Welcome to our new international magazine, Together: Stories of Collective Impact
Thank you for reading.
Why a magazine?
We have elevated our longstanding newsletter to a magazine to recognize that this international community has been contributing stories for years now, well beyond what we might expect in a typical newsletter. Thank you and many thanks to this readership and community for sharing your innovation, research, and stories relating to collaborative healthcare and education.
Why now?
We know that health teams are recovering from a challenging few years. We know that collaboration and interprofessional education is key to this recovery. Our magazine, Together, will provide a tangible space for us to connect, learn, share, celebrate, and champion how we work and learn together for a healthier world.
What will it look like?
The magazine will be online only, and feature regular, recurring columns, focused on:
1. Staying in Touch: News, Events, & Celebrations
2. Learning in Motion: Education & Practice
3. Including & Engaging: Community & Partnership
4. Integrating Ways of Knowing: Research & Innovation
5. Inspiring Change: Systems, Policy, & Leadership
We will curate, invite, and write. Our cover art will be an open submission. And most of all, we will share and celebrate.
We look forward to your submissions, feedback, and reactions
With gratitude,
Stella Ng CACHE Director,on behalf of the CACHE Team
This art piece hopes to increase the awareness of imposter syndrome amongst healthcare professionals. Transitioning from online academic studies during the COVID-19 pandemic to working in the field, the high aspirations of making positive change in patients’/clients’ lives are faced with the feeling of self-doubt and feeling out of place.
Imposter syndrome is defined as a psychological pattern of fear and self-doubt. Individuals with imposter syndrome doubt their accomplishments and worry that they would be
found frauds. This can manifest as having extremely high expectations of oneself associated with high pressure to meet those expectations. However, individuals tend to downplay their achievements. This starts to create a vicious cycle and exacerbates imposter syndrome. Eventually, this can lead to burnout and becoming emotionally exhausted. Our goal was to create a blackand-white drawing that can be interpreted in different ways to show the different phases of imposter syndrome. We hope to challenge the high expecta-
tions and pressure to succeed and the unrealistic standards that we have in the healthcare field. Acknowledging the presence of imposter syndrome is the first step in creating a supportive healthcare community.
The Interprofessional Health Arts & Humanities program helped us foster relationships with our colleagues in different health professions, develop more empathy, and become more open-minded. It taught us to become better collaborators, communicators, and critical thinkers.
Dr. Sacha Agrawal
We are pleased to announce Dr. Sacha Agrawal has joined the CACHE team as Inclusion and Co-Production Advisor and guiding CACHE on enacting meaningful inclusion, per our strategic aspirations. As CACHE prioritizes co-creation, collaboration, and partnership, we are set up for opportune learning and growth within our Centre, and in all our outreach, by learning and working with Sacha.
Sacha is an Assistant Professor in the Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto and a clinician educator at CAMH, where he is the Education Lead for the Division of Schizophrenia. He completed medical school at the University of Toronto, his psychiatry residency and Master’s degree in health research methodology at McMaster University, and a fellowship in Public Psychiatry at Yale University. He works as a community psychiatrist at the Centre for Addiction and Mental Health, where he is a member of an assertive community treatment team. He enjoys spending time with his family, cooking and eating plant-based foods, and making music.
Dr. Rahim Karim, BSc, DC, MBA, CHE, ICD.D was installed as the 10th President and CEO of the Canadian College of Naturopathic Medicine on September 23, 2022, and some CACHE team members were most honoured to be able to attend in-person and via livestream and celebrate Rahim! The new President signals an era of partnerships and global reach for CCNM. Read the full press release: https://bit.ly/3yalNfx
CACHE Awards of Merit for Excellence in Interprofessional Education (IPE) 2021-2022 Awards announcement:
Each year the Centre for Advancing Collaborative Healthcare & Education (CACHE) recognizes educators, preceptors, leaders, and students who have demonstrated dedication and engagement in interprofessional education and care. We would like to congratulate the following outstanding individuals as winners of the 2021-2022 CACHE IPE Awards of Merit
Ivy Oandasan Leadership Award for Outstanding Contributions in Advancing IPE
Voula Christofilos
Manager, Centre for Education, North York General Hospital
“
Voula has had significant impact at NYGH over the past 21 years as a teacher, educator, scholar, and education leader. She has had sustained impact in teaching excellence and also for her broad contributions to education at NYGH and beyond.”
Patient/Family Partner, Unity Health
Toronto
“Helen is a Patient Family Partner (PFP) at Unity Health, with a strong commitment to interprofessional education (IPE), demonstrated through her longstanding teaching and leadership at Unity Health. She is a dedicated, innovative, and well-respected member of the Collaborative Learning Committee (CLC) who generously shares her ideas and experience and makes suggestions for change, based on evaluation data.”
Kristyn Lee
Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto
“
Kristyn has demonstrated collaborative leadership skills through her involvement with the Interprofessional Healthcare Students’ Association (IPHSA). During her first year, she was the Occupational Science and Occupational Therapy year 1 class representative, and sat on several IPSHA sub committees. In her final year, Kristyn took on the role of the IPHSA President where she continued to support her peers and focused on strengthening the connection between faculty, students, and CACHE ”.
A big congratulations to this year’s amazing winners!
SAVE THE DATE!
Award of Merit for Excellence in Interprofessional Education Celebration Event
Wednesday November 9th, 2022 • 5:00pm - 7:00pm
More details to come! Should you have any questions please contact Fatima.Mimoso@uhn.ca
A six-module virtual learning series covers key best practices and core competencies for interprofessional education (IPE) and virtual facilitation.
The newest technologies and virtual active learning strategies are co-facilitated and modelled by two CACHE faculty, leveraging didactic theory bursts, small group breakouts, large group discussions/reflections, virtual stretch breaks, real-time polling, chat boxes and team simulation videos. The unique use of best practice videoconferencing team norms supports participant psychological safety, equity, and attention to engagement in a new virtual environment.
