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 Creating the
Health Care Team
of the Future
A volume in the series The Culture and Politics of Health Care Work
Edited by Suzanne Gordon and Sioban Nelson
For a list of books in the series, visit our website at www.cornellpress.cornell.edu
 Creating the
Health Care Team
of the Future

The Toronto Model for

Interprofessional Education and Practice

Sioban Nelson, Maria Tassone,

and Brian D. Hodges

ILR Press
an imprint of
Cornell University Press

Ithaca and London

Copyright © 2014 Cornell University

All rights reserved. Except for brief quotations in a review,

this book, or parts thereof, must not be reproduced in any
form without permission in writing from the publisher. For
information, address Cornell University Press, Sage House,
512 East State Street, Ithaca, New York 14850.

First published 2014 by Cornell University Press

First printing, Cornell Paperbacks, 2014

Printed in the United States of America

Library of Congress Cataloging-in-Publication Data

Nelson, Sioban, author.

Creating the health care team of the future: the Toronto
Model for interprofessional education and practice / Sioban
Nelson, Maria Tassone, and Brian D. Hodges.
pages cm. -- (The culture and politics of health care work)
Includes bibliographical references and index.
ISBN 978-0-8014-5300-7 (cloth : alk. paper) --
ISBN 978-0-8014-7941-0 (pbk. : alk. paper)

1. Medicine--Study and teaching (Continuing education)--On-

tario--Toronto. 2. Health care teams--Training of--Ontario-
-Toronto. 3. Interprofessional relations--Study and teaching
(Continuing education)--Ontario--Toronto. I. Tassone, Maria,
1968- author. II. Hodges, Brian David, 1964- author. III. Title.

R845.N45 2014
610.9713’541--dc23 2013043153

Cornell University Press strives to use environmentally respon-

sible suppliers and materials to the fullest extent possible in the
publishing of its books. Such materials include vegetable-based,
low-VOC inks and acid-free papers that are recycled, totally
chlorine-free, or partly composed of nonwood fibers. For further
information, visit our website at www.cornellpress.cornell.edu.

Cloth printing 10 9 8 7 6 5 4 3 2 1
Paperback printing 10 9 8 7 6 5 4 3 2 1
 Contents

Acknowledgements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  VII

Introduction: Why a Toronto Model Workbook? . . . . . . . . . . . . . . . . . . . . . . . . . .  1

1. Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  13

Reflection Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

2. Structuring for Success . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  33

Reflection Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
4

3. Building the Curriculum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  47

Reflection Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

4. Creating a Strong Education–Practice Interface . . . . . . . . . . . . . . . . . . . . . . . .  81

Reflection Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 19

5. Thinking about Impact and Sustainability from the Start. . . . . . . . . . . . . . . .  121

Reflection Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132

Notes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  133

Further Reading: S elect Toronto Scholarship on IPE/C. . . . . . . . . . . . . . . . . . .137

 VII

Acknowledgements

T
he authors for the workbook personify the university–
clinical partnership that is at the heart of the Toronto
Model, the University of Toronto’s approach to inter-
professional education and care (IPE/C); Sioban Nelson, Vice
Provost Academic Programs, University of Toronto; Maria
Tassone, Director of the Centre for Interprofessional Educa-
tion and Assistant Professor, Department of Physical Therapy,
Faculty of Medicine at the University of Toronto; and Senior
Director, Interprofessional Education & Care at the Univer-
sity Health Network; and Brian Hodges, Vice President Edu-
cation at the University Health Network, professor, Depart-
ment of Psychiatry at the University of Toronto, Scientist at
the Wilson Centre for Research in Education. Each of the af-
filiated teaching hospitals and health professional faculties of
the university–hospital partnership participated in the project
by furnishing case studies of their IPE/C activities and linking
the workbook team with educators, clinicians, students, and
patients who could provide their perspectives and enrich the
text with examples of creativity and innovation. The full list
of those who were part of this collaborative project and the
nature of their contribution is provided below.
The project was made possible through the support of the
Deans of the Health Sciences at the University of Toronto (U of
T) and the CEOs of the Toronto Academic Health Science Net-
work (TAHSN). Their collective support, both financial and
moral, was critical to garner the participation and enthusiasm
of faculty, clinicians, patients, and students in the project.
Many of those who began the work that evolved into the
Toronto Model from the 1990s have subsequently moved on,
but the work has been carried forward by new generations of
IPE/C focused teachers and practitioners. In this book we have
tried to honour the many hands and multiple ideas that creat-
VIII C r e at i n g t h e H e a lt h C a r e Te a m o f t h e F u t u r e

