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Qualitative data was extracted from the articles and assessed using thematic synthesis. RESULTS 78 articles were identified for full text review, 60 of which met inclusion criteria. Four categories of barriers emerged on thematic synthesis educational, operational, cultural, and cognitive. Within these categories, 12 initial descriptive themes and 9 suggested interventions were identified. CONCLUSIONS Descriptive themes of disrespect disinterest, environmental factors, redundancy, poor recall, conflicting goals and perspectives, t