Together: Stories of Collective Impact (Vol. 2.2 Spring 2024), An international magazine by CACHE

Volume 2, Issue 2

Spring 2024

WELCOME

Welcome to our international magazine, Together: Stories of Collective Impact

Welcome to volume two, issue two (2.2) of our international magazine, Together: Stories of Collective Impact . If you are reading Together for the first time, WELCOME! We hope you find this collaborative forum one of connection and celebration, championing the work and learnings within our systems. Your commitment to Together elevates this community, promoting ways to co-create and discovering opportunities for engagement between CACHE and our partners. Our hope is that Together will continue to foster a connected community through the sharing of stories.

In this issue, we highlight the recently published Centre for Advancing Collaborative Healthcare & Education (CACHE) Biennial Report - let’s take a moment to celebrate the work that you all have contributed to as part of the extended CACHE community over the past two years (2021 - 2023), read it here !

To all who are reading this magazine, thank you for continuing to share your stories, events, and cover art. We look forward to your f uture submissions , feedback, and reactions

With Gratitude, Elizabeth (Eli) Cadavid Lead Editor, on behalf of the CACHE Team

CACHE Editorial Team, Spring 2024

Eli Cadavid (Lead Editor)

Belinda Vilhena

Farah Friesen

Sofia Mirzazada

Stella Ng

COVER ART

Waves of Healthcare: Lessons from the Ocean

Covert Art by: Dana Asbury (Nursing Student, University of Toronto); Saba Aslani (Medicine Student, University of Toronto); Mariam El-Diraby (Pharmacy Student, University of Toronto); Dorsa Fathianpour (Physical Therapy Student, University of Toronto); Gagan Purba (Pharmacy Student, University of Toronto)

Being in medical professional training and clinical placements can feel like: treading water, being thrashed by tidal waves, crushed by pressure, chaos, sinking, and terror.

The Interprofessional Health, Arts and Humanities (HAH) sessions have been like intermittent rafts, balance, paths in the sea, and lights in a harbour. HAH and the skills we’ve learned in perspective taking, cultivating curiosity, and seeing/hearing/ making things we didn’t or couldn’t see/hear/make before, helped us experience the ocean as possibility—a place to practice teamwork, full of life and death, of trajectories and altered courses, a place that in its tumult can cultivate flexibility and responsiveness. Still, it can be scary and dangerous and risky and consume us.

This three-panel piece titled Waves of Healthcare: Lessons from the Ocean is our group’s effort to creatively represent our varied experiences navigating health professional training (metaphorized as ocean) as first-year students in physical therapy, medicine, nursing, and pharmacy. The ocean—and health professions training programs—can feel like crushing pressure and chaos just as much as they can be sites for exploration, possibility, and generative transmission.

Panel 1 uses paint, marker, and modeling clay to depict an interprofessional team holding hands and pulling struggling colleagues to shore through supportive relationships. This panel asks, what do we gain when investing in interprofessional collaboration? This piece reflects the themes we returned to throughout the program—interprofessional exchanges and creating supporting relationships.

Panel 2 features paint and magazine clippings to sketch a long calm path through a turbulent parted sea. This piece calls us to keep perspective on our goals and commitments whenever we feel overwhelmed in our practice and health care encounters. Panel 3 is a mixed media painting/collage of acrylic paint,

magazine clippings, reflective beads, torn exam gloves, and excerpts from Arthur Kleinman’s The Illness Narratives arranged to depict a deep-sea scape with lessons, reflections, and surprises flourishing in the waves. This piece asks, what becomes possible when instead of fighting transmission, we reframe and encourage it?

This piece brings perspective to the word transmission: Transmission has multiple meanings relevant to health, interprofessional exchange, and patient-centered care. Often in our professional healthcare education/practice we focus on limiting or preventing transmission of infectious agents through the use of barriers like gloves, gowns, and masks. For good reason we aim to control and contain our environments. Also though, with the HAH program, we practiced how to enhance and expand communication and understanding within our interprofessional relationships, and between providers and patients by recognizing and removing barriers. We learned about the healing potential of sharing or “transmitting” our perspectives and personal stories to one another, in contrast to traditional models of healthcare practice where providers were encouraged to be emotionally distant or detached from patients. Panel 3 represents relinquishing efforts to control or fight against the force of the ocean so we may discover possibilities in the drifts and waves—the waves mechanically transmit us, or our ideas, from one place of potential to another.

STAYING IN TOUCH NEWS & CELEBRATIONS

CACHE Patient/Family/Caregiver Partner Advisory Committee

Awarded UHN Local Impact Award for President’s Patient Partner

CACHE Editorial Team

On November 8, 2023, in the Schatz Hall of the Michener Institute of Education, Jennifer Boyle (Patient Partner), Janet Rodriguez (Patient Partner), and Elizabeth Cadavid (Education Coordinator, CACHE) were pleased to accept the UHN Local Impact President’s Patient Partner Award on behalf of the The Patient/Family/ Caregiver Partner Advisory Committee. This award recognizes a group of Patient Partners who contribute their time to help deliver the best patient-centered care possible.

Here’s a link all cued up to the exciting moment for your viewing: https://www.youtube.com/live/ MZECCmdwq7k?feature=shared&t=1260

The Patient/Family/Caregiver Partner Advisory Committee was established in 2019 to provide direction to the University of Toronto (UofT) Interprofessional Education (IPE) Curriculum (administered through the UofT’s Centre for Advancing Collaborative Healthcare & Education (CACHE) at University Health Network) offered annually to approximately 4200 health and social care students from eleven health science programs.

This dedicated Committee has accomplished much that will influence the care patients and families/ caregivers will receive in the future. The work of this Committee has been instrumental in shifting student understanding of the inclusion of patients and their families/caregivers as full partners on the healthcare team, moving beyond the patient-centred approach to one of full engagement in the decision-making process. They have advocated for the recognition of efforts of the patient/family/ caregiver partners involved in the curriculum by creating criteria to guide equitable distribution of honoraria. Furthermore, members have elevated issues of equity, diversity, inclusion, and accessibility (EDIA) as well as the impact of social determinants of health.

Through the leadership of this Committee, the patient/family/caregiver program has grown and matured, contributing to the education of future health and social care professionals. We have heard and witnessed firsthand some of the transformative impacts on students’ perspectives and anticipated changes in their practices.

To learn about how you can get involved in the patient/family/caregiver partner community at CACHE, please contact eli.cadavid@uhn.ca

Kathryn Parker, Associate Director of Transformative Change

CACHE Editorial Team

Kathryn Parker, PhD , expanded her role at CACHE in December of 2023 as the new Associate Director of Transformative Change. This role serves to support CACHE’s vision with particular emphasis on the integration, scale, and spread of Student-Led Environments (SLEs) . Kathryn will also collaboratively support the curriculum team in the implementation of ongoing evidence-informed and co-created curricular renewal, and as co-lead of the Professional Development (PD) portfolio, collaboratively lead the vision, growth, and sustainability of CACHE’s PD programs. She will also explore and nurture collaborative partnerships to bring educational innovations to life that align with CACHE’s mission, vision, and strategic plan. As a member of the Wilson Centre and supported by her appointment at The Institute for Education Research (TIER), Kathryn’s passion for re-imagining program evaluation to accelerate change in healthcare will continue to be the focus of her scholarly pursuits. Outside of her professional work, Kathryn loves to exercise her sea kayaking skills and nurture her love of travel as long as it enables her to be outdoors as much as possible. She also takes immense joy in spending time with her daughter, Rachel.

Celebrating, Connecting, and Checking In: CACHE 2021-2023 Biennial Report

CACHE Editorial Team

The Centre for Advancing Collaborative Healthcare & Education (CACHE), University of Toronto at University Health Network, is pleased to announce the publication of our 2021-2023 Biennial Report. The report shares integrative impact stories built around our three strategic aspirations, all achieved in partnership and through an interprofessional approach.

We invite you to peruse the report by clicking on the image or link below.

Thank you , our extended CACHE community, for your support and involvement with CACHE. We truly appreciate every moment of engagement, and the opportunity to learn with and from you. If you would like to become more involved, or read more about our latest news, initiatives, etc. please visit our website here

We look forward to continued shared successes in the coming years, and continuing to connect as we aim to learn together for a healthier world.

Click HERE to read our 2021-23 Biennial Report.