ed both the opportunity for IPE/C at U of T and the eventual

program. Writers Susan Pedwell and Dave Ross were engaged
in interviewing stakeholders to get the background and con-
text straight. Another writer, Sydney Goodfellow, interviewed
student groups and visited the student-run Interprofessional
Medical and Allied Groups for Improving Neighbourhood En-
vironments Clinic, better known as the IMAGINE Clinic. The
patient perspective was provided by individuals affiliated with
the Health Mentor Program and the ehpic™ program at the
U of T, and the Patient Educator Program at Holland Bloor-
view Kids Rehabilitation Hospital. Interview materials have
been integrated as narrative in each of the chapters, as well as
in pull-out quotes that reflect the diversity of stakeholders and
voices. Although the narrative has been woven together from
individual interviews, the IPE/C program and its growth and
success have been the result of thousands of people in Toronto,
a true team effort.
We are deeply indebted to former and current Centre for
IPE faculty and staff for all the assistance they have provided,
and in particular for the valuable insights and thoughtful edits
as the book evolved. We would like to thank Ivy Oandasan,
the key leader in interprofessional education when we began
on this road. Ivy has generously provided detailed feedback on
the manuscript and offered suggestions that have enhanced it
greatly. Dave Ross was the project officer, and he did a fan-
tastic job holding the thousands of pieces together. Sofia Mar-
timianakis and Alexandra Harris compiled the annotated
bibliography, as well as assisted in pulling together the final
manuscript. Gil Martinez was enormously helpful in assisting
us to organize the material visually, adapting and developing
figures, and transforming the text to a workbook. Liz Ross
provided a careful edit of the manuscript prior to submission.
Suzanne Gordon has been a champion of this project from
the start. The book was entirely her idea. She read the draft
manuscript thoroughly and provided helpful, detailed feed-
back.
Our greatest thanks go to all the hundred or so individuals
who generously provided written material, personal recollec-
tions, and information for this project. So many people have
worked tirelessly to develop a new way of practice and to sup-
port the next generation of health professionals to function as
collaborative team members who can work effectively to meet
the needs of patients and families. It has been a great privilege
for the editors to tell their collective story.
Case studies were provided by partners from across the To-
ronto Academic Health Science Network. Ruth Barker of Sunny-
brook Health Sciences Centre contributed “A Story of Energy
 Acknowledgements IX

and Enthusiasm—Interprofessional Education at Sunnybrook

Health Sciences Centre.” Faith Boutcher of Baycrest provided
“The Centre for Learning, Research and Innovation.” Dale
Kuehl from the Centre for Addiction and Mental Health provid-
ed “Transforming the Lives of People with Mental Health Prob-
lems.” Paula Rowland of Toronto East General Hospital con-
tributed information on partnership councils. Andrea Cameron
wrote “Teamwork—Your Future in Interprofessional Health
Care” in the Faculty of Pharmacy. A study on the “Dying and
Death Seminar” from the Faculty of Social Work was provided
by Michele Chaban. Bonnie Fleming-Carroll of the Hospital
for Sick Children profiled the “Partnered Learning Project: A
Study in Interprofessional Collaboration and Learning.” Patri-
cia Houston and Rob Fox from St. Michael’s Hospital wrote
on the Student Experience Committee and its role in IPE edu-
cation at the Li Ka Shing International Healthcare Education
Centre. Karen Gold from Women’s College Hospital contribut-
ed information on the Intimate Partner Abuse learning activity,
and worked with Mandy Lowe of the Centre for IPE and Patti
McGillicuddy from the University Health Network to contrib-
ute “Handle with Care: Do You Know How? – Using Read-
er’s Theatre to Surface Interprofessional Ethics, Values, and
Care Relationships.” Darlene Hubley from Holland Bloorview
Kids Rehabilitation Hospital provided “Exploring Patients and
Families in IPE Teaching and Learning.” St. Joseph’s Health
Centre and Elizabeth McLaney profiled their Interprofessional
Skills Fair. Rick Penciner and Susan Woollard of North York
General Hospital outlined their iPed faculty development pro-
gramming. Donna Romano from Mount Sinai Hospital pro-
filed Interprofessional Team Check-Ins on Inpatient Psychiatry.
Jay Rosenfield from the Faculty of Medicine addressed IPE in
the Transition to Clerkship and Residency learning activities.
Dr. Gajanan Kulkarni from the Faculty of Dentistry provided
“Infant and Child Oral Health Promotion: A New Dentistry-
Led Interprofessional Education Initiative.” Finally, Tracy
Paulenko contributed information on the creation of IPE Struc-
tured Placements at Toronto Rehab, now part of the University
Health Network.
Interviews were conducted with the following individuals:
from Baycrest, Jennifer Reguindin and Karima Velji; from the
Centre for Addiction and Mental Health, Susan Morris, Ivan
Silver, and Rani Srivastava; from the Centre for IPE, Maria
Tassone, Mandy Lowe, Sylvia Langlois, Dante Morra, Ivy
Oandasan, Lynne Sinclair, and Susan Wagner; from the Fac-
ulty of Dentistry, Daniel Haas; from Holland Bloorview Kids
Rehabilitation Hospital, Golda Milo-Manson, Kathryn Par-
ker, Darlene Hubley, and Crystal Chin; from the student-run
X C r e at i n g t h e H e a lt h C a r e Te a m o f t h e F u t u r e

IMAGINE clinic, Yick Kan Cheung, Enoch Ng, Michael

Bonores, and Mahwesh Saddiqi; from the Interprofessional
Healthcare Students’ Association IPHSA, Nikki Fischer, Kas-
par Ng, and Elisa Simpson; from KPMG Global Centre of Ex-
cellence for Health, Mark Rochon; from the Faculty of Medi-
cine at the University of Toronto, Catharine Whiteside, Sarita
Verma, Salvatore Spadafora, and Jay Rosenfield; from Mount
Sinai Hospital, Donna Romano and Virginia Fernandes; from
the Faculty of Nursing at the University of Toronto, Maureen
Barry, Sioban Nelson, Freida Chavez, and Judy Watt-Watson;
from the Faculty of Pharmacy, Henry Mann, Andrea Cam-
eron, and Wayne Hindmarsh; from the Faculty of Social Work,
Faye Mishna and Michele Chaban; from Sunnybrook Health
Sciences Centre, Joshua Tepper; from the University Health
Network, Brian Hodges, Mandy Lowe, Patti McGillicuddy,
and Emily Lap Sum Musing; from St. Michael’s Hospital, Pa-
tricia Houston and Rob Fox; from the Hospital for Sick Chil-
dren, Bonnie Fleming-Carroll; from St. Joseph’s Health Cen-
tre, Elizabeth McLaney; and from Women’s College Hospital,
Karen Gold. We are also grateful for the interviews held with
our Patient Mentors, who have chosen to remain anonymous.
 Creating the
Health Care Team
of the Future
 Introduction

Why a Toronto Model

Workbook?

