Medicine and Health Sciences Commons^™

The Impact Of Cannabinoids On Reproductive Function, Daniel Hardy

Physiology and Pharmacology Publications

In brief: This review article summarizes the effects of pre- or peri-conceptual exposure to cannabinoids on female and male reproductive function, along with pregnancy outcomes from 2014 to 2024. In particular, it addresses the gaps in knowledge regarding the specific contributions of the major constituents of cannabis, THC and CBD, on reproduction. Abstract: With increased use of cannabis worldwide, especially in our young adult population, there is a great impetus to understand the impact of cannabis and its constituents (i.e. THC and CBD) on pregnancy, fetal outcomes and male and female reproductive function. This review assessed the current evidence (2014–2024) …

A Qualitative Study Of The Role Of Hearing Aid Use And Physical Fit Accessories In A Sample Of Older Adults, Mohamed Rahme, Paula Folkeard, Susan Scollie

Communication Sciences and Disorders Publications

Objective: The purpose of the study was to qualitatively describe the experiences of hearing aid andphysical fit accessories use during physical activity and exercise participation in a sample of older adultswith hearing loss.

Design: A prospective qualitative research design was employed with the use of focus groups with older adult participants who were fitted with hearing aids and physical fit accessories.

Study Sample: Twelve older adults with hearing loss (six experienced and six new hearing aid users, age range 64 – 88 years) were recruited in this study.

Results: The barriers to hearing at physical activity and exercise environments were …

Process Evaluation Of The Hockey Fans In Training Lifestyle Intervention (For Men With Overweight Or Obesity)., Wendy M Blunt, Marisa L Kfrerer, Dawn P. Gill, Katie J Shillington, Brendan Riggin, Jennifer D Irwin, Brooke Bliss, Robert J Petrella

Department of Medicine Publications

BACKGROUND: Despite the proven relationship between lifestyle and morbidity and mortality, rates of chronic disease (e.g. obesity) continue to rise in paradox to the myriad of studies supporting lifestyle behaviour change. Men have been less likely to seek out preventative care or lifestyle programs, putting them at risk. In response, Hockey Fans In Training (Hockey FIT) was developed as a group-based, lifestyle intervention leveraging the draw of hockey fandom to engage middle-aged men with overweight or obesity in lifestyle change. Encouraging pilot study results informed the optimization and delivery of the intervention through a cluster randomized controlled trial in 42 …

Exploring The Impact Of Biological Sex On Intrinsic Connectivity Networks In Ptsd: A Data-Driven Approach., Andrew A Nicholson, Jonathan M Lieberman, Niki Hosseini-Kamkar, Kristen Eckstrand, Daniela Rabellino, Breanne Kearney, David Steyrl, Sandhya Narikuzhy, Maria Densmore, Jean Théberge, Fardous Hosseiny, Ruth A Lanius

Medical Biophysics Publications

INTRODUCTION: Sex as a biological variable (SABV) may help to account for the differential development and expression of post-traumatic stress disorder (PTSD) symptoms among trauma-exposed males and females. Here, we investigate the impact of SABV on PTSD-related neural alterations in resting-state functional connectivity (rsFC) within three core intrinsic connectivity networks (ICNs): the salience network (SN), central executive network (CEN), and default mode network (DMN).

METHODS: Using an independent component analysis (ICA), we compared rsFC of the SN, CEN, and DMN between males and females, with and without PTSD (n = 47 females with PTSD, n = 34 males with PTSD, …

Real-World Assessment Of Listener Preference For Hearing Aid Technology Levels In Socially Involved Situations, Danielle Glista, Robin O'Hagan, Krystal Beh, Jeff Crukley, Susan Scollie, Leonard Cornelisse

Communication Sciences and Disorders Publications

Introduction: Current hearing aids have an abundance of feature options and technologies. It is important to understand the clinical impact of hearing aid technology selection and how to individualize fittings to optimize hearing aid performance according to listening environment. To probe the naturalistic listening experiences researchers can use in-situ outcome measures. Survey based real-world assessments can increase knowledge of hearing aid users’ everyday scenarios, beyond the limits of lab-based scenarios. This study aimed to assess the relationship between subjective preference ratings of adult listeners and hearing aid technology level using Ecological Momentary Assessment (EMA). A secondary research question explored survey …

