ACT

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UNDERSERVED COMMUNITIES

• ACT
• Memorial University
• Dalhousie University
• University of Saskatchewan
• University of British Columbia

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Rural Mental Health Interprofessional Training
Program

• Memorial University of Newfoundland
• P. Cornish, E. Church, V. Curran,
• C. Bethune, T. Callanan, J. McVicar
• Presented by Lisa J. Fleet

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Goals and Objectives of the Project

• To enhance awareness of mental health issues for
  health professionals in rural communities
• To develop knowledge of, and skills in, mental
  health intervention for health professionals in
  rural communities
• To enhance participants confidence in addressing
  mental health issues in rural communities
• To raise awareness of collaborative approaches to
  mental health intervention in rural communities
• To develop interprofessional teamwork skills

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Project Process (Methods)

• Developed a training program for rural physicians
  and allied health workers
• Pilot program
• Bonavista, NL (chosen based on previous needs
  assessment conducted)
• 19 weeks (Feb-June 2005)
• 1 full-day onsite session 8 videoconferencing
  sessions
• Pre and post training survey package
• Formative and summative evaluation conducted
• Program accredited for physicians

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Outcomes

• 20 participants 18 allied health and 2
  physicians
• Effective use of blended learning for training in
  mental health treatment and interdisciplinary
  team development
• Increased interprofessional collaboration along
  with knowledge and skills related to mental
  health care
• Maintained the belief in the overall importance
  of interprofessional health care
• Facilitated greater understanding of the role and
  knowledge base of other health professionals
• Opportunity for informal linkages with other
  professionals

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Challenges and Successes

• Retaining physician participation was difficult
  allied health participation was consistent
• Barriers to participation timing, financial
  compensation, coverage problems
• Technical difficulties and impersonal nature of
  technology
• Balancing the need for participants to bring case
  examples to the program with the lack of
  anonymity sometimes involved with living in a
  rural community

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Evaluation

• Pre and post training survey package
• 3 surveys
• Analysis of data showed that participants either
  maintained or increased their perceived value of
  interprofessional teamwork
• Formative evaluation
• Feedback form after each session
• High level of satisfaction with the training was
  reported (at least 4.5 out of 5)
• Summative evaluation
• Interviews with each participant
• Reported increased confidence in the skills
  presented in the modules
• Reported the ability to utilize new skills
  immediately

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Sustainability

• Next steps
• Curriculum revisions
• Provision of the program to 6 rural communities
  (3 in Fall 2006 3 in Winter 2007)
• Communities have been selected, but details not
  yet finalized
• Website is under development

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Project Presentations and Publications
(conferences, journals etc.)

• Poster Presentation to be presented at CACHE
  2006 (September 2006)
• Physicians and Psychologists as Team Builders
  Interprofessional Rural Mental Health Care
  Training

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Reducing Health Disparities for Members of
Marginalized Populations Changing Worlds
Diversity Health Care

• Dalhousie University
• Blye Frank, Ph.D. Doug Sinclair, M.D.

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Goals and Objectives of the project

• This funding supported the Changing Worlds
  Diversity and Health Care initiative. The goal
  of this initiative is to build an educational
  program on diversity across disciplines and
  professions to increase the cultural competency
  of faculty and staff in the Faculties of
  Dentistry, Health Professions, and Medicine at
  Dalhousie.
• The ultimate, long-term objective of the program
  is to make a contribution to the reduction of
  health disparities for members of diverse
  populations who have been historically
  marginalized.

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Project Process (Methods)

• The program addresses the potential role of
  education in contributing to the reduction of
  health disparities.
• Based on the expertise and guidance of an
  interdisciplinary advisory committee, a planning
  group and an evaluation committee, we are
  currently delivering weekly seminars, journal
  clubs and film viewings for faculty, staff and
  students in the Faculties of Medicine, Dentistry,
  and Health Professions at Dalhousie University.
• These sessions focus on health disparities,
  inequities and discrimination, working and
  teaching in diverse settings and health care
  delivery.
• These events have generally been well-attended
  and feedback has been positive and informative.