I
n the spring of 2012, when a group of University of Toron-
to Centre for Interprofessional Education faculty finished
up a workshop at Indiana University, they got a big surprise:
the forty participants simultaneously rose to their feet and
applauded. The senior academic leaders in medicine and nurs-
ing present at the workshop were clapping excitedly about the
interprofessional education (IPE) training program they had
just completed.
What evoked a standing ovation from an audience that day
in Indiana? A small group of dedicated IPE proponents had
successfully convinced the University of Toronto’s health fac-
ulties and teaching hospitals that to best serve the needs of
complex patients, better promote health, improve quality, and
increase patient safety, they needed to adopt a new model of
education and practice—interprofessional education and care
(IPE/C). The audience response was also inspired by the will-
ingness of the Toronto team to share not only their successes
but their frustrations, mistakes, wrong turns, and solutions
to the vexing problems that many of those struggling to es-
tablish IPE programs share. This response also reflected the
audience’s desire to respond to the problems of patient safety,
job stress and caregiver burnout, and escalating health care
costs that have been highlighted in countless reports over the
past two decades.
In 2000, the Institute of Medicine’s landmark report To Err
Is Human1 launched the contemporary patient safety move-
ment with its clarion call to the health care systems all over
the globe to act to prevent the errors that kill over 100,000
patients a year and harm many thousands more in the United
States alone. Ten years later, in 2010, the World Health Or-
ganization’s (WHO) “Framework for Action on Interprofes-
2 C r e at i n g t h e H e a lt h C a r e Te a m o f t h e F u t u r e

sional Education and Collaborative Practice”2 was released,

as was the Lancet Commission report “Health Professionals
for a New Century: Transforming Education to Strengthen
Health Systems in an Interdependent World.”3 In fact, over
the past decade or more, studies have documented that, far
from improving, in countries such as the United States and
Canada, there has been little progress in preventing patient
deaths and harm. Original calculations such as those done by
the Institute of Medicine in 2000 are now considered to have
been dramatic underestimations of the harm done to patients
in health care institutions around the world.
Although the complexity of today’s high-tech health care
systems is often used as a rationalization for the maintenance
of the status quo, all these groundbreaking reports argue
that team-based, or interprofessional, care is a key strategy
to move our current underperforming health care systems
toward a more safe, efficient, integrated, and cost-effective
model. Contemporary health care institutions do indeed have
a bewildering number of players. Despite this, the responsibil-
ity for ensuring that patients receive the right care at the right
time from the right providers relies on a few basic principles:

1. Practitioners need to understand they are part of a

diverse team.
2. Practitioners must communicate effectively with the
patient and family, as well as with other members of
their team.
3. Practitioners need to know what other team members
do to limit duplication and prevent gaps in care.
4. Practitioners need to know how to work together to
optimize care so that the patient journey from inpatient
care to home care, or from primary care to the special-
ist clinic is experienced as seamless.

None of this can happen if there is no education in team-

work from the very beginning of the health care professional’s
educational journey—in a health professional school—and if
that education is not continued throughout their entire career
in whatever practice setting they work in. Since the traditional
education of the health care professional has most often taken
place in siloed programs that have little connection to one an-
other, and traditional care tends to involve parallel play in the
practice setting, it has become clear to those concerned with
patient safety and health care education that a profound cul-
ture change is required to produce interprofessional care and
optimal teamwork.4 Patient safety will improve only when we
change the way health professionals relate to each other, the
 Introduction | W h y a To r o n t o M o d e l W o r k b o o k ? 3

way they see themselves in relation to members of their own

profession and to colleagues from other disciplines. This kind
of change cannot be an abstract classroom exercise. It must
be learned, modeled, and reinforced. There must be organiz-
ational commitment and professional willingness to go down
this path of partnership between education and practice. But
first there must be an education program that starts learn-
ers on this road and brings them together with mentors who
are committed to new ways of delivering care and working
together.
All over the world, educators and practitioners are begin-
ning to recognize this and have embarked on efforts to set
up interprofessional education and practice programs. In re-
sponse to these influential calls for a new way of practice and
new models of education, health professional programs across
North America have begun to pilot programs that introduced
collaborative learning opportunities into their curricula. The
Josiah Macy Jr. Foundation has been a major supporter of
this movement, seeding educational initiatives across the
United States through their funding program and supporting
faculty development through their fellowship program. Ac-
creditation and certification agencies have likewise supported
this shift. In 2012, the Liaison Committee on Medical Edu-
cation (LCME) adopted a new accreditation standard (ED-
19-A) that will come into effect in 2015 for medical schools
in North America.5 This standard will require all medical
education programs in the United States to prepare students
to function collaboratively on health care teams that include
other health professionals. For their part, hospitals and other
health care settings are being similarly challenged to fulfill
their mandate to begin to practice in a more interprofessional
way and to conduct in-house education to teach clinicians and
other health care workers how to do so.
This transition of IPE from “nice to do” to “must do” has,
not surprisingly, been accompanied by an enormous upsurge
in interest in models of IPE/C from the many health profes-
sional schools struggling to respond to the new mandate to
include interprofessional education in their curricula, often
with little guidance or support. That is why we have written
this workbook.
Since 2000, the eleven health professional programs at the
University of Toronto and the forty-nine teaching hospitals
associated with them have developed an Interprofessional
Education and Care (IPE/C) program that begins in the first
year of a health professional student’s entry into his or her
program, continues through various educational activities
throughout their studies, and straddles the education/prac-
4 C r e at i n g t h e H e a lt h C a r e Te a m o f t h e F u t u r e

