Background: Simulation in healthcare lacks a dedicated framework and supporting taxonomy for instructional design (ID) to assist educators in creating appropriate simulation learning experiences. Aims: This article aims to fill the identified gap. It provides a conceptual framework for ID of healthcare simulation. Methods: The work is based on published literature and authors' experience with simulation-based education. Results: The framework for ID itself presents four progressive levels describing the educational intervention. Medium is the mode of delivery of instruction. Simulation modality is the broad description of the simulation experience and includes four modalities (computer-based simulation, simulated patient (SP), simulated clinical immersion, and procedural simulation) in addition to mixed, hybrid simulations. Instructional method describes the techniques used for learning. Presentation describes the detailed characteristics of the intervention. The choice of simulation as a learning medium is based on a matrix of simulation relating acuity (severity) to opportunity (frequency) of events, with a corresponding zone of simulation. An accompanying chart assists in the selection of appropriate media and simulation modalities based on learning outcomes. Conclusion: This framework should help educators incorporate simulation in their ID efforts. It also provides a taxonomy to streamline future research and ID efforts in simulation.

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This article addresses one of the most important unresolved issues of interprofessional education (IPE): assessment. Here we describe our process and experiences designing and operationalizing a toolkit of qualitative and quantitative IPE assessment instruments for online and face-to-face education programs developed concurrently in both English and French. The toolkit includes a) the quantitative W(e)Learn program evaluation survey, which aligns with the W(e)Learn framework, b) the quantitative Interprofessional Collaborative Competencies Attainment Survey (ICCAS), to self-assess competency development in collaborative practice using a post-post design, and c) qualitative team and learner contracts, with explanatory exemplars, that serve as both learning and assessment tools. These instruments are currently undergoing validation in hopes of a) increasing the likelihood that IPE experiences are planned and delivered effectively and b) increasing the justification and accountability of IPE experiences and practical outcomes. Although this validation process will continue for some time, the development of the IPE assessment tools is worthy of particular attention in order to guide further work in this field.French and English copies of the toolkit assessments can be downloaded from http://ennovativesolution.com/WeLearn/IPE-Instruments.html. Although these instruments were designed with interprofessional healthcare teams in mind, we feel they could readily be transferable to a variety of interdisciplinary tasks and settings, such as social work and human services education.Keywords: Interprofessional education; Healthcare; Toolkit; Survey; Learner contract Introduction Interprofessional education (IPE) entails engaging professionals to learn with, from, and about each other in order to work more effectively in teams. Although this article addresses interprofessional healthcare education, we feel the processes and products described can be applied to a variety of interdisciplinary tasks and settings, such as social work and human services education.Education and training can teach methods and approaches to increase clinical capacity for interprofessional care (IPC), optimize the use of staff expertise and skills, improve communication among healthcare professionals, and increase the efficiency of case management [1,2]. Researchers have argued that "by learning and working together in educational settings, healthcare professionals will be able to work more effectively with one another in occupational settings" [3]. Barr [4] proposed that IPE is fundamental to a more efficient and effective healthcare system and, ultimately, better patient care.

Background: Delirium is extremely common in dying patients, and appears to be a major threat to the family's moral experience of a good death in end-of-life care. Aim:To illustrate one of the ways in which hospice caregivers conceptualize end-of-life delirium, and the significance of this conceptualization for the relationships that they form with patients' families in the hospice setting. Design: Ethnography.Setting/participants: Ethnographic fieldwork was conducted at a nine-bed, freestanding residential hospice, located in a suburban community of eastern Canada. Data collection methods included 15 months of participant observation, 28 semi-structured audio-recorded interviews with hospice caregivers, and document analysis. Results:Hospice caregivers draw on a culturally established framework of normal dying to help families come to terms with clinical end-of-life phenomena, including delirium. By offering explanations about delirium as a natural feature of the dying process, hospice caregivers strive to protect for families the integrity of the good death ideal. Conclusions:Within hospice culture, there is usefulness to deemphasizing delirium as a pathological neuropsychiatric complication, in favour of acknowledging delirious changes as signs of normal dying. This has implications for how we understand the role of nurses and other caregivers with respect to delirium assessment and care, which to date has focused largely on practices of screening and management.