LEARNING IN MOTION EDUCATION & PRACTICE

High Pressure, High Reward: Interprofessional Collaboration at Centennial College’s “Mock Disaster” Event

Stefan Chua, BSc Pharm, RPh (Pharmacy Technician Program, Centennial College)

Since 2005, Centennial College has hosted an annual Mock Disaster event—a collaboration between Centennial College’s School of Community and Health Studies and the University of Toronto’s Emergency Medicine program—that pushes students to practice their skills while working together in a simulated mass casualty environment—one that would make even Edward Murphy Jr. pause to catch his breath.

This year’s Mock Disast er saw “Centennial City” hit with record-breaking freezing temperatures, spiking casualties, and creating an influx of patients surging into hospitals and community centres. Alongside real volunteer professionals, including first responders, physicians, nurses, and social work staff, over 300 students worked together through high pressure and high stress situations. Although the goal of the Mock Disaster is to provide students with the opportunity for practical learning, the event also promotes interprofessional partnership and teamwork.

For many students, the Mock Disaster was not just their first time making critical decisions on demand, but also their first time working and interacting with other healthcare professions in an interprofessional team. As a pharmacist volunteer situated in the simulated emergency room, I was treated with a front row seat to the mayhem that offered so many students the opportunity for collaboration.

Working with a team of pharmacy technician students, I saw many rise to the occasion to take on collaborative leadership responsibilities, responding and adapting to emergency after emergency, working in teams with nurses and doctors to formulate and implement care. Students were able to clarify their roles in dialogue with other professions, giving each a better understanding of their own place in the dynamic interprofessional team. Over the course of three hours, they began to see their responsibilities within the wider scope of healthcare, and how each profession has a vital role in enhancing health outcomes.

Yet, sometimes the pressure does get to even the best of us. Even in a simulated scenario, our best practices can break dow n when the heat gets too hot—or, in this case, when things get a little too cold. That is why I love events like these - it’s when we’ll need interprofessional collaboration most of all.

Collaboration in Action: Health Environment Services Management Students, Occupational Therapist Assistant, and Physiotherapist Assistant Students Working Together to Ensure Patient Safety

Karen Barnes (Coordinator and Professor, Healthcare Environmental Services Management Program, Centennial College); Karen Koseck, MSc, BScOT, OT Reg. (Ont) (Coordinator and Professor, Occupational Therapist Assistant and Physiotherapist Assistant Program, Centennial College); Kala Subramaniam, MSc, BScOT, OT Reg. (Ont) (Professor, Occupational Therapist Assistant and Physiotherapist Assistant Program, Centennial College)

On March 18, 2024, Healthcare Environmental Services Management (HESM) and Occupational Therapist Assistant and Physiotherapist Assistant (OTA & PTA) students were brought together to develop an interprofessional teaching and learning exchange. At the start of the session, one student representative from each program provided a brief definition of their respective professions – what we do and how we do it. The introductions served as role clarification, to help learners understand their roles and the roles of the other professions within the healthcare system (2010, CIHC). Then, the OTA & PTA students created teaching demonstrations on how to use a variety of therapy equipment including gait aids (canes, crutches, walkers etc.), a patient lift, standard wheelchairs, and tilt and recline wheelchairs. The HESM students developed an educational demonstration of cleaning procedures, preventative maintenance plan, and an inspection checklist for mobility devices such as lifts with slings, stretchers, hospital beds, wheelchairs, tilt chairs, walkers, and other gait aides.

There were many “aha” moments as each group realized the importance of effective collaboration to keep everyone, especially patients, safe. Students actively listened to each other to ensure a common understanding of care decisions (CIHC, 2010). The OTA & PTA students were surprised at how much bacteria can grow on high use equipment if not consistently cleaned properly. The HESM students found it particularly helpful to see how to use the rehabilitation equipment that they help clean and maintain. By effectively working together, students demonstrated collaborative leadership by evaluating how their own service delivery can enhance health outcomes through patient safety measures (CIHC, 2010). The students were excited to each share their expertise and effectively embraced their complementary roles as future healthcare workers.

References

Canadian Interprofessional Health Collaborative (CIHC). (Feb, 2010). A National Interprofessional Competency Framework. Retrieved from: https:// phabc.org/wp-content/uploads/2015/07/CIHC-NationalInterprofessional-Competency-Framework.pdf

An Interprofessional Partnership between Clinical and Educational Partners: Applying Didactic Learning to Real World Inquiry

Kalli Stilos RN, BScN, MScN, (CHPCA) (APN Palliative Care Consult Team, Division of Palliative Care); Lise Huynh, MD, CCFP (PC), FRCPC, MSc (QIPS) (Palliative Care Physician, Division of Palliative Care); Lisa Di Prospero, BSc MSc MRTT (Director, Practice-based Research and Innovation); Sara Morassaei, MSc PhD (Program Management Research)

Innovation through education drives Sunnybrook Health Sciences Centre forward as a premier academic health sciences centre in Canada. As stated in Sunnybrook’s Education Strategic Plan, we are committed to broadening and deepening Sunnybrook’s footprint in education by expanding the reach to include members of the Sunnybrook community in a meaningful way.

In 2023, Sunnybrook partnered with The Michener Institute of Education at University Health Network to pilot a collaboration with a research methods course for Medical Laboratory Technology and Respiratory Therapy learners. As part of the innovation, students taking the course were asked to choose a real world inquiry submitted by clinical research teams at Sunnybrook. The students partnered with the clinical research teams throughout the course to use this inquiry as the basis of their assignment to apply their learning.

Students completed a methodologically sound literature review and critical appraisal of selected articles on a clinically relevant topic. Students sought out feedback from the clinical research teams during the process to ensure they maintained relevance and appropriate search direction. The outcome of this pilot partnership was an updated literature review of a clinically relevant topic presented as a scientific poster.

Subsequent debrief with all stakeholders, including students and faculty from both organizations, pointed to a successful partnership with plans for further expansion. One group’s poster was submitted to ‘Sunnybrook’s Impact through Innovation’ to

highlight the collaboration. Key to the success was embedding Sunnybrook’s core competencies of interprofessional collaboration throughout the learning, specifically, communication, shared decision making, and interprofessional values and ethics.

Developing Interprofessional Leaders and Best Practices: Skin and Wound Champions

Susan Chandler RN, MClScWH, NSWOC, WOCC(C) (Sunnybrook Health Sciences Centre); Kathryn Rego RN, BScN, NSWOC (Sunnybrook Health Sciences Centre); Sukaina Muhammad RN MClSc-WH NSWOC WOCN (C) (Sunnybrook Health Sciences Centre)

The Champion Role creates an opportunity for clinicians at Sunnybrook to develop leadership skills and advance knowledge within their best practices. Champions further play an influential role in best practices at Sunnybrook through collaboration and knowledge translation within their teams.

Skin and Wound Champions are the frontrunner in re-establishing this best practice initiative, with the first inaugural day led by the Complex Wound Service team in February 2024.

Over 50 staff came together from across all campuses, including the Veterans Centre, Pine Villa, Reactivation Care Centre, Holland Centre, and Bayview site. This interprofessional event included Nurses, Advanced Practice Nurses, Occupational Therapists, Registered Dieticians, Patient Service Partners, and Students from inpatient and outpatient settings.

The educational and practical sessions allowed for full collaboration across the spectrum of professions,

while applying principles of patient-centred care, communication, and collaborative leadership. Participants engaged in learning about the vision of the champion role, pressure injury staging, impact of linen and clothing layers, how and why pressure is off loaded using devices, and the value of nutrition to optimize pressure injury prevention. The afternoon consisted of a practical session with hands-on stations supported by industry representatives and clinical experts including, wound measuring and documentation using potato models, low air loss surfaces, and offloading equipment such as boots, wedges, and dri-flow pads.

Participants were excited and engaged, with many sharing interest to include their unit interprofessional teams in quality improvement moving forward. We garnered additional interest in the wound champion role, as champions brought knowledge of the day back to their units. The next wound champion day is planned for May 2024 and quarterly thereafter.

Manipulation and Movement: A Fusion of Interdisciplinary Expertise between Massage Therapy and Exercise Science Students

Adam Balan, MSc., BSc. (Hon.), B.Ed., CSCS (Centennial College, Baseball Injury and Performance Initiative)

In 2016, Centennial College’s Massage Therapy (MT) and Fitness and Health Promotion (FTHP) programs created an interprofessional education (IPE) assignment centered on experiential learning through a professional exchange of services. The creation of this assignment was motivated by some challenges observed in student competence within specific areas. MT program coordinator Lori Copeland identified that students were unaware of the personal trainer’s scope of practice and how exercise professionals are beneficial for referrals, self-care, and longevity. I recognized that many of my FTHP students were unable to identify the basic techniques of massage therapy and the scope of practice of these healthcare professionals. For example, during the inaugural rollout of the IPE assignment, after fielding a question from one FTHP student, I responded,

“Massage Therapist, not masseuse, is the appropriate title.” This type of comment validated our intentions of creating this new assignment.