Program Dates: October 25 - November 10, 2022 (Tuesdays and Thursdays)
Each module is 90 minutes from 10:00am - 11:30am (Eastern Standard Time)
Module 1: Overview of IPE/IPC Evidence, Literature and Best Practices
Module 2: Role Clarification
Register by October 18th!
Module 3: Interprofessional Communication and Conflict - Focus on Patient Safety / Quality Improvement
Module 4: Relationship Centred Care: Patients / Caregivers and Teams
For more information visit our website or email belinda.vilhena@uhn.ca
Module 5: Team Functioning/TeamworkPsychological Safety and Leadership - Pulling it All Together
Module 6: Interprofessional Facilitation Simulation, Tips and Resources
OPEN for Registration!
November 22, 2022 from 8:30am-11:00am (Virtual)
We are offering an innovative foundational team-based care workshop in a virtual synchronous interactive 2.5-hour format with an aim to improve interprofessional collaborative practice for clinical and project teams across organizations. We welcome interprofessional team members to come together to work collaboratively on their teamwork or individually to bring learnings back to their team. To optimize collaborative learning, we utilize virtual large group reflections, small group breakout discussions, video team simulation and best practices in virtual team facilitation. Teams in all areas of health care are striving to provide collaborative models of care that optimize patient outcomes and experiences, particularly with the challenges and silver lining of a COVID-19 impacted system. This is an opportunity to enhance the collaborative practice environment for all staff and students.
By the end of this workshop, participants will be able to:
• Apply interprofessional competency-based tools to optimize communication, conflict and performance for virtual and non-virtual teams
• Promote a climate of psychological safety and team functioning in virtual and non-virtual interactions and meetings
• Reflect on and develop an action plan for improving quality, safe team-based care in your context
For more information visit our website or email sabrina.bartlett@uhn.ca
JOIN US on Wednesday November 23, 2022 - 4:00pm - 5:30pm via Zoom for our Community of Practice event: Exploring the role of patients/ caregivers within the collaborative team
Presenters:
• Dr. Kateryna Metersky – “Do I have a role in my care?”: Patient Roles on Interprofessional Teams
• Sarah Coppinger & Lisa Muc – Care Partners Program at Michael Garron Hospital
Register to attend via: https://us06web.zoom.us/meeting/register/tZYocOigrTssE92Lbms3rCVl6PgANTb06Dz9
CCL is a certificate program offered by the University Health Network (UHN) in collaboration with the University of Toronto (UofT) Centre for Advancing Collaborative Healthcare & Education (CACHE).
During the COVID-19 pandemic, our alumni are reaching out to share that the Collaborative Change Leadership (CCL) Program has enhanced their ability to be the leaders needed for these challenging and uncertain times. As alumni are engaging their teams and communities in compassionate and meaningful ways to co-create and sustain system change, they are achieving rapid, efficient and unprecedented results. CCL is specifically designed for the time in which we find ourselves. The need for emergence, adaptation, co-creation, and highly effective implementation rooted in compassion has never been more critical. As such, we are delighted to continue offering a synchronous, virtual CCL Program in January 2023.
• January 26 - 27, 2023
• March 30 - 31, 2023
• June 8 - 9, 2023
• September 28 - 29, 2023
• November 30 - December 1, 2023
Application Deadline: November 30, 2022. For more information visit the program website or email belinda.vilhena@uhn.ca
We are now accepting proposals for Convergence2023!
Our 4th annual Healthcare Education Conference will offer unique and exciting opportunities to network, learn and co-create in a safe space.
Visit www.michener.ca/convergence for more information and to submit your proposal today! Call for proposals closes October 21st.
Teaching for Transformation:
Conference+ (TforT:AC+) March 27-29, 2023
Call for abstracts now open Registration now open
Teaching for Transformation: Annual Conference+ (TforT:AC+) is a three-day immersion in the education paradigms and practices needed for today’s health care work. TforT: AC+ involves keynote facilitated sessions, nominated emerging work (NEW) talks, workshops, submitted short talks, roundtables, and space for open dialogue. TforT:AC+ will take place online, enabling an international reach. TforT:AC+ is more than a conference. Registration is limited to foster a dialogic learning environment. Additionally, registrants will gain access to a private website of resources and activities for their ongoing use and an online community of support.
Call for Abstracts
The TforT:AC+ Planning Committee invites Short Talk abstracts on finished studies, works in progress, or innovations on the topics of transformative education, transformative learning, critical pedagogy, and more--within the context of health professions and health sciences education. Abstracts will be reviewed and a limited number invited for presentation. This year, we will have fast-paced short talks (presenters will speak for approximately 3 minutes each) followed by breakout spaces for engaging in deeper dialogue.
Abstract Deadline: November 14th, 2022, 11:59pm EST.
Abstract Review Committee: Beck McNeil, Jeffrey Kiyoshk Ross, Sarah Wright (Chair)
TforT:AC+ Registration
TforT:AC+ invites educators, patient/family/caregiver partners, clinicians, administrators, leaders, and scholars interested in the theory and practice of humanistic and transformative education and critical pedagogies and practices. Don’t miss the early bird discount! Click HERE to register For more information visit the TforT:AC+ website or Email: tfortac2023@teachingfortransformation.com
Teaching for Transformation (TforT) is jointly offered by Centre for Faculty Development and Centre for Advancing Collaborative Healthcare & Education.
Collaborating Across Borders (CAB) VIII Conference is coming and welcoming abstracts!
Collaborating Across Borders VIII (CAB VIII) is focusing on advances in interprofessional practice and education, research and innovation, and policy, systems and leadership with a newly added French-language stream. The University of Toronto’s Centre for Advancing Collaborative Healthcare and Education (CACHE) is honoured to host in collaboration with the Canadian Interprofessional Health Collaborative (CIHC) and the American Interprofessional Health Collaborative (AIHC). The theme of the conference is Hope and Trust in Health and Social Care. CAB VIII is currently seeking abstract submissions from a diverse representation of disciplines, organizations and experiences. All submitted abstracts will be vetted through a blind-review process and evaluated by professionals from across the interprofessional health education community.