Heterogeneous Knowledge Of Childhood Seizures And Epilepsy Care In Canadian Healthcare Providers: Identifying The Gaps, Michelle Kregel, Sherry Coulson, Emily Guarasci, Andrea Andrade

Paediatrics Publications

Epilepsy is the most common chronic neurological condition in children. Many barriers exist in early recognition which cause delay in care and impact quality of life. Some of these children require advanced treatments which are underutilized due to lack of education, awareness and referrals. Overall, childhood epilepsy is underdiagnosed and poorly understood by non-expert providers. We investigated awareness and knowledge about epilepsy from primary care providers via the quality of their referrals. We prospectively collected and examined all epilepsy related referrals to the Paediatric Neurology Division at Children’s Hospital in London, Ontario, Canada during a six-month period. We developed a …

Encouraging Movement Opportunities Through Theory-Informed Video Education Among Undergraduate Students: The Move Study, Carmen Labadie, Nia Contini, Varsha Vasudevan, Matthew Bourke, Shauna Burke, Patricia Tucker, Jennifer Irwin

Health Studies Publications

Objective: To explore the impact of a theory-informed educational video on undergraduates’: motivational readiness, self-efficacy, and decisional balance about changing sedentary time; sedentary time; and perceptions of sedentarism over time and compared to a control. Participants: Undergraduates (N = 160) from a Canadian institution. Methods: A single-blind randomized controlled trial using an intervention (sedentary video) and control (sleep video) group. Participants completed two validated questionnaires at baseline, immediate post-intervention, and one-month follow-up plus open-ended questions. Linear mixed models and content analysis were used. Results: No significant differences were observed between groups. Increases in self-efficacy (p = .016; d = 0.27) …

The Hockey Fans In Training Intervention For Men With Overweight Or Obesity: A Pragmatic Cluster Randomised Trial, Robert Petrella, Dawn Gill, Nárlon C. Boa Sorte Silva, Brendan Riggin, Wendy Blunt, Marisa Kfrerer, Melissa Majoni, Jacquelyn Marsh, Jennifer Irwin, Saverio Stranges, Merrick Zwarenstein, Guangyong Zou

Health Studies Publications

Background: Obesity disproportionately impacts men’s health yet fewer men engage in preventive healthcare. We examined the effectiveness of Hockey Fans in Training (Hockey FIT), a gender-sensitised lifestyle intervention that engages men with overweight/obesity through their passion as fans of a local sports team, on weight change and other health indicators.Methods: Pragmatic, cluster randomised trial (aged 35–65 years, body mass index ≥ 27 kg/m2 ) within 42 community-based sites in Canada and the United States, randomly assigned (1:1) to intervention (Hockey FIT) or control (waitlist) and stratified by region. Sites were selected based on partnerships with local major junior/professional hockey teams …

Using Causal Diagrams Within The Grading Of Recommendations, Assessment, Development And Evaluation Framework To Evaluate Confounding Adjustment In Observational Studies, Kevin Mcintyre, Karina N Tassiopoulos, Curtis Jeffrey, Saverio Stranges, Janet Martin

Epidemiology and Biostatistics Publications

BACKGROUND AND OBJECTIVES: The current Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system instructs appraisers to evaluate whether individual observational studies have sufficiently adjusted for confounding. However, it does not provide an explicit, transparent, or reproducible method for doing so. This article explores how implementing causal graphs into the GRADE framework can help appraisers and end-users of GRADE products to evaluate the adequacy of confounding control from observational studies.

METHODS: Using modern epidemiological theory, we propose a system for incorporating causal diagrams into the GRADE process to assess confounding control.

RESULTS: Integrating causal graphs into the GRADE framework enables …

The Hockey Fans In Training Intervention For Men With Overweight Or Obesity: A Pragmatic Cluster Randomised Trial., Robert J Petrella, Dawn P. Gill, Nárlon C Boa Sorte Silva, Brendan Riggin, Wendy M Blunt, Marisa Kfrerer, Melissa Majoni, Jacquelyn Marsh, Jennifer D. Irwin Phd, Saverio Stranges, Merrick Zwarenstein, Guangyong Zou

Family Medicine Publications

BACKGROUND: Obesity disproportionately impacts men's health yet fewer men engage in preventive healthcare. We examined the effectiveness of Hockey Fans in Training (Hockey FIT), a gender-sensitised lifestyle intervention that engages men with overweight/obesity through their passion as fans of a local sports team, on weight change and other health indicators.