tice divide. Over the past decade, the university and teaching
hospital partners have been engaged in the co-development
and support of the IPE curriculum for learners. They are also
investing in the development of faculty and the ongoing train-
ing of staff to support and model collaborative practice and
team-based care. What we have come to think of as the “To-
ronto Model” is integrated across all sites and professions and
includes classroom, simulation, and practice education.
The Toronto Model has been developed through trial and
error over the past decade. But how did we move from a series
of abstract principles to an impressive array of concrete pro-
grams that span educational and practice institutions? This
is the question Maria Tassone, the director of the Centre for
Interprofessional Education, is always asked when she speaks
about the activities at Toronto in North America and around
the world (see Figure 2). This and other frequently asked ques-
tions (FAQs) that educators and practitioners all over the world
ask Tassone and others at the university are what inspired this
book and form its core. Everyone, it seems, wants to know:

•• How did you start?

•• How did you get everyone to participate?
•• How did you find common curriculum time?
•• How did you make it mandatory?
•• How did you find placements? How did you find faculty?
•• How do you continue to grow and sustain this work in
education and practice?

We decided to focus this book on these practical questions.

This is not to say our approach has been atheoretical or un-
scientific. However, we have found that presenting a lot of
theory does not help people struggling to figure out what to
teach, how to teach it, and how to begin to travel down the
challenging and meaningful road of changing both pedagogy
and practice.
What we have tried to do in this workbook is capture the
collective activity and creativity, and to relay the outcomes
and lessons learned. We do not wish to suggest that these
successes are the result of individual initiatives or that others
simply replicate what we have done; rather, we aim to share
lessons learned and show how this collective work has been
fundamental to the successes achieved thus far. Every school
or service provider will have its own cultural specifications
to which an IPE/C approach must be adapted. We can share
what our issues were and how we managed them.
This workbook is geared toward a broad audience of health
professional teachers (pre- and post licensure) charged with
 Introduction | W h y a To r o n t o M o d e l W o r k b o o k ? 5

revising curricula to include interprofessional components, as

well as to clinical faculty who are introducing IPE/C in their
clinical training programs and professional development activ-
ities. It also addresses those who are charged with enhancing
quality and patient safety—and even patient satisfaction—in
their institutions. It is drawn from the experiences of faculty,
clinical teachers, and health care practitioners across univer-
sity and practice settings and across all the health sciences.
What worked for us, as well as what did not, is at the core
of this text. As professional programs and service providers
struggle to both create and train teams of health professionals
that are willing and able to work together, and to raise the bar
with respect to service integration and better patient care, we
share how far we have come along this path. These lessons
may be helpful for those who are just setting out and wonder-
ing where to start. Or, if you have been building bridges and
getting things moving, but are not sure how to take the pro-
gram forward to build interprofessional approaches to care,
this book aims to help. “Scaling up” is a common challenge
in IPE/C; that is, how to move from innovative pilot studies
to systemwide change. At the University of Toronto we have
moved beyond the “thousand points of light” of innovations
to a formally mandated curriculum that has made IPE a core
component of what it means to be a health sciences student.
The journey is not over; the end is not even close. But along
the way we are learning about the power of process, collab-
oration, and collective vision. For the thousands of educators
and clinicians all over the world on a similar journey, we share
our efforts.
Through the case studies we present different kinds of cur-
ricula, teams, and clinical settings. We provide insights on
how to get started and the important role of champions in
cultural change. Some of these case studies are presented in
the narrative, while others are pull-out case studies, side col-
umns, and boxes. These design features are to facilitate the
“drop in, drop out” nature of the text. For those interested in
the theoretical and methodological aspects of IPE/C program
development, we have added a Further Reading section at the
end of the book, which provides detail on selected published
work that has been produced over the years by Toronto fac-
ulty. We would also direct readers to the key journal in the
field of IPE/C, the Journal of Interprofessional Care.
Over the years, the Centre for IPE has built an impressive
array of tools to assist the process of implementing IPE/C
into diverse environments and to build capacity through edu-
cate-the-educator approaches. In this workbook we provide
some of these basic tools and information. We also provide
6 C r e at i n g t h e H e a lt h C a r e Te a m o f t h e F u t u r e