The conference will be held on May 16-18, 2023 with pre-conference activities on May 15, 2023.
Call for Abstracts is now open for CAB VIII with the deadline of October 17, 2022. Visit the website to read the Abstract Submission Guidelines and to submit an abstract: https://events.myconferencesuite.com/CAB-VIII/page/CallforAbstracts
Please hold the date & time, and spread the word!
For more information: www.collaboratingacrossborders.com
ECHO is a program that provides healthcare providers with support for treating patients with complex chronic conditions, within their own communities. ECHO sessions happen virtually all year long with a focus on case based learning, and supplemented by a curriculum with subject expert presentations. Our in person offerings will be ramped up the following year, offering in person workshops that provide hands-on experience in providing training from managing opioids to physical assessments. All primary care providers from across the province are invited to register and join our CPD programs.
What is ECHO?
• ECHO links primary care providers in Ontario with each other and with a specialist team during weekly videoconference sessions.
• Participants gain knowledge, skills and support.
• Each session includes a short didactic and real (de-identified) case discussions.
• Participants earn CPD hours, and there is no cost to join (funded by the Ontario Ministry of Health).
ECHO at UHN offers programs in Chronic Pain & Opioid Stewardship, Rheumatology, Liver Diseases and Concussion. Our concussion program starts a new curriculum program on September 19. For more program information, times, and how to register, visit us at https://uhn.echoontario.ca
Best Practice in Education Rounds (BPER) is a partnered program between the Centre for Faculty Development (CFD), The Wilson Centre, and CACHE. Collaborating between our Centres allows us to leverage our expertise and networks to provide more impactful, relevant offerings.
BPER provides the opportunity to share innovative and emerging ideas with a wide audience of interested health professional teachers, educators, leaders, and scholars. BPER aims to reach a diverse audience, including patient/client and family partners and a range of professional/health worker backgrounds. Learn more about upcoming rounds here: https://centreforfacdev.ca/best-practice-in-education-rounds/
Month of October
• Occupational Therapy Month
November 6-12, 2022
• Medical Radiation Technologists (MRT) Week
• Perioperative Nurses Week
November 8, 2022
• National Aboriginal Veterans Day
November 11, 2022
• Remembrance Day
November 20, 2022
• Transgender Day of Remembrance
We are excited to welcome back students, educators, patient/ family/ caregiver partners, facilitators, community partners, all those who engage and support our collaborative learning community. There is much to look forward to as we cautiously transition back to some in-person activities. We are ready to collaborate, learn, and venture through the 2022-2023 academic year with you!
Ahuge thank-you to Mark Bonta for 10 years of work on the InterFaculty Curriculum Committee (IFCC) and supporting the engagement of medical students in the IPE curriculum. Mark was involved in leading and supporting several curriculum working groups throughout the years including Roles of Health Professions & Team Dynamics, and Conflict in Interprofessional Life. Students and faculty have greatly benefited from his input and guidance. We wish Mark the best in his future endeavours.
We are pleased to welcome Evan Tannenbaum to the InterFaculty Curriculum Committee (IFCC).
Evan is an obstetrician gynaecologist at Mount Sinai Hospital. In his new role as the MD Program Collaborator Theme Lead and IFCC member he shares, “I am enthusiastic about teaching our learners about interprofessional collaboration and how we can work together to improve patient/client outcomes”. Evans’ background is in medical education and he completed an MSc in Health Sciences Education from McMaster University in 2019.
Join us in welcoming Evan! Please read as he graciously shares a little about himself and his work below.
“In my day-job as an obstetrician, I have learned first-hand the benefits of working together. I am passionate about bringing an evidence-based approach to teaching and evaluating collaboration as I aim to help our learners realize the importance of collaboration in providing care to patients/clients and their families.
Transforming care through collaboration means building and maintaining teams of healthcare providers that provide comprehensive care to patients/clients and their families. It involves health professionals from a range of backgrounds bringing their own personal and professional perspectives to create a mosaic of care that is skilled, comprehensive, coordinated, and holistic. When our unit seamlessly springs into action to assist in the birth of the newborn, it can be hard to recognize the amount of time and effort that has gone into creating and maintaining a functional team. Transforming care through collaboration means building the types of teams that function seemingly effortlessly.
One of the things that has been exciting for me to experience lately is the increased use of simulation to teach collaboration. Simulation provides a safe space to make mistakes and learn from each other. Like a baseball player in the batting cage, our health professions students can benefit from learning and practicing in controlled settings where structured feedback and debriefing can be facilitated.
Finally, at the center of interprofessional education and collaboration is the importance of respect, listening, and equity. I am currently working on developing an interprofessional learning activity that explores how equity, diversity, and inclusion (EDI) principles impact the way we work together to care for our patients/clients.”
Timothy Zhang, MD 2024
Asa University of Toronto (UofT) third year medical student I, alongside my classmates, had the opportunity to shadow various healthcare professionals as part of our transition to clerkship. Organized through a collaborative effort between UofT’s medical academies, the Centre for Advancing Collaborative Healthcare & Education (CACHE), and the clinical staff who generously provided the experience, I was fortunate to be paired with Leora Wanounou, a nurse practitioner, working in hemodialysis at St. Michael’s Hospital. We accompanied Leora through her morning of rounding on the dozens of hemodialysis patients under the purview of herself and another hemodialysis nurse practitioner, all with varying needs, levels of disease, and comorbidities. Aside from the varied patient load, what perhaps was most prominent were the genuinely amiable relationships Leora had with her patients; Leora was an undoubtedly comforting force as hemodialysis patients often require treatment for 3-4 hours, multiple times per week. Towards the end of the week, we also had the opportunity to debrief in small groups on our interprofessional shadowing experiences. I heard about fellow classmates’ experiences with spiritual care, speech language pathology, ultrasound technicians, and others. Debriefing allowed us to learn more about the roles and scopes of practice for healthcare professions we have not yet been exposed to. Most importantly, acquainting ourselves with challenges in their roles served as a humbling reminder that there is often much more we can do as future physicians to be better allies with our team.
