Introductory Session Research Articles

Workplace mentoring of residents in generic competencies by an independent coach.

IntroductionDuring postgraduate education in pulmonology, supervisors are responsible for training residents in generic competencies such as communication, professionalism and collaboration, but their focus commonly lies more on medical-technical competencies. As an alternative approach to supporting residents to develop generic skills, we developed a personal mentoring program with a non-medical professional as mentor. In this study, the residents’ experiences with the mentoring program were evaluated.MethodsAfter an introductory session in which individual learning goals were established, pulmonology residents received at least six, 60–90-minute, individual, mentoring sessions largely consisting of feedback after being observed during daily clinical activities, over a period of 9 months. The residents’ experiences with mentoring were explored through in-depth interviews followed by a qualitative content analysis.ResultsFrom March to November 2016, ten residents in pulmonology completed the program. Despite initial scepticism, mentoring encouraged residents to reflect deeply on their professional interactions. This caused an increased awareness of the effects of their communication and behaviour on patients. Experimenting with communication and different behaviours in subsequent interactions felt rewarding and contributed to further development, resulting in increased self-confidence and job satisfaction.DiscussionMentoring residents by non-medical coaching was associated with improved residents’ proficiency in generic competencies.

Computerized positive mental imagery training versus cognitive control training versus treatment as usual in inpatient mental health settings: study protocol for a randomized controlled feasibility trial

BackgroundEnhancing the capacity to experience positive affect could help improve recovery across a range of areas of mental health. Experimental psychopathology research indicates that a computerized cognitive training paradigm involving generation of positive mental imagery can increase state positive affect, and more recent clinical studies have suggested that this training could be used as an adjunct treatment module to target symptoms related to positive affect deficits, specifically anhedonia. The current study investigates the feasibility of adding a positive mental imagery computerized training module to treatment for patients in inpatient mental health settings, with a focus on increasing positive affect and reducing anhedonia. The positive mental imagery training (PMIT) is added to treatment as usual (TAU) in the inpatient setting, and compared to TAU alone, or TAU plus an alternative cognitive training module not hypothesized to increase positive affect, cognitive control training (CCT).MethodsThe study is a feasibility randomized controlled trial with three parallel arms. Up to 90 patients admitted to inpatient mental health treatment clinics in Germany will be randomized to PMIT + TAU, CCT + TAU, or TAU on a 1:1:1 ratio. PMIT or CCT consist of an introductory session followed by up to 8 full training sessions over 2 weeks. All three arms (including TAU) include regular completion of mood measures over the 2-week period. Outcome measures are completed pre and post this 2-week training/monitoring period, and at 2-week follow-up. Data will be presented in the form of both raw means and standardized effect sizes, with 95% confidence intervals, for both intention-to-treat and per-protocol samples.DiscussionThe study will inform feasibility of conducting a fully powered randomized controlled trial investigating the addition of the positive mental imagery training as a treatment adjunct to inpatient treatments for mental health, including potential refinement of study procedures, inclusion/exclusion criteria, and preliminary indications of the likely range of effect sizes.Trial registrationclinicaltrials.gov, NCT02958228 (date registered: 4 November 2016)

Usability and Acceptability of Everhealthier Women, a Mobile Application to Enhance Informed Health Choices

ObjectiveTo explore women’s use and acceptance of Everhealthier Women, a mobile health (mHealth) application (app) designed to provide women with easy access to preventive health information and to promote adherence to life-saving clinical screenings and disease prevention behaviors. DesignQualitative descriptive study. SettingA Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) office in a large Northeastern U.S. city. ParticipantsFifteen low-income women ages 18 to 30 years who used WIC services. MethodsParticipants completed a baseline survey regarding their use of technology to obtain health information. Next, they received an introductory session to Everhealthier Women on a mobile device by a study staff member and individually explored the app. Afterward, they completed a questionnaire in the waiting room to assess their initial views on the acceptability and usefulness of the app. Participants were then contacted over a period of 3 weeks to elicit feedback about their app use through a series of open-ended questions. Descriptive statistics were calculated, and content analysis was performed. ResultsFourteen of the 15 participants reported using the Internet to search for health information in the past. Seven participants had used mHealth apps, and 14 believed that Everhealthier Women was easy to navigate and beneficial for women of all ages. They reported being more likely to use the app if it was recommended by a friend or health care provider. The app was mainly used to search for health information and set appointment reminders. ConclusionmHealth apps can be powerful public health tools; however, evidence should inform their development. Research about specific apps, such as Everhealthier Women, advances our knowledge about the benefits of mHealth and implementation challenges and could inform stakeholders of the optimal level of investment in new technologies. Consideration of financial, time, and personal constraints is needed to evaluate the use of mHealth apps by economically disadvantaged populations.

