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When it was passed in 1938, the Fair Labor Standards Act (FLSA) sought to address the “evils” of underpay and overwork by establishing an hourly minimum wage and requiring premium overtime pay. However, today's low‐wage, hourly workers more often face underwork than overwork, as well as fluctuating, unstable schedules, neither of which is addressed by the FLSA. This paper presents and assesses the effectiveness of an alternative approach to wage and hour regulation, the “reporting pay” guarantee. We begin by examining the problem of work‐hour insecurity, particularly employers’ practice of sending workers home early from scheduled shifts. We then move to a detailed assessment of state laws that require reporting pay, as well as reporting pay guarantees in union contracts and private‐employer practices that attempt to address the problem of work‐hour insecurity. We conclude by considering paths for strengthening such protections in law.

Background Major trauma care is complex and requires individuals and teams to perform together in time critical, high-stakes situations. Scenario-based simulation is well established as a strategy for trauma teamwork improvement, but its role in the relational and cultural aspects of trauma care is less well understood. Relational coordination theory offers a framework through which we aimed to understand the impact of an established trauma simulation programme. Methods We studied simulation activities using a narrative survey of trauma providers from anaesthesia, emergency medicine, medical imaging, surgery, trauma service, intensive care, and pre-hospital providers at Gold Coast University Hospital, in conjunction with data from an ethnography. Data analysis was performed using a recursive approach—a simultaneous deductive approach using the relational coordination framework and an inductive analysis. Results Ninety-five of 480 (19.8%) staff completed free-text survey questions on simulation. Deductive analysis of data from these narrative survey results using the RC framework domains identified examples of shared goals, shared knowledge, communication and mutual respect. Two major themes from the inductive analysis—“Behaviour, process and system change” and “Culture and relationships”—aligned closely with findings from the RC analysis, with additional themes of “Personal and team learning” and the “Impact of the simulation experience” identified. Conclusions Our findings suggest that an established trauma simulation programme can have a profound impact on the relational aspects of care and the development of a collaborative culture, with perceived tangible impacts on teamwork behaviours and institutional systems and processes. The RC framework—shared knowledge, shared goals and mutual respect in the context of communication that is timely, accurate, frequent and problem-solving based—can provide a common language for simulation educators to design and debrief simulation exercises that aim to have a translational impact.

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