Timing was perfect: Centennial’s School of Community and Health Studies had recently committed to integrating more multi-disciplinary, collaborative initiatives into curriculum. In the beginning, this IPE assignment was centered on role clarification and interprofessional communication from the National Interprofessional Competency Framework (CIHC, 2010). In the first part of the initial assignment, small groups of MT and FTHP students met to discuss the partnering professional’s scope of practice and client assessment tools. Part two of the assignment originally centered on framework domain #6 (interprofessional conflict resolution). Groups created a treatment, rehabilitation, and return-to-play (return-to-life for non-athletes) protocol for a hypothetical case study client.

Two years from the inception of the assignment, part two was modified to a professional exchange of services. FTHP students received a massage therapy session and MT students received a personal training session. Although this modification reduced the level of interprofessional problemsolving, it bridged the gap between theory and actual hands-on practice.

The exchange fostered better understanding and mutual respect among partnering professionals. These outcomes were validated in part three of the assignment, in which students submitted written reflections of their experiences.

Initiatives like this are crucial in shaping the collaborative mindset of our graduates. Through this IPE initiative, our students learned to appreciate the unique contributions of each profession and gained insight into the value of interprofessional referral networks.

References

Canadian Interprofessional Health Collaborative (CIHC). (Feb, 2010). A National Interprofessional Competency Framework. Retrieved from: https://phabc.org/wp-content/ uploads/2015/07/CIHC-National-InterprofessionalCompetency-Framework.pdf

Reflecting on

Collaborative Leadership:

Preceptor Insights from Student-Led Interviews

Alex Tang BSc (Pharm), MEd, RPh (Faculty of Pharmaceutical Sciences, University of British Columbia); Gabriella Wong BSc(Pharm), MHA, RPh (Faculty of Pharmaceutical Sciences, University of British Columbia); Meg Wang (Pharmacy student, Faculty of Pharmaceutical Sciences, University of British Columbia); Sara Hamidi (Pharmacy student, Faculty of Pharmaceutical Sciences, University of British Columbia)

Last October, six pharmacy students participated in a 4-week interprofessional collaboration practicum, precepted by clinicians from different disciplines. During an interview activity with their preceptors, students sought to gain insights on collaborative leadership, which is one of the competencies articulated by the Canadian Interprofessional Health Collaborative. Here is what our preceptors had to say:

Q: What does successful collaborative leadership look like for you within your practice?

Collaborative leadership (CL) was emphasized as understanding when to refer or recommend patients to other healthcare professionals, ensuring patients receive care from the appropriate healthcare professional. The initiative encouraged individuals to experience other practitioners’ treatments (when appropriate) to understand the patient experience. This helps to foster new perspectives for other dimensions of healthcare that are crucial in CL. Participants stressed role clarity and leveraging the strengths within the team as successful CL. For instance, connecting with a nurse practitioner or physician after hormone follow-up appointments in case of a dose change. Weekly meetings with physicians, nurses, nurse practitioners, social workers, and health navigators can promote collaboration. Another foundational element of CL is direct collaboration with patients because patients are an integral part of their own healing process and a CL approach ensures that patient concerns are truly heard.

Q: What does the process of establishing shared goals entail when there are differences in clinical opinions and judgements?

It was noted that open and respectful conversation among healthcare providers is vital when opposing clinical perspectives arise. Ensuring inclusion and involvement of the patient and their family about their diverse points of view allows the team to understand the patient’s priorities better, supporting informed decision-making. The use of witnessed conversations (which are facilitated discussions by a third-party witness) can help people see different viewpoints and resolve conflict.

Anonymous surveys provide a safe space to voice concerns and team-building activities to address concerns proactively can facilitate communication of different opinions and establishing shared goals despite differences in opinion. Team relationships can be further strengthened through meetings and retreats.

Q: What inspired you to pursue a collaborative practice instead of a traditional practice?    Participants cited the benefits of collaborative practice such as reducing burnout, bridging care gaps, and facilitating seamless transitions in care.

The UBC Faculty of Pharmaceutical Sciences would like to thank our preceptors for hosting our students.

Brianne Davidson, Dietitian Courtney Mosdell, Physiotherapist

Dr. Daniel Ngui, Physician

Dr. Khaled Dossa, Chiropractor

Dr. Patrick Callas, Naturopathic Doctor

INCLUDING & ENGAGING COMMUNITY & PARTNERSHIP

Strengthening Community Support for Eating Disorder Care

Taylor Hamilton, MSW, RSW (Brain and Mental Health Practice Lead, Boomerang Health powered by SickKids); Lara Pietro-Lungo, RN, BScN, MN (Executive Director, Boomerang Health powered by SickKids); Dr. Susan Lambert, Ph.D, C. Psych (Brain and Mental Health Manager, Boomerang Health powered by SickKids); Sara Roesel, RPN (Nursing Lead, Boomerang Health powered by SickKids); Selina Lutfi, RPN (Nurse, Boomerang Health powered by SickKids)

It is well-known that mental illness is the leading cause of premature death in Canada (Statistics Canada, 2023), yet many are not aware that the mental illnesses with the greatest mortality rate for Canadians are eating disorders (Arcelus et al., 2011). Access to early (child and adolescent) intervention is key to preventing these dire outcomes for individuals living with these diagnoses (Rodgers et al., 2020). The nature of these illnesses requires an interdisciplinary approach, as eating disorders are categorized as both mental and physical illnesses. Hospital-based programs across the country provide this interprofessional care.

However, since the COVID-19 pandemic, there has been a concerning rise in wait times for in-hospital care. In some cases, families are waiting over a year to access life-saving treatment (Rodgers et al., 2020). Meanwhile, traditional community-based, private clinics typically provide isolated care, often limited to a single professional.

In response to the need for timely eating disorder intervention, Boomerang Health, powered by SickKids, established an interprofessional eating disorder clinic within our community-based private clinic. Leveraging our expertise in providing a range of interdisciplinary services, including mental health, nutrition, nursing, and general paediatrics, we were well-equipped to launch the eating disorder interprofessional practice model – an approach that ensures we deliver essential and life-saving treatment with the utmost expertise and compassion.

Our eating disorder team organically functions collaboratively and includes interprofessional treatment planning and execution. Paediatricians provide referrals and manage the medical stability of patients within the clinic. Nursing staff collaborate with medical partners in the community to provide regular medical monitoring of patients who are not being seen in the clinic. Simultaneously, social workers and dietitians work directly with children and their families to provide evidence-based mental health care. We prioritize interprofessional team communication through regular eating disorder rounds, ensuring comprehensive support for our patients.

In summary, with the launch of the interprofessional eating disorder clinic, Boomerang Health continues providing intervention or interim support to maintain patients’ health and safety while waiting for hospitalbased care. This comprehensive model meets a need in the community, offers best-practice care to our most vulnerable children, and allows for clinicians to thrive in a collaborative work environment.

References

Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry. 2011 Jul;68(7):724-31. doi: 10.1001/archgenpsychiatry.2011.74. PMID: 21727255.

Rodgers RF, Lombardo C, Cerolini S, Franko DL, Omori M, Fuller-Tyszkiewicz M, Linardon J, Courtet P, Guillaume S. The impact of the COVID-19 pandemic on eating disorder risk and symptoms. Int J Eat Disord. 2020 Jul;53(7):11661170. doi: 10.1002/eat.23318. Epub 2020 Jun 1. PMID: 32476175; PMCID: PMC7300468.

Statistics Canada, Table 13-10-0801-01 (formerly CANSIM 102-0564).

Collaborative Coaching: The Many Benefits for New Leaders in Healthcare

Sarah Rydahl PT eMHA, MSc., B.Sc.PT, B.Sc.H (Manager of Access & Flow, St. Joseph’s Health Centre, Unity Health Toronto); Dr. Donna Romano, RN, MSc, PhD, CPMHN(C) (Manager, Mission & Values, St. Michaels Hospital, Unity Health Toronto)

As a clinician transitioning to a formal leadership role, the value of coaching cannot be understated. Having a coach as a new leader is invaluable as you embark on your healthcare leadership journey. Coaching sessions are a supportive and encouraging way to develop a leader within an organization.Coaching contributes to leadership development, as it not only supports

the coachee in identifying areas of priority and strength, it also contributes to the development of the coachees’ personal leadership style. In doing so, the coaching process provides valuable guidance and motivation in achieving the leaders’ set goals related to their professional development.