Understanding Bottlenecks: An Operations Management Experiential Learning Exercise

ABSTRACTUnderstanding bottlenecks is an in‐class experiential learning exercise designed to improve students’ understanding of production system capacity issues. After an introductory teaching session on capacity and constraint management, students are formed into groups of six to assume the roles of one raw material handler, four production workers, and one finished goods receiver and are asked to produce 20 units of product beta. Prior to the start of the exercise, the students are asked to predict the completion time of the 1st, 10th, and 20th units of product beta. When all 20 betas are completed, students compare their predicted completion times to the actual completion times. The results of the game show that while students can easily identify the system's bottleneck, they often have difficulties distinguishing the practical implications of the process time of the system versus the process cycle time; thus, their predicted completion times of the 10th and 20th units are typically overinflated compared to actual completion times. A debrief session is then used to solidify students’ understanding of the relationship between bottlenecks and capacity. The exercise is well‐received and highly rated by students; furthermore, it is not resource‐intensive, requiring 40‐45 minutes of classroom time, 20‐25 strips of paper per group, and a visible stopwatch.

Obstetrics and Gynaecology Simulation Session for First-Year Residents

Objectives: First-year trainees in certain Canadian surgical subspecialty programs have organized simulation and didactic training in their respective fields at the beginning of residency. The McGill University Obstetrics and Gynaecology program does not currently provide such an introductory session. The current resident-driven initiative aimed to develop an interactive session for first-year residents to heighten their confidence in basic knowledge and clinical conducts at the onset of residency.

I Wear Many Masks

The first time I met Karen Manuel she was laughing as she entered my classroom for the introductory session of Language 10. Several other girls stuck close to her like princesses around a queen. Even at fifteen Karen Manuel was tall and heavy. Her hair was dusty blond, cut short, and gelled back from a pale face without make up. Her eyes were dark magnets that drew you to her. In that first class she never spoke, but I was always aware of her. I was also scared, not physically afraid of her, but scared because here was a woman nobody seemed able to explain or predict.

Actuarial prediction of psychotherapy retention among Iraq-Afghanistan veterans with posttraumatic stress disorder.

The present study aimed to identify predictors of treatment retention in a sample of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans with posttraumatic stress disorder (PTSD) who were referred for PTSD-focused treatment through completion of a Veterans Affairs (VA) specialty clinic introductory information session. A total of 124 returning veterans (89% male, 53% Caucasian, 40% African American, 2% Latino; average age = 37 years) participated in an introductory session intended to facilitate informed decision making about treatment selection for PTSD. To evaluate patient, therapist, and system characteristics that were associated with risk of prematurely dropping out of psychotherapy for PTSD, we used recursive partitioning or "classification tree" methods commonly used to derive actuarial models of risk for high or low scores on a particular outcome when the set of independent or predictor variables is large. Findings revealed interactions among predictors involving access to care, readiness for change, histories of traumatic brain injury, and previous PTSD treatment. Results from the exploratory recursive model indicated that participation in therapy was highest when veterans entered psychotherapy within 68 days of the information session, believed that they needed help, and had a history of traumatic brain injury, while participation was lowest when entry into treatment exceeded 68 days and belief in needing help was low. Effects associated with partitions in the recursive model were substantial, with Cohen's d statistics ranging from .60 to 1.75. Results of the present effectiveness study implicate the importance of access to care as well as motivation for treatment in the returning cohort of OEF/OIF/OND veterans seeking help for PTSD. (PsycINFO Database Record

Unfamiliar technology: Reaction of international students to blended learning

This study enquires into learners’ behavioural intentions towards the use of a blended learning program designed for post-graduate international IT students. The aim of this research is to develop a testing mechanism to measure the extent to which international students have built up digital capital. We use the unified theory of acceptance and use of technology (UTAUT) as a framework for this investigation, built around social influence (behavioural intention) performance and effort expectancy (attitude), and facilitating conditions (ease and usefulness), using a critical theoretical approach. We further attempt to understand whether motivation for engagement with blended learning comes from intrinsic or extrinsic sources. For this study, 95 Project Management students were introduced to a blended learning approach using Blackboard, a Learning Management System. Following an introductory session, data on attitude, social influence and facilitating conditions was gathered. Hierarchical multiple regressions were used to assess the influence of each variable in determining first behavioural intentions and latter attitude towards blended learning. This study contributes to the body of knowledge through identifying that social influence has a strong impact on both performance and effort expectation as well as behavioural intentions. This suggests that, overall, the social environments from which the cohort originated provided sufficient economic, social and cultural capital to also develop some digital capital.

