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Overall, this paper contributes to our substantive understanding of how immigration and HHR policies do or do not intersect to shape the economic integration of refugee healthcare professionals in the UK and Canada in distinct ways. Such cross-national comparisons are lacking in the current literature. Conceptually, broadening the analytical concept of "employability" contributes to a more comprehensive understanding of not merely the initial but rather the fundamental and complex challenges impeding the successful economic integration of refugee healthcare professionals and, indeed, immigrant refugees more generally.
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Of all our cultural policy tools, the regulation of Canadian content has had the most significant impact. The regulatory framework for the broadcasting industry has proven to be extremely effective in supporting Canadian cultural industries while respecting foreign interests. The industry attributes the increase in viewing of Canadian English-speaking television programs and the strength of Canada's sound recording industry to the Canadian content rules.
Fortunately, significant work is happening on the research, management and policy fronts. Researchers have worked hard to bring together data on effective teamwork in healthcare and to extract key messages for management and policy. This includes teams here in Canada (Lemieux-Charles and McGuire 2006) and abroad (Baker et al. 2005a). System managers and policy makers are also making significant attempts to transform healthcare workplaces into effective team-based environments. This includes efforts on the national level, such as the great strides made by the 2004 Health Canada Initiative on Interprofessional Education for Collaborative Patient-Centred Practice (IECPCP), which developed an evolving framework to help accomplish the task; as well as the Enhancing Interdisciplinary Collaboration in Primary Healthcare Initiative, funded by Health Canada's Primary Healthcare Transition Fund. In addition, a major contribution has come from the health human resource sector studies funded by the federal government.
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In this paper, we examine barriers to the integration of refugee doctors and nurses in Canada and the United Kingdom. Key obstacles impeding the integration of internationally trained health professionals are well documented, but less attention has been paid to the integration of refugee health professionals, particularly in Canada. Based on documentary analysis and semi-structured interviews with 46 Canadian and 34 UK stakeholders, our research shows that there are no simple solutions to mitigating the core obstacles that prohibit the professional integration of refugee doctors and nurses into host countries. The targeted approach adopted in parts of the UK does provide some promising practices for Canada, which has yet to develop policies and initiatives specific to health professional refugees. This study is intended to contribute to our understanding of how immigration and health human resources policies have shaped the economic integration of refugee healthcare professionals in the UK and Canada in distinct ways.
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Technological developments have had and will continue to have a profound impact on culture. The very notion of "cultural industries" derives primarily from the influence of technology, i.e. printed books/magazines, film, sound recordings, radio, televisions and multimedia. Advances in recent years have transformed the way Canadians access cultural product, and there are two broad reactions to these developments. Some people believe these changes have made Canada's cultural policies obsolete, and that it will, in future, be almost impossible to regulate the inflow and transmission of electronic content. Others, however, have said technological change has made Canada's cultural policies even more essential, and have emphasized that technological advances have in the past been accommodated in Canadian cultural policies and measures, and can be in the future.
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The empirical evidence from high-risk work environments tells us that collaboration and teamwork is a way to produce high-quality results. In the health workplace, the evidence for inter-professional coordination and effective teamwork continues to grow. One of the most critical tasks facing researchers, managers, policy makers and clinicians will be to work together to create, share and use all forms of evidence, including methods and techniques for effective and ineffective implementation. The path toward effective teamwork in Canadian healthcare will probably be bumpy and windy, but it is one that all stakeholders, particularly patients, are likely to demand both more frequently and vocally.