Holland Bloorview Kids Rehabilitation Hospital continues to look for new and innovative ways to bring the perspectives of people with lived experience of childhood disability to interprofessional learning for students in the health professions. This past summer, four of our family as faculty leaders (family leaders who have been trained as educators) Protibha Gupta, Matt Swan, Meredith Sandles, and Marion Knutson, co-facilitated two IPE structured clinical placements for clinical students. The exciting part of the structured clinical placements involved virtual home visits to the family as faculty leaders’ homes. Meeting the families, seeing the home environment, and having casual and heartfelt conversations was very meaningful for the 13 students representing medicine, music therapy, pharmacy, speech-language pathology,
and recreation therapy. When asked what they will take away from the experience, one student commented, “Collaboration, deeper listening, hearing the story not just the diagnosis, involving families directly in the care plan, and empowering the child.” Family as faculty leader Matt Swan reflected that, “teaching is about giving back: sharing your experience, both the joys and the pains, to provide a fuller capacity for compassion and understanding. I feel that my role helps bridge the gap between the theory they learned and the practical experience of working with families at Holland Bloorview.” For more information about the role of family as faculty and the IPE structured clinical placement with a virtual home visiting component, please contact Darlene Hubley, IPE Leader, Holland Bloorview at dhubley@hollandbloorview.ca
Jennifer Lovering, BHSc, BScN, RN, MN (student) Sunnybrook Health Sciences Centre
Sunnybrook has focused on building education and career pathways in an effort to create high functioning teams and contribute to staff retention. Part of this work involves the Clinical Extern program which allows health professions students and
Internationally Educated Nurses to be immersed in the socio-cultural setting of hospitals, while developing clinical expertise, specialty knowledge, and self-confidence. Sunnybrook’s Clinical Externs have been instrumental in supporting direct patient care and staffing to enhance safety and quality care across the organization. Collaboration between Nursing Education and Interprofessional Practice facilitated a Clinical Extern shadow opportunity in specialty areas that have recruitment needs and limited student placements, including the Emergency Department, Critical Care, Post Anesthesia Care Unit, and the Women and Babies program. The shadow opportunities aimed to expose future staff to clinical skills and interprofessional teamwork, while providing a chance to engage with local experts and participate in thoughtful reflection during a facilitated debrief. Clinical Externs acknowledged the value of this experience, with 100% of respondents recommending the shadowing opportunity. One Clinical Extern stated, “We can get a chance to look in the unit deeply with a shadowing shift. The nurses are really helpful and willing to share.” Survey responses indicated an increase of 32% in the proportion of Clinical Externs who are very or extremely interested in working in the clinical area shadowed. We look forward to offering future opportunities for career pathway growth and team-based learning.
Vani Patterson, MPH
Michigan Center for IPE Administrative Director
University of Michigan (U-M) Center for IPE tracks 5 interprofessional competencies for approximately 35 IPE offerings and 5000 students from 10 professional schools-- which all require reporting on IPE for accreditation. The Center faced challenges in tracking offerings, student participation, and IPE competencies achieved by learners, complicated by use of diverse formats, including formal courses, online courses, modules embedded in courses, one-time events, and experiential settings. The U-M Center for IPE collaborated with U-M Information Technology and Services (ITS) to implement a vision for managing data within and across programs, schools, and campuses. The resulting process leverages the learning outcomes in Canvas (with shell Canvas courses for offerings outside the typical for-
mat), student-level data from the Registrar’s office, and the IPE database containing all details of the IPE offerings. This new U-M “Competency-Based Tracking for Interprofessional Education Leveraging Institutional Data” received a 2022 award from 1EdTech, a nonprofit collaborative advancing education technology and learning impact. “It is a big step forward in being able to track IPE competencies that students achieve through diverse learning experiences from our different health science schools,” said Gundy Sweet of the U-M College of Pharmacy, a leader on the project. “Building the critical infrastructure for us to share data across our schools isn’t easy to do,” said U-M Center for IPE director Raj Mangrulkar. “It required creative thinking in IT, data systems, and integration with existing structures in order to visualize the progress of our learners in IPE.”
https://interprofessional.umich.edu/2022/06/10/u-mteam-wins-learning-impact-award-for-ipe-data-tracking/
Supriyati, Dr., M.Med., BSS
Center of Health Behavior and Promotion, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada - Community and Family Health Care with Interprofessional Education, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
Siti Rokhmah Projosasmito, M.D., M.Ed.(L,P&C), M.B.B.S.Department of Medical Education and Bioethics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada - Community and Family Health Care with Interprofessional Education, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
Healthliteracy is not limited to the person’s ability to read and understand the health message. Health literacy is the ability to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Health literacy is essential to help people stay healthy during pandemics. Faculty of Medicine, Public Health, and Nursing at the Universitas Gadjah Mada empowered interprofessional students to increase community health literacy during the COVID-19 pandemic. There were 86 small groups that each consisted of five students from medicine, nursing, and dieticians. First, students attended the capacity building to conduct a need assessment arranged by the faculty. Secondly, they conduct a need assessment in the partner community, and discussed with their field supervisor to develop a plan of action. Afterwards, they carried out a health literacy improvement program for a partner community (consisting of 10 households) in Sleman Regency, Yogyakarta Special Province, Indonesia. The health literacy improvement program addressed many knowledge areas such as how to improve the community’s healthy diet and physical activities during the pandemic. Most of the programs were carried out online by using Instagram, WhatsApp, Zoom meetings, and other platforms, since health protocols were of importance during the program. The program helped people choose the trusted health information and kept them practicing healthy behaviours.