METHODS: Pragmatic, cluster randomised trial (aged 35-65 years, body mass index ≥ 27 kg/m

FINDINGS: Between November 13, 2018-November 12, 2021, 20 sites (n = 497) were allocated to intervention and 22 sites (n = 500) to control. Participants with baseline weight and weight at 3 or 12 months, were …

Thoughts From The Frontlines: Canadian Perspectives In Adopting And Implementing Recommended Clinical Labels In Preschool Speech-Language Pathology, Alison Lynn Csercsics, Lauren Denusik, Barbara Jane Cunningham

PRECISe Preschool Speech and Language Publications

Purpose:

Method:

Directionality In Bicros Hearing Aids: An Investigation Of Objective And Subjective Outcomes, Hasan K. Saleh, Paula Folkeard, Volker Kuehnel, Solveig C. Voss, Jinyu Qian, Susan Scollie

Communication Sciences and Disorders Publications

Objectives: To assess the effect of forward and omnidirectional microphone configurations in BiCROS versus monaural hearing aids on objective and subjective outcomes in different noise conditions.

Design: After fitting and a 4-week acclimatisation period, speech recognition and sound quality were measured using forward directional, omnidirectional, and unaided settings. Two noise configurations were used, surrounding noise and noise presented from the aided (better) ear. Subjective outcomes were assessed using the SSQ-b and BBSS questionnaires and participant interviews.

Study sample: Eighteen adult participants (mean: 74.6 y; range: 61–94 y; ten males, eight females) with mild to moderately severe SNHL in their better …

Belonging Through Meaningful Activity In The Transition From Unhoused To Housed, Patricia Y. Plett, Rebecca Gewurtz, Abe Oudshoorn, Cheryl Forchuk, Carrie Marshall

Occupational Therapy Publications

Background

Belonging is closely associated with well-being, yet individuals with experiences of being unhoused are likely to experience social exclusion and challenges with developing a sense of belonging. Engagement in meaningful activity has been linked to belonging; however, there are no focused studies exploring experiences of how engaging in meaningful activities influences belonging. Meaningful activities are things we do that bring value to our lives.

Purpose

To explore how engaging in meaningful activities may influence experiences of belonging following homelessness through a secondary analysis of qualitative interviews.

Method

Using interviews conducted in a community-based participatory action study exploring the transition …

From Brazil To Canada: Translation And Cross-Cultural Adaptation Of An App For Breastfeeding Premature Babies, Gabriela Ramos Ferreira Curan, Cindy-Lee Dennis, Flavia Casasanta Marini, Rosangela Aparecida Pimenta, Thaila Correa Castral, Gracielle Schwenk, Kimberley T. Jackson, Edilaine Giovanini Rossetto

Nursing Publications

Objective: Translating and culturally adapting the AmamentaCoach app, originally developed in Brazil, for use by mothers of premature babies in Canada, through international research collaboration. Method: This is applied research in the form of technological development, in which the World Health Organization’s recommendations for the translation and cultural adaptation of instruments were taken into account. Five Canadian researchers who are experts in breastfeeding promotion evaluated the appearance, language, and content of the new version of the app. An 18-item instrument was used with Likert scale response options indicating the degree of agreement for each statement, where 1=Strongly Disagree, 2=Disagree, 3=Neutral, …

Measuring Compassion In Virtual Primary Care Encounters: Report On A Pilot Study, Bridget L. Ryan, Megann Dong

Family Medicine Publications

The Virtual Compassionate Primary Care Scale (VCPC) was developed as part of a larger study whose aim was to establish specific actions and activities that should be included within virtual primary care encounters to ensure compassionate care. We pilot tested patient and family physician 9-item versions of the VCPC to assess the degree of compassion within patient-family physician virtual encounters.

