Exploring the literature on racism and health practitioner regulation: a scoping review protocol.

INTRODUCTION: Racism in healthcare leads to significant harm to healthcare professionals and the clients, families and communities they serve. Increasingly, health practitioner regulators-responsible for protecting the public and ensuring practitioner competence-are recognising the importance of reforming policies and practices to contribute to antiracist regulatory approaches. Examples of this work include developing specific standards of practice related to antiracism and antidiscrimination, supporting education and training, re-evaluating discriminatory licensure policies for internationally educated professionals and reforming internal governance structures to address unconscious bias. An understanding of the current state of literature can help identify knowledge gaps and inform the development of research agendas that can build the evidence base required to improve health practitioner regulators' approaches to addressing racism.The objective of this scoping review is to explore the nature, extent and range of literature focused on racism and health practitioner regulation and identify gaps in the literature. METHODS AND ANALYSIS: The review will be conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. Database searches will include OVID MEDLINE, EMBASE, CINAHL, Scopus and Web of Science Core Collection. The review will include papers that discuss how health practitioner regulation can contribute to and perpetuate interpersonal and institutional racism, and how regulatory policies and practices can help address racism. We will also search for grey literature using the websites of leading regulatory organisations. Data will be analysed using descriptive statistics and conventional content analysis. Findings will be presented using evidence tables and a narrative summary. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. ETHICS AND DISSEMINATION: Ethics approval is not applicable to this review protocol. Findings will be disseminated through presentations, meetings with health practitioner regulators and a publication in a peer-reviewed journal.

Nursing Regulation Literature in Canada: Protocol for a Scoping Review.

BACKGROUND: Significant reforms are occurring in health practitioner regulation across Canada. Within the nursing profession, growing workforce challenges and health system demands have accelerated the pace of changes to nursing regulation policies and practices. There is significant political investment to modernize and harmonize nursing regulation across Canada, and evidence is needed to guide regulatory decision-making. To better understand the current state of scholarship and the gaps that exist, a comprehensive understanding of the available literature informing nursing regulation in Canada is first warranted. OBJECTIVE: The objective of this scoping review is to examine the nature, extent, and range of literature focused on nursing regulation in Canada. METHODS: The review will be conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. We will search electronic databases, including Ovid MEDLINE, Ovid EMBASE, CINAHL, Scopus, and Web of Science Core Collection. We will also search for grey literature using the websites of Canadian nursing regulatory bodies, nursing organizations, and other leading Canadian regulatory organizations. No limitations will be placed on the year of publication. The review will include papers that explore nursing regulation in Canada, including topics such as education program accreditation or approval, licensure, standards of practice and code of conduct/ethics development and enforcement, continuing competence, discipline and conduct, regulatory models, governance, and reform. We will extract data using a predeveloped tool. Data will be analyzed using descriptive statistics and conventional content analysis. RESULTS: A preliminary search in Ovid MEDLINE was undertaken on December 7, 2023, and a full search was conducted in 5 academic databases on March 15, 2024. Findings will be presented using evidence tables and a narrative summary. Reporting will follow the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines. This scoping review is expected to be completed in early 2025. CONCLUSIONS: The results will be disseminated through conference presentations and a publication in a peer-reviewed journal. The findings will provide a comprehensive overview of the state of nursing regulation literature across Canada and inform the development of a focused research agenda. TRIAL REGISTRATION: Open Science Framework osf.io/3qk8t; https://osf.io/bm7jv. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56163.

Professional regulation in the digital era: A qualitative case study of three professions in Ontario, Canada.

Technology is transforming service delivery and practice in many regulated professions, altering required skills, scopes of practice, and the organization of professional work. Professional regulators face considerable pressure to facilitate technology-enabled work while adapting to digital changes in their practices and procedures. However, our understanding of how regulators are responding to technology-driven risks and the impact of technology on regulatory policy is limited. To examine the impact of technology and digitalization on regulation, we conducted an exploratory case study of the regulatory bodies for nursing, law, and social work in Ontario, Canada. Data were collected over two phases. First, we collected documents from the regulators' websites and regulatory consortiums. Second, we conducted key informant interviews with two representatives from each regulator. Data were thematically analyzed to explore the impact of technological change on regulatory activities and policies and to compare how regulatory structure and field shape this impact. Five themes were identified in our analysis: balancing efficiency potential with risks of certain technological advances; the potential for improving regulation through data analytics; considering how to regulate a technologically competent workforce; recalibrating pandemic emergency measures involving technology; and contemplating the future of technology on regulatory policy and practice. Regulators face ongoing challenges with providing equity-based approaches to regulating virtual practice, ensuring practitioners are technologically competent, and leveraging regulatory data to inform decision-making. Policymakers and regulators across Canada and internationally should prioritize risk-balanced policies, guidelines, and practice standards to support professional practice in the digital era.

