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,MSW Nicole Ranger B.Sc.

Conflict Disclosure Information Presenters:  Diane Mageau, consultant with College Boreal with respect to simulation and Interprofessional Education  Gayle 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? We have no financial or personal relationships to disclose

Conflict Disclosure Information: Presenter: Title of Presentation: Financial Disclosure Grants/Research Support: Speakers Bureau/Honoraria: Consulting Fees: Other: (ie Employee of…) Non-Financial Disclosure Member of: (ie. Personal interest group) Other:

Conflict Disclosure Information: Presenter: Title of Presentation: I have no financial or personal relationships to disclose

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 communication  Enhanced collaboration abilities  Improved referral outcomes  Enhanced patient care and health outcomes  Recognize 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- services  appropriate use of specialist clinical resources  health outcomes for people with chronic diseases  patient care and safety (World Health Organization, 2010)

Collaborative Practice Can decrease:  total patient complications  length of hospital stay  tension and conflict among caregivers  staff turnover  hospital admissions  clinical error rates  mortality rates World Health Organization, 2010

The “WHY”…Patient Safety  Human Factor Analysis  An epidemic in communication errors  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:  st 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

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 Canadian Interprofessional Health Collaborative, (2010). A national interprofessional competency framework. Retrieved July 26, 2010 from 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), 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,