The pilot testing took place within individual interviews with patients and family physicians (not patient-family physician dyads) where we asked them to reflect on a recent specific encounter receiving [for patients] or providing [for family physicians] virtual care. Seventeen patients …

An Innovative Patient-Centred Approach To Heart Failure Management: The Best Care Heart Failure Integrated Disease-Management Program, Christopher Licskai, Anna Hussey, Madonna Ferrone, Cathy Faulds, Melissa Fisk, Shanil Narayan, Tim O'Callahan, Andrew Scarffe, Shannon Sibbald, Dhssraj Singh, Teresa To, Jari Tuomi, Robert Mckelvie

Health Studies Publications

BACKGROUND: The management of heart failure (HF) is challenging because of the complexities in recommended therapies. Integrated disease management (IDM) is an effective model, promoting guideline-directed care, but the impact of IDM in the community setting requires further evaluation.

METHODS: A retrospective evaluation of community-based IDM. Patient characteristics were described, and outcomes using a pre- and post-intervention design were HF-related health-service use, quality of life, and concordance with guideline-directed medical therapy (GDMT).

RESULTS: 715 patients were treated in the program (2016 to 2023), 219 in a community specialist-care clinic, and 496 in 25 primary-care clinics. The overall cohort was predominantly …

Chromium And Cobalt In Leather: A Danish Market Survey, Mikkel Bak Jensen, Farzad Seyed-Alinaghi, Ivan Chen, Jonas F. Hedberg, Yolanda S. Hedberg, Claus Zachariae, Jeanne Duus Johansen

Chemistry Publications

Introduction

Leather has been a significant source of chromium (Cr) allergy in Denmark since the 1990s. More recently, cobalt (Co) allergy has been identified in leather as a source of allergic contact dermatitis.

Objectives

To measure Cr and Co levels in Danish leather goods.

Methods

A total of 87 leather samples were collected, all tanned in Europe. Handheld X-ray fluorescence (XRF) device was used to screen for the presence of Cr and Co. The 20 leather samples with the highest concentrations of Co and Co were tested using International Organization for Standardization (ISO)-standards.

Results

XRF analysis showed Cr in 78/87 …

A Rapid Review Of The Barriers And Facilitators Of Mental Health Service Access Among Veterans And Their Families, Natalie Ein, Julia Gervasio, Kate St. Cyr, Jenny J.W. Liu, Clara Baker, Anthony Nazarov, J. Don Richardson

MacDonald Franklin OSI Research Centre

Introduction: Transitioning to civilian life after military service can be challenging for both Veterans and their families. Accessible mental health services are crucial during this period to provide support. The objective of this review was to conduct a rapid review to capture the barriers and identify facilitators that influence access to mental health services for Veterans and their families during the post-service transition period.

Methods: This review was conducted using the Cochrane Handbook for Systematic Reviews of Interventions as a methodological framework and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Rapid Review (PRISMA-RR).

Results: A total …

Quantifying Sustained Health System Benefits Of Primary Care-Based Integrated Disease Management For Copd: A 6-Year Interrupted Time Series Study., Christopher Licskai, Anna Hussey, Véronique Rowley, Madonna Ferrone, Zihang Lu, Kimball Zhang, Emilie Terebessy, Andrew Scarffe, Shannon Sibbald, Cathy Faulds, Tim O'Callahan, Teresa To

Health Studies Publications

BACKGROUND: Severe exacerbation of chronic obstructive pulmonary disease (COPD) is a trajectory-changing life event for patients and a major contributor to health system costs. This study evaluates the real-world impact of a primary care, integrated disease management (IDM) programme on acute health service utilisation (HSU) in the Canadian health system.

METHODS: Interrupted time series analysis using retrospective health administrative data, comparing monthly HSU event rates 3 years prior to and 3 years following the implementation of COPD IDM. Primary outcomes were COPD-related hospitalisation and emergency department (ED) visits. Secondary outcomes included hospital bed days and all-cause HSU.

RESULTS: There were …

Hearing At The Mall: Multibeam Processing Technology Improves Hearing Group Conversations In A Real-World Food Court Environment, Paula Folkeard, Niels S. Jensen, Homayoun K. Parsi, Sascha Bilert, Susan Scollie

Communication Sciences and Disorders Publications

How can hearing aids make group conversations easier in noisy public spaces?

Hearing aids often struggle to help users follow conversations in noisy, real-world environments like busy food courts. This study found that a new hearing aid technology using multiple adaptive beams to track different speakers improved users' ability to understand and focus on group conversations in a mall food court setting. These results suggest that advancements in hearing aid algorithms that account for the natural head movements and multiple conversation partners could significantly enhance the listening experience for people with hearing loss in challenging everyday situations.