Mobile technology in a mathematics trail program: how does it works?

The aim of the study reported upon in this paper is to explore the potential of the use of mobile technology for supporting math trail program. An explorative study was conducted in the city of Semarang in Indonesia involving 30 students of SMPN 10 Semarang. The study consisted of an introduction session, a math trail activity supported by the use of mobile phone app, and a debriefing session. Data were gathered by means of participatory observation, students' work, and interviews. Findings indicate that math trail programs supported by the use of mobile phones have promoted the engagement of students in mathematical activities. The use of mobile technology has the potential to support the program. Mobile app has been able to play a role in guiding students in math trail activities with features offered, such as: navigation features, help buttons, and direct feedback.

Combined treatment with aripiprazole and antidepressants reversed some MK-801-induced schizophrenia-like symptoms in mice.

Atypical antipsychotic drugs have some efficacy in alleviating the negative and some cognitive symptoms of schizophrenia but those effects are small and mechanisms of this action are still unknown A few clinical reports have suggested that antidepressants (ADs), are able to augment the activity of atypical antipsychotic drugs. Thus, in the present study, we aimed to evaluate the effect of ADs, escitalopram (ESC) or mirtazapine (MIR) and aripiprazole (an atypical antipsychotic drug) given separately or jointly, on the MK-801-induced positive and cognitive symptoms of schizophrenia in mice. The experiments were conducted on male Albino Swiss mice. ADs and aripiprazole were given 30min before MK-801 injection. Locomotor hyperactivity induced by MK-801 (0.3mg/kg) was measured for 30min, starting 30min after MK-801 administration. In the novel object recognition test, MK-801 (0.2mg/kg) was given 30min before the first introductory session. Memory retention was evaluated for 5min, starting 90min after the introductory session. Aripiprazole (0.3mg/kg) reduced the locomotor hyperactivity induced by MK-801(0.3mg/kg). Co-treatment with an inactive dose of aripiprazole and ESC or MIR inhibited the effect of MK-801. Moreover, MK-801 (0.2mg/kg) decreased the memory retention. Aripiprazole (0.3mg/kg) reversed that effect. Co-treatment with an inactive dose of aripiprazole and ESC or MIR abolished the deficit of object recognition memory induced by MK-801. The obtained results suggest that ADs may enhance the antipsychotic-like effect of aripiprazole in the animal tests used for evaluation of some positive and cognitive symptoms of schizophrenia.

The reliability of data produced by isokinetic dynamometry (IKD) of knee extension and flexion movement

To investigate the feasibility of using isolated knee performance to measure the f-v profile of human muscle in vivo, we were using isokinetic dynamometry (IKD) technique that span the entire f-v profile of skeletal muscle. With institutional ethics approval, eleven healthy males (mean ± SD: age, 24.9 ± 3.1 years; body mass, 80.2 ± 10.1 kg; height, 176.2 ± 7.1 cm) completed this study. The participants were physically active and were familiarized with the techniques and protocol prior to completing 4 experimental sessions (1 introductory session and 3 repeated experiment sessions). The sessions was used a protocol of knee extensor function on IKD at isometric mode and angular velocities of 60˚.s-1, 120˚.s-1, 240˚.s-1 and 450˚.s-1. IKD data were not significantly different across the 3 repeated trials, demonstrating there was no evidence of systematic bias. The average coefficient of variation (CV) of IKD was 9.3 ± 3.0% ranging from 7.0 to 15.7%. Therefore the isolated knee performance to measure the f-v profile of human muscle in vivo using the IKD was feasible.Keywords: f-v profile, isokinetic dynamometry, skeletal muscle

Exploring Practical Responses of M3LC for Learning Literacy

This study aims to explore the responses of participants toward Mathematics-Language Literacy Learning Courseware (M3LC) for learning literacy. There are five practical aspects concerned by involving 30 participants in the focus group discussion. In the beginning, participants were given some response sheet and introduced to M3LC by watching learning video of M3LC. At the end, they were asked to concern about response sheet and give comments related what they saw during the introduction session. The results show that the responses of users’ agree and strongly agree are still higher than those of users’ disagree or strongly disagree, with below 30% of responses are in the fair category. It means that the participants tend to give a positive opinion that M3LC is a useful courseware since it is qualified to satisfy 5 practical aspects, including knowledge use, knowledge construction, evaluation practice, social programming, and valuing to support literacy learning. In future, the implementation of using this courseware can be enhanced to further recognition of literacy level so that students can be well-prepared before starting learning activities in the classroom.

