A framework of operating models for interdisciplinary research programs in clinical service organizations is presented, consisting of a "clinician-researcher" skill development model, a program evaluation model, a researcher-led knowledge generation model, and a knowledge conduit model. Together, these models comprise a tailored, collaborative approach to enhancing research-informed practice in community-based clinical service organizations. The models place different degrees of emphasis on the development of research-related skills in practitioners, the generation of knowledge tailored to clinical practice, and knowledge sharing. The nature, philosophical basis, roles of research staff members, outputs and impacts, and strengths and limitations of each model are described, in the context of a long-standing, interdisciplinary research program in a children's rehabilitation service organization. The use of the model framework as a tool for the design of interdisciplinary, community-based research programs is discussed.
Numerous recommendations on the initial evaluation and treatment of the head injured patient have been proposed over the last several years. Most assume there is readily available access to computed tomography and neurosurgical specialists. Many clinicians in Alaska must evaluate and begin treatment of head injured patients in circumstances quite different from this. Vast distances, severe weather and limited medical evacuation capability are factors that come into play while caring for these patients. The current medicolegal climate also contributes to clinician anxiety over missing rare but potentially serious injuries. These guidelines developed by Alaska clinicians from multiple specialties are meant to assist clinicians dealing with this very common problem and represent a reasonable approach to these patients in remote and rural Alaska.