Mental Health Hospitalizations In Canadian Children, Adolescents, And Young Adults Over The Covid-19 Pandemic, Saptharishi Lalgudi Ganesan

Data and Test Instruments

ImportanceThe COVID-19 pandemic resulted in multiple socially restrictive public health measures and reported negative mental health impacts in youths. Few studies have evaluated incidence rates by sex, region, and social determinants across an entire population.ObjectiveTo estimate the incidence of hospitalizations for mental health conditions, stratified by sex, region, and social determinants, in children and adolescents (hereinafter referred to asyouths) and young adults comparing the prepandemic and pandemic-prevalent periods.Design, Setting, and ParticipantsThis Canadian population-based repeated ecological cross-sectional study used health administrative data, extending from April 1, 2016, to March 31, 2023. All youths and young adults from 6 to 20 years …

Pandemic Stringency Measures And Hospital Admissions For Eating Disorders, Saptharishi Lalgudi Ganesan

Data and Test Instruments

IMPORTANCE Hospitalizations for eating disorders rose dramatically during the COVID-19pandemic. Public health restrictions, or stringency, are believed to have played a role inexacerbating eating disorders. Few studies of eating disorders during the pandemic haveextended to the period when public health stringency restrictions were lifted.OBJECTIVE To assess the association between hospitalization rates for eating disorders andpublic health stringency during the COVID-19 pandemic and after the easing of public healthrestrictions.DESIGN, SETTING, AND PARTICIPANTS This Canadian population-based cross-sectional studywas performed from April 1, 2016, to March 31, 2023, and was divided into pre–COVID-19 andCOVID-19–prevalent periods. Data were provided by the Canadian Institute for …

Addressing The Stigma Of Homelessness Through Employment And Community Education: Experiences Of Participating In Two Novel Initiatives In Kingston, Ontario, Canada, Carrie Marshall, Julia Holmes, Corinna Easton, Shauna Perez, Patricia Y. Plett, Elham Javadizadeh, Rebecca Goldszmidt

Occupational Therapy Publications

Stigma is a serious issue affecting the lives of persons who experience homelessness and use substances. It influences every aspect of their daily lives including where they exist in public places, where they can live following homelessness, and access to housing, employment, and other opportunities that would enable thriving. In this report, we present the findings of two distinct studies which explore the experiences of administering or participating in two initiatives aimed at mitigating the stigma of homelessness in the lives of individuals who experience homelessness and use substances in Kingston, Ontario, Canada. These two initiatives were designed and led …

Prenatal Tetrahydrocannabinol And Cannabidiol Exposure Produce Sex-Specific Pathophysiological Phenotypes In The Adolescent Prefrontal Cortex And Hippocampus, Daniel Hardy, Mohammed Sarikahya, Kendrick Lee, Sebastian Vanin, Andrea Kocsis, Steven Laviolette

Data and Test Instruments

Clinical and preclinical evidence has demonstrated an increased risk for neuropsychiatric disorders following prenatal cannabinoid exposure. However, given the phytochemical complexity of cannabis, there is a need to understand how specific components of cannabis may contribute to these neurodevelopmental risks later in life. To investigate this, a rat model of prenatal cannabinoid exposure was utilized to examine the impacts of specific cannabis constituents (Δ9-tetrahydrocannabinol [THC]; cannabidiol [CBD]) alone and in combination on future neuropsychiatric liability in male and female offspring. Prenatal THC and CBD exposure were associated with low birth weight. At adolescence, offspring displayed sex-specific behavioural changes in anxiety, …

Primary Care Payment Models And Avoidable Hospitalizations In Ontario, Canada: A Multivalued Treatment Effects Analysis., Nibene Habib Somé, Rose Anne Devlin, Nirav Mehta, Sisira Sarma

Epidemiology and Biostatistics Publications

Improving access to primary care physicians' services may help reduce hospitalizations due to Ambulatory Care Sensitive Conditions (ACSCs). Ontario, Canada's most populous province, introduced blended payment models for primary care physicians in the early- to mid-2000s to increase access to primary care, preventive care, and better chronic disease management. We study the impact of payment models on avoidable hospitalizations due to two incentivized ACSCs (diabetes and congestive heart failure) and two non-incentivized ACSCs (angina and asthma). The data for our study came from health administrative data on practicing primary care physicians in Ontario between 2006 and 2015. We employ a …