Developing Policy Infrastructure to Guide Genomics-Informed Oncology Nursing in Canada: An Interpretive Descriptive Study.

BACKGROUND: Genomic technologies such as genetic testing and precision treatments are rapidly becoming routine in oncology care, and nurses play an increasingly important role in supporting the growing demands for genomics-informed healthcare. Policy infrastructure such as competencies, standards, scope of practice statements, and education and curriculum frameworks are urgently needed to guide these practice and education changes. PURPOSE: This study is part of a larger three-phase project to develop recommendations and catalyze action for genomics-informed oncology nursing education and practice for the Canadian Association of Nurses in Oncology and the Canadian Association of Schools of Nursing. This phase aimed to enhance understanding of policy needs and action drivers for genomics-informed oncology nursing education and practice through the perspectives of Canadian oncology nurses and patient partners. METHODS: Interpretive description methodology guided the study. Twenty semi-structured virtual interviews were conducted; 17 with oncology nurses in various domains of practice, and three with patient partner representatives. Data collection and analysis occurred concurrently. RESULTS: Our analysis identified three themes: 1) nurses and patients recognize that it is time for action, 2) nurses and patients see advantages to executing intentional, strategic, and collaborative policy development, and 3) leadership and advocacy are required to drive action. CONCLUSION: Nursing policy infrastructure is required to increase genomic literacy, support nurses in providing safe patient care, and establish clear roles, responsibilities, and accountabilities within the interdisciplinary team. Strong leadership and advocacy at the practice, organizational, and systems levels are vital to accelerating action.

Environmental Sustainability and Climate Change Content in Canadian Baccalaureate Nursing Programs.

BACKGROUND: This study analyzed publicly available resources related to environmental and climate change material available within the Canadian Bachelor of Nursing Program curricula. METHOD: This thematic review project contained two stages of data collection: (1) a comprehensive team-based review of Internet materials and (2) a digital survey of program faculties. RESULTS: Most content reviewed included references to climate change. According to survey responses from program directors (n = 12), barriers to integrating climate change content included lack of institutional support, the perception that content was not important in undergraduate curriculum, a conviction that the material would be more appropriate for public health, and an overall lack of understanding of the topic by course authors. CONCLUSION: With increasing emphasis on the importance of geopolitical health and climate change to many facets of nursing practice, nurse educators require support from colleagues and postsecondary institutions to incorporate this material into undergraduate nursing curricula. [J Nurs Educ. 2024;63(4):212-217.].

Integrating genomics into Canadian oncology nursing policy: Insights from a comparative policy analysis.

AIM: To learn from two jurisdictions with mature genomics-informed nursing policy infrastructure-the United States (US) and the United Kingdom (UK)-to inform policy development for genomics-informed oncology nursing practice and education in Canada. DESIGN: Comparative document and policy analysis drawing on the 3i + E framework. METHODS: We drew on the principles of a rapid review and identified academic literature, grey literature and nursing policy documents through a systematic search of two databases, a website search of national genomics nursing and oncology nursing organizations in the US and UK, and recommendations from subject matter experts on an international advisory committee. A total of 94 documents informed our analysis. RESULTS: We found several types of policy documents guiding genomics-informed nursing practice and education in the US and UK. These included position statements, policy advocacy briefs, competencies, scope and standards of practice and education and curriculum frameworks. Examples of drivers that influenced policy development included nurses' values in aligning with evidence and meeting public expectations, strong nurse leaders, policy networks and shifting healthcare and policy landscapes. CONCLUSION: Our analysis of nursing policy infrastructure in the US and UK provides a framework to guide policy recommendations to accelerate the integration of genomics into Canadian oncology nursing practice and education. IMPLICATIONS FOR THE PROFESSION: Findings can assist Canadian oncology nurses in developing nursing policy infrastructure that supports full participation in safe and equitable genomics-informed oncology nursing practice and education within an interprofessional context. IMPACT: This study informs Canadian policy development for genomics-informed oncology nursing education and practice. The experiences of other countries demonstrate that change is incremental, and investment from strong advocates and collaborators can accelerate the integration of genomics into nursing. Though this research focuses on oncology nursing, it may also inform other nursing practice contexts influenced by genomics.

