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APPLICATION FOR PROGRAM APPROVALfor a Supervised Pastoral Education Centre

PERSONAL INFORMATIONName of Applicant

(Supervisor) PAUL PETERS DERRYSupervisory Status Third Provisional

Address FRED DOUGLAS SOCIETY1275 Burrows Ave Winnipeg, MB R2X 0B8

Telephone home 204.489.1024office 204.586.8541 x135

Mobile 204.990.6359Email [email protected]

CENTRE INFORMATION

Name of SPE Centre INTERFAITH HEALTH CAREASSOCIATION OF MANITOBA

CASC Region ManitobaAddress N5067 – SBGH Education Building

409 Taché Ave Winnipeg, MB R2H 2A6Stream CPE ☒ PCE Unit based ☐

PCE Course based ☐ Blended CPE/PCE ☐Is this program applicationfor a Residential Program? Yes ☐ No ☒

Start Date of Intended Unit September 12, 2016End Date of Intended Unit April 24, 2017

OVERVIEW

mailto:[email protected]

http://www.spiritualcare.ca/

of 21APPLICATION FOR PROGRAM APPROVAL for a Supervised Pastoral Education Centre

Interfaith Health Care Association of Manitoba | Paul Peters Derry, D.Min.

1. Provide a brief description of the host site/centre for the SPE unit:location or setting/type/size of centre or facility, population(s) with which students will be working,programs, unique learning opportunities.

The Interfaith Health Care Association of Manitoba (IHCAM) is a voluntary, non-profit provincial association created in 1995 and comprised of health and social care organizations that are owned and operated by nine faith groups; Baptist, Catholic, Jewish, Lutheran, Mennonite, Pentecostal, Salvation Army, Seventh-Day Adventist and United. IHCAM advocates on behalf of its membership the value of faith-based health care and governance. IHCAM’s thirty-one member organizations represent over 13% of Manitoba’s health care budget employing over 10,000 staff and attracting over 2000 community volunteers.The IHCAM Extended CPE unit will be based out of Fred Douglas Lodge, and will offer a wide range and variety clinical experiences in ICHAM member facilities: from acute-care/tertiary-care clinical settings at St Boniface General Hospital to Misericordia Health Centre (medicine, surgery, ER, adult psychiatry, chronic care, geriatric medicine, palliative care), to personal care home options (Fred Douglas Lodge, Holy Family Home or St Joseph’s Residence (with focus on care for persons with Alzheimer’s disease and related dementias, palliative care and end-of-life care) and supportive housing facilities (e.g., Fred Douglas Heritage House).

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Reference attached document:☐ UCTS/University of Winnipeg SPE/CPE brochure

2. Has there previously been an SPE Program at this centre? Yes ☒No ☐

If YES, please provide a brief history of the previous SPE unitsand connect information to the current proposed program.

In 2009-10 and 2010-11, IHCAM contracted with Harry Ritchie, CASC Teaching Supervisor to offer an extended CPE Unit, with clinical placements in various IHCAM sites. This reflected IHCAM’s longstanding commitment not only for spiritual and religious care within its member facilities, but clinical training and professional accountability for its spiritual health care staff. During the second year of IHCAM’s partnership with Harry Ritchie, Fred Douglas Lodge became one of the participating clinical sites, welcoming Doug Koop as a Spiritual Care Intern. Fred Douglas Lodge’s Coordinator Spiritual Care, Paul Peters Derry, served as Doug’s “preceptor.”

In April 2011, Harry retired after 25 years of continuous work as a CPE Teaching Supervisor. IHCAM expressed interest in continuing to sponsor a CPE program, reflecting its on-going commitment to professionalism in multifaith spiritual care, and education and training for spiritual care practitioners within and beyond its member facilities.

Paul Peters Derry, having worked at St Boniface General Hospital, Victoria General Hospital, Concordia General Hospital and Selkirk Mental Health Centre, and since October 2007 as Coordinator Spiritual Care at Fred Douglas Lodge and Fred Douglas Heritage House (respectively, the personal care home and supportive housing facilities within Fred Douglas Society), received CASC Certification as a Clinical Specialist in Spiritual and Religious Care in 2012. With encouragement from colleagues at Fred

http://www.ihcam.ca/index.html?lang=en

APPLICATION FOR PROGRAM APPROVAL for a Supervised Pastoral Education CentreInterfaith Health Care Association of Manitoba | Paul Peters Derry, D.Min.

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Douglas Lodge, peers within the Winnipeg Spiritual Care network (including Harry Ritchie, as well as the members of his Certification Review, Kathleen Rempel Boschman and Larry Hirst) and The University of Winnipeg’s United Centre for Theological Studies (UCTS), Paul applied for Admission to Provisional Supervisory Education, and his application was granted in August 2012.During Paul’s 1st Provisional Unit (2012-13, Selkirk Mental Health Centre), one student did their clinical placement at Fred Douglas Lodge. During Paul’s 2nd Provisional Unit (2013-14, Victoria General Hospital), one student did their full clinical placement at Fred Douglas Lodge, another student commenced their clinical placement at the Lodge, but in February/March, with Paul’s agreement, transferred their placement the IHCAM facility (St Joseph’s Residence) where they were already working as Spiritual Care Coordinator, another student did their placement at Holy Family Home, and still another student did their placement at St Boniface General Hospital.The fact that we were able to place a student at St Boniface General Hospital, with the full and welcoming support of Ela Partyka, Manager – Spiritual Care Services, marked the beginning of CPE’s return to that tertiary-care facility, where the last time a CPE student had done clinical placement there was as part of the 2010-11 IHCAM CPE program, and the last complete CPE unit was offered by Tim Frymire in 2006-07. Misericordia Health Centre likewise had one of Harry Ritchie’s students in 2009-10 and 2010-11, and going back even further, George Neufeld supervised CPE program for several years at that site before his appointment as Provincial Coordinator for Pastoral/Spiritual Care in 1998.


Reference attached documents:☐

STAFFIf supervising a provisional supervisor answer for both teaching and provisional supervisor.

3. Briefly describe the Teaching/Associate/Provisional Supervisors professional and academic credentials for this SPE unit and include their areas of expertise as applicable to the SPE program. Include information about the role of each supervisor at the Centre.