https://www.instagram.com/cfhc.ipe.ugm/?hl=en
ProjectECHO is a virtual education method that uses a hub-and-spoke model to connect community health and social care providers (spokes) with an interprofessional team of specialists (hub). Sessions involve a didactic presentation from the “hub,” followed by a “spoke” provider’s presentation of an anonymized patient case. The discussions that follow offer opportunities for everyone to share recommendations that providers can use in the future. We are medical students who worked at the Azrieli Neurodevelopmental Centre at CAMH where we observed an ECHO focused on the health of adults with intellectual and developmental disabilities (AIDD). Through this, we furthered our understanding of cross-sectoral approaches to caring for people with IDD and developed a greater appreciation for interprofessional, case-based learning. A major takeaway from ECHO AIDD was the importance of the “all teach, all learn” approach, especially when individuals often excluded from typical education, such as caregivers and self-advocates, are involved. This approach fostered an environment where everyone was comfortable sharing opinions on real life challenges. Participants drew from both professional knowledge and their lived experiences, which we do not often see in the classroom, to give a broad range of recommendations that were interdisciplinary and patient-centered. Observing the ECHO was invaluable, as it gave us a greater understanding of different disciplines involved in healthcare and tangible examples of interdisciplinary teamwork. We hope to see similar spaces in the future where learners, professionals, caregivers, and patients all feel comfortable to teach, learn, and share experiences to improve healthcare for everyone involved.
https://camh.echoontario.ca/programs-aidd
Our patient//family/caregiver partners contribute significantly and meaningfully to the learning experience of students from over 12 health sciences professions across the Toronto landscape. The patient//family/caregiver partners thus impact the education of over 1000 new students per year and over 4000 at any given time. Our patient//family/caregiver partners help ensure that future health care workers will be relationship- and person-centered in their approach, providing more compassionate and collaborative care. Thanks to the generous financial donation of the Townsends in November 2021, CACHE has been able to launch a fundraising fund and matched funds to be used for our patient/client and family/caregiver partners program.
In health care, collaboration makes a world of difference. New discoveries, high-quality care, and compassionate experiences rely on strong collaboration, teamwork, and system integration. Teams must include: patient and family voices, students as leaders, and thriving health care providers and staff. Healthy teams are built through effective education and bolstered by well-designed systems. Our Centre is transforming care through collaboration across 11 health sciences programs, 15 hospitals, and a world of education, care, and research partners. Your generous donation will help us recognize the important contributions of patient and family partners in education, create collaborative student leadership opportunities, and reinvigorate depleted teams as they recover from the pandemic and prepare to excel into the future. Your donation is an investment in our collective future: working together for a healthier world.
Sunnybrook Health Sciences Centre’s Jennifer Tory Trauma Recovery Clinic (TRC) recently celebrated its one year anniversary! The clinic is the first of its kind in Canada and offers co-located, client-centered, interprofessional services to the trauma population, which previously did not exist. The team is comprised of Allied Health professionals (Physiotherapist, Occupational Therapist and Social Worker), Mental Health professionals (psychologist and psychiatrist), physician/specialized care teams including Trauma Surgery, Neurosurgery, Plastic Surgery, the Traumatic Brain Injury Clinic, the Complex Spinal Cord Injury Clinic, and Chronic Pain Management, a patient navigator, and an administrative associate. The primary goal of the TRC is to provide an interprofessional model of care to improve patients’ functional and psychological outcomes after experiencing a traumatic injury up to one year post-discharge from hospital. Patients receive follow-up services from multiple providers in one visit, in one clinic, in one room; thus, providing a holistic and seamless approach to patient care. It enables the opportunity for collaborative discussions to take place with patients, families, and their healthcare team. It ensures that follow-ups are accessible for this patient population, who can often experience barriers to social determinants of health and who often live outside of the GTA. The TRC collaborates with other sites, such as St. John’s Rehab, and internal programs, such as BRAVE, in connecting patients with supports they may not have had access to otherwise. We are proud to be part of such an innovative clinic and excited to see its continued growth in assisting the trauma population.
https://sunnybrook.ca/content/?page=jennifer-torytrauma-recovery-clinic
Noor Yassein Curriculum & Communications Coordinator, CACHE
Thispast September, three health professionals gathered to advise a group of 40 eager, engaged high school and university students. For the second time, the Centre for Advancing Collaborative Healthcare & Education (CACHE) held the Exploring Health Teams event - an evening which aims to inform students of different careers in healthcare. This event was planned for students by students, in collaboration with CACHE. The students involved are pictured above. This year, we hosted Dr. Andria Bianchi (a bioethicist), Naomi Sutcliffe (a social worker), and Siobhan McKittrick (a physiotherapist), also pictured above. The first part of the night consisted of three categories of questions: careers, collaboration, and ‘real talk’ & general advice. Afterwards, the students in attendance had the chance to ask their own questions to the panel, and their participation gained them entry into the raffle held at the end of the night. The speakers had much advice to impart; some topics of discussion included how they chose their career, advice to their younger self, and how they all work together in daily practice. It was a fascinating discussion for all.
Read more about the speakers on https://exploringhealthteams.ca/team-2, and keep an eye on the website for more information on next year’s event!
With the rising number of opioid-related deaths across the country, the Ontario Chiropractic Association (OCA) partnered with medical professionals to develop the Opioid and Pain Reduction Collaborative and address the opioid crisis head-on. The Collaborative is designed to help chiropractors and other manual therapists coordinate care plans with a physician or nurse practitioner (NP) to manage their shared patients’ chronic back, shoulder, and neck pain, while tapering their opioid use. The Collaborative includes three components:
1. An evidence-based Manual Therapy for musculoskeletal (MSK) Pain clinical tool the Centre for Effective Practice (CEP) was hired to develop in consultation with an interprofessional advisory panel, which included physicians, chiropractors, and a patient. It informs physicians and NPs with best available evidence for musculoskeletal (MSK) pain and has been accessed over 6,000 times since its 2020 launch.