QR Codes (matrix, or two-dimensional, barcode) in the mar-

gins for the reader to link directly with more extensive and
continually updated resources on the website.
These resources are much requested, heavily accessed from
our website, and disseminated through multiple workshops
and education programs offered around the world. But people
want more. The Centre for IPE is being constantly contacted
http://www.ipe. directly by those downloading the resource material who love
utoronto.ca the resources but are not sure how to apply them to their specif-
ic context, or even where to begin. This workbook responds
to this need by guiding the reader step-by-step through the
various aspects of program development and implementation.
The workbook provides an integrated framework through
which to decide what tools are appropriate for your program
and a guide for how to use them.
A workbook is not intended to be read sequentially or at
one sitting. The emphasis is on “how to,” and areas of interest
will vary both among readers and, over time, for individual
readers. Thus some of the descriptive material is intentional-
ly repetitive to demonstrate core principles and process issues
that must be dealt with in varying sites and contexts, with
different clinical populations and different constellations of
team members. The goal is to facilitate the reader’s ability to
work with the examples that are most relevant to their needs.
Finally, a note on evaluation of IPE/C and outcome data.
Interprofessional education is an emerging field, and we are
at the beginning stages of a mass movement. The University
of Toronto is a global leader in IPE/C and yet, even for us, the
full mandatory curriculum is barely four years old. While we
are constantly evaluating these programs, it is not yet possible
for us to state what outcomes they have produced at this stage
of development. That said, the current priority for Toronto
and other IPE programs around the world is to develop an
evaluative framework and build the data sets. It will come.
Right now we are on the cusp of having the critical mass ne-
cessary to generate robust data, and we expect to see very
different discussion around IPE/C over the next decade. What
we can say is that all around the world people are struggling
with the problem of how to bring large-scale paradigm-break-
ing change without the “evidence” usually required to justify
such change. We believe the program at Toronto is, in itself,
a major outcome. It has been implemented, is supported, and
has become a core mission for both the university and the
clinical setting—no small feat. This book provides an analysis
of what led to that outcome.
In the spirit of IPE/C, multiple voices are heard in this book.
Contributors range from undergraduate students to senior
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A LIST OF HEMIPTERA COLLECTED IN THE VICINITY
OF BELLAIRE, OHIO.

Herbert Osborn.

The following record of species represents the collections of

Hemiptera made during four days (Aug. 28, Sept. 1, 1900) at points
within five miles of Bellaire, all on the Ohio side of the river. Wooded
hillsides, valleys, creek bottoms and shore and island of the river
were worked during a part of each day and as the list includes one
hundred and forty-nine species, it is probably fairly representative
for the common species of the season.

HOMOPTERA.
Cicadidæ. Cicada tibicen L. One specimen found dead.
Membracidæ. Entilia sinuata Fab., Publilia concava Say, Ceresa
diceros Say, Ceresa bubalus Fab., Thelia bimaculata Fab., Acutalis
calva Say, Vanduzea arcuata Say.
Fulgoridæ. Scolops sulcipes Say, Scolops sp., Ormenis pruinosa
Say, O. septentrionalis Fab., Amphiscepa bivittata Say,
Bruchomorpha dorsata Fh., B. oculata Newmn., Issus? sp. Pissonotus
ater VanD., Stobera tricarinata Say, Stobera sp., Liburnia campestris
VanD., L. ornata Stal, Liburnia sp.
Cercopidæ. Lepyronia 4-angularis Say, Clastoptera obtusa Say, C.
proteus Fh., C. xanthocephala Germ.
 Bythoscopidæ. Macropsis apicalis O. & B., Agallia sanguinolenta
Prov., A. 4-punctata Prov., A. constricta VanD., A. novella Say,
Idiocerus pallidus Fh., I. snowi G. & B., I. verticis Say.
Tettigonidæ. Aulacizes irrorata Fab., Tettigonia bifida Say, T.
tripunctata Fh., T. gothica Sign., T. hartii Wdw. (mss), Diedrocephala
coccinea Forst., D. mollipes Say, Helochara communis Fh., Gypona
octolineata Say.
Jassidæ. Xestocephalus pulicarius VanD., X. tessellatus VanD.,
Platymetopius acutus Say, P. frontalis VanD., Deltocephalus sayi Fh.,
D. sylvestris O. & B., D. apicatus Osb., D. weedi VanD., D. obtectus
O. & B., D. inimicus Say, D. flavicosta Stal, D. nigrifrons Forbes,
Scaphoideus immistus Say, S. auronitens Prov., S. scalaris VanD.,
Athysanus curtisii Fh., A. (Limotettix) exitiosa Uhl., Athysanella
acuticauda Bak., Lonatura catalina O. & B., Eutettix seminudus Say,
Phlepsius irroratus Say, P. decorus O. & B., Thamnotettix clitellarius
Say, Chlorotettix unicolor Fh., C. galbanata VanD., Jassus olitorius
Say, Cicadula 6-notata Fall., C. punctifrons Fall., Gnathodus
punctatus Thunb., G. abdominalis VanD., Empoasca smaragdula Fall.,
E. obtusa trifasciata Gill., E. mali LeB., Dicraneura flavipennis Fab.,
Typhlocyba comes vitis Harr., T. comes basilaris Say, T. comes comes
Say, T. c. ziczac Walsh, T. obliqua Say, T. vulnerata Say, T. tricinta
Fh., T, trifascaita Say, T. querci bifasciata Gill., T. hartii Gill.
Aphididæ. Pemphigus populi transversus Riley, On Cottonwood.
Aleyrodidæ. Aleurodes sp. Abundant on Sycamore leaves.
Coccidæ. Chionaspis salicis Harr.