Strategies to Mitigate Age-Related Bias in Machine Learning: Scoping Review.

BACKGROUND: Research suggests that digital ageism, that is, age-related bias, is present in the development and deployment of machine learning (ML) models. Despite the recognition of the importance of this problem, there is a lack of research that specifically examines the strategies used to mitigate age-related bias in ML models and the effectiveness of these strategies. OBJECTIVE: To address this gap, we conducted a scoping review of mitigation strategies to reduce age-related bias in ML. METHODS: We followed a scoping review methodology framework developed by Arksey and O'Malley. The search was developed in conjunction with an information specialist and conducted in 6 electronic databases (IEEE Xplore, Scopus, Web of Science, CINAHL, EMBASE, and the ACM digital library), as well as 2 additional gray literature databases (OpenGrey and Grey Literature Report). RESULTS: We identified 8 publications that attempted to mitigate age-related bias in ML approaches. Age-related bias was introduced primarily due to a lack of representation of older adults in the data. Efforts to mitigate bias were categorized into one of three approaches: (1) creating a more balanced data set, (2) augmenting and supplementing their data, and (3) modifying the algorithm directly to achieve a more balanced result. CONCLUSIONS: Identifying and mitigating related biases in ML models is critical to fostering fairness, equity, inclusion, and social benefits. Our analysis underscores the ongoing need for rigorous research and the development of effective mitigation approaches to address digital ageism, ensuring that ML systems are used in a way that upholds the interests of all individuals. TRIAL REGISTRATION: Open Science Framework AMG5P; https://osf.io/amg5p.

Design, delivery and effectiveness of health practitioner regulation systems: an integrative review.

BACKGROUND: Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions. METHODS: We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework. FINDINGS: This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures-processes-outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners. CONCLUSION: We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.

Workplace Violence Against Nurses in Canada: A Legal Analysis.

Workplace violence against nurses is a significant global occupational health problem, with incidents of violence increasing in frequency since the COVID-19 pandemic began. In this article, we provide a review of recent legislative amendments meant to bolster workplace safety in health care in Canada, analyze legal cases where nurses were the victims of violence, and discuss what these legal reforms and decisions reveal about how nurses' work is treated within the Canadian legal system. Under criminal law, the limited number of cases we could find with oral or written sentencing decisions show that, historically, the fact a victim was a nurse was not always considered an aggravating factor on sentencing. Recent legislative amendments make this a specified aggravating factor and it is important to track the impact of these amendments when judges exercise their discretion in sentencing. Under employment law, it appears that, despite the government's efforts to increase the deterrence factor under legislation with significantly increased fines for employers who fail to protect their employees from injury, courts remain reluctant to impose such sanctions. In these cases, it is also important to track the impact of harsher penalties. We conclude that combating the widespread normalization of workplace violence in health care, and specifically against nurses, is acutely needed to help ensure that these ongoing legal reforms aimed at improving the safety of health workers are effective.

Measuring negative emotional responses to climate change among young people in survey research: A systematic review.

BACKGROUND: Climate change is a threat to the mental and emotional wellbeing of all humans, but young people are particularly vulnerable. Emerging evidence has found that young people's awareness of climate change and the danger it poses to the planet can lead to negative emotions. To increase our understanding about this, survey instruments are needed that measure the negative emotions young people experience about climate change. RESEARCH QUESTIONS: (1) What survey instruments are used to measure negative emotional responses to climate change in young people? (2) Do survey instruments measuring young people's negative emotional responses to climate change have evidence of reliability and validity? (3) What factors are associated with young people's negative emotional responses to climate change? METHODS: A systematic review was conducted by searching seven academic databases on November 30, 2021, with an update on March 31, 2022. The search strategy was structured to capture three elements through various keywords and search terms: (1) negative emotions, (2) climate change, and (3) surveys. RESULTS: A total of 43 manuscripts met the study inclusion criteria. Among the 43 manuscripts, 28% focused specifically on young people, while the other studies included young people in the sample but did not focus exclusively on this population. The number of studies using surveys to examine negative emotional responses to climate change among young people has increased substantially since 2020. Survey instruments that examined worry or concern about climate change were the most common. CONCLUSION: Despite growing interest in climate change emotions among young people, there is a lack of research on the validity of measures of such emotions. Further efforts to develop survey instruments geared to operationalize the emotions that young people are experiencing in relation to climate change are needed.