Coaching sessions are reflective, strength-based, and collaborative by nature. For example as a new leader, my coach and I designed collaborative coaching sessions between the professions of Nursing and Physiotherapy using a five-point question tool that my coach and I developed. We used this tool to facilitate conversations with team members during 1:1 meetings. This tool served to identify individual and team strengths and learning needs which enhanced our team functioning and role clarification. In addition, this tool enabled me as the coachee to interpret work in a variety of ways. By using purposeful questions, I was able to gain clarity on a particular issue, and/or process improvements within the department. For example, a small team was established to review and implement a quality improvement process to improve status reports. Another team was to review and update on-boarding and orientation tools for new staff coaching.

The five-point question tool can assist the coachee to address issues in their team environment or explore a leadership goal they hope to achieve. Through this coaching process, I realized my own strengths and successfully achieved my set goals. Having experienced the many benefits of coaching, I would recommend it to others as they embark on their healthcare leadership journey.

Beyond Traditional Healthcare Partnership: Empowerment of Early Childhood Educator for Paediatric Growth and Nutrition

Screening

Siti Rokhmah Projosasmito, MD, MEd(L,P&C) (Medical Education and Bioethic, Universitas Gadjah Mada); Savitri Shitarukmi, MD, MHPE (Medical Education and Bioethic, Universitas Gadjah Mada); Noviarina Kurniawati, MD, MSc (Medical Education and Bioethic, Universitas Gadjah Mada)

Early childhood education is important in preparing children both physically and psychologically. Physically, childhood health outcomes predict adult health outcomes. Children spend a lot of time in community settings through early childhood education (ECE) institutions. Teachers in ECE interact with children in a manner that allows them to observe growth and developmental milestones. Therefore, it would be beneficial to integrate teachers’ observations in education settings with community health knowledge.

Anthropometric measurement is one of the parameters for children’s growth and nutrition status. In this project, we created a partnership with an ECE institution aiming to increase ECE teachers’ skills in measuring and interpreting paediatric anthropometric measurement as a part of children’s growth and nutrition status screening.

This project involves undergraduate medical students and nutrition students in the process. Students train the kindergarten teachers on how to take measurements of body circumference and BMI, as well as interpret and communicate the results in a written and oral report. The training commenced in a series of meetings held in the ECE institution under faculty supervision. Students also received feedback from the faculty for their performance during the project.

We consider the project to be correlated to one of the six competency domains of The National Competency Framework of Canadian Interprofessional Health Collaborative, i.e. patient/ client/family/community-centred care. In this activity, students seek out, integrate, and value, as a partner, the input and engagement of the community members (i.e., kindergarten teachers) in designing and implementing service. They also learn to share information with patients/clients (or family and community) in a respectful manner and in such a way that it is understandable, encourages discussion, and enhances participation in decisionmaking.

This activity promotes the development of empowering ECE institutions in terms of healthcare partnerships. Despite the limitation of the current implementation, we aspire to widen the events to other ECE institutions in the region. Our goal is to increase the health status or outcomes of not only the directly involved children and the families but also the community where they reside.

U-M Hypertension Pharmacists’ Program: CDC Expanding Model to other

States

Lindsay

Groth (College of Pharmacy, University of Michigan); Kim North Shine (Michigan News, University of Michigan)

Embedding pharmacists as part of the health care team at University of Michigan (U-M) primary care clinics and community retail pharmacies has proven very effective in controlling blood pressure that the Centers for Disease Control and Prevention (CDC) is now replicating the model of care and expanding it to the southeastern United States.

A CDC evaluation of U-M’s Hypertension Pharmacists’ Program (HPP) found that 66% of patients who met with an HPP pharmacist had their hypertension under control within three months, compared with 42% of patients who did not meet with a pharmacist. At six months, 69% had their blood pressure under control, compared with 56% of nonparticipants.

The CDC’s Division for Heart Disease and Stroke Prevention is seeking to scale up and extend the U-M model to other regions of the country as part of its goal to close the health disparity gap by 5% among African American adults.

Hae Mi Choe , Clinical Professor at the U-M College of Pharmacy and Chief Population Health Officer for Michigan Medicine, first developed the pharmacistcentric care model in 1999. The program has since expanded to select primary care clinics and community retail pharmacies in Michigan.

The model provides patients who have or have been newly diagnosed with hypertension or high blood pressure with individualized, accessible care and education provided by specially trained pharmacists in tandem with their primary care physician. Pharmacists are embedded within the care team

and receive specialized training. They adjust the therapeutic regimen to improve patient outcomes in coordination with the physicians. By having pharmacists working alongside physicians, patients are seeing improved outcomes, highlighting this program as a wonderful example of collaborative care.

“Pharmacists are an essential part of the care team, and HPP has shown they can be part of the answer to improving access to care and outcomes, too,” Choe said. Having the pharmacist as part of the patient care team gives patients quicker access to a health care provider and frees up the time of physicians, she says.

In late 2023, the CDC Division for Heart Disease and Stroke Prevention invited proposals from health care systems and community pharmacy settings in the southeastern U.S. interested in implementing HPP in settings that serve African American patients. One site will be selected to implement the core components of HPP, and the CDC will evaluate outcomes.

P.S. I Love You

Tracy White (Patient Partner, Centre for Interprofessional Healthcare & Education [CACHE]; Policy/Regulatory Advisor; Holistic Autistic; Hatching Ideas Lab, Ottawa Hospital Research Institute)

Tracy White is an autistic artist, researcher, and writer who lives in Ottawa, Ontario, with her partner and their two cats. She was a dedicated public servant working in regulatory and policy development and analysis. She was diagnosed with autism in her early 40s and has since developed a passion for informing autism research and treatment. She has an awesome 8 year old son who she loves dearly, who is also neurodivergent. Much of her passion comes from a desire to ensure quality medical care through the lifespan. CACHE has provided a wonderful opportunity to do so, following her engagement within their Patient Partner Program in late 2023. She has spoken to health and social care students at the University of Toronto about the importance of listening to the patient, and how interprofessional collaborations bring a unique perspective to the table.

Through the diagnostic process, Tracy learned about the pattern recognition capacities inherent in many people on the autism spectrum, and uses this skill to write stories about her life and experiences. She has created many stories using song and book titles as inspiration. She was recently part of the Community Showcase at the Canadian Autism Leadership Summit in April 2024, where she first presented her piece entitled “A Lyrical Tale for a True Model of Authenticity”, which served as homage to her neuropsychologist, who has enabled her to effectively manage her co-occurring conditions.

The following piece showcases a story she put together for a dear friend after he supported her through a very difficult experience in 2022.

So I tell you I’m Down , dejected, Because I wanna be a Paperback Writer but I’ve Got a Feeling It Won’t Be Long before you say Don’t Bother Me , and really, I Should Have Known Better, because that’s the norm In My Life . But instead, you say “ Good Day Sunshine ”, even when I’m feeling Misery, and you keep reminding me that “ Tomorrow Never Knows”, and “You must Think for Yourself ”, but that just in case, “ You Know My Name (Look Up the Number), okay? Good Night .”

And The Night Before , well it was A Hard Day’s Night and Every Little Thing Here, There and

Everywhere , for Eight Days a Week was making it seem like I was on a Magical Mystery Tour, seeing S trawberry Fields Forever, shouting Help! and If I Needed Someone , he’s Nowhere Man , and so I Call Your Name , because you Don’t Let Me Down in The End . And While My Guitar Gently Weeps , I decide that I’ll Cry Instead because I’m So Tired . I Will Get Back … I’ll Be Back , for This Boy, because I don’t want him thinking She’s Leaving Home , Not a Second Time , so Cry Baby Cry…

Because I worry that If I Fell , You Won’t See Me anymore either, and I Want to Tell You

that the Things We Said Today reminded me of Yesterday, and is this Hello, Goodbye? I’ll Follow the Sun , if you Tell Me Why you Love Me Do because I’m a Loser, and I’ll be broken if I Need You and there’s No Reply, but you tell me...

You Can’t Do That , Carry That Weight for such a Long, Long, Long time… It’s All Too Much unless There’s a Place you can go, Any Time at All , where you can be Within You Without You , with Something to aid in Getting Better, and when you’re scared you’re Back in the U.S.S.R. , and start thinking Happiness Is a Warm Gun , I’ll remind you that All You Need Is Love , and you’ll laugh in surprise and say, “Really? It’s Only Love?! That’s the Ticket to Ride?”

“ Yes It Is”, you continue, “now Tell Me What You See . I Want to Hold Your Hand , and We Can Work It Out .”