Effect of cardiac rehabilitation programme following elective percutaneous coronary angiography on depressive symptoms: A cohort study

BackgroundDepression is a common condition in cardiac patients. We investigated the effect of cardiac rehabilitation on depressive symptoms as detected by Beck depression inventory II score (BDI) in patients who underwent percutaneous coronary intervention (PCI). MethodsIn this cohort, 95 patients met our criteria. Patients were then studied in two groups based on their participation in the rehabilitation program to rehabilitation (exposure) and the control (non-exposure) groups. The control group consisted of those who only participated in the introductory session and decided not to continue the program. Finally, demographic and clinical parameters as well as the BDI scores were compared between the study groups. ResultsData of 35 patients who completed rehabilitation program was compared with 60 patients who did not. There was no significant difference between the study groups regarding the demographic and clinical variables, except for a higher frequency of family history for CAD in the control group (p<0.001). The frequency of the patients with no or mild depression was significantly higher in the rehabilitation group than the controls (p=0.02). There was also a significant increase in the BDI score of the control group and a significant decrease in the rehabilitation group (p<0.001). After adjustment for confounders (family history and severity of CAD), not attending the rehabilitation program was a strong risk factor for depression (OR=10.8, 95% CI: 1.3, 88.5; P=0.027). ConclusionOverall, this study showed that not attending cardiac rehabilitation program following elective PCI was a risk factor for depression.

Role of Visuohaptic Surgical Training Simulator in Resident Education of Orthopedic Surgery.

We sought to assess the validity of a virtual surgical training system on lumbar pedicle screw placement for residents. Ten inexperienced residents were randomly assigned to the simulation training (ST) group (n= 5) and control group (n= 5). The ST group performed the lumbar pedicle screw placement on the virtual surgical training system, and the control group was given an introductory teaching session before the cadaver test. A total of 8 adult fresh cadavers including 5 males and 3 females were collected and randomly allocated to the 2 groups. Each group performed the bilateral L1-L5 pedicle screw instrumentation in the cadaver specimens, respectively. Accuracy was assessed by computed tomography after instrumentation. The screw penetration rates, acceptable rates, and average screw penetration distance of the 2 groups were compared using statistical analysis. The screw penetration rate of the ST group (12.5%) was significantly lower than the control group (37.5%, P < 0.05). The screw acceptable rates in ST and control groups were 100% and 85%, respectively, with statistical differences between each other (P < 0.05). There was also a statistically significant difference of the average screw penetration distance between the ST (1.37 ± 0.62 mm) group and control group (2.42 ± 0.51 mm, P < 0.05). The virtual surgery simulation with greater accuracy is superior to the traditional teaching methods in surgical training of pedicle screw placement and can be used as a promising alternative for training of neurosurgical procedures.

Volunteer patients and small groups contribute to abdominal examination's success.

BackgroundPrior to 2007, we taught the abdominal examination in a hospital based group to 40 students, at one hospital. We used volunteer patients, small groups, repetition, and required faculty development sessions. In 2007, our medical school changed its “Introduction to Physical Examination” session so that the entire class was to be taught in a geographically central session. Our hospital was selected to lead the abdominal examination portion of the session.AimOur aim was to answer three questions. First, could we quadruple the recruitment of volunteer patients, and faculty? Second, was it volunteer patients, small groups, repetition, or faculty training that was most valued by the students? Third, would volunteer patients and/or faculty agree to participate a second time?MethodsA total of 43–46 patients and 43–46 faculty were recruited and 43–46 examining rooms were obtained for each of the 5 years of this study. Teachers were required to attend a 1-hour faculty development session. The class of about 170 students was divided into 43–46 groups each year. The teacher demonstrated the abdominal examination and each student practiced the examination on another student. Each student then repeated the full abdominal examination on a volunteer patient.ResultsOver the 5-year time period (2008–2012), the abdominal examination ranked first among all organ systems’ “Introductory Sessions”. The abdominal examination ratings had the best mean score (1.35) on a Likert scale where 1 is excellent and 5 is poor. The students gave the most positive spontaneous comments to having volunteer patients, with small groups coming in as the second most appreciated educational element.ConclusionWe successfully quadrupled the number of faculty, patients, and examining rooms and created a highly rated educational program as measured by anonymous student evaluations, patient and faculty participation, and the medical school’s selecting the abdominal examination methods as an “Advanced Examination” for the Pathways Curriculum.