As Provisional Supervisor, Paul Peters Derry will be working in concert with a CPE Supervisory Team, comprised of Tim Frymire and Mary Holmen. In addition to information provided about Paul above, in response to the previous question, a copy of Paul’s most recent curriculum vitae is attached. Paul also received his STM degree at The University of Winnipeg’s Spring Convocation on June 10, 2016, a degree begun as a “parking lot” for his CPE credits which then evolved into an opportunity for further specialization in spiritual care, as well as ecumenical and multifaith challenges and opportunities.Mary Holmen is a priest of the Anglican Church of Canada, ordained in 1978. After over 20 years of congregational ministry, Mary served 15 ½ years as Interfaith Chaplain at the Selkirk Mental Health Centre, retiring in 2014. Mary completed two Basic and three Advanced units of CPE. She was certified as a Specialist in Pastoral Care in 2001 and a Teaching Supervisor of CPE in 2009. Mary's special areas of interest include mental health, spirituality and health, liturgy and ritual, and ethics. Mary has held a number of roles at both regional and national levels of CASC, and recently completed ten years on the



Professional Practice Commission. She is currently a member of the Accreditation Committee.Tim Frymire began his career in Spiritual Care in 1989 as a chaplain at St. Boniface Hospital, working five years in Adult Psychiatry and Long Term Care. Five years in Cardiac and Renal units were followed by seven years in Palliative Care and teaching CPE. In 2007, he replaced Glen Horst as the Coordinator of Spiritual Care and supervisor of the CPE Residency at Riverview Health Centre. He retired in the spring of 2016 after 27 years in Spiritual care and 15 years of CPE supervision. Tim has been active on both regional and national CASC commissions, presently serving on the National Ethics Commission. He is currently the webmaster for CASC in his “free” retirement time.


Reference attached documents:☐ Paul Peters Derry - Curriculum vitae, 15-Jun-16

4. Identify to whom, at the Centre , the Teaching/Associate/Provisional Supervisorof the program is accountable.

Provisional and Teaching Supervisors are accountable to: Wilmar Chopyk, IHCAM Executive Director Roslyn Garofalo, Fred Douglas Society Chief Executive Officer The United Centre for Theological Studies, The University of Winnipeg through

the Dean of Graduate Studies, Mavis Reimer: a relationship managed through regular meetings of Department of Supervised Pastoral Education (SPE).

Paul Peters Derry, as Coordinator Spiritual Care, has a direct-reporting relationship with Fred Douglas Society’s CEO, and is a member of Fred Douglas Lodge’s Leadership Team. As an ordained minister within The United Church of Canada, he is a member of, accountable to and certified for the practice of spiritual care by Winnipeg Presbytery of the Conference of Manitoba & Northwestern Ontario. Since ownership of this program rests with IHCAM, Paul’s time commitment for teaching and other supervision-related activities (preparation, follow-up and “marketing” within IHCAM constituency and beyond) will be part of a Secondment Agreement between IHCAM and FDS.


Reference attached document:☐ Secondment Agreement between IHCAM and FDS

5. Describe how the Centre supports the continuing educationof the Teaching/Associate/Provisional Supervisor.

IHCAM and FDS have demonstrated consistent support for Paul’s continuing education:

Payment of expenses related to attendance at AAMFT-Approved Clinical Supervision Course (Vancouver, August 2011).

Additional salary compensation 1st Provisional C.P.E. Unit (2012-13) and 2nd Provisional C.P.E. Unit (2013-14), including financial support for hiring of part-time chaplain on teaching days to cover Paul’s absence from Fred Douglas Lodge.

Paid leave for Paul to attend CASC/ACSS Code of Ethics Education Module (May 6, 2016)


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The budget approved at the IHCAM Board’s September 2015 meeting, included a line for payment of the IHCAM CPE Supervisor’s expenses related to registration, travel and accommodation at the annual CASC/ACSS national conference. While the intention had been for Paul to attend the CASC 2016 conference, this did not happen due to Paul’s medical leave following gastric by-pass surgery (elective/planned, September – October 2015) and an emergency appendectomy (January – March 2016) and graduated return-to-work (April 2016).


Reference attached document:☐ Financial Plan – Spiritual Care Education, 2015-17

6. If the Teaching Supervisor is supervising a provisional supervisor at a distance,describe how supervision will take place.

In process of completing his Application for Admission to Associate Supervisory Education, and having compiled his Formal Documentation, Paul anticipates completing his Professional Papers over the summer months. Given the strong, positive recommendations from Paul’s 1st and 2nd Provisional Units, the expectation is for Paul to assume the work of designing the program, and take most of the initiative and leadership for its delivery.Mary and Tim will provide ongoing oversight a of Paul’s work. They will be present for the opening days of welcoming/orientation, and return for mid-unit and final assessments. Both Mary and Tim will be scheduled to offer a didactic presentation. Individual supervision of Paul will be offered more intently at the beginning of the program, then reduced in frequency and transitioned into peer consultation. Oversight and supervision of Paul’s individual supervision, teaching and group facilitation will be accessed in a variety of ways: face-to-face, video-taping/review of the same, reflection reports, sharing of Paul’s ongoing supervision notes on each student. Paul will “cc” Tim and Mary when returning assignments to students (verbatim reports, reflection reports, etc.), where Paul uses the “insert-comments” function as the means for providing provocative feedback as well as supportive critique. Moreover, the Department of SPE, as part of its tradition:, expects provisional, associate, and even on occasion, teaching supervisors, to present a case for peer consultation and review.