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Outcomes

• The Changing Worlds program, through its
  regular offering of workshops, seminars,
  information sessions, etc., has been a
  significant presence in the Dalhousie University
  community.
• The sessions were attended by a wide range of
  participants who, otherwise, may not have had the
  opportunity to participate in formally scheduled
  activities addressing issues of diversity and
  health disparity.
• Through the program, we have also purchased a
  number of workshop manuals, texts and films which
  are currently available for members of the
  community to borrow.
• Established www.changingworlds.dal.ca

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September October 2005
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November December 2005
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January and February 2006
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March April 2006
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May June 2006
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Challenges and Successes

• Challenges
• Logistics were our principle challenge where to
  hold events, when, who to ask to present, etc
• Successes
• Making available regularly scheduled events
  focused on taking issues of diversity into
  account.
• Our project was informed by an interdisciplinary,
  multisectoral advisory committee. There was a lot
  of collaboration between different schools,
  faculties and also with the broader community.
• Good attendance

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Evaluation

• While some educational programs addressing
  cultural competence or diversity education exist,
  there is little understanding of how well such
  programs work.
• Existing standardized measures fail to critically
  analyse the multifaceted issues of power and
  privilege that underline issues of social
  difference.
• Thus, we are using a qualitative approach to
  evaluate the Changing Worlds Diversity and
  Health Care program to gain evidence and better
  understand the efficacy not only of this
  particular program, but also of this method of
  diversity education in a medical education
  context.

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Sustainability

• In the spirit of sustainability, this funding
  supported a previously funded (through the
  Department of Canadian Heritage) initiative.
• Additionally, it is out intention to continue to
  seek funding, both institutionally and
  externally, to continue this critical work.

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Project Presentations and Publications
(conferences, journals etc.)

• Frank, B MacLeod, A. (2005). Beyond the four
  Ds of multiculturalism Taking difference into
  account in medical education. Medical Education,
  39(12), 1178-1179.
• Kumas-Tan, Z., Beagan, B., Loppie, C., MacLeod,
  A. Frank, B. (2006). Measuring cultural
  competence Examining hidden assumptions in
  instruments, Academic Medicine (submitted).

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Project Presentations and Publications
(conferences, journals etc.)

• Poster Presentation AFMC 2006, London, Ontario
• Poster Presentation Medical Education Symposium
  Day, Halifax, Nova Scotia
• Short Communication AMEE 2006, Genoa, Italy
  (forthcoming)
• Short Communication ASME 2006, Aberdeen,
  Scotland (forthcoming)

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Socially Accountable Continuing Professional
Development in an Urban Underserved Community
(CPDiQ Saskatchewan Project)

• University of Saskatchewan
• Penny Davis,MD
• Karen Barber, MSc,BPT

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Goals and Objectives of the project

• To identify the learning needs of health
  professionals related to working collaboratively
  in urban underserved community settings
• To identify and develop relevant and accessible
  educational programming to address the identified
  needs
• To assist health professionals to develop the
  skills to identify available resources and
  resource gaps in the community

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Project Process (Methods)

• Community health professionals needs
  assessments diabetes related complications
  selected as 1 health concern
• 3-session module health team and patient actors
  discuss concerns collaboratively develop a
  comprehensive care plan to address immediate and
  long term needs
• Evaluation of the module

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Outcomes

• Employing actors was an appropriate/useful/
  realistic approach (median score 9.0)
• The module served as a useful approach for
  inter-professional education (median score 8.0)
• The module provided a useful tool to address some
  of the gaps and barriers to effective
  inter-professional communication/ teamwork
  (median score 9.0).
• Ratings were based on a 10-point scale where 1
  was Strongly Disagree and 10 was Strongly Agree