2. A Chiropractor’s Toolkit, which includes a dialogue map and fillable pain reduction forms to support collaborations between manual therapists, patients, and their prescribing health care professionals.
3. The Role of Chiropractic in Opioid Use Reduction online continuing education course, developed with the Canadian Memorial Chiropractic College (CMCC) and expert advice from chiropractors and a physician. This course helps practitioners safeguard their patients’ health and foster collaboration with prescribing professionals to manage, reduce, or eliminate opioid dependency. The goal of the OCA Collaborative is to educate and empower health care professionals to work together to help patients who depend on opioids relieve their MSK pain.
Aday in the life of the Sunnybrook Neonatal Follow-Up Clinic starts first thing in the morning, with a chart-review or team huddle where we look ahead for the week or prepare for the day. Our team serves to monitor and support children who were born pre-term (before 30 weeks) or who have medical complications at birth, as these little ones are at a higher risk for developmental challenges as they grow. After the meeting, we wait for the families to start walking through the door or logging on to the Zoom calls. Since COVID, we have adopted a hybrid model of practice where certain check-ins are done in-person, while others happen virtually. Our team includes physicians (neonatologists and developmental pediatricians), occupational therapists, a physiotherapist, a speech and lan-
guage pathologist, a nurse and a psychotherapist. During the visits, therapists will conduct assessments or provide consultation on developmental strategies, and the physicians will meet with families to summarize the findings and view next steps. It is not uncommon for team members to get pulled into a visit to share their expertise. We truly collaborate across disciplines to provide complete medical and developmental guidance for our families. At the end of the appointment, we provide families with recommendations for how they can support their little one at home, and community resources they can access. We believe supporting our families through an interprofessional approach makes a huge difference and allows us to provide a high quality of care. We love our team and we love what we do!
Victoria Boyd, PhD(c) , The Institute of Health Policy, Management and Evaluation, University of Toronto and The Wilson Centre, UHN
Collaborative practice begins with collaborative pedagogies.
Dialogic pedagogy, which involves engaging learners in a collaborative small-group conversation, can facilitate interprofessional education by bringing together different professional perspectives and inviting learners to question the professional norms and assumptions that drive their practice. A recent study published in the Research in Medical Education (RIME) special issue of Academic Medicine shows that dialogic pedagogy can foster critically reflective practice. Critically reflective practice – the capacity to challenge harmful assumptions and power dynamics – has been shown to optimize interprofessional communication and collaboration. The study, led by PhD Candidate Victoria Boyd, aimed to examine whether dialogue prepared an interprofessional group of students for critically reflective practice when writing mock clinical letters for children with disabilities. To explore this, medical, occupational therapy, and speech-language pathology students participated in either a reflective discussion
or a critically reflective dialogue, which was informed by theories of dialogue and critical disability. All students then participated in an individual exercise that involved writing a clinical letter for a fictional child who needed health services and supports at school. The research team analyzed the letters for the presence or absence of critical reflection. The results showed that dialogic pedagogy impacted how students wrote clinical letters. Students who participated in a critical and collaborative dialogue were significantly more likely to write letters that were coded as critically reflective, compared to students who participated in a discussion. These letters considered systemic constraints related to resource allocation, attended to power dynamics through a collaborative tone, and advanced a person-centred approach through strengths-based language. This study joins a growing body of research highlighting dialogic pedagogy as an approach that advances interprofessional education and collaborative practice.
https://journals.lww.com/academicmedicine/ Abstract/9900/Examining_the_Impact_of_Dialogic_ Learning_on.165.aspx
Farah Friesen, MI Research Associate, Centre for Advancing Collaborative Healthcare & Education (CACHE)
In partnership with CQUIPS (Centre for Quality Improvement and Patient Safety) and CFD (Centre for Faculty Development), CACHE has been awarded the Advancing the Science of CPD Grant by the Office of CPD, Temerty Faculty of Medicine, University of Toronto. The study will explore the intersections of curriculum and pedagogy in continuing interprofessional and QI education. Focusing on the social processes and structures (e.g., power relations, gender roles, institutional racism, organizational norms) that are core to, and link together, QI and interprofessional education and care presents a key CPD opportunity. CPD that pays explicit attention to these topics requires paradigmatically-aware and aligned educational approaches. Despite evidence of the critical influence of social processes and structures to interprofessional and quality of care practices, curricula and pedagogy to meaningfully learn about and transform these processes and structures, have received only limited attention in CPD spaces. These past two years included a global pandemic, increased attention to inclusion, diversity, equity, and accessibility in education and healthcare, and a shift to online teaching, learning, and caring. These events have created some opportunities to think differently about the social processes and structures that influence healthcare practices and patient outcomes, and how this knowledge might benefit CPD. This project therefore aims to advance this goal through a study of continuing interprofessional and QI education at the University of Toronto.
Chris Rose
Public Relations Strategist
University of New England, Maine
Administration,
faculty, and professional staff from the University of New England (UNE) in Maine showcased their innovations in interdisciplinary collaboration at the fourth annual Heartland Interprofessional Education Conference of Clarkson College, held in July.
Shelley Cohen Konrad, Ph.D., LCSW, FNAP, Director of UNE’s Center for Excellence in Collaborative Education (CECE), gave the keynote speech at the conference, “Re-envisioning ‘About, From, and With’: Thoughts about the Future of Interprofessional Health Education and Practice.” Cohen Konrad also presented as part of a panel titled: “A Humble Reflection on Present Challenges, Impending Changes, and Future Possibilities.” Both presentations invited the national audience of more than 170 attendees to consider the next steps needed to improve health, health education, and team-based health care practice. Collyn J. Baeder, M.P.H., associate clinical professor and internship coordinator for Health, Wellness, and Occupational Studies; Susan E. Farady, J.D., associate professor of Marine Affairs; and Alethea Cariddi, M.S.Ed., assistant director of Sustainability, gave an oral presentation titled “An Innovative Event Production & Implementation Model to Advance Sustained Transdisciplinary Collaboration in Higher Education.” They discussed their work on UNE’s Planetary Health Council (PHC), as part of the international Planetary Health Alliance. In collaboration with Cohen Konrad and CECE, the PHC team develops semesterly events, each involving an interdisciplinary panel of three UNE experts. Recognized as a national IPE leader, UNE is the only institution in New England that is part of the National Center for Interprofessional Practice and Education’s prestigious Innovation Network.