…and I know I don’t have to worry that You Like Me Too Much , because What Goes On when I ask, ” Do You Want to Know a Secret ?” Well, you don’t Run for Your Life , and so I tell you that All My Loving makes me feel like The Fool on the Hill , Flying Across the Universe , and I’m Looking Through You , and Baby, You’re a Rich Man because What You’re Doing…

And you say, “ Let It Be , I’m Happy Just to Dance with You , You Never Give Me Your Money because we all need to Come Together, and All Together Now to find The Inner Light , so we can all feel like Lucy in the Sky with Diamonds , and withstand the Helter Skelter while we’re waiting on Revolution 9 . So Good Morning Good Morning , I’m Only Sleeping those Golden Slumbers so I can Drive My Car, because after A Day in the Life , it’s my zen. And When I Get Home , Another Girl - a Day Tripper - She Said She Said “ Don’t Pass Me By, it’s my Birthday !”

“And then I said, “We all need a Yellow Submarine , otherwise we might believe that The Long and Winding Road is full of Rain”, and then All I’ve Got to Do is remind her to Wait , for Here Comes the Sun , and That Little Child , I Saw Her Standing There , and I said, “ Honey Pie…I would Love You To say The Word and I’ll Get You what you need With a Little Help from My Friends , just don’t Ask Me Why You’ve Got to Hide Your Love Away, and tell everyone “ I Feel Fine ”, because Girl , From Me to You , I Don’t Want to Spoil the Party, but the Two of Us know why. And while you can’t Hold Me Tight when the overwhelm comes, my DMs are always open, And Your Bird Can Sing , Any Time at All .”

INTEGRATING WAYS OF KNOWING RESEARCH & INNOVATION

New Approaches to Care: Yoga Therapy for People in Residential Care

Ingrid

Wirsig, C-IAYT, BA (Hon), MSc (Sunnybrook Health Sciences Centre); Sayanthen Sathyakumar, BSc (Hon) (Sunnybrook Health Sciences Centre)

OThe ever-evolving diverse needs of people in residential care require collaborative and innovative approaches. In 2022, Sunnybrook Veterans Centre received seed funding from Veterans Affairs Canada to introduce a novel yoga therapy program to promote residents’ independence, strength and mobility, mood, and overall quality of life.

Alongside the Yoga Therapist, staff members including recreation therapists, music therapists, nurses, and activity aids collaborated to facilitate the program on multiple units at the Veterans Centre. The program achieved enthusiastic participation, with over 100 residents actively engaging in sessions. Feedback from participants consistently emphasized their enjoyment of the program and its positive impact on their lives.

To investigate the program’s effects and implications for future endeavours, our research team conducted a comprehensive evaluation. Through insightful focus group discussions with residents, six key themes emerged: Meaningfulness, Physical Activity, Mental Well-being, Social Connection, Tailored to Individual Needs, and Program Popularity. Interprofessional collaboration played an important role in the success of this program across the six themes. Recreation therapists supported the integration of yoga therapy

into resident programming. Nurses encouraged residents to attend and advised the yoga therapist of any health or behavioural issues. Activity aides and volunteers brought residents to and from class each week and assisted with individual needs. Volunteers also kept residents engaged during the transition periods before and after classes. On a cognitive support unit, a music therapist co-facilitated a weekly yoga therapy session, which helped improve focus and increase engagement among residents. Staff members on the units occasionally sat in on yoga classes for residents to enjoy a mindful movement break and gain a different perspective of resident abilities. This collaborative approach strengthened the sense of shared purpose among staff members, enhanced quality of life for residents, and promoted a culture of teamwork and innovation at the Veterans Centre.

Overall, residents of the Sunnybrook Veterans Centre expressed gratitude for the program, referencing improvements in physical and mental wellbeing, as well as overall quality of life. They appreciated its personalized approach and the opportunity it provided for social interaction with fellow residents. Staff members lauded the program’s uniqueness and meaningfulness. At the conclusion of the initial grant, staff and residents advocated for ongoing funding of the yoga therapy program. The implementation of this novel program would not have been possible without the support of leadership and engagement of front line staff, highlighting the importance of interprofessional collaboration and innovative approaches in promoting the well-being of people in residential care settings.

Photo Credits: Kevin Van Paassen

Collaborating to Design a PGME Curriculum on Health Harming Legal Needs

Rami Shoucri, MD, LLM (University of Toronto Department of Family and Community Medicine, St. Michael’s Hospital Academic Family Health Team); Melanie Henry, MD (MarkhamStouffville Hospital, Vice-Chair of Community and Partnerships in the Department of Family and Community Medicine, University of Toronto); Jennifer Stone, JD (Manager Health Justice Program at St. Michael’s Academic FHT, Faculty of Law, University of Toronto); Helen Anderson (Director of CLEO Connect, Community Legal Education of Ontario); Yael Feinberg, MD (St. Joseph’s Family Health Team); Jackie Bellaire, MD (Michael Garron Family Health Team); Janet Rodriguez (Patient Expert Advisor); Kristin Marshall, JD (Lawyer, Community Legal Education Ontario); Fatima Mazhar, MD (Family Medicine Resident, Markham-Stouffville (class of 2025)); Joyce NyhofYoung, PhD (Department of Family and Community Medicine and Office of Education Scholarship, University of Toronto)

Our interprofessional group is collaborating to design a novel curriculum for post-graduate medical education (PGME) learners on identifying and addressing what we call “health harming legal needs” in primary care.

The social and structural determinants of health (SDOH), especially for low-income patients, are known to have a profound impact on health and wellbeing (Welch, K. 2021). Housing, food and income insecurity, precarious immigration status, domestic violence, and precarious work are all increasingly common social needs that have a critical impact on patients’ health (Tobin-Tyler, E. 2023), including their ability to engage in primary care. They may also have legal solutions and they may be eligible for legal aid services in Ontario. Currently, there is little to no training available in medical education in Canada on identifying and addressing these needs and collaborating to navigate a complex legal aid system.

We will build on our expertise from the Health Justice Program (HJP) at St. Michael’s Academic Family

Health Team (a partnership with four community legal aid clinics), Community Legal Education of Ontario (CLEO), patients, current residents, the Department of Family and Community Medicine (DFCM) Health Equity Leads (HEL) committee and the Office of Education Scholarship (OES) to develop the curriculum.

The OES is supporting careful design, evaluation, and reporting on our education innovation. CLEO’s primary mandate is to provide reliable legal information for Ontarians and has particular expertise in training “trusted intermediaries,” such as health care providers to provide legal information to community members, such as our low-income patients. The HJP has been providing resident directed education for approximately 5 years and is in the final stages of publishing a textbook through the University of Toronto Press on Health Harming Legal Needs. The HEL Committee is facilitating the inclusion of resident and faculty input into the design; the identification of ideal sites to pilot the curriculum; an opportunity to scale up the curriculum; and the opportunity to integrate the curriculum with other novel SDOH-focused educational initiatives at the DFCM, including the Poverty and Health, Stand up for Health, Black Health, and Preventative Care Recommendations to Promote Health Equity programs.

References

Tobin-Tyler E, Boyd-Caine T, Genn H, Ries NM. Health Justice Partnerships: An International Comparison of Approaches to Employing Law to Promote Prevention and Health Equity. Journal of Law, Medicine & Ethics. 2023;51(2):332-343. doi:10.1017/jme.2023.84

Welch, K., Robinson, B., Martin, M.L. et al. Teaching the social determinants of health through medical legal partnerships: a systematic review. BMC Med Educ 21, 302 (2021). https://doi.org/10.1186/s12909-021-02729-1

Examining the Impact of COVID-19 on Discourses of Wellbeing in Interprofessional Collaboration

Maya Fields, BSc (Centre for Advancing Collaborative Healthcare and Education), Stella Ng, PhD, Reg CASLPO (Centre for Advancing Collaborative Healthcare and Education), Elizabeth McLaney, MEd, BScOT, OT Reg. (Ont), BAH (Psychology) (Centre for Advancing Collaborative Healthcare and Education; Sunnybrook Health Sciences Center), Tracey DasGupta, RN, MN (Sunnybrook Health Sciences Center; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto), Sabrina Bartlett, MEd, BEd, BSocSc (Centre for Advancing Collaborative Healthcare and Education), Brett A. Diaz, PhD (The Wilson Centre; Centre for Faculty Development)

Sources of funding support: the Ontario Ministry of Colleges and Universities’ Early Researcher Award and the AMS Healthcare Fellowship in Compassion and Digital Technology/AI

1Introduction

The Interprofessional Collaboration Showcase, a conference focused on Interprofessional Education (IPE) and Collaboration (IPC), started in 2010 as a hospital-specific event, designed to support internal exchange, related to developments in IPE and IPC. By 2018, the conference became a collaborative endeavour, co-hosted by Sunnybrook Health Sciences Centre and the University of Toronto’s (UofT) Centre for Advancing Collaborative Healthcare and Education, with participants from across the Toronto Academic Health Science Network (TAHSN), which is comprised of UofT and 14 affiliated academic hospitals.

