunities that will enhance practice in Canada.
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Affiliation(s)
- Giulia Mesaroli
- Department of Physical Therapy, University of Toronto, Toronto
| | | | - Ellen McCurry
- Department of Physical Therapy, University of Toronto, Toronto
| | - Allison Condren
- Department of Physical Therapy, University of Toronto, Toronto
| | | | - Michelle Fraser
- Global Health Division, Canadian Physiotherapy Association, Ottawa
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