Reference attached document:☐ Possible Hours for Teaching Supervisors to provide oversight for Paul as Provisional

Supervisor

7. Who are the faculty, community members, or staff members, offering didactics for the program?

A list of didactic topics has been included as part of the course syllabus, and the calendars for both of Paul’s provisional units points to the range of didactics that will be offered. CPE supervisors (active and retired: Joanne Biggs, Tim Frymire, Lynn Granke, Mary Holmen, Glen Horst), along with a number of CASC Certified Specialists (Ferdinand Funk, Beth Sawatsky) form part of the roster of presenters. Paul’s work at Fred Douglas Lodge since 2007 as well as involvement with other Winnipeg Regional Health Authority (WRHA) facilities means that he has contacts from other healthcare disciplines, and other “persons



of interest” outside WRHA.In his capacity as Coordinator Spiritual Care, Paul has been working with Fred Douglas Society’s Board of Directors to engage ethical challenges around Medical Assistance in Dying with a view to developing a statement of foundational values, and as part of this, lead a series of “focus groups” with front-line staff. Even as we have awaited federal legislation along with provincial and regional policy directives, the Board’s draft statement of values affirms “that our dying residents and their families will not be abandoned at any point in the dying process, even if/when the resident has made a choice for Medical Assistance in Dying.” This will also form the basis for a didactic session early in the fall term, given the timely nature of these conversations, and Paul will encourage his students to see this is the kind of work as potentially part of their practice as spiritual care workers.Our goal is to have the fall term didactics confirmed by late August. Some sessions will be left unscheduled to allow for mutual teaching opportunities with the VGH CPE program, student input as to preferences, and didactics which address specific issues or concerns emergent in student clinical placements.


Reference attached document:☐ Course Syllabus☐ Schedule of Didactics from 1st and 2nd Provisional Units

Answer 8 and 9 only if the students’ clinical placementsare in locations separate from the organization or main centre hosting the SPE.

8. Describe who will be the on-site supervisor for the studentand how sufficient integration of theory and practice will occur.

Because the majority of IHCAM member facilities have paid spiritual care staff, most, if not all students will have a paid professional spiritual care provider as their clinical mentor or “preceptor.” Criteria for clinical sites will include: 1) an established “presence” as well as relative “stability” within the spiritual care department, 2) a clinical context amenable to the student’s learning goals, 3) documented support from senior management, and 4) a member of the Spiritual Care staff who has completed a minimum of two CPE units, and demonstrated commitment to the action/reflection learning model as well as a spiritual care practice grounded in theological reflection, who is prepared to act as clinical mentor or “preceptor” in partnership with the IHCAM CPE Supervisory Team.During Paul’s 2nd Provisional Unit, Teaching Supervisor Lynn Granke recognized the importance of clarity around roles and expectations for preceptors and students in the clinical setting. Both Paul and Lynn admit to learning the hard way how lack of clarity with reporting structures, scope of mentoring, etc., can lead to misunderstanding and conflict. (Aside from Victoria General Hospital’s partnership with Riverview Health Centre, which saw VGH accept one of the RHC residency program students, and occasionally, a VGH student did their placement at Riverview, the 2013-14 extended unit was the first CPE unit Lynn supervised where students did their clinical work off-site.) With another placement, the student’s extended absences led to a too-late-to-resolve deterioration in working relationships with that site’s Spiritual Care team. They had delayed taking action, not just because the student was able to keep up with their didactic day attendance and completion of assignments, but out of sensitivity for the student’s personal crises. As this student (finally) got around to completing their clinical hours and last assignments, we realized that better communication with the clinical site and early intervention could have saved us, the preceptor and the student much heartache. Based on these learnings, Paul is developing a set of guidelines on how to handle conflict, delineation of responsibilities, boundaries, etc.,


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and has already started the process of bringing clinical mentors on board through a combination of visits to each site, individual briefing of preceptors and group education with preceptors, and through the preceptors, bring their management team “on board” with the philosophy, practice, education and opportunities afforded through having a CPE student.Preceptors will be included in evaluation processes, and asked to submit written feedback form as part of mid-unit and final assessments. On occasion, and of course subject to their availability, preceptors might also be present as their student presents a verbatim in group supervision. We are also exploring possibilities for holding a didactic day in each clinical sites, something that happened as part of both of Paul’s provisional units, giving peers a greater appreciation for each other’s unique contexts for spiritual care, and making it possible for preceptors to share in the “group supervision” component.Per your suggestion, Paul has begun to network with Margaret Clark (Alberta) and Brian Walton (Saskatchewan) for their guidelines on use of preceptors.


Reference attached document:☐

9. Describe the written contract which specifies the relationship between the Centreand the individual satellite locations, include the amount of time students will provide clinical careat the placement, and the functions students will be expected to carry out.

As outlined in our responses to questions 21 and 23, our program will operate with the expectations that students complete a total of 200 clinical hours in addition to the 200 didactic hours. Because of the unique variety, structure and composition of this IHCAM program, the general description of student duties will be tailored to individual clinical sites. The draft Memorandum of Understanding – Clinical Placement Site (adapted from the MOU used by Harry Ritchie) has been shared with satellite locations that have already expressed interest in hosting a student. The “Spiritual Care Assistant” position description developed by Fred Douglas Lodge for the person who will be hired to provide coverage for Paul on didactic days (continuing the pattern established during Paul’s Provisional Units) will be offered as a recommended template for clinical sites, as it highlights the range of standard duties and responsibilities for spiritual care workers.


Reference attached document:☐ Memorandum of Understanding – Clinical Placement Site☐ FDS Position Description Manual: Position Description – Spiritual Care Assistant

RESPONSIBLE RELATIONSHIPS

10. Please identify the theological school or faculty with whom the SPE unit will be affiliated.Attach a letter from the theological school that will provide consultation for the SPE programincluding a description of the relationship between it and the SPE program.



The IHCAM CPE Program will be offered in partnership with The United Centre for Theological Studies (UCTS), as part of The University of Winnipeg’s Faculty of Graduate Studies. Even as UCTS enters a period of transition, with a

shifting of resources, degree programs and the end of its Association of Theological Schools (ATS) accreditation, CPE students will continue to register through The University of Winnipeg, have access to university services, and receive 12 credits for each CPE unit. In return, students and supervisors will continue to be bound by university policies, and have access to the university library and other services. Students registered in a University of Winnipeg degree program are eligible to apply for university bursaries.Experiences in Paul’s 1st and 2nd Provisional Units afforded new appreciation for the structures of accountability and support that are part of this institutional affiliation, a matter further delineated in our response to question 18.

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Reference attached document:☐ IHCAM-UW Institutional Affiliation Agreement, 22-Jun-16☐ Course Offering Information Form, submitted January 2016, updated May 2016

11. Provide written endorsement from a member of the Senior Management Team or Governing Bodyfrom the Centre ’s administration which includes an expression of willingness to support the SPE program.