Baseline Characteristics and Technology Training of Underserved Adults With Type 2 Diabetes in the Mobile Diabetes Detective (MoDD) Randomized Controlled Trial.

Purpose The purpose of this study is to describe the characteristics and technology training needs of underserved adults with type 2 diabetes mellitus (T2DM) who participated in a health information technology (HIT) diabetes self-management education (DSME) intervention. Methods The baseline physiological, psychosocial, and technology use characteristics for 220 adults with poorly controlled T2DM were evaluated. Intervention participants received a 1-time intervention training, which included basic technology help, introduction to the Mobile Diabetes Detective (MoDD) website and text message features, and account activation that included subject-specific tailoring. Four additional on-site sessions for participants needing computer or Internet access or technology support were made available based on need. Data regarding on-site visits for usual care were collected. Data were analyzed using descriptive statistics and bivariate analysis. Results The participants were predominately Hispanic and female with a baseline mean A1C of 10% (86 mmol/mol). Only half of the participants regularly used computers or text messages in daily life. The average introductory MoDD training session lasted 73.6 minutes. Following training, approximately one-third (35%) of intervention participants returned for basic and MoDD-specific technology assistance at their federally qualified health center. The most frequently reported duration for the extra training sessions was 30 to 45 minutes. Conclusions Training and support needs were greater than anticipated. Diabetes educators should assess technology abilities prior to implementing health information technology (HIT) diabetes self-management education (DSME) in underserved adults. Future research must invest resources in technology access, anticipate subject training, and develop new training approaches to ensure HIT DSME use and engagement.

“Looking from the other side”: Using Design Thinking for Strategic Projects at the Basque Health Service

Introduction and description of the practice implemented: The Basque Country has been implementing integrating care policies since 2010 (1). One of the cornerstones of this strategy has been the launch of 13 Integrated Health Care Organisations (IHOs) to integrate under the same structure Primary and Secondary Care Services (2). Nevertheless, structural integration does not deliver better care by its own; and in 2015 the Basque Health Service (BHS) launched a project called IntegraSarea (Network for Integration in Basque) to facilitate cultural change and to create a shared narrative of what integration means based on a People Centred Care approach (3). More than 100 people including managers, patients, carers and health professionals across the Basque Country have been part of this network and the rest of the health workforce (30.000 people) is informed via newsletter, fb and twitter in order to have the maximum amount of people onboard. In this context Design Thinking was chosen to be the method used to help health professionals think “out of the box” and analyse the challenges the health system faces from a user/patient perspective. To reach this goal, four different workshops involving more than 100 people were conducted. Methodology: (Theory of change) Design Thinking (DT) is a methodology that originates from Service Design and was first used in urban planning in 1987 (4). Nowadays the shift to the customer-in-the center of the process is one factor that has motivated companies and other institutions to use Design Thinking as a method to improve and re-design processes from a user perspective. Although the term has changed across time (5) it is widely accepted that DT is a methodology for problem-solving and has five basic steps (see figure 1): empathize, define, ideate, prototype and test. Its use in the health sector is still to be developed and has a huge potential since there is often a gap between patient experience & expectations and the care provided. The latter can be outstanding following traditional indicators of efficacy and efficiency (ie: hip replacement with no complications) and the former could still be bad (ie: despite replacement patient cannot walk due to pain). In the Basque context DT has been fully applicable since the challenges the health sector faces demand multidisciplinary teams and consensus to be successfully implemented, and these are two aspects that DT helps to build. Discussion: Four workshops were designed based on three key areas (Person Cantered Care, care pathways and community networks). After an introductory session on DT, each participant had to carry out fieldwork using different qualitative and ethnographic techniques to identify improvement areas from a patient perspective. This has allowed each Organisation in the BHS to have several of its professionals trained on this methodology, which will have a snowball effect in the future. Moreover, it should be emphasized the importance of inviting patients/users into internal strategic and training projects, which brings in different views and also challenges the status quo of everything for the patient without the patient. Conclusion: The methodology has been strongly accepted by the participants of the workshops like a valid instrument to identify the gaps between patient experience & expectations and the care provided. The Final Report of the workshops details all 52 actions that are proposed to tackle the improvement areas identified and will be presented at the Conference.