An Examination of Self-Employed Nursing Regulation in Three Canadian Provinces.

The COVID-19 pandemic and its related stresses such as short-staffing, heavy workloads, and burnout are prompting nurses to re-consider institutional employment, bringing a renewed interest in self-employed nursing and its regulation. There is limited research on the regulation of self-employed nursing roles, and published work focuses on nurses' experiences rather than on regulatory practices themselves. This qualitative case study research aimed to examine the regulation of self-employed nurses by comparing the regulatory policies and processes of nursing regulatory bodies in Ontario, Alberta, and Saskatchewan. The findings demonstrated wide variation in the regulation of self-employed nurses across these jurisdictions. The article includes recommendations to clarify and harmonize the processes used to regulate self-employed nurses.

Regulating During Crisis: A Qualitative Comparative Case Study of Nursing Regulatory Responses to the COVID-19 Pandemic.

Background: The COVID-19 pandemic placed intense pressure on nursing regulatory bodies to ensure an adequate healthcare workforce while maintaining public safety. Purpose: Our objectives were to analyze regulatory bodies' responses during the pandemic, examine how nursing regulators conceptualize the public interest during a public health crisis, and explore the influence of a public health crisis on the balancing of regulatory principles. We aimed to develop a clearer understanding of regulating during a crisis by identifying themes within regulatory responses. Methods: We conducted a qualitative comparative case study examining the pandemic responses of eight nursing regulators in three Canadian provinces and three U.S. states. Data were collected from semi-structured interviews with 19 representatives of nursing regulatory bodies and 206 publicly available documents and analyzed thematically. Results: Five themes were constructed from the data: (1) risk-based responses to reduce regulatory burden; (2) agility and flexibility in regulatory pandemic responses; (3) working with stakeholders for a systems-based approach; (4) valuing consistency in regulatory approaches across jurisdictions; and (5) the pandemic as a catalyst for innovation. Specifically, we identified that the meaning of "public interest" in the context of high workforce demand was a key consideration for regulators. Conclusion: Our results demonstrate the intensity of effort involved in nursing regulatory responses and the significant contribution of nursing regulation to the healthcare system's pandemic response. Our results also indicate a shift in thinking around broader public interest issues, beyond the conduct and competence of individual nurses, to include pressing societal issues. Regulators are beginning to grapple with these longer-term issues and policy tensions.

Protecting the public interest while regulating health professionals providing virtual care: A scoping review.

Technology is transforming service delivery in many health professions, particularly with the rapid shift to virtual care during the COVID-19 pandemic. Health profession regulators must navigate legal and ethical complexities to facilitate virtual care while upholding their mandate to protect the public interest. The objectives of this scoping review were to examine how the public interest is protected when regulating health professionals who provide virtual care, discuss policy and practice implications of virtual care, and make recommendations for future research. We searched six multidisciplinary databases for academic literature published in English between January 2015 and May 2021. We also searched specific databases and websites for relevant grey literature. After screening, 59 academic articles and 18 grey literature sources were included for analysis. We identified five key findings: the public interest when regulating health professionals providing virtual care was only implicitly considered in most of the literature; when the public interest was discussed, the dimension of access was emphasized; criticism in the literature focused on social ideologies driving regulation that may inhibit more widespread use of virtual care; subnational licensure was viewed as a barrier; and the demand for virtual care during COVID-19 catalyzed licensure and scope of practice changes. Overall, virtual care introduces new areas of risk, potential harm, and inequity that health profession regulators need to address as technology continues to evolve. Regulators have an essential role in providing clear standards and guidelines around virtual care, including what is required for competent practice. There are indications that the public interest concept is evolving in relation to virtual care as regulators continue to balance public safety, equitable access to services, and economic competitiveness.

Protecting the public interest when regulating health professionals providing virtual care: a scoping review protocol.