After thorough reviews by both IHCAM and Fred Douglas Society Boards of Directors, as well as much discussion, negotiation and number-crunching, Paul and Roslyn presented Wilmar with a multi-year proposal in August 2015. It included a detailed financial plan for 2015-17, outlined the steps to becoming a fully-accredited teaching site and preparation for a Site Accreditation Visit per CASC standards, and was shared for information with the FDS Board, and approved by the IHCAM Board.

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Reference attached document:☐ Excerpt of IHCAM Board Minutes – September 15, 2015☐ Excerpt of FDS Board Minutes

12. The SPE program is to have a team that provides advice, consultation and feedback regarding the program.The team will be unique to the needs of the Centre, but is often inter-disciplinary and represents diversity.Please include the names, role and contact information of the membership of the SPE Advisory Committee.If applicable, please attach the terms of reference.

Wilmar Chopyk reports that “The last Committee was comprised of Harry, Bob Girard (former board member, Catholic Health Association of Manitoba, and Manager, Pastoral Care at St Boniface General Hospital) and myself. We reviewed applications, interviewed and selected candidates. We would meet on an as-needed basis, e.g., progress reports from Harry.” This admittedly “limited” committee made sense for that time, given that Harry supervised the IHCAM program as an “interim” project, knowing that he would fully retire


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after its second offering (2010-11).Preliminary discussion has brought agreement that this will be an IHCAM committee, with representation from IHCAM member facilities in addition to Paul and Wilmar as ex officio members. Our plan is to establish a new committee, using as a starting point the Terms of Reference from Riverview Health Centre’s CPE Professional Consultation Committee. An initial meeting will be held over the summer months. In addition to determining its Terms of Reference and providing general oversight of the program and accountability to the IHCAM Board of Directors, priority will be given to updating Policy & Procedure statements.Glen Horst, CASC member emeritus, and for over two decades, Supervisor of the Riverview Health Centre CPE Residency, has agreed to serve a one-year term on this committee. We are grateful for the expertise and long-term knowledge that he will offer us. We likewise accept your recommendation to add staff members and community faith leaders to the SPE advisory committee to expand knowledge and awareness of the role of the students, and Wilmar Chopyk and Paul have started thinking about other possible members, both within and beyond the IHCAM network. As you can see with our response to question 16, Paul approached one of his WRHA colleagues, Holly Mulvihill, to be part of the screening interviews, in the hope that as she got a sense of what our program offers, and who will be involved, that she too will catch the “CPE bug” and be open to considering becoming part of our Advisory Committee.In terms of advisory support, Paul and IHCAM will likewise benefit from the cadre of supervisors who form the Department of SPE, not only before and during, but after achieving status as Associate Supervisor.


Reference attached document:☐ SPE Advisory Committee Terms of Reference

– draft from Riverview Health Centre CPE Residency Program

FACILITY/CENTRE13. Check off all supportive structures that apply:

☒ office space for students☒ group supervision rooms☒ space for confidential individual supervision☒ educational equipment (i.e. video/audio-taping/observation room)☒ access to administrative assistance support☒ access to photocopying/scanning/faxing services☐ student access to computers for charting or workload if required☒ access to library facilities☒ access to financial assistance for students☒ access to distance education technology (i.e., webinars, video conferencing)

Describe any further supportive structures that support the student’s learning:Our plan is to use the Fred Douglas Lodge Chapel for didactic sessions, group supervision and other teaching day activities. It is located adjacent to Paul’s office (where IS will take



place), and has a screen and ceiling-mounted LCD projector. Individual office space for students is not available, however, students will have access to secure locker space, and it is hoped that individual clinical sites will provide the same.Where students chart and where they write their own notes will depend on each site, as IHCAM member facilities offer a range of charting options, from paper- to e-charting. Students will have access to resident/patient charts, and will be expected to engage that as part of their clinical work in whatever form that takes at their clinical site.For this first offering of our program, we are not planning to access distance education technology except for possible participation in telehealth workshops/presentations. This could be explored with future units. As a registered program through The University of Winnipeg, a secure course website will be created via the university’s Nexus system for downloading of assignment templates, articles and other suggested resources, and submission and return of Reflection Reports, Verbatim Reports, etc.Reference attached document:

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14. Describe the variety of clinical placement opportunities the SPE students will have at your Centre.

To reiterate our response to question 1, IHCAM offers 31 possible sites within its association. As was the case with Paul’s 1st and 2nd Provisional Units, at least one student will do their clinical placement at Fred Douglas Lodge. Thus far, Luther Home and Holy Family Home have indicated willingness to host a student placement, as has Misericordia Health Centre. With St Boniface General Hospital looking at re-establishing a CPE program there in 2017-18, we anticipate this large tertiary care centre as another possible site. Even as our priority remains placements within IHCAM member facilities, our program seems to be generating interest across Winnipeg Regional Health Authority (WRHA).



POLICIES AND PROCEDURES15. Briefly describe the Admissions Policy/Procedure and attach the document sent

to interested students in the SPE program. Note how diversity and respect for all persons is ensured.

Diversity and respect for all persons is highlighted in the UCTS SPE brochure, and the following excerpt was read at the beginning of each of the screening interviews conducted on July 7th:

The purpose of programs in Supervised Pastoral Education is to assist the provider of spiritual care to become more effective in the practice of ministry. This form of theological education includes developing a better understanding of people, their difficulties and deeper spiritual experiences and achieving greater self-awareness in relation to spiritual care. This experientially-based approach provides: intensive involvement with people in crisis, supervised

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http://www.misericordia.mb.ca/

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http://www.holyfamilyhome.mb.ca/

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clinical calls, clinical conferences with other professionals, seminars, reading, worship, theological reflection. These programs are designed for all persons interested in providing spiritual care, such as clergy, religious volunteers, and theology students. Opportunities are available for qualified participants to move toward certification as a Specialist in Spiritual Care and/or a Teaching Supervisor. This training is in accordance with the standards of The Canadian Association for Spiritual Care. Academic credit is available upon application to qualified students through The United Centre for Theological Studies, University of Winnipeg. The CPE Supervisors are part of the Educators group within the UCTS.