Due to the COVID-19 pandemic, the 2020 and 2021 conferences embraced a virtual format. COVID-19 impacted the way people experience, talk about, and understand health care and work. The annual conference presented an opportunity to learn about these impacts from affected professionals.

This article reports findings from our analysis of the talk at these conferences. We interpret three prominent themes in the conferences’ talks: compassion and resilience, psychological safety, and conflict management. Our analysis suggests that wellbeing,

empathy, and compassion have become embedded as a major ethos in discourses surrounding IPC during the pandemic. Findings from the conferences suggest this ethos should continue to be prioritized and explored in a post-pandemic world.

Background

Wellbeing has become increasingly prominent in the hospital-university system and extends broadly to teams. With COVID-19, unprecedented pressures and concerns for team functioning and mental health arose. Prominent subjects relevant to IPC and wellbeing include strategies to mitigate stress and burnout (Gorbenko et al., 2020; Pfaff et al., 2017; Podgurski et al.,2019; Zhang et al.,2018), IPC/team development to improve satisfaction and belonging (Bajnok et al., 2012; Raderstorf et al., 2020), and increasing compassion (Pfaff et al., 2017), resilience (Heath et al., 2020), and psychological wellbeing (Allen et al., 2020). At different points during the first two years of the pandemic, it was hypothesized that the framing of wellbeing/wellness in IPC could look quite different. Our gathering of IPC educators, researchers, and practitioners presents a key opportunity to discover what changes in ways of talking about IPC have occurred, if any.

2 Methods

Data

Data consisted of verbatim, zoom-generated transcripts from the 2020 and 2021 professional conferences. Both conferences included a panel discussion with 2-3 discussants, and individual and team presentations.

Analysis

We employed an inductive thematic coding technique and content analysis (Hsieh and Shannon, 2005). This method of content analysis aligned with our goal to describe these events and what participants talked about. Descriptive codes covered what was discussed relating to topics in IPC (relevant themes in Table 1), and how they were discussed relating to dimensions of evaluation (positive, negative emotions) (Kiesling, 2022), and levels of confidence (talk with high or low epistemic confidence). Two research team members coded the same section of the transcript separately, comparing applications during biweekly discussions regarding code pattern and application review. Codes

were compared and revised until agreement was reached regarding application. Annotation, memoing, and analysis were completed regularly over 3 months. Content analysis included key words and phrases, and code co-occurrence.

Theoretical Framework

Our report is informed by affect analysis and stance analysis (Kiesling, 2022). Work in affect science has found that two dimensions of emotion, valence and arousal, are consistently present in language and cross culturally (Barrett, 2006; Barrett, 2007). Valence refers to positive or negative evaluation of an object or experience, in this case through the talk of presenters. We additionally drew on epistemic stance analysis, which occurs when a speaker makes a knowledge- or certainty-related claim about the object of discussion. Both emotion (affect) and knowledge (epistemics) were major figures in participants’ talk, making their analysis crucial to investigating experiences of IPC during the pandemic.

3 Results

We interpreted three main themes (Table 1) from the data: compassion and resilience, psychological safety, and conflict management. In most cases, talk about wellbeing was cross-coded with skills and practices, talked about positively, and with epistemic confidence.

Table 1.

Themes and Coding Logics

Theme Code Logics

Compassion & Resilience

Skills and practices for team support

Talk about vulnerability

Psychological Safety Addressing stigmatized topics

Psychological distress

Leadership roles

Conflict Management Negative wellbeing / negativity

Skills and practice for team growth

Comfort with conflict & mental health

3.1 Compassion and Resilience

(a) “have some support and that you’re not in this alone” (2020 conference)

(b) “embracing that vulnerability and sharing it with each other was important” (2020 conference)

IPC professionals emphasized togetherness and sharing vulnerability (Excerpt 3.1a, b). Presenters discussed team support as a skill and practice to ensure team members did not feel alone during the pandemic. They proposed that embracing and sharing vulnerability between team members could help others feel supported and heard. We found repeated references to ways that enacting these forms of support made teams’ stronger and created trust.

3.2 Psychological Safety

(a) “recognize psychosocial distress and to normalise it and then some evidence-based and evidence-informed approaches to trying to support healthcare workers during this time” (2020 conference)

(b) “The wellness of our team [is] incumbent on us as leaders.” (2021 conference)

One participant discussed recognizing psychological distress and normalizing it, to support healthcare workers during the pandemic (Excerpt 3.2a). Addressing stigmatized topics helped improve the psychological safety of team members. Presenters emphasized that wellness of teams depended on leadership (Excerpt 3.2b). If leaders did not prioritize and act upon changes to improve team wellbeing, team wellbeing did not improve and could deteriorate.

3.3 Conflict Management

(a) “Should we develop skills in embracing conflict and sitting with it and learning from it.” (2021 conference)

(b) “The problem with conflict though, is that oftentimes we internalize it. Or we personalized conflict.” (2021 conference)

(c) “How we treat one another… We are all human beings. Respect, intuition, and acceptance is modelled at all levels.”(2021 conference)

Participants discussed turning conflict into an opportunity for conflict management, a skill and practice to grow as a team (Excerpt 3.3a, c). Speakers emphasized comfort with conflict as necessary for its management, lessening anxiety, and decreasing negative effects on mental health. Learning to sit with and becoming comfortable with conflict can help prevent its internalization (Excerpt 3.3b).

4 Discussion

Our study suggests that the pandemic brought concerns about wellbeing into specific practices and an ethos in IPC, and that compassion and resilience have become increasingly important to professionals. Psychological safety is a key theme for wellbeing/wellness, and is associated with vulnerability, uncertainty, fears, and trust. To foster wellbeing in IPC, participants focus on using skills and practices, such as talk, dialogue, building empathy, and checking in with teammates.

In IPC training, conflict management is a core competency (Canadian Interprofessional Health Collaborative, 2023), but is not tied directly to talk of wellbeing. In 2021, aspects of conflict management become apparent in the dialogue surrounding wellbeing, which is unique. Focuses shift to using skills and practices, such as dialogue and listening, to build empathy and manage and resolve conflict, which are associated with negative wellbeing. These skills help destigmatize conflict and create opportunities to learn from it.

Throughout the two conferences, wellness/wellbeing are discussed alongside skills and practices. This makes sense, as IPC often focuses on what people do (skills) to understand how teams work together (Green and Johnson, 2015). Trust building is one way that teams improve wellbeing, forming an ethos to confront the uncertainty of COVID-19.

All three themes emphasize the importance of building trust in teams through skills. For example, psychological safety is necessary for team members to feel safe and non-defensive when practicing conflict management. Developing trust may be a prerequisite for team-based wellbeing in practice.

Conference presenters emphasized that when team members trust they are treated with respect and dignity, conflict is resolved more quickly and fully. When professionals have the skills and practices founded on values, such as compassion and empathy, they can address the root issue resulting in conflict (3.3.a). However, for team members to feel safe enough to be vulnerable and discuss conflicts, they must trust their teammates (Vangen and Huxham, 2003).

Limitations

These conclusions are drawn from a study of two IPC conferences. Our findings, while drawn from a diverse and large group of experienced professionals, are limited in scope. They present preliminary findings, and potential starting directions for research and training in IPE and IPC.

5

Conclusions

The IPC conference has evolved over 13 years into a collaborative IPC and IPE endeavour, focusing on celebrating excellence in team-based learning, collaborative care, interprofessional research, and leadership. COVID-19 pushed this conference into a virtual event, and presented an opportunity to learn about how COVID-19 has impacted the way people experience, talk about, and understand interprofessional health care and work. This article reported findings from our analysis of the talk at these conferences. Findings suggest that wellbeing, empathy, and compassion seem to be embedded as a major ethos in the discourse surrounding IPC practice during the pandemic. They suggest that this ethos should continue to be prioritized and explored further in a post-pandemic world.

6

Author Contributions

MF and BAD coded the two transcripts and wrote the manuscript. SN, EM, TD, and SB assisted in editing and refining the manuscript, and background information collection. EM, TD & SB co-chaired the planning committee for the IPC Showcase and were co-leads in executing the conferences.