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Challenges and Successes

• Size of the health team too large, artificial
• Lack of clarity/understanding regarding the roles
  of the various team members
• Difficulty envisioning how the approach will be
  implemented at the primary health centre
• Quality of the actors
• Working as a team to address care of the patient
  learning the roles of the team members
• Learning an integrative approach to health care

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Evaluation

• Debriefing with health team after each session
• Debriefing with actors as themselves after final
  session
• Educational module survey
• Feedback survey approximately six months
  following the pilot project

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Sustainability

• Impractical to apply the module format to general
  patient interaction in a primary health care
  setting
• Approach used in module useful guideline for
• interaction with patients and other
  professionals
• clinical teaching
• Cost-effective way of bringing people together to
  talk
• Module approach already being used in
• shared mental health setting
• undergraduate case-based clinical setting with
  preceptors

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Project Presentations and Publications
(conferences, journals etc.)

• College of Medicine brown bag lunch seminar
  presentation (February, 2006)
• Conference presentations and journal submissions
  currently in development

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Symbiosis of community and academiaAboriginal
Partnership inInterprofessional Training

• The University of British Columbia

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Distributed learning

• Community partnership?
• Underserved?
• Perception of Health?

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Goals and Objectives of the project

• Overall Project Goal
• Community centered curriculum
• Understand Aboriginal context on Health
• Education improving access
• Objectives
• Community-Academia partnership how?
• Interprofessional, situational learning
• Novel faculty development clinical delivery

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Project Process People

• Community leaders, Curriculum, evaluation
• Mt. Currie Health Centre (Pemberton)
• Tsewulhtun Health Centre (Cowichan)
• Medicine, Nursing, Pharmacy, Social Work
• College of Health Disciplines
• First Nations House of Learning
• Iterative, mutual engagement discussion
• Course supervisor instructors
• Summer 2006 2 groups IP students

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Project Process Actions

• Curriculum community owned
• Evaluation framework
• Ethics approval
• UBC Accreditation IHHS 408
• Departmental time table matching
• Student selection process

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Momentum
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Momentum builders

• Shared vision of planning team
• Meaningful community partnership
• Supportive faculties
• Enthusiastic students
• 2 Grants
• UBC TLEF 35,400
• BCAHC 148,100

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Project Exposure

• Poster Presentation
• Where is the Patients Voice in Health
  Professional Education?
• November 3-5, 2005, Vancouver, BC
• Ministry of Health Press Release
• Aboriginal Planning Conference
• May 23-25, 2006, Prince George, BC

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Emerging Lessons
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Lessons Challenges

• Engaging community co-develop course
• Coordinating curriculum, implementation,
  evaluation and delivery
• Implementing Matching intent and action
• Engaging faculty level of experience
• Funding develop, evaluate, sustain

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Keys to Success

• Right People on Planning Committee
• Experts curriculum, evaluation, implementation
• Connection community trust
• Integrity champions for success
• Motivated communities full partners in all
  stages
• Funding
• Stimulation from CPDiQ
• Develop, evaluate and sustain
• Symbolic early success of collaboration

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Evaluation
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Evaluation

• Student Evaluation tool
• Instructor Evaluation tool
• Program (Course) Evaluation
• Planning committees perspective. . 
• Feedback course instructors, preceptors,
  students, community course developers
• The community supports evaluation
• Ownership, Control, Access, Possession
• Prefer talking circles, elder led conversations

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Sustainability Planning
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Planning Committee

• Evan Tesla Adams
• James Andrew
• Lesley Bainbridge
• Manon Beaudrie
• Annette Browne
• Shaunee Casavant
• Judith Gohn
• Peter Granger
• Kendall Ho
• Sandra Jarvis-Selinger
• Eduardo Jovel
• Leanne Kelly
• Jennifer Kouwenberg

• Helen Novak Lauscher
• Yolanda Liman
• Framin Mark
• Lydia Seymour
• Elizabeth Stacy
• Leah May Walker
• Vince Verlaan
• Myrna Wallace
• Carl Whiteside
• Charlotte Williams
• Ivy Williams
• Robert F. Woollard

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