Paul’s revamping of Victoria General Hospital CPE Program’s policies and procedures during its 2010-11 Self Study will form the basis for our functioning as a CPE program. These documents will have their “institutional home” with the IHCAM Board, and as indicated in our response to question 12, policy and procedure statements on 1) Admissions, 2) Dismissal/Withdrawal, and 3) Grievances will be reviewed and updated as part of the SPE Advisory Committee’s initial work.Even as the challenge of reaching out to non-Christian faith expressions and cultures is shared by all CPE programs in this region, an undergirding commitment to diversity, welcome and inclusion remains part of IHCAM’s, FDL’s and Paul’s basic “DNA.” As evidence, we highlight IHCAM’s foundational identity alongside its history of selecting students from a variety of faith expressions. From his Convention Baptist roots, Paul has journeyed through Anglican-United shared ministry, pursued further studies in ecumenism/interfaith dialogue, and was part of the Canadian delegation at the World Council of Churches Consultation in Nashville, TN (October 2015).

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☐ UCTS/University of Winnipeg SPE/CPE brochure

16. Briefly describe the interview and selection process.Identify who participates in the interviews (i.e. colleagues or member of the SPE Advisory Committee).

Building on the experience gained through his Provisional Units, when Paul was forwarded copies of student applications that had been received by the Teaching Supervisor, and subsequently participating alongside the Teaching Supervisor in interviews with individual students and compiling information from the references provided, Paul has taken this further:

Responding via email, phone or text message to inquiries from potential students, with appropriate documentation of the same;

Upon initial inquiry and/or request for application package, sending an information email with Application for Interview (Word/PDF) and Course Syllabus included as attachments;

For students new to CPE/SPE, providing a Sample Verbatim as a “full disclosure” starting point for conversation about work involved and engagement of the “action – reflection – integration” pedagogical model;

Pre-application face-to-face information meetings scheduled upon request.Paul fielded inquiries over the past 18 months, as potential students became aware of this developing program. In December 2015, Paul secured approval from Angela Schmidt to submit the Course Offering Information form, per UCTS, Graduate Studies and University of Winnipeg timelines for submission (January 2016). Announcement that the program would be moving forward came through a memorandum circulated among IHCAM CEOs on

http://www.united-church.ca/news/talking-about-evangelism-time

http://www.united-church.ca/news/talking-about-evangelism-time



May 24th.As of June 30th, Paul received new fewer than 17 inquiries, though a couple of these were from students indicating their preference to defer application until 2017-18. A couple of applications were been ruled out, based on unprofessional conduct in previous units. Of the individuals who submitted complete applications, 8 were offered an interview, with 7 accepting, and 1 declining, having accepted a place in the VGH Extended CPE Unit. Interviews took place on July 7th, conducted by Paul, Wilmar, Glen Horst and Holly Mulvihill, RN (currently WRHA Patient Safety Consultant, and someone with whom Paul has worked as part of a Critical Incident investigation at Fred Douglas Lodge). Criteria for selection include a demonstrated sense of call to either parish/congregational ministry or the practice of institutional spiritual careInterview questions and scoring of applicants will be based on templates obtained from VGH, SMHC and RHC CPE programs. Once we have determined the make-up of our student group, students chosen will receive a letter of acceptance outlining the steps to be followed in terms of registering through the university, etc., securing police records and adult/child abuse registry checks, providing proof of immunizations, etc. Students not selected will receive a letter thanking them for their interest in the program, and as much as possible, given some feedback on to how they can better prepare themselves for another offering of the program, if in fact there were reasons why they were not offered a place in this program. Letters will be signed, scanned and emailed as file-attachments as soon after the interviews as possible.To summarize: Paul has developed a thorough, comprehensive and responsive process that is based on his experience of what was followed at VGH and SMHC. He looks forward to updating the policy and procedure statements to ensure that it aligns with the practice we seem already to have in place.

Word Count: 503 /250Reference attached documents:

☐ Template for Information Email Acknowledging Inquiry☐ Application for Interview☐ Template for Email Confirmation of Interview☐ Screening Interview Guide and Screening Interview Scoring Sheet, based on

templates developed by Glen Horst and Tim Frymire as part of the Riverview Health Centre CPE Residency

☐ Email correspondence with Tim Frymire and Mary Holmen, summarizing discernment process for determining composition of student group

☐ Templates for Email and Letter of Acceptance (for candidates offered a place in the Unit) and Follow-Up Email/Letter (for candidates interviewed but not or not yet offered a place, or candidates not interviewed)

17. I acknowledge that I will provide a copy of the following documents to the SPE studentsand will make reference to them during orientation.

☒ CASC/ACSS Code of Ethics☒ CASC Grievance Policy☒ CASC Dismissal Policy☒ A confidentiality agreement (PHIA)

These documents will be made available via the course website, and highlighted as part of initial orientation days. With regard to agreement for maintaining confidentiality of interactions with residents, patients and family members, as well as interactions with staff and volunteers, this will be accomplished in one of two ways:

If the student is currently working at a healthcare facility within Manitoba, they will have already received PHIA training and signed the requisite declaration.

If the student is new to working as part of the multidisciplinary team, Paul is one of


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Fred Douglas Lodge’s Privacy Officers and thus authorized to administer PHIA training and witness the signing of a PHIA declaration. This could happen as part of the initial orientation days. Alternatively, students could receive PHIA training at the satellite location as part of their site orientation.

As indicated with our response to questions 12 and 15, Paul’s revamping of the VGH CPE Program’s policies and procedures during its 2010-11 Self Study included work on the Dismissal/Withdrawal and Grievances policies and procedures, and these will be reviewed and updated as part of our Advisory Committee.

Word Count: 185 /250Reference attached documents:

☐

18. Describe the process at your Centre for addressing both formal student complaintsand student withdrawal from the SPE program.