HETEROPTERA.
Cydnidæ. One specimen as yet undetermined.
Pentatomidæ. Podisus cynicus Say, Brochymena annulata Fab.,
Cosmopepla carnifex Fab., Euschistus fissilis Uhl., E. tristigma Say, E.
variolarius P. Beauv., Trichopepla semivittata Say, Thyanta custator
Fab.
 Coreidæ. Neides muticus Say, Jalysus spinosus Say, Corizus
lateralis Say, C. nigristernum Sign., C. bohemani Sign., (?) C.
noveboracensis Sign.
Lygaeidæ. Nysius thymi Wolff, N. angustatus Uhl., Orsillacis
producta Uhl., Ischnorhynchus didymus Zett., Blissus leucopterus
Say, Cymus angustatus Stal. Geocoris limbatus Stal, G. fuliginosus
Say, Myodocha serripes Oliv., Ligyrocoris sylvestris L., Ptochiomera
nodosa Say, Lygaeus kalmii Stal, L. turcicus Fab.
Capsidæ. Megalocoerea debilis Uh. (?), Miris affinis Reut.,
Compsocerocoris annulicornis Reut., Calocoris rapidus Say, Lygus
pratensis L., L. plagiatus Uhl., Poecyloscytus basalis Reut.,
Camptobrochis nebulosus Uhl., Eccritotarsus elegans Uhl., Hyaliodes
vitripennis Say. Episcopus ornatus Uh., Ilnacora stalii Reut.,
Pilophorus bifasciatus Fab, Malacocoris irroratus Say, Garganus
fusiformis Say, Halticus uhleri Giard, Styphrosoma stygica Say,
Neoborus laetus Uhl., Plagiognathus obscurus Uhl., Plagiognathus
sp., Agalliastes associatus, Uhl.
Acanthiidæ Triphleps insidiosus Say.
Tingitidæ. Corythuca ciliata Say.
Phymatidæ. Phymata fasciata Gray.
Nabidæ. Coriscus ferus L.
Reduviidæ. Sinea diadema Fab., Acholla multispionosa DeG.,
Diplodus luridus Stal.
Hygrotrechidæ. Hygrotrechus remigis Say, Stephania picta H. Schf.
Saldidæ. Salda interstitialis Say.
Corisidæ. Corisa alternata Say.
Of the above list nearly thirty have not been recorded for the state
hitherto and there are a few specimens which are as yet
undetermined.
ADDITIONS AND CORRECTIONS TO THE “ODONATA
OF OHIO.”

James S. Hine.

Since the publication of the Odonata of Ohio, there have been

several species of dragonflies added to the State list, and we have
had reasons to change our minds regarding the identity of two
species at least.
Enallagma Fischeri, Kellicott, is a synonym of Agrion antennatum,
Say, consequently the species will henceforth be known as
Enallagma antennatum, Say.
Our Gomphus lividus, Selys, is Gomphus sordidus, Selys, and
Gomphus externus, Selys, is Gomphus crassus, Hagen.
The following species have been added:
1. Lestes eurinus, Say, taken June 3, 1900, by E. B. Williamson in
Portage County. Numbers of both males and females of the species
were taken on Cedar Point, at Sandusky, July 10 of the present year.
2. Progomphus obscurus, Ramb., first taken at Ironton, June 1,
1899, by R. C. Osburn. The present year I took several specimens at
Vinton, June 10th.
3. Gomphus abbreviatus, Hagen, (?) was taken at Loudonville,
June 10, 1899, by J. B. Parker and R. C. Osburn. The species was
common at the same locality June 14, of the present year.
 4. Neurocordulia obsoleta, Say, has been taken at Cincinnati by
Chas. Dury and his associates for three consecutive seasons.
5. Neurocordulia yamaskanensis, Prov., was procured on
Rattlesnake Island in Lake Erie, June 28, 1900, by Prof. Osborn.
6. Nasiæschna pentacantha, Rambur, was taken near Kent, Ohio,
June 21, 1900. In company with R. C. Osburn we procured three
pairs of this species. Others were seen.
 DRAGONFLIES TAKEN IN A WEEK.

Raymond C. Osburn and James S. Hine.