References

1. Allen, M.L., Groll, M., Emlund, M., King, D.E., Sonnichsen, J., Bayer, K., Echeverria, G. (2020) Healthcare Students’ Psychological Well-Being in a Diabetic Ketoacidosis Simulation. Clin Simul Nurs., 39,1-6. doi:10.1016/j.ecns.2019.10.005

2. Bajnok, I., Puddester, D., Macdonald, C.J., Archibald, D., Kuhl, D. (2012). Building positive relationships in healthcare: Evaluation of the teams of interprofessional staff interprofessional education program. Contemp Nurse J Aust Nurs Prof., 42(1),7689. doi:10.5172/conu.2012.42.1.76

3. Barrett, L.F. (2006). Valence is a basic building block of emotional life. Journal of Research in Personality, 40(1),35-55. doi:10.1016/j.jrp.2005.08.006

4. Barrett, L.F., Lindquist, K.A., Gendron, M. (2007). Language as context for the perception of emotion. Trends in Cognitive Sciences, 11(8),327-332. doi:10.1016/j.tics.2007.06.003

5. Canadian Interprofessional Health Collaborative. A national interprofessional competency framework. Vancouver, BC: Canadian Interprofessional Health Collaborative; 2023.

6. Gorbenko, K., Mendelev, E., Keefer, L. (2020). Can multidisciplinary team meetings reduce burnout? J Eval Clin Pract., 26(3),863-865. doi:10.1111/jep.13234

7. Green, B.N., Johnson, C.D. (2015) Interprofessional collaboration in research, education, and clinical practice: working together for a better future. J Chiropr Educ., 29(1),1-10.https://doi. org/10.7899%2FJCE-14-36

8. Heath, J., Walmsley, L.A., Aker, R.M., Ferrin, S., Stone, D., Norton, J.C. (2020). CPR to the Rescue! Clin Nurse Spec J Adv Nurs Pract., 34(2),63-69. doi:10.1097/ NUR.0000000000000506

9. Hsieh, H.F., Shannon, S.E. (2005) Three approaches to qualitative content analysis. Qual Health Res., 15(9),1277-1288. doi:10.1177/1049732305276687

10. Kiesling, S.F. (2022) Stance and Stancetaking. Annu Rev Linguist., 8(1),409-426. doi:10.1146/annurevlinguistics-031120-121256

11. Pfaff, K.A., Freeman-Gibb, L., Patrick, L.J., DiBiase, R., Moretti, O. (2017) Reducing the “cost of caring” in

cancer care: Evaluation of a pilot interprofessional compassion fatigue resiliency programme. J Interprof Care., 31(4),512-519. doi:10.1080/13561820 .2017.1309364

12. Podgurski, L., Greco, C., Croom, A., Arnold, R., Claxton, R. (2019) A Brief Mindfulness-Based SelfCare Curriculum for an Interprofessional Group of Palliative Care Providers. J Palliat Med., 22(5),561565. doi:10.1089/jpm.2018.0550

13. Raderstorf, T., Melnyk, B.M., Ackerman, M., Bibyk, S. (2020) An Outcomes Evaluation of an Innovation Studio on Interprofessional Learning, Job Satisfaction, and Intent to Stay Among Clinicians. JONA J Nurs Adm., 50(2),109-114. doi:10.1097/ NNA.0000000000000850

14. Vangen, S., Huxham, C. (2003) Nurturing collaborative relations: Building trust in interorganizational collaboration. J Appl Behav Sci., 39(1),5–31. https:// doi.org/10.1177/0021886303039001001

15. Zhang, C., Myers, C.G., Mayer, D.M. To Cope with Stress, Try Learning Something New. Harv Bus Rev. Published online September 4, 2018. Accessed January 19, 2022. https://hbr.org/2018/09/to-copewith-stress-try-learning-something-new

VR Technology Boosts Empathy in Future Healthcare Professionals, UNE Study Finds

Alan Benne tt, B.A. (University of New England)

Virtual reality (VR) technology may be a promising pedagogical tool in enhancing empathy among future healthcare providers, a new study from an interprofessional team of University of New England (UNE) researchers suggests. The recent findings were published in Gerontology & Geriatrics Education in March.

Empathy, recognized as a crucial aspect of patient care, has long been a focal point in medical education. However, finding effective methods to cultivate empathy in healthcare professionals has remained a challenge. The UNE study sought to address this gap by exploring the impact of VRassisted learning models on empathy development.

The resulting article, “ Teaching Empathy: Comparison of a Virtual Reality Experience Using Head-Mounted Display Versus Group Streaming ,” was written by an interprofessional group of faculty from UNE Library Services, osteopathic medicine, and UNE’s Physician Assistant program.

The study focused on comparing the effects of immersive head-mounted display (HMD) VR experiences to streamed VR modalities on empathy levels among Physician Assistant (PA) students. Named the “Alfred Lab,” the VR experience allowed students to inhabit the perspective of a 74-yearold African American man with vision and hearing impairments, providing a unique immersive encounter. The unique educational tool is used across a broad array of health-related professions, programs, and courses, making for a common learning experience across disciplines.

The UNE research involved two cohorts of PA students, with one group experiencing the VR lab using HMD devices and the other group utilizing a streamed VR modality due to COVID-19 safety protocols. These labs were completed as part of UNE’s Interdisciplinary Geriatrics Education Program. Pre- and post-surveys were administered to gauge changes in empathy levels, with both groups showing a remarkable increase after completing the VR lab.

The study found that empathy and understanding were significantly enhanced through both the HMD VR and the streaming VR experiences, the researchers found. “These research findings confirmed that the streaming modality was as effective in increasing students’ feelings of empathy and understanding,” the researchers wrote.

While the publication focuses on physician assistant students, since 2016, thousands of UNE students have experienced the Alfred Lab from across colleges and disciplines, including osteopathic medicine, allied health, dental medicine, and the liberal arts. The breakthrough holds significant implications for medical education, particularly in addressing the challenges posed by the COVID-19 pandemic.

Together

Stories of Collective Impact

Have you read our previous issues?

Click HERE to read Together: Stories of Collective Impact, Volume 1.1 (Fall 2022)

Click HERE to read Together: Stories of Collective Impact, Volume 1.2 (Winter 2023)

Click HERE to read Together: Stories of Collective Impact, Volume 1.3 (Spring 2023)

Click HERE to read Together: Stories of Collective Impact, Volume 1.4 (Summer 2023)

Click HERE to read Together: Stories of Collective Impact, Volume 2.1 (Fall 2023)

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COMING TOGETHER: EVENTS & ANNOUNCEMENTS

The Advantages of Interprofessional Team-Based Practice in Healthcare are Widely Recognized, but How Do You Get Started?

Jody Thompson (MS Digital Audience Strategy, Digital Audience Strategy Specialist & Project Manager, Center for Advancing Interprofessional Practice, Education & Research)

The award-winning Center for Advancing Interprofessional Practice, Education and Research (CAIPER ) has launched a new course to equip healthcare professionals and students with the knowledge and skills needed to excel as integral members of collaborative teams in primary care settings.

Interprofessional Practice in Primary Care is an accredited 4-hour eLearning course that places a strong emphasis on team-based decision-making and essential skills crucial in both current and evolving primary care practices. Select topics include care coordination and integrated care, team decision-making, and the habits of high-performing teams.

The fully asynchronous eLearning course is thoughtfully designed to seamlessly integrate into existing curricula or workforce training programs. Topics are concise and engaging, and all course content has been carefully developed and reviewed by subject matter experts to provide evidencebased strategies and knowledge essential for teambased practice in primary care.

With an urgent need for an expanded primary care workforce and the improvement of team-based collaborative care, CAIPER’s Interprofessional Practice in Primary Care course is ready-togo resource for learning, growth, and practical application.

The full course and additional resources are included in the $19 enrollment fee. Four Continuing Education Credits in six health and social care professions are available for an additional $25. Package pricing is available for educational institutions, non-profits and business organizations. Please contact Yvonne Price with questions or for more information on package pricing.

UNE “Poised to be National Leaders in Interprofessional Education,” National Expert Says

Matt Shinberg, B.A. (University of New England)

Members of Maine’s healthcare and education communities gathered at the University of New England’s (UNE) Portland Campus for Health Sciences in mid-December to hear from a national expert and advocate about the importance of integrating interprofessional education (IPE), which promotes team-based collaborative practice, into clinical learning, to improve the quality of patients’ health outcomes.

At the event, Christine Arenson, M.D., director of the National Center for Interprofessional Practice and Education , addressed why interprofessional teamwork is a foundational tool to combat crises facing healthcare in the United States today, like workforce shortages, increased violence against staff, and provider burnout.

