1. “Bringing the Global Perspective Home: Issues in Assessing and Testing International Pharmacists” Christyna Schillemore R. Ph., B.Sc.Phm., M.Ed. Manager, Registration Programs Ontario College of Pharmacists Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona

2. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Setting the Context Ontario received 57% of immigrants to Canada Quebec 16% British Columbia 15% 2001 to 2003

3. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Setting the Context In 2003 approx 120,000 immigrants to Ontario – 84% settle in GTA 70% have post secondary education

4. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Setting the Context Ontario has the most diverse population in Canada - 27% are foreign born 44% of Toronto residents are foreign born Immigrants account for 50% of Canada’s population growth

5. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Acronyms ACPE American Council for Pharmacy Education AFPC Association of Faculties of Pharmacy of Canada CCAPP Canadian Council for Accreditation of Pharmacy Programs IPG International Pharmacy Graduate MTCU Ministry of Training Colleges & Universities OCP Ontario College of Pharmacists PEBC Pharmacy Examining Board of Canada SPT Structured Practical Training

6. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Ontario College of Pharmacists 10,000 Members 25% are educated outside Canada 25% are educated in other provinces and the U.S. 50 % are educated at the University of Toronto

7. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Requirements for Licensure as a Pharmacist in Ontario Pharmacists Educated in Canada/US Pharmacists Educated Outside North America Degree from Accredited program (Practical training through clinical rotations) Degree/Credentials evaluated by PEBC Fluency, PEBC Evaluating Exam 12 weeks internship48 Weeks In-Service Training 16 Weeks IPG program 16 Weeks Studentship 16 Weeks Internship PEBC Qualifying Exam Jurisprudence Exam

8. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Rationale for IPG Program Trends – increase in number of internationally trained pharmacists Adoption of a set of National Competencies for pharmacists Changes in training requirements Changes in the National Licensing Exam

9. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Feedback from focus groups of international pharmacists & preceptors Results from Quality Assurance Practice Review Different standards between Canadian Pharmacy programs and those outside North America Rationale for IPG Program cont’d

10. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona International Pharmacy Graduate (IPG) Program OCP Grant to Faculty of Pharmacy, University of Toronto for 3 years Developmental costs Faculty to provide access to resources and existing courses Goal: Similar competency outcomes for IPGs and U of T/Canadian students

11. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona IPG Program Expansion $3 million in grants from MTCU Partnership between the Government, University Faculty and OCP

12. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona IPG Program Overview PRIOR LEARNING ASSESSMENT – to evaluate each individual’s specific learning needs and level of practice readiness EDUCATION – customized learning from curricula packaged as 2 eight week academic modules (CPS I & II) MENTORSHIP – to enhance links to the pharmacist community and to facilitate professional enculturation and post-program employment DISTANT TECHNOLOGIES – to reduce barriers to access & make program components available throughout the province

13. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Lessons Learned from the IPG Program Build on fluency with profession specific language and supports Previous Canadian Workplace experience to provide context for learning Enculturation to Canadian workplace is important

14. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Lessons Learned from the IPG Program cont’d Need close linkages to employers for training placements, financial supports & job opportunities Communication pathways important Sustainability of program Accessibility of program (geographic & financial) Marketing value of the program

15. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Challenges in Assessment and Testing IPG Program International Candidates are treated as a homogeneous group but are not Ethical perspectives and cultural contexts misperceptions Formative feedback Cultural competence vis a vis test taking Self assessment Role play

16. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Challenges in Assessment and Testing cont’d National Licensing Exam (PEBC) Limit on the number of attempts on the national licensing exam Some candidates do not take the limit seriously until too late Computer based testing not currently available- cost, security concerns Testing not available outside Canada Nature of OSCE does not allow widespread testing

17. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Challenges in Licensing IPG program is a mandatory but exemptible requirement It appears on paper that circumventing the IPG program is cheaper, faster route to licensure IPG program is not yet widely available across the province University is not ready to guarantee the offering of IPG program without base funding

18. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Culture “Culture is like water to a fish. A fish does not know water exists until it jumps out of it.”

19. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Cultural Competence “…is defined as a set of congruent behaviours, attitudes, and policies that come together in a system, agency or among professionals and enables that system, agency or those professionals to work effectively in cross-cultural situations”. (Cross et al., 1989; Isaacs & Benjamin 1991.)

20. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Cultural Competence Language of practice Social language- verbal/nonverbal Understanding of Canadian healthcare system Values and norms (e.g. ethics) Workplace norms ( teamwork, management, performance, hierarchy)

21. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Hidden Costs of Pharmacists Lacking Cultural Competence Lack of confidence or ability to use professional judgment Lack of communication skills and cultural competency can result in the escalation of dispensing errors Impact of using inappropriate or overly technical language in counselling Failure to thrive in the workplace

22. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Websites of Interest Regulators Consortium www.regulators4access.ca www.regulators4access.ca OCP www.ocpinfo.comwww.ocpinfo.com IPG Program www.ipgcanada.cawww.ipgcanada.ca PEBC www.pebc.cawww.pebc.ca

23. Presented at the 2005 CLEAR Annual Conference September 15-17 Phoenix, Arizona Speaker Contact Information Christyna Schillemore Ontario College of Pharmacists 483 Huron Street, Toronto, Ontario Canada M4R 2R4 Phone: 416-962-4861 x242, Fax: 416-847-8265 cschillemore@ocpinfo.com www.ocpinfo.com