During the week beginning June 17th, we collected insects and

fishes in the region of small lakes near Kent, Ohio. A list of the
Odonata taken during that week is interesting, as it shows the
richness of the Odonat fauna of north-eastern Ohio and also the
number of species of this group that may fly in a certain locality at
the same time.
 1. Calopteryx maculata, Beauv.
2. Calopteryx æquabilis, Say.
3. Hetærina americana, Fabr.
4. Lestes uncatus, Kirby.
5. Lestes rectangularis, Say.
6. Lestes vigilax, Hagen.
7. Lestes inequalis, Walsh.
8. Argia putrida, Hagen.
9. Agria violacea, Hagen.
10. Argia tibialis, Rambur.
11. Argia apicalis, Say.
12. Erythromma conditum, Hagen.
13. Nehalennia posita, Hagen.
14. Nehalennia irene, Hagen.
15. Amphiagrion saucium, Burm.
16. Enallagma traviatum, Selys.
17. Enallagma civile, Hagen.
18. Enallagma carunculatum, Morse.
19. Enallagma hageni, Walsh.
20. Enallagma geminatum, Kel.
21. Enallagma exsulans, Hagen.
22. Enallagma antennatum, Say.
23. Enallagma signatum, Hagen.
24. Enallagma pollutum, Hagen.
25. Ischnura verticalis, Say.
26. Ophiogomphus rupinsulensis, Walsh.
27. Gomphus dilatatus, Rambur.
28. Gomphus quadricolor, Walsh.
29. Gomphus fraternus, Say.
30. Gomphus furcifer, Hagen.
31. Gomphus spicatus, Selys.
32. Gomphus sordidus, Selys.
33. Gomphus exilis, Selys.
34. Dromogomphus spinosus, Selys.
35. Anax junius, Drury.
36. Basischna janata, Say.
 37. Epiæschna heros, Fab.
38. Æschna verticalis, Hagen.
39. Nasiæschna pentacantha, Rambur.
40. Macromia illinoiensis, Walsh.
41. Epicordulia princeps, Hagen.
42. Tetragoneuria cynosura, Say.
43. Tetragoneuria semiaqua, Burm.
44. Tramea lacerata, Hagen.
45. Libellula basalis, Say.
46. Libellula pulchella, Drury.
47. Libellula semifasciata, Burm.
48. Libellula exusta, Say.
49. Libellula incesta, Hagen.
50. Plathemis trimaculata, DeGeer.
51. Celithemis eponina, Drury.
52. Celithemis elisa, Hagen.
53. Celithemis fasciata, Kirby.
54. Leucorhinia intacta, Hagen.
55. Sympetrum rubicundulum, Say.
56. Perithemis domitia, Drury.
57. Mesothemis simplicicollis, Say.
58. Pachydiplax longipennis, Burm.

Number 2 was taken for the second time in the State. The species
was common along the Cuyahoga River, where both males and
females were found resting on foliage near the water’s edge or
flitting nervously from one resting place to another.
Number 27 is one of our rarer Gomphids. Only one specimen of
the species was taken.
Both male and female of 30 were taken. This is the first time the
female of this species has been taken in Ohio.
Number 39 was taken for the first time in Ohio. Three pairs of this
fine species were taken.
 Two years ago I took males of number 48 at Stewart’s Lake. The
species has not been taken in the State since until this year when
we took both males and females at the same lake.
Number 53 has been considered a very desirable species, but it
seems that it is a common form in the lake region near Kent. About
thirty specimens were procured.
 ADDITIONS TO THE OHIO FLORA.

The Fourth State Catalogue of Ohio Plants published in April,

1899, by Kellerman, contained 2025 species of Cormophytes. In the
first Annual Supplement, published April, 1900, 69 additions were
made. The following 22 additional species therefore bring the total
to 2116 plants growing without cultivation in the state. The numbers
correspond to the Fourth State Catalogue so that those who desire
can easily copy the additions and bring their catalogue up to date.
212a Bouteloua hirsuta Lag. Hairy Mesquite-grass. Ohio State
University Campus, Columbus. F. J. Tyler.
212b Bouteloua oligostachya (Nutt.) Torr. Mesquite-grass. Ohio
State University Campus, Columbus. Alice Dufour.
258a Bromus asper Murr. Hairy Brome-grass (London, Mrs. K. D.
Sharp, Coll., E. Monroe, Highland Co., W. A. Kellerman, Coll.) Alice
Dufour.
265b Bromus breviaristatus (Hook.) Buckl. Short-awned Chess.
Ashtabula, (W. A. Kellerman, Coll.) Alice Dufour.
472a Wolffia braziliensis Wedd. Brazil Wolffia. Sandusky Bay.
Abundant at times. R. F. Griggs.
538a Convallaria majalis L. Lily of the Valley. Abundantly escaped
in Cemetery, Worthington. R. F. Griggs.
619a Salix nigra x amygdaloides. A. D. Selby, 8th Report Academy
of Science, p. 22, and others.
629 Change S. fluviatilis Nutt, to S. interior Rowlee. Rowlee in Bull.
Torr. Bot. Club. 27: 247, 1900.
 629a Salix interior var. wheeleri Rowlee. Cedar Point, W. A.
Kellerman and R. F. Grigs.
636a Salix sericea x cordata. Ashtabula. (W. A. Kellerman Coll.) R.
F. Griggs.
637a Salix peliolaris var. graciles. Toledo. (J. A. Sanford, Coll.
1879.) R. F. Griggs.
638a Salix candida x cordata. Castalia, Erie County. R. F. Griggs.
864a Berberis aquilifolium. Pursh. (Mahonia aquilifolium Nutt.)
Seeding in Cemetery, Worthington. R. F. Griggs.
898b Diplotaxus muralis (L.) DC. Diplotaxus. Cleveland, Ohio. Wm.
Krebs.
963 Philadelphus inodorus L. Mt. Pleasant, Jefferson County. W. A.
Kellerman.
1039a Cratægus cordata (Mill.) Ait. Washington Thorn.
Steubenville, Ohio. H. N. Mertz.
1045a Cratægus multipes n. sp. (W. W. Ashe in Bulletin 175 N. C.
Experiment Station, August, 1900.) Ohio, E. E. Bogue, Coll.
1132a Dolichos lablab L. Hyacinth Bean. Escaped from cultivation
in several places in Columbus. Found growing on vacant lots,
surrounded by large weeds. John H. Schaffner.
1188a Rhus cotinus L. Escaped, Mt. Pleasant, Jefferson County. W.
A. Kellerman.
1219a Ampelopsis cordata Michx. Scioto County. Previously
reported for Ohio. W. A. Kellerman.
1255 Lechea minor L. Steubenville, Ohio. H. N. Mertz.
1487a Gilia coronopifolia Pers. Growing in a cemetery near
Madison, Lake County. Spreading slowly. F. J. Tyler.
1729 Euphorbia lathyris L. Pomeroy, Meigs County. W. A.
Kellerman.
 1919a Polymnia canadensis var. radiata Gray. Cedar Point. Very
abundant. R. F. Griggs.
1943a Helianthus maximiliani Schrad. Sandusky. A single plant
along railroad tracks. R. F. Griggs.
 COLLECTING AND PRESERVING MICROSCOPIC
PLANTS.

