Literature Collection

Professionalism in any field requires keeping pace with change, and nowhere is it more true than medicine. Knowledge flow has changed dramatically since today's accreditation standards were developed, and change continues more rapidly than ever. It's time for a fresh look at how best to achieve care in this altered environment, where valid knowledge may come from the patient as well as from clinician resources: a sociological change driven by technological change. The power structure of the clinical relationship is inevitably altered as constraints on patient knowledge are loosened by the internet, apps, and devices, undermining a paradigm of patients as uninformed recipients of care based on a one-way flow of wisdom from providers. Case after case is presented showing that patients today have generated undeniable value, violating the expectations and assumed best practices of the old model. To understand this sociological (yet scientific) change, this article reviews the role of paradigms in the history of sciences as described in Thomas Kuhn's landmark book The Structure of Scientific Revolutions and describes how these anomalous patient stories force the conclusion that the traditional paradigm of patients is no longer supportable and a new paradigm is needed. This in turn means our standards of professionalism and appropriate care must be updated, lest we fail to achieve best possible care in our increasingly overburdened system. Our new standard must be to teach clinicians to recognize, welcome, and work with empowered "e-patients" in the new model of participatory medicine.

Peer Navigation in mental health follows the success of similar roles in community health since the 1960s, with early intervention found during the HIV crisis and into cancer care. This integrative review identified existing studies outlining peer support and, in particular, navigation in mental health services. Three databases (CINAHL, Scopus, and PsycINFO) were systematically searched in July 2025, along with grey literature and hand searching. A total of 15 papers met the inclusion criteria. Studies that were not mental health-focussed, such as populations with cancer, HIV, or addictions specific, were excluded. Studies that focussed on the consumer movement or the inclusion of mental health consumers in research were also excluded, as they did not have relevance to the contribution of peer navigation roles to clinical mental health service delivery. Studies primarily reported program effects on continuum of care outcomes. Four themes were identified from the literature: (1) Benefits for families, significant others, and organisational cultural gain; (2) Being accountable to peers offers reciprocal gain; (3) Being understood as you navigate the system; and (4) A need for role clarity even when goals and values differ. Further research is required to capture the role mental health peer navigators play in promoting quality of life, mental health, self-advocacy, and management in diverse settings and populations. Peer programs are complex social interventions. This paper fills a gap in evaluating detailed information about peer navigators, their activities, the quality of peer engagement, as well as employee and community support structures to improve quality and impact. If we are to truly embrace the person with lived experience in partnerships for care delivery, then an understanding of the emergent role and contribution of the peer navigator is required.