https://www.une.edu/
Nancy McNaughton, PhD
Scientist, Wilson Centre & Assistant Professor, IHPME, University of Toronto
Tina Martimianakis, PhD
Scientist and Associate Director, Collaborations and Partnerships & Professor and Director of Medical Education Scholarship, Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto
Nicole Woods, PhD
Scientist & Associate Director of Operations/UHN, The Wilson Centre & Director, The Institute for Education Research (TIER) at UHN
Lisa Di Prospero, BSc MSc MRT(T)
Director, Practice-based research and innovation & Director, Sunnybrook Hub for Applied Research in Education (SHARE), Sunnybrook Health SciencesLesley Gottlieb-Conn
Associate Scientist, SHARE
Sciences and Humanities Research Council (SSHRC)
Connections Grant has been awarded to Nancy McNaughton, Tina Martimianakis, Nicole Woods, Lisa Di Prospero, and Lesley Gottlieb-Conn for their project, “Fostering Expertise for Collaborative Capacity Building Across Professions.” The initiative is organized as a two-day symposium aimed to create sustainable and meaningful processes for different kinds of educational knowledge to flow across disciplinary and professional training and practice boundaries. The two-day program will bring together local and international thought leaders to develop a strategy for mobilizing education science across health care learning organizations and across health professions. Education science scholars, health professions educators, interprofessional clinical practitioners, patient engagement representatives, and interprofessional learners from across TAHSN will be invited to address systemic barriers to the mobilization of education science in the health professions through discussions and small group presentations. The anticipated outcomes of the collaboration include increased learning leading to better quality of care and practice, creation of pathways that allow health care practitioners to contribute new knowledge to their respective fields with scholarship, and innovation aimed at enhancing integration, access, and flow of knowledge across professions and across organizations.
and University of Toronto’s Centre for the Study of Pain (UTCSP) examined student perspectives in relation to pain knowledge acquisition and presentation effectiveness at the UTCSP-InterFaculty Pain Curriculum (IPC) over a 10-year period (2009–2019). Pain is an increasing problem for individuals, families, and societies with physical, psychological, social, and economic implications. Interprofessional approaches hold promise for more effective pain management, with the International Association for the Study of Pain (IASP) identifying the importance of reshaping health professions education to ensure collaborative, patient-centred working skills. Learners in the UTCSP-IPC gained new and clinically relevant information and clarity regarding interprofessional roles and responsibilities in pain management. The study findings highlight theoretically informed curricular design principles that develop therapeutic skills in humanistic care and interprofessional collaboration to improve the quality and outcomes of pain care.
https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC8635288/
https://journals.lww.com/painrpts/Fulltext/2022/10000/Ten_year_mixed_method_evaluation_of_prelicensure.14.aspx
Maria Tassone, MSc, BScPT Executive Director, Education, University Health Network (UHN), Health Systems and Policy Advisor, CACHE, and Assistant Professor, Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto
We seem to be living a paradox. Across society, people need rest and recovery from the pandemic, and yet, the health human resources (HHR) crises that are closing emergency departments, operating rooms and hospital beds push that pause further away. From a health systems and policy perspective, there is much that the last 15 years of interprofessionalism in Canada can offer in the way of remedy, stability, and innovation. Our HHR Contribution: The current HHR discourse sounds largely familiar to the one that anchored interprofessional education (IPE) for many years: access to care, full scope of practice, and new professions. Novel technical roles and professional skill mixes are emerging that aim to extend the role of, for example, respiratory therapists, anesthesia assistants, and radiation therapists: technical roles blended with care responsibilities that allow regulated providers to shift their focus to more complex tasks and functions. We are also seeing an expansion of roles, such as personal support workers (PSWs) in acute care settings. While not a new role, within my own organization, there were few PSWs prior to the pandemic, yet over 400 today. Much expertise has been honed over the last decade or more on integrating new team members into interprofessional models of care, particularly through team competency development. Thirty years of implementation failures related to models of care have been mainly due to lack of role clarity. We know that it is not just about adding people, but ensuring new team members feel a sense of belonging. Building team capacity is a strength of
our field, and it is needed more than ever, especially given issues of inclusion, diversity, equity, and accessibility.
Exploring Rapid Collaboration: During the pandemic, centres like CACHE led many “rapid” health professions education initiatives. These experiments on the fly helped explore questions such as, ”what’s possible when we move fast, yet stay true to the essence of collaboration and co-creation?” High quality, accessible, and reliable educational programs were created, but we shortened the typical program development cycle to weeks instead of months. How did we do that? What was different? An obvious answer is that many typical siloes simply came down. There was openness to collaborate, and that openness was immense. Topics like intellectual property were not even raised given the urgency and massive redeployments across the continuum of care. How can our centres build on these experiences and privilege more explicit conversations about power and hierarchy? How might we advocate for more tightened educational development cycles at universities and colleges, ones that are nimbler and more responsive to health care needs?
Being Mindful of Our Language: For those who know me well, you will have heard me say “words create worlds.” The current focus on resilience is a great example. Our field has done much to understand and enable team resilience, and that needs to continue. Resilience, however, has potentially become what Peter Cahn calls a dirty word that can undermine learning. The cracks have started to appear in people I would consider immensely resilient. Thus, how do we ensure that our educational offerings are just-intime, appropriately framed, and relevant to the reality of people’s lives? How do we support rest and recovery when we know there are not enough people at the point-of-care, but clinicians are simultaneously asking for opportunities to grow and develop?