Small plants like Desmids, Diatoms, etc., may be preserved in

water, in homeopathic vials, provided a drop of carbolic acid is added
to each bottle of material. In this way they will keep for a long time
with very little change of color and contents.
J. H. S.
 Ohio State University

Six distinct and independent Colleges, each with a Dean and

Faculty of its own.
THIRTY SEVEN Agriculture, Arts, Law,
DEPARTMENTS.
THIRTY DISTINCT Engineering, Pharmacy,
COURSES.
Veterinary Medicine.
Superior facilities for education in Applied Science. Short or special
courses for mature students not candidates for degrees.
One hundred and twenty one instructors. Over thirteen hundred students.

FINEST GYMNASIUM IN THE WEST.

For further information address the President,
Dr. W. O. Thompson, State University, Columbus.

Ohio Forest Trees Identified by Leaves and Fruit.

By W. A. Kellerman, Ph. D., Ohio State University.
A neat pamphlet for every one who wishes to learn our native
forest trees. Keys simple. Description plain. Can learn the names of
the trees easily.
Price reduced from 25 cents to 10 cents.
The Fourth State Catalogue of Ohio
Also,
Plants.
 Bound copies at cost of binding, namely 20 cents.
Gives list of scientific and common names; distribution by counties.
Teachers and others will also be interested in Prof. Kellerman’s
Phyto-theca or Herbarium Portfolio, Practical Studies in Elementary
Botany, Elementary Botany with Spring Flora, all published by
Eldredge & Bro., Philadelphia, to whom apply.
For information or copies of Forest Trees and Catalogue or names
of plant specimens of your region address
W. A. Kellerman, Columbus, Ohio

American Entomological Co.

1040 DE KALB AVENUE, BROOKLYN, N. Y.
Lepidoptera Price List No. 2.—Price 5 cents (Refunded to Buyers)
Issued November 15th 1900.

Dealers of all kinds of Entomological Supplies

Manufacturers of the Original and Celebrated SCHMITT INSECT
BOXES.
Builders of INSECT CABINETS, ETC.

The Twentieth Century Text Books of Biology.

PLANT RELATIONS, 12mo, cloth $1.10
PLANT STRUCTURES, 12mo, cloth 1.20
PLANT STUDIES, 12mo, cloth 1.20
PLANTS, 12mo, cloth 1.80
 ANALYTICAL KEY TO PLANTS, 12mo, flexible .75
cloth
All by JOHN MERLE COULTER, A. M., Ph. D., Head of Dept. of Botany, University of
Chicago.

They are already the preferred texts, and the reasons will be
apparent on examination.

ANIMAL LIFE: A First Book of Zoology.

By DAVID S. JORDAN, M. S., M. D., Ph. D., LL. D., President of the
Leland Stanford Junior University, and VERNON L. KELLOGG, M.
S., Professor in Leland Stanford Junior University. 12mo. Cloth,
$1.20. Now ready.
Not a book for learning the classification, anatomy, and nomenclature of
animals, but to show how animals reached their present development, the
effects of environment, their place in Nature, their relations to one another
and to the human race. Designed for one-half year’s work in high schools.
Send for sample pages.

ANIMAL FORMS: A Second Book of Zoology.

By DAVID S. JORDAN, M. S., M. D., Ph. D., LL. D., and HAROLD
HEATH, Ph. D., Professor in Leland Stanford Junior University.
Ready in February, 1901.

D. APPLETON AND COMPANY, Publishers, New York,

Chicago, London.
 Recent Scientific Works
In Astronomy, Dr. Simon Newcomb’s new book, published
October, 1900; in Physics, the Johns Hopkins text of Professors
Rowland and Ames; also in Physics for second and third year
high school work, the text of Dr. Hoadley, of Swarthmore; in
Physiology, the text by Drs. Macy and Norris, based on the
Nervous System; also the High School Physiology indorsed by
the W. C. T. U., written by Dr. Hewes, of Harvard University; in
Geology, the Revised “Compend” of Dr. Le Conte, and the
two standard works of Dana,—The Manual for University
Work, and the New Text Book, revision and rewriting of Dr.
Rice, for fourth year high school work; in Chemistry, the
approved Storer and Lindsay, recommended for secondary
schools by the leading colleges; in Zoology, the Laboratory
Manual of Dr. Needham, of Cornell; and the Series “Scientific
Memoirs” edited by Dr. Ames, of Johns Hopkins. Nine volumes
ready.
The publishers cordially invite correspondence.

AMERICAN BOOK COMPANY, Cincinnati

Transcriber’s Notes:
Missing or obscured punctuation was corrected.
Typographical errors were silently corrected.
Inconsistent spelling and hyphenation were made
consistent only when a predominant form was found in
this book.
*** END OF THE PROJECT GUTENBERG EBOOK THE O. S. U.
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