BACKGROUND: Virtual care is transforming the nature of healthcare, particularly with the accelerated shift to telehealth and virtual care during the COVID-19 pandemic. Health profession regulators face intense pressures to safely facilitate this type of healthcare while upholding their legislative mandate to protect the public. Challenges for health profession regulators have included providing practice guidance for virtual care, changing entry-to-practice requirements to include digital competencies, facilitating interjurisdictional virtual care through licensure and liability insurance requirements, and adapting disciplinary procedures. This scoping review will examine the literature on how the public interest is protected when regulating health professionals providing virtual care. METHODS: This review will follow the Joanna Briggs Institute (JBI) scoping review methodology. Academic and grey literature will be retrieved from health sciences, social sciences, and legal databases using a comprehensive search strategy underpinned by Population-Concept-Context (PCC) inclusion criteria. Articles published in English since January 2015 will be considered for inclusion. Two reviewers will independently screen titles and abstracts and full-text sources against specific inclusion and exclusion criteria. Discrepancies will be resolved through discussion or by a third reviewer. One research team member will extract relevant data from the selected documents and a second will validate the extractions. DISCUSSION: Results will be presented in a descriptive synthesis that highlights implications for regulatory policy and professional practice, as well as study limitations and knowledge gaps that warrant further research. Given the rapid expansion of virtual care provision by regulated health professionals in response to the COVID-19 pandemic, mapping the literature on how the public interest is protected in this rapidly evolving digital health sector may help inform future regulatory reform and innovation. SYSTEMATIC REVIEW REGISTRATION: This protocol is registered with the Open Science Framework ( https://doi.org/10.17605/OSF.IO/BD2ZX ).

The impact of COVID-19 on the mental health and substance use health (MHSUH) workforce in Canada: a mixed methods study.

BACKGROUND: The increased need for mental health and substance use health (MHSUH) services during the COVID-19 pandemic underscores the need to better understand workforce capacity. This study aimed to examine the pandemic's impact on the capacity of MHSUH service providers and to understand reasons contributing to changes in availability or ability to provide services. METHODS: We conducted a mixed method study including a pan-Canadian survey of 2177 providers of MHSUH services and semi-structured interviews with 13 key informants. Survey participants answered questions about how the pandemic had changed their capacity to provide services, reasons for changes in capacity, and how their practice had during the pandemic. Thematic analysis of key informant interviews was conducted to gain a deeper understanding of the impact of the pandemic on the MHSUH workforce. RESULTS: Analyses of the survey data indicated that the pandemic has had diverse effects on the capacity of MHSUH workers to provide services: 43% indicated decreased, 24% indicated no change, and 33% indicated increased capacity. Logistic regression analyses showed that privately funded participants had 3.2 times greater odds of increased capacity (B = 1.17, p < 0.001), and participants receiving funding from a mix of public and private sources had 2.4 times greater odds of increased capacity (B = 0.88, p < 0.001) compared to publicly funded participants. Top reasons for decreases included lockdown measures and clients lacking access or comfort with virtual care. Top reasons for increases included using virtual care and more people having problems relevant to the participant's skills. Three themes were constructed from thematic analysis of key informant interviews: the differential impact of public health measures, long-term effects of pandemic work conditions, and critical gaps in MHSUH workforce data. CONCLUSIONS: The COVID-19 pandemic has had a substantial impact on the capacity of the MHSUH workforce to provide services. Findings indicate the importance of increasing and harmonizing funding for MHSUH services across the public and private sectors, developing standardized datasets describing the MHSUH workforce, and prioritizing equity across the spectrum of MHSUH services.

Regulating for-profit virtual care in Canada: Implications for medical profession regulators and policy-makers.

For-profit virtual medical care has been expanding rapidly in Canada, creating new societal and practical challenges requiring policy and regulatory reform. We mapped the current state of regulatory policy across 10 Canadian provinces by analyzing practice standards and guidelines for virtual care from medical profession regulators. Through a comparative framework, we assessed the extent to which virtual practice policies addressed issues around mobility and licensure, equitable access, privacy, complaints, and continuity of care. We also compared these regulatory documents to the model standards from the Canadian medical regulatory consortium and considered implications for practicing in for-profit virtual environments. We found considerable variation across provincial regulatory bodies, with most existing frameworks not adequately addressing equity, access, and practitioner competency and not providing flexible, nuanced, or risk-based approaches to virtual care provision. As we compared jurisdictions, we identified gaps and leading practices to inform recommendations for professional regulators and policy-makers.