Consistent with policies followed at other sites within our region, students will direct formal complaints related to the program first to the supervisor (and before Paul completes his process as an Associate Supervisor, to the supervisory team of Mary Holmen and Tim Frymire). Formal complaints related to matters arising in a student’s clinical placement will be directed first to the clinical mentor (“preceptor”). If unresolved, students will access subsequent levels of response, per the policy/procedure statement and flow-sheet that will be reviewed as part of opening orientation days.Paul’s work with these policies and procedures will continue to be informed by experiences gained through his provisional supervisory training, demonstrating a capacity for working within CASC/University protocols, whilst with creativity even “pushing the envelope,” advocating with students. During his 1st Provisional Unit, one of the students withdrew from the program in late-October following an incidence of academic misconduct (specifically, an attempt to present a plagiarized verbatim report as their own). During the first semester of Paul’s 2nd Provisional Unit, when it became clear that a student for whom English was not their first language (and someone who was also working with an undiagnosed learning challenges, having lived much of his childhood and adolescence in refugee camps), Paul pressed Terry Hidichuk, then Executive Director of The United Centre for Theological Studies to provide funding for tutoring support for one of the students for whom English was not their first language. Not to minimize the seriousness of the first student’s academic misconduct, Paul nevertheless wondered in retrospect if it might have been possible to suggest this more supportive option as a way of that student remaining in the program.Also in Paul’s 2nd Provisional Unit, still another student announced their intention to withdraw from the program in late-February. This happened the night before the group’s regular didactic day. The following morning, Paul helped the group process feelings around their peer’s unilateral decision to “vote themselves off the island.” When this student stopped by Paul’s office the next day to return their ID badge, Paul suggested a possible way forward (adjusting the frequency of assignments that needed to be submitted, and agreeing to shift their clinical hours to the IHCAM facility where they were already working) that allowed the student to return and in some ways engage the CPE process in ways that up to that point they had been either unwilling or unprepared to do.


☐ Grievance Policy - Steps To Resolution

19. Describe the method of storing and disposing of student information including final evaluations.



Secure handling, storage and disposal will be accomplished as follows: As a registered program through The University of Winnipeg, students have access

to a secure course website submission and return of Reflection Reports, Verbatim Reports, etc.

Paul’s personal laptop and his work laptop computer are password-protected. Hard-copies of student documents (when made and retained) will be stored in a

locked filing cabinet. The following stipulation will appears on all Final Assessments:

This CASC/ACSS SPE Summary and Assessment must be signed by both the Student and Supervisor(s).

By my signature, I authorize my supervisor to use this evaluation, without disclosure of identity,for any consultation process in CASC/ACSS he/she may be undertaking.

Both the Student’s Final Self-Assessment and Summary and the Supervisor’s Final Assessment and Summary are property of the student assessed and an educational tool. These documents will be kept on file (hard-copy and electronic) for a period of five (5) years, after which

it will be destroyed. Copies of these documents will not be released to anyone without written permission of the student assessed.


☐

THE PROGRAM20. Provide a statement of the program goals and objectives

and of their relationship to goals (strategic plan) of the Centre.

IHCAM describes itself as “comprised of faith related health care facilities and organizations in Manitoba … a semi-formal group which meets for the purpose of sharing religious values and to discuss common concerns and issues in health care,” and its overall direction, particularly with respect to the practice of spiritual care, remains very much in keeping with CASC goals for CPE. As evidence, we can highlight the following:

As indicated with our response to question 2, when Harry Ritchie retired as Teaching Supervisor. ICHAM expressed interest in continuing to sponsor a CPE program, reflecting its on-going commitment to professionalism in multifaith spiritual care, and education and training for spiritual care practitioners within and beyond its member facilities.

During an initial meeting with Paul, Harry and FDS CEO Roslyn Garofalo (May 2012), Wilmar expressed it this way: “When we look at the delivery of spiritual care services within IHCAM member institutions, we have to admit that we are at best on par with what’s offered in other healthcare facilities. IHCAM believes strongly that the level of spiritual care we offer our patients, residents, families and staff needs to be above that which happens in non-IHCAM facilities. IHCAM’s offering of a CPE program reflects this belief, provides opportunities for our spiritual care staff to see further training and education, and demonstrates serious attentiveness to the need for succession-planning.”

Over the past year, IHCAM has contracted with CASC members emeriti Glen Horst and Ron Long to conduct a survey on the future of spiritual care within Manitoba, Spiritual Care Consultation Report: Moving Ahead. As mentioned in our response to


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question 12, Glen Horst has agreed to serve a one-year term on our SPE Advisory Committee.

IHCAM’s evolution as an organization highlights parallels and synchronicity with the goals of CPE/PCE, as articulated in the CASC/ACSS Manual, demonstrating adaptability to changing circumstances and contexts through its evolution from the exclusively Catholic Health Care Association of Manitoba (CHAM) to the ecumenical and multifaith Interfaith Health Care Association of Manitoba (IHCAM), and, more recently, to include Manitoba Association of Residential and Community Homes for the Elderly (MARCHE) as part of its identity and focus.

3.Goals of CPE/PCE3.1 To become aware and demonstrate awareness of one's personhood in the practice of

spiritual care and of the ways one's spiritual care practice affects other persons, including sensitivity to ecumenical, multifaith and multicultural issues.

3.2 To become aware and demonstrate awareness of how one's attitudes, values and assumptions affect one's spiritual care practice.

3.3 To become aware and demonstrate awareness of one's spiritual care presence in interdisciplinary relationships.

3.4 To develop the ability to utilize the experiential method of learning.3.5 To develop the ability to utilize the peer group for support, dialogue and feedback in

a way that integrates personal characteristics with spiritual care functioning.3.6 To use individual and group supervision for personal and professional growth and for

developing the capacity to evaluate one's spiritual care practice.3.7 To integrate the learnings of theology, spiritual/religious theories and the social and

human sciences in understanding the human experience.


☐

21. Provide a statement of the total number of weeks and the number of hours each week for the students in the program. What activities are included in didactic hours as compared to the direct contact (client care) hours?

The IHCAM extended CPE unit is scheduled to coincide with the extended unit offered at VGH, with both set to begin on September 12, 2016 and conclude on April 4, 2017. Didactic days will run from 8:30 am to 4:30 pm. Students will complete 8 hours/week of clinical service, either as a full-day (Tuesday – Friday) or two half-days, if the latter is more amenable to their personal schedules.Continuing the practice followed by Harry Ritchie, as well as accommodation made with one of the students in Paul’s 2nd Provisional Unit, provision can be made for students to do a portion of their clinical hours at their regular work site. In offers of acceptance extended to successful candidates following the screening interview, the expectation is “to complete at least 50% of your clinical hours at an IHCAM site of our choosing.”Individual Supervision (IS) will be scheduled in addition to didactic/clinical days. In other words, if a student chooses to schedule IS as part of a clinical day, this is done with the understanding that they will make up that time through additional clinical hours.