Reframing Evaluation: Our decade-long focus at CACHE on developmental evaluation was another important contribution during the pandemic. For many, the concept was not only new, but it challenged mainstream notions of planned change. Developmental evaluation questions, such as, “what’s emerging,” “how do we adapt,” “what’s working,” and “what are we learning as we go,” became normalized in rapid change initiatives. There seems to be growing recognition that healthcare is not a simple or complicated system, but a complex one where learning, adaptation, and constant inquiry need to be explicit and embedded in everything we do.
Understanding Our Sphere of Influence: Given our work at the interface of education, practice, research and policy, we have a unique lens into how higher education and healthcare organizations work. We understand their structures, how to navigate them, where educators are sometimes ‘hidden’ within these structures, and the accountabilities within and across varied leadership roles. We know how to leverage relationships and the ‘right’ people across professional practice, education, human resources, quality, and clinical operations portfolios, all the while ensuring the siloes that opened during COVID remain open. We also have a growing responsibility to advocate for organizational practices that support learning; real investments of time, human and fiscal resources, not only for team-based learning, but for professional development more broadly. Education lines in organizational budgets have been whittled away over the years, and in some organizations are now non-existent. How do we help organizations ‘see’ learning as an imperative for high quality care, patient/client experience and joy in work?
As healthcare organizations reinvest in professional development as part of retention, we can also adapt some of our student learning models for practicing professionals. Pre-entry-to-practice learners have shadowing opportunities within their curricula, and it would be relatively simple to adapt these to the practice context. Throughout COVID, shadowing and redeployment offered people a welcome change and a different way to connect to one’s organizational mission. How might we help healthcare organizations embed in their processes what we offer to our students as part of their IPE curricula?
My hope is that these strategies, considerations, and reflective questions help make your collaborative healthcare and education efforts even more relevant and meaningful in the months ahead. We would love to hear from you the ideas and experiences that would be valuable to share with our community as a whole.
For more on learning about health professions education innovations during the pandemic:
https://podcasts.apple.com/us/ podcast/how-innovations-inhealthcare-learning-development/ id1612285143?i=1000578825411
How do we help organizations ‘see’ learning as an imperative for high quality care, patient/client experience and joy in work?
Compassionate Competency:
Healing the Heart of Healthcare
Inmoving towards an ideal version of healthcare, the significance of interprofessional education (IPE) reveals itself. IPE is uniquely situated to address multiple issues existing within this space. The reason is simple. It focuses on one area frequently overlooked. Relationships. During my second year of residency, I rotated through general surgery. My area of growing expertise was oral and maxillofacial surgery. Like all residents, I rotated through various departments broadening my scope of knowledge. An assigned patient required pain medication having had a major surgical procedure. I promptly wrote the orders as expected. Hours later, I discovered the medication was never given. When I inquired as to why not, I was told the nurse didn’t think I had appropriate authority. Although I was completing a medical residency and equivalent to any medical (M.D.) resident, my written orders were disregarded. There was a disdainful dismissal of training in dentistry and a complete lack of knowledge regarding my particular specialty. Consequently, the patient experienced needless suffering. As a young resident, I questioned my competence, belonging, and if I could be considered a valued colleague. The nurse lost by failing to recognize me as an integral member of the team, potentially increasing her own burden. It is the world of IPE that squarely addresses the web of relationships comprising healthcare. As members of this community, taking an active role in leadership subsequently shapes these environments. Patients feel cared *for* and healthcare workers feel cared *about* as we continue to create the compassionate and collaborative environments we all deserve.
http://emelia-sam-zlei.squarespace.com/
Manager Professional Practice, Trillium Health Partners and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
Director of Interprofessional Practice, Sunnybrook Health Sciences Centre and Adjunct Lecturer, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
Healthcare is experiencing unprecedented workforce pressures which have been magnified by the pandemic. There is an imperative to co-create system solutions that build inclusive work environments for Internationally Educated Nurses (IENs) and professionals in Canada. As a result, a cross-sectoral coalition,
including healthcare organizations in southern Ontario, organically formed to collectively advance the new Supervised Practice Experience Partnership (SPEP) program. The SPEP was launched in collaboration with Ontario Health (OH) and the College of Nurses of Ontario (CNO), to provide an opportunity for IENs to consolidate entry to practice nursing skills and to become familiar with Canadian practice environments and cultures. This invaluable partnership has enabled organizational leaders to build relationships, foster innovative solutions, engage in generative thinking, and collectively learn from each other. Areas of collaboration include the following:
• Exploring standardization of processes and decisions across sites (e.g. average number of practicum hours, inclusion of controlled acts);
• Coordinating communication with OH and CNO to answer common questions and seek guidance;
• Discussing approaches to assessment/evaluation of language proficiency;
• Sharing tools/resources.
• Developing approaches to welcoming IENs, creating inclusive environments and advancing equity and diversity;
• Fostering a spirit of system-level collaboration to support our workforce.
• Sharing successes, opportunities and supporting each other through a time of great change.
As a result of learning together, IENS are experiencing personal and professional success; “We may have started this journey alone, but we are finishing with a whole organization supporting us”, RN, SPEP Graduate.
Participating Organizations: Unity Health Toronto; Sunnybrook Health Sciences Centre; Trillium Health Partners; Hamilton Health Sciences; St. Joseph’s Healthcare Hamilton; Scarborough Health Network; Niagara Region; Queensway Carlton Hospital; Peterborough Regional Health Centre.
Teaching for Transformation: Annual Conference+ (TforT:AC+) is a three day immersion in the education paradigms and practices needed for today’s health care work. TforT:AC+ involves keynote facilitated sessions, nominated emerging work (NEW), workshops, submitted short talks, roundtables, and space for open dialogue. TforT:AC+ will take place online, enabling an international reach.
Conference +
TforT:AC+ is more than a conference. Registration is limited to foster a dialogic learning environment. Additionally, registrants will gain access to a private website of resources and activities for their ongoing use and an online community of support.
teachingfortransformation.com/ac
tfortac2023@teachingfortransformation.com