Spinal Cord Injury Peer Mentorship: Applying Self-Determination Theory to Explain Quality of Life and Participation

ObjectivesTo investigate the role of spinal cord injury (SCI) peer mentorship on quality of life (QoL)/participation, and test a self-determination theory model that explains the role of SCI peer mentorship on these outcomes. DesignA static group comparison design. SettingCommunity. ParticipantsA convenience sample of mentees (individuals receiving peer mentorship) (n=68) and nonmentees (n=63) who had an SCI, were older than 18 years, and spoke either English or French. InterventionsMentees: at least 4 peer mentorship sessions over the past 5 years; nonpeer mentees: 0 or 1 brief introductory session. Main Outcome MeasuresQoL (ie, life satisfaction and positive and negative affect), participation (eg, autonomous indoor; family role), and the psychological needs of autonomy, competence, and relatedness. ResultsNo group differences were found, but years since injury was a moderator indicating that, generally, peer mentees living with SCI for longer (∼30y) appear to benefit more from peer mentorship interactions compared with nonmentees and mentees living with SCI for approximately 6 years. Competence and relatedness mediated the peer mentorship–outcome relationship for QoL and some participation variables, indicating that peer mentorship predicted competence and relatedness, which in turn were related to the outcomes. ConclusionsSatisfaction of competence and relatedness needs requires greater attention in SCI peer mentorship. Years since injury modified the relationship between peer mentorship and outcomes, which provided new insights on the role of SCI peer mentorship. Further studies are needed to determine SCI peer mentorship–specific outcomes that are important across the years-since-injury spectrum.

Using expert patients to co-facilitate an introductory information session: does informed patient choice enhance engagement with pulmonary rehabilitation?

Objective: As the pulmonary rehabilitation service has developed, demand on resources has increased. Patient ‘opt-in’ sessions aimed at reducing initial patient assessment Did Not Attend (DNA) rate were introduced. It was also hoped that facilitating informed patient choice would increase programme completion rates.Method: For a period of one year ‘opt-in’ sessions – 30 minute education sessions co-facilitated by ‘expert patients’ explaining the specifics of pulmonary rehabilitation – were introduced. Expert patients are patients who have successfully completed the programme, have shown evidence of fully engaging with self-management and associated maintenance behaviours, and encourage others based on their own lived experiences. Assessment appointment attendance and group completion data were collected and compared for two patient cohorts over a period of 1 year prior to, and post, instigation of the opt-in sessions.Results: Initial assessment appointment DNA rate decreased from 22.4% (original service) to 10.6% (enhanced service) with a net clinical time saving of 66 h. Programme completion rate increased from 50.2% (original service) to 77.0% (enhanced service).Conclusion: The evidence here shows that this simple intervention is associated with improved service efficiency without requiring additional resources. Opt-in sessions could be adopted by other services promoting self-management of long-term conditions.

Continuing professional development: pedagogical practices of interprofessional simulation in health care

ABSTRACTThe increasing complexity of health care practice makes continuing professional development (CPD) essential for health care professionals. Simulation-based training is a CPD activity that is often applied to improve interprofessional collaboration and the quality of care. The aim of this study is to explore simulation as a pedagogical practice for the CPD of health care professionals. Specifically, the study focuses on how a professional development activity, the simulation, is enacted to support interprofessional collaboration and learning. A practice theory perspective is used as the theoretical framework. In this, the professional practice is conceptualised as being embodied, relational and situated in sociomaterial arrangements. Ten introduction and reflection sessions following interprofessional full-scale manikin-based simulations with professionals were video-recorded. The recordings were analysed following a stepwise qualitative collaborative approach developed for the purpose. The key findings suggest that the professional competence activity is enacted and interconnected with and governed by historical traditions of institutional teaching practices as well as simulation practices. Despite the intentions of team and interprofessional training, the institutional teaching and simulation practices constrain and hinder the intended outcomes of professional development in interprofessional collaboration.