Didactic/classroom hoursOrientation

days 15

http://marchemb.ca/

http://marchemb.ca/

http://www.ihcam.ca/index.html?lang=en

http://www.cham.mb.ca/



Didactic presentations/workshops 41Group supervision 81

IPR 41Mid-Unit Assessments 8

Final Assessments 15 200Clinical hours 200Individual Supervision 15TOTAL 0


Reference attached document:☐ Sample Teaching Day Schedule☐ ICHAM CPE Schedule 2016 – 2017

22. If using video/tele-conferencing (distance education), identify the technology format (e.g. WebEx, OTN), what will be offered (i.e. supervision, didactics) and how you will ensure sufficient support for the students or on-site supervisor. (See Video-Conferencing Standards and attach the agreement with the on-site clinical supervisor)

For this first offering of a CPE extended unit under Paul’s leadership, we will not be using distance education technology, with the possible exception of occasional participation in video-conference presentations or webinars. Given IHCAM’s membership and mandate extends beyond Winnipeg, this is something we might be exploring with subsequent units.


☐

23. Describe the use of learning contracts or learning goals with students.

Consistent with the statement on the CASC membership form about a “covenantal understanding,” and reflecting the strong place held by covenants within many religious traditions and spiritual practices, our program will bring a covenantal understanding to learning contracts and goals with students.Essential aspects will include:

Expectation of 200 hours didactic time, 200 hours clinical time, and 1 hour of individual supervision (IS, bi-weekly) with additional consultative support (email, phone, face-to-face) as needed.

CASC, Institutional and University policies will be observed, with further expectation that students take initiative in familiarizing themselves with the same.

Honest and respectful communication and interaction between students and supervisor(s) and students and their peers.

With IPR, a covenant of basic foundational agreements, assumptions and understandings will be developed over the first several weeks.

The “Holiday Inn” promise – “no surprises”: timely submission as well as return of assignments, students will be told what is in the Final Assessment long before it is shared, with clear feedback provided at Mid-Unit, or earlier, if peer engagement, written assignments or clinical service is felt to be below standard.

Confidentiality will be maintained, including but not limited to Manitoba’s Freedom of Information and Protection of Privacy Act (“FIPPA”), Protection for Persons in Care Act (“PPCA”), Personal Health Information Act (“PHIA”), Personal Information Protection and Electronic Documents Act (“PIPEDA”), and any other applicable legislation or institutional policy directive.


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CASC/ACSS Code of Ethics will be observed.Word Count: 234 /250


24. Provide a description of the didactic content. Include information about the method of program delivery(lectures, group learning, on-line, student lead seminars, self-learning, etc.).

Further to our response to question 7, and continuing the pattern established through Paul’s provisional units, didactics will be offered through a variety of program delivery options. Even as “preacher-teacher” is an essential part of Paul’s ministerial identity, he welcomes the sort of engagement that happens through dialogue and group learning, role-playing of clinical experiences and alternative scenarios. PowerPoint presentations, discussion of journal articles, webinars, as well as viewing and critical reflection of movies, television shows with analysis of their implications for the practice of spiritual care… all of that, and more, will form the basis for the didactic component of this program. Again, Paul brings a wealth of experience to this, including having taught “Ethical Method & Ministry – Professional Ethics and the Practice of Spiritual Care” through The University of Winnipeg’s Faculty of Theology (as UCTS was previously known) in 2010.


Reference attached document:☐ Schedule of Didactics from 1st and 2nd Provisional Units

25. Describe how your program incorporates the ten CASC Spiritual Care and Counselling Competencies.

One of the benefits through the timing of Paul’s Basic and Advanced Units (which were completed when the former method of evaluation was used) and his Provisional Units (completed as the competency-based assessment was introduced) is that Paul experienced and learned through the challenge of this new approach. (At the same time, it was a return to the familiar, as Paul’s M.Div. work at Vancouver School of Theology occurred when that institution followed a competency- rather than course-based curriculum, and rather than a non-letter-grade means for evaluation, the assessments of either “approved,” “not yet approved” and “exceptional” were used.)Paul focussed his attention on tracking students via the ten CASC Spiritual Care and Counselling competencies— especially with his 2nd Provisional Unit. As occasions arise, didactics, verbatim reports and possibly even IPR sessions will be noted as engaging or demonstrating relevance for a particular competency, e.g. Spiritual Assessment and Care, Multi-Dimensional Communication, Documentation and Charting, Brokering Diversity, and Ethical Behaviour. Self-Awareness and Spiritual and Personal Development will receive particular attention during IS. Ethical Behaviour, Collaboration and Partnerships as well as Leadership and the importance of Research will be part of the lingua franca throughout the unit.



26. Describe the number and types of reports required of the students.

A Course Handbook (distributed in hard-copy on the opening orientation days, and accessible in electronic form via the course website) will cover the following assignments:



Learning Covenant (LC), developed in conjunction with the Supervisors; Bi-weekly Reflection Reports (RR) submitted one day prior to scheduled Individual

Supervision (IS) sessions; Ten (10) Verbatim Reports (VR) or other approved clinical reports, submitted

according to program schedule; Two (2) Book Reflections (BR) or Literature Review (LR), i.e., review of current

articles from professional/academic peer-reviewed journals; Theology/Philosophy of Spiritual Care integrative paper (TPSC); Mid-Unit and Final Self-Assessments (MUSA, FSA).

Other course requirements include: Regular attendance and participation in all seminars and group sessions; One hour of Individual Supervision (IS) bi-weekly; Completion of 200 hours of clinical (spiritual care) service; Leadership of worship/spiritual reflection in the student group on a rotating

basis; Preparation and leadership of one worship celebration for residents/patients,

staff, and family members.Throughout the program, and in particular via IS, students will be assessed on progress toward meeting their learning goals which will be developed according to CASC Spiritual Care and Counselling Competencies.At the supervisor’s discretion, some adjustment may be made to these requirements, based on the student’s learning goals and/or abilities. In cases where the student needs to be absent for a group/didactic day, they are expected to take initiative in accessing didactic material via the course website. In these instances, which are expected to be kept to the minimum for continuity and maintenance of peer relationships, the supervisor may ask for assign an additional reading, clinical or reflection assignment.