Regulating in the public interest: Lessons learned during the COVID-19 pandemic.

This article has three aims. First, to reflect on how conceptualizations of the public interest may have shifted due to COVID-19. Second, to focus on the implications of regulatory responses for the health workforce and corresponding lessons as health leaders and systems transition from pandemic response to pandemic recovery. Third, to identify how these lessons lead to potential directions for future research, connecting regulation in a whole-of-systems approach to health system safety and health workforce capacity and sustainability. Pandemic regulatory responses highlighted both strengths and limitations of regulatory structures and frameworks. The COVID-19 pandemic may have introduced new considerations around regulating in the public interest, particularly as the impact of regulatory responses on the health workforce continues to be examined. Clearly articulating practitioner practice parameters, reducing barriers to practice, and working collaboratively with stakeholders were primary aspects of regulators' pandemic responses that impacted the health workforce.

Out from the shadows: What health leaders should do to advance the mental health and substance use health workforce.

The Mental Health and Substance Use Health (MHSUH) impacts of the COVID-19 pandemic are proving to be significant, complex, and long-lasting. The MHSUH workforce-including psychologists, social workers, psychotherapists, addiction counsellors, and peer support workers as well as psychiatrists, family physicians, and nurses-is the backbone of the response. As health leaders consider how to address long-standing and emerging health workforce challenges, there is an opportunity to move the MHSUH workforce out from the shadows through full inclusion in health workforce planning in Canada. After first examining the roots and consequences of the long-standing exclusion of the MHSUH workforce, this paper presents findings from a recent study showing how the pandemic has compounded MHSUH workforce capacity issues. Priorities for MHSUH workforce action by health leaders include closing regulation gaps, engaging the public and private sectors in coordinated planning, and accelerating data collection through a central health workforce registry.

Measuring negative emotional responses to climate change among young people in survey research: a systematic review protocol.

INTRODUCTION: Many young people report experiencing negative emotional responses to their awareness of climate change and the threats it poses to their future. With that, an increasing number of survey instruments have been developed to examine young people's negative emotional responses to their awareness of climate change. This report describes a protocol for a systematic review that aims to identify, synthesise and critically appraise how negative emotional responses to climate change among young people have been measured in survey research. The research questions addressed in this review are: (1) How has negative emotional responses to climate change been defined and measured among young people? (2) How do survey instruments measuring young people's negative emotional responses to climate change vary in terms of reliability and validity? (3) What factors are associated with negative emotional responses to climate change among young people? METHODS AND ANALYSIS: Seven academic databases (CINAHL, ERIC, MEDLINE, PsycINFO, Web of Science, Scopus, and Environment Complete) will be searched to retrieve studies published between 1 January 2006 and 31 March 2022 and published in English. Studies including survey instruments that measure negative emotional responses among young people (aged 10-24 years) will be eligible for inclusion. Targeted journals will be hand-searched. This review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for systematic reviews. The methodological quality, in terms of reliability and validity, of the included studies will be assessed using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist for risk of bias of patient-reported outcome measures. To rate the quality of the instruments, we will use a modified Grading of Recommendations, Assessment, Development and Evaluations technique defined by the COSMIN guidelines. ETHICS AND DISSEMINATION: Ethical approval is not applicable for this study. We will disseminate the findings through publication in peer-reviewed journals and presentations. PROSPERO REGISTRATION NUMBER: CRD42022295733.

Pan-Canadian Registration and Licensure of Health Professionals: A Path Forward Emerging from a Best Brains Exchange Policy Dialogue.

The regulation of health professions differs across Canadian provinces and territories, often resulting in an unstandardized approach to licensure and registration. These siloed regulatory frameworks hinder health workforce mobility and virtual care - with implications for patient safety and equitable access to healthcare - and pose a barrier to integrated health workforce planning. The authors report on a Best Brains Exchange policy dialogue held in October 2019 on pan-Canadian registration and licensure (CIHR 2019), highlighting leading practices and presenting a potential path forward through pan-Canadian regulatory mechanisms. Situating these findings within the context of the COVID-19 pandemic demonstrates the urgency for governments to move on this reform.