An Examination of the Students’ Perceptions of their Role as Future Health Professionals in the Delivery of Health Services to Francophones in Northern Ontario following an Interprofessional Simulation Activity

Research Team: Diane Mageau R.N., B.ScN., Med.Lise Bonin R.N., B.ScN., M.ScN. Gayle Adams-Carpino, CYW,RSW,MSWNicole Ranger B.Sc.

Conflict Disclosure InformationPresenters: Diane Mageau, consultant with College Boreal with respect to simulation and Interprofessional EducationGayle Adams-Carpino, Interprofessional Education Program Lead, Faculty Lecturer Title of Presentation:Examining the Perceptions of Future Health Professionals regarding Health care delivery in French within collaborative practice and following Interprofessional learning activities inclusive of clinical simulation?

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Funding

Consortium National de Formation en Santé (CNFS) Secrétariat National

Collège Boréal

Objectives

Develop an awareness of the role of interprofessional simulation activities in the education system

Describe the role of each member of the collaborative team

Recognize the opportunities of integrating culturally sensitive scenarios into collaborative simulated activities

We Need You!

Timelines for today’s workshop

Context: 10 minutes History between Boreal and NOSM: 10 minutes Mini- Interprofessional Education (IPE)

workshop: 20 minutes Experience with Standardized Patient: 20

minutes De-briefing: 20 minutes Questions from audience: 10 minutes

Context of our Collaboration 2005 provincial funding for simulation and

examining integration into curriculum 2009: Development of Boreal’s 2 day

simulation experience “A Day in the Life of a Nurse” including student’s from Paramedics, Radiology, Ultrasound, Dental (Orientation to clinical setting)

2010: beginning collaboration between Boreal and NOSM: introduction of pharmacy learner from Waterloo, examining how to provide foundational IPE understanding of collaborative practice

2011: 3 hour mini IPE workshop prior to simulation event

Historical Context 2011: 11 programs, 187 students, 20 from

health sciences faculty from Boreal participated in IPE workshop followed by simulation event taking place 3 weeks following workshop

January 2012: IPE workshop includes 6 NOSM learners who also participated in Simulation event 3 weeks later

Community Interprofessional Learning hours for NOSM learners

Research: prior to NOSM’s involvement simulation event always delivered in French…’aha moment’

Power of Reflection for Change

Creating a way of thinking: Collaboration

Health and education systems need to work together to coordinate workforce strategies…

what does this mean for you and your organization?

Distribution of Francophones

Interprofessional Education

IPE is most defined as” “occasions when members of two or more disciplines learn from, with, and about each other to improve collaboration and the quality of care” (CAIPE, 2002).

Interprofessional Education

Role Clarification

Learners/practioners understand their own role and the roles of those in other professions, and use this knowledge appropriately to establish and meet patient/client/family and community goals (CIHC 2010)

Activity # 1 Talking Wall 5 minutes

Role Clarification

Teams who have a good collective understanding of professional roles have:Effective communicationEnhanced collaboration abilitiesImproved referral outcomesEnhanced patient care and health outcomesRecognize the unique geographical challenges of Northern Ontario and the importance of understanding roles and the context of role blurring

Role Blurring and Stereotypes

Blurring of the Roles…in Northern Ontario Health Care…significance to you in health and social care?

Culture, values, teamwork and patient/client/community centred care…what does it involve?

How cultural differences affect our interpersonal relationships and how care is delivered

“how” do we understand cultural diversity, what does it mean and what does it look like when providing care?

Cultural Competency – What is that about?

• “a set of congruent behaviours, attitudes and policies that come together in a system, agency or amongst professionals and enable that system, agency or those professionals to work effectively in cross-cultural situation” (Cross et al., 1989)

• “the ability of systems to provide care to patients with diverse values beliefs, and behaviours, including tailoring delivery of care to meet patients’ social, cultural, and linguistic needs” (Commonwealth Fund, 2002)

Collaboration; complex yet essential

Interprofessional learning leads to collaborative practice creating practical opportunities…A Day

in the Life of a Nurse discover how your roles and

responsibilities relate in the real world

Collaborative Practice

Can improve:access to and coordination of

health-servicesappropriate use of specialist clinical

resourceshealth outcomes for people with

chronic diseasespatient care and safety (World Health Organization, 2010)

Collaborative Practice

Can decrease: total patient complications length of hospital stay tension and conflict among

caregiversstaff turnoverhospital admissionsclinical error ratesmortality rates

World Health Organization, 2010

The “WHY”…Patient Safety

Human Factor Analysis An epidemic in communication errors 195 000 hospital deaths from

preventable medical errors between 2000 and 2002 (Canadian Medical Journal, 2009)

Why examine culture and values?

How cultural differences affect our interpersonal relationships

Understand and value diversity

Groups are defined by and exist because of their values

Cultural Competency – What does it all mean?

Providing culturally competent programs and care, which includes paying attention to culture, language, literacy, and health literacy, thus builds inclusion and aims to:

reduce long-standing health inequities; improve access, quality of service and

health outcomes; and decrease liability and improve health

system efficiency.

French Language Health Services How Are You Making a Difference?

Awareness Availability of services Availability of resources

Working together…client centered care

Decreased duplication Less chance of “falling through the

cracks” and blaming others Recognize the skills, expertise and

knowledge of other professions (D’ Amour & Oandason, 2005)

Methodology Qualitative Phenomenological Study The « The What and How » learners

experienced the IPE and Simulation collaborative activities

Reflecting on personal experiences, perceptions and assumptions

Examining how effective patient centered

care is delivered to Francophone populations

Methodology Dissemination of focus group discussion

following the simulation event Participants: 20 - 1st Year Boreal Baccalaureate of

Nursing learners 6 - 1st Year NOSM learners Significant phrases or sentences will be

identified Meanings generated will be clustered

into themes Submission to Journal of

Interprofessional Care

To care for someone, I must know who I am. To care for someone, I must know who the other is.

To care for someone, I must be able to bridge the gap between myself and the other.

Jean Watson (Cited by J. Anderson, RN, PhD, 1987)

References Accreditation of Interprofession Health Education. (2009). Prinicples and practices for integrating interprofessional education into the accreditation standards for six health professional in Canada. Retrieved November, 18, 2011 from http://www.afmc.ca/aiphe-afiss/activities-forum.html

Canadian Interprofessional Health Collaborative, (2010). A national interprofessional competency framework. Retrieved July 26, 2010 from http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf

Creswell, W.J. (2007). Qualitative Inquiry & Research Design-Choosing Among Five Approaches. Thousand Oaks: SAGE Publications.

Johnstone, M.J., & Kanitsaki, O. (2006). Culture, language, and patient safety: making the link. International Journal Quality Health Care, 18(5), 383-388.

Kohn, L., Corrigan, J., & Donaldson, M. (2000). To Err is Human: Building a Safer Health System. Institute of Medicine. National Academy Press. Washington D.C.

References…

Meads, G., Ashcroft, J., Barr, H., Scott, R., & Wild, A. (2005). The Case for Interprofessional Collaboration. Blackwell Science: Oxford.

Special report on French Language Health Services Planning in Ontario, Office of the French Language Services Commissioner,2009, www.flsc.gov.on.ca