☐ Course Syllabus

27. Describe how students are evaluated throughout the program.Include information regarding opportunities to observe the students’ clinical activities and competencies.

Students are evaluated with written Mid-Unit Self-Assessments (last week before the December-January break), Final Self-Assessments (last week of the course, April 24th – 25th) and Final Assessments prepared by the Supervisor with input from Clinical Mentors/Preceptors.Long before these formal assessments, comments will be provided using the “insert-comment” function within Microsoft Word on bi-weekly Reflection Reports (RR), Verbatim Reports (VR), Critical Incident Reports (CIR), etc. Reflection Reports will be submitted no later than 24 hours prior to each bi-weekly Individual Supervision (IS), and, ordinarily, a student’s RR provides basis for IS conversation, dialogue, affirmation and challenge. Alternatively, by mutual negotiation and agreement, a VR, clinical intervention, or other “critical occurrence” from the student’s clinical work, peer group experience, or yet other significant experience from within or beyond the student’s participation in the program, could become “grist for the mill” for that particular instance of the supervisor-student relationship. Ideally, Paul will provide written feedback either before or during IS, or when not possible, as soon afterwards as possible.



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Reference attached document:☐ Course Syllabus

28. Describe how the faculty/supervisors evaluate the program and how the student feedbackis acquired and processed to improve future SPE units.

We anticipate program evaluation via several avenues: Reflection Report/IS feedback from students regarding the effectiveness and

relevance of individual didactic sessions; Mid-unit and Final Assessments; A written questionnaire administered to students at the end of the unit evaluating:

variety of pedagogical approaches and learning methods; quality of education received; quality of feedback; from the Teaching Supervisor, Clinical Mentors/Preceptors and others; the Centre as an educational facility, in addition to individual clinical sites, administration of the program; opportunities for student input; opportunities for resolving difficulties, complaints and grievances; and finally, an overall assessment of the program with endorsement (or non-endorsement) of the program to prospective students;

Evaluation from staff in participating IHCAM member facilities (unit managers, and others with whom students have close interaction) of the effectiveness and impact of the program for their facility;

A follow-up questionnaire sent to students six months after completion of a unit evaluating the program’s effectiveness and relevance for their practice of ministry and relevance of the training to personal and spiritual growth, with endorsement or not of the program to prospective students.

This will likewise be one of the ongoing tasks for the SPE Advisory Committee.Word Count: 192 /250


29. Is there anything else you would like to tell us about your programthat has not already been included?

As part of this Program Application, we make two additional requests:

1. While this will be Paul’s “3rd Provisional Unit,” given the fact that he is in process of making Application for Admission to Associate Supervisory Education, and on the strength of positive recommendations from his 1st and 2nd Provisional Units, we propose modelling this after the “Post-Advanced Consultancy” Unit developed for and occasionally accessed by students in the Riverview Health Centre CPE Residency Program. Rather than registering through The United Centre for Theological Studies for a 3rd Provisional Unit and paying full tuition, student fees, etc., Paul will undertake this unit as “course instructor” and Provisional Supervisor in-process-of-becoming Associate Supervisor.As long-time Riverview Supervisor Glen Horst explains,

“This consultancy unit was for students who had completed 2 units of Advanced CPE and were deemed ready to move intentionally toward certification. They then used their next/last unit in the residency program to begin working on (and presenting) the papers required for certification and to undertake increased levels of spiritual care responsibility in the centre as they prepared for employment in the healthcare field. This kind of consultancy program was tailored for each student according to their needs and interests, but always with an eye to what was required to demonstrate the level of competency necessary for certification.”



We believe this model offers a better fit for Paul’s supervisory status. Paul’s Supervisory Team (Tim Frymire and Mary Holmen), as well as Joanne Biggs (Regional Admitting Chair for CASC Manitoba) are in full support of this proposal.

2. As indicated with our response to question 16, we’ve had phenomenal response to this program offering in a relatively short period of time. In response to this demand, as well as the fact that the Riverview CPE Residency is “on hold” (and in the opinion shared by many within CASC Manitoba, may sadly not be returning to that facility at any point soon), we request permission to admit six (6) students into the program. Following our marathon day of screening interviews, we are prepared to extend offers of acceptance to 6 of the 7 candidates interviewed.After the screening interviews conducted on July 7th, offers of acceptance were extended on July 9th to six candidates, with the seventh candidate placed on a waiting list. Four of the six candidates accepted our offer, and two indicated they were discerning whether CPE could be part of their current work schedule. On July 22nd, both of those candidates indicated that they would decline our offer, at least for this “go-round.” We then extended an offer of acceptance to the seventh candidate, who accepted. This means that we are currently looking at a peer group of five students, though it is possible we might conduct further interviews to fill the sixth placement spot.


☐ Final Assessments – Recommendations from Paul’s 1st and 2nd Provisional Units

30. I am aware of the following (check off each that applies):

☒ After receiving program approval, I will submit changes to the program to the Accreditation Committee.

☒ I will be preparing for a Site Accreditation Visit after several units or after three years.☒ The SPE Advisory Committee will themselves, or will appoint a subgroup, to form the

study/review group in preparation for a site accreditation.


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Prepared by Paul Peters Derry, in consultation with Wilmar Chopyk, Tim Frymire and Mary Holmen, and acknowledging with appreciation documentation, policies and procedures statements, and templates from CPE Programs at Brandon Regional Health Centre (Joanne Biggs, Teaching Supervisor), Riverview Health Centre (Glen Horst and Tim Frymire, Teaching Supervisors), Selkirk Mental Health Centre (Mary Holmen, Teaching Supervisor), and Victoria General Hospital (Lynn Granke, Teaching Supervisor).

Respectfully submitted,

Paul Peters Derry, Provisional Supervisor Date

Tim Frymire, Teaching Supervisor Date

Mary Holmen, Teaching Supervisor Date

Wilmar Chopyk, IHCAM Executive Director Date

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