Volatile Gas Scavenging In The Paediatric Intensive Care Unit: Occupational Health And Safety Assessment, Katherine Reise, Jason Mccartney, Richard La, Angela Jerath, Marat Slessarev, Brian Cuthbertson, Saptharishi Lalgudi Ganesan, Nicole Mckinnon

Data and Test Instruments

IntroductionThe use of volatile anesthetic agents in the paediatric intensive care unit (PICU) is experiencing increased interest since the availability of the miniature vapourizing device. However, the effectiveness of scavenging systems in the presence of humidifiers in the ventilator circuit is unknown.Approach (Methods)We performed a bench study to evaluate the effectiveness of the Deltasorb® scavenging system in the presence of isoflurane and active humidity by simulating both infant and child ventilator test settings. A total of four ventilators were set to ventilate test lungs, all with active humidity and a Deltasorb scavenging canister collecting exhaled ventilation gas. Two ventilators also …

Prenatal Maternal Depression In Canada: Are Current Protocols Adequate?, Britney A. Glasgow-Osment, Farah Wahib, Madeleine Zanin, Shama Kassam

Master's in Interdisciplinary Medical Sciences Graduate Program

Throughout pregnancy, maternal and fetal health are influenced by a multitude of factors. Prenatal maternal depression is one such factor. It is well documented that prenatal maternal depression causes negative pregnancy outcomes for both the mother and baby, including irregular placental function, psychological distress, and pre-term birth, among others. In Ontario, the incidence of prenatal maternal depression is alarmingly high, at 10.3%.As such, the current tools for managing prenatal maternal depression must be effective, efficient, and comprehensive. We hypothesized that the current protocols for screening and treating prenatal maternal depression in Canada are inadequate. To investigate this, a literature review …

Evaluation Of A Unique And Innovative Diabetes Care Model In Primary Care In Ontario, Canada: Protocol For A Multiple-Methods Study With A Convergent Parallel Design, Maria Mathews, Rhiannon Lyons, Stewart Harris, Lindsay Hedden, Yun-Hee Choi, Jennifer Donnan, Michael E Green, Elisabeth Harvey, Sonja M Reichert, Bridget Ryan, Shannon Sibbald, Leslie Meredith

Health Studies Publications

INTRODUCTION: The growth and complexity of diabetes are exceeding the capacity of family physicians, resulting in the demand for community-based, interprofessional, primary care-led transition clinics. The Primary Care Diabetes Support Programme (PCDSP) in London, Ontario, is an innovative approach to diabetes care for high-risk populations, such as medically or socially complex and unattached patients. In this study, we will employ a quadruple-aim approach to evaluate the health system impacts of the PCDSP.

METHODS AND ANALYSIS: We will use multiple methods through a convergent parallel design in this project across five unique studies: a case study, a patient study, a provider …

Transdisciplinary Understanding And Training On Research-Primary Health Care (Tutor-Phc): Knowledge Mobilization Symposium, Judith Belle Brown, Amanda Terry

Family Medicine Publications

The Transdisciplinary Understanding and Training on Research-Primary Heath Care (TUTOR-PHC) Knowledge Mobilization Symposium was held in London, Ontario on April 27 and 28^th, 2023. This event brought together TUTOR-PHC alumni and current trainees, as well as patient-partners, mentors, and knowledge users from practice, policy-making, and research organizations, and funding agencies. The focus of the Symposium was on knowledge mobilization where TUTOR-PHC alumni and current trainees shared their research, and where all participants actively created an enhanced network of individuals committed to PHC research. The Symposium provided a venue where research results were translated into action by the co-creation …

Thematic Analysis Of Using Visual Methods To Understand Healthcare Teams, Muhammad Faisal Ahmed, Konain Ali, Muskaan Mann, Shannon L. Sibbald

Health Studies Publications

In healthcare, teams are essential in solving today’s toughest challenges. However, narrow disciplinary perspectives have limited our current understanding of how teams function in various healthcare contexts. Researchers often rely on traditional survey methods as their primary tool, which can prevent them from gathering comprehensive data. To overcome this limitation, sharing stories and narratives visually allows participants to create representations of their perceptions of team experiences and complex encounters using a variety of approaches. Despite the potential of this method, there is little empirical guidance on how to use it in health sciences research. To address this gap and provide …