“Business as usual isn’t working,” Arenson said, noting that UNE and its Center to Advance Interprofessional Education and Practice — the host of the talk — is poised to be a national leader in this effort.

“This university, I would say, is the national leader in how we engage patients and community members in educating our students and helping them to really practice patient-centered care,” she said.

The push to advance IPE in health education began in the early 2000s when a series of reports cited a lack of communication and collaboration between providers as key reasons for increased medical errors and decreased quality of healthcare in the United States. In the wake of those reports, many universities, UNE included, began initiatives to advance IPE in curriculums.

“Our call at the national center is to work at changing our underlying ideology and culture that crosses professional and institutional borders,” Arenson said, adding that the COVID-19 pandemic forced healthcare systems to rapidly change, opening the door for newer, more adaptable team-based practice models.

“This is a moment in time when we must be reflective in how we’re educating current and future practitioners to affect workforce change,” she said before asking, “Are we ready to question our beliefs?”

Arenson encouraged those in attendance to make stronger connections between practice and education by engaging with their colleagues.

“The people in this room can help address this. Effective interprofessional teamwork may be one of our strongest levers to pull to address the workforce crisis,” she said.

Interdisciplinary Trauma Conference

Corey Freedman, MHI (Sunnybrook Health Science Centre)

On March 1st, 2024, Sunnybrook Health Sciences Centre, St. Michael’s Hospital, and the Hospital for Sick Children, partnered to host the University of Toronto Interdisciplinary Trauma Conference.

The all-day conference had a theme of ‘readiness’ across all levels of the trauma system, with a heavy emphasis on Ontario’s designation of new Level 3 trauma centres.

The conference was held at the BMO IFL in Scarborough, with a full room of ~300 participants (including physicians, nurses, allied health, paramedics, hospital administrators, and more).

This was the first time this conference was held in person since 2019, and it was great to see the renewed healthcare community interest in attending!

The conference also included an outdoor feature from Toronto Paramedic Services, including their mass casualty incident (MCI) bus and special ops vehicles.

Feedback from the conference was overwhelmingly positive, and it was great to see such excitement and interest in trauma care across disciplines!

The Teaching for Transformation: Annual Conference+ (TforT:AC+) 2024

Stella Ng, PhD, Reg CASLPO (Director & Scientist, Centre for Advancing Collaborative Healthcare & Education); Lindsay Baker, MEd, BEd (Associate Director, Curriculum Integration and Partnerships, Centre for Faculty Development)

TheTeaching for Transformation: Annual Conference+ (TforT: AC+) took place from March 25-27, 2024, online with one in-person social event. We welcomed 100 participants and a diverse program of speakers and facilitators. The theme of TforT: AC+ 2024 was Teaching toward Collaborative Approaches to Care.

The conference opened with a focus on love as the antidote to some of the challenges we see in healthcare today. Katie Lee Bunting and Thirusha Naidu inspired us to rejuvenate the shared core of humanity through educational practices – so we may work together toward a better health and social care system for all. The theme continued through additional presentations on Indigenous approaches to education, questioning constructs of professionalism toward greater

inclusion, and workshops and roundtables on practical approaches such as Student-Led Environments and culminating in a closing workshop on pluralistic approaches to education.

A highlight of the conference was the submitted abstract Short Talks highlighting the innovative work of conference participants. In fact, the Short Talks were of such high quality and relevance that in future TforT: AC+ planning we will look to invite additional submissions, e.g. for workshops.

Participants commented on the engaged community feel of the conference, the provocative and inspiring sessions, and the idea that while transformation is daunting, the weight is lifted by a collective that lightens the load and offers hope.

To all participants in TforT: AC+ past and future, we thank you for building a collective of varied people and perspectives, aiming for positive changes in care through excellent education.

Participants at the TforT: AC+ Social March 27, 2024

MCACHE at ICAM 2024

Stella Ng, PhD, Reg CASLPO (Director & Scientist, Centre for Advancing Collaborative Healthcare & Education)

embers of the CACHE team attended the International Congress on Academic Medicine (ICAM) in Vancouver from April 12-15. CACHE presented a range of talks and workshops highlighted here:

We were also pleased to be exhibitors, sharing with colleagues at The Institute for Education Research (TIER) and networking with colleagues from around the world.

A highlight of the conference included a plenary entitled ‘Leveraging Team Based Education to Enhance Team Based Care: A Tool for Addressing the Human Health Resource Crisis’. Featuring Ivy Oandasan, Maxime Le, and Renee Stalmeijer, this plenary reinforced the role of health professions education in supporting Team Based Care, and how teams in turn can address the health workforce challenges of today and tomorrow.

On the same theme, Sarah Gregor, Dean Lising, and Lynne Sinclair of CACHE also presented work from CACHE’s work with the Team Primary Care: Training for Transformation initiative, focusing on the BOOST! (Building Optimal Outcomes from Successful Teamwork) program and team assessments.

We look forward to the next ICAM in 2025.

Lecture in partnership with the Office of Indigenous Health, Temerty Faculty of Medicine

Indigenous Wisdom and Health Professions Education Theories and Practice

Monday, May 27, 2024 1:00-4:00 pm EDT

HYBRID: BMO Education & Conference Centre, Toronto, ON

Shouldn’t we get to know each other before we jump into research together? Building research relationships with Indigenous communities

Speakers: Michael Anderson, MD FRCSC; Sophie Soklaridis, PhD; Gemma Woticky, PhD(c)

Registration is open: https://events.myconferencesuite.com/ IndigenousWisdom2024

Society for Academic Continuing Medical Education

Promoting Research in Medical Education

June 18 - 21, 2024 Toronto, ON

Across 4 days in Toronto, we are bringing together experts and budding scholars in continuing professional development (CPD) and continuing medical education (CME).

Designed for both experienced and novice individuals who are looking to advance their research, evaluation, and scholarly skills, you will learn how to incorporate the latest research and scholarship into your CPD/CME practice.

You will have the chance to develop your expertise in the investigation and evaluation of learning and change in CPD/CME. The small group and intensive nature of this program allows attendees to network with professionals who are leading the evolution in CPD/CME research. With a focus on interactive learning, breakout discussion, and knowledge generation, you will be prepared to take the next step in your career within CPD/CME and contribute to the scholarship of CPD/CME.

Ready to catalyze your knowledge and skills to make a lasting impact in CPD/CME? Join us in Toronto for a week of connection and collaboration.

Visit the website to learn more and register online, https://sacme-cpdscholarship.org/

15th Annual Hybrid Interprofessional Collaboration Showcase 2024

Indigenous Knowledges for Team Collaboration & Health Care Delivery

Wednesday June 19, 2024 | 2:00-5:00pm EDT

BMO Education & Conference Centre – 60 Leonard Avenue, Toronto, ON Register Now: https://www.surveymonkey.com/r/IPCShowcase2024_registration

The Interprofessional Collaboration (IPC) Showcase celebrates excellence in team-based learning, collaborative care and leadership, interprofessional research, and quality improvement across our healthcare system. Offered jointly by Sunnybrook Health Sciences Centre, the University of Toronto’s Centre for Advancing Collaborative Healthcare & Education (CACHE), and Unity Health Toronto, this hybrid forum will provide a variety of speakers, presentations, and opportunities to connect. The IPC Showcase brings together people in diverse professions and roles to network with like-minded colleagues, share ideas, and create new opportunities for collaboration.

Agenda

Keynote Speaker

Dr. Suzanne Stewart PhD, C.Psych., is the TC Energy Chair in Indigenous Health & Wellbeing and Director of the Waakebiness Institute for Indigenous Health at the University of Toronto. She is a member of the Yellowknives Dene First Nation and a registered psychologist. Her research interests are Indigenous mental health and homelessness and Indigenous research ethics. She has over 20 years of experience with community driven research and clinical practice aimed at breaking barriers for Indigenous youth and families in mental health and healing.

• We are pleased to offer this event at no charge.

• Select in person seats will be available at the BMO Conference Centre. When you visit the registration link, you will have the opportunity to indicate your interest in attending in person.

• Zoom (virtual) attendance is unlimited.

• Please register at https://www.surveymonkey. com/r/IPCShowcase2024_registration

• Light refreshments will be served for those who attend in-person.

• If you have any questions please contact Fatima.Mimoso@uhn.ca

Centre for Faculty for Faculty Development Upcoming Programs

New & Evolving Academic Leaders (NEAL)

The NEAL program is designed for people in an academic health science context who are committed to becoming change agents in their spheres of influence and beyond by centering principles of equity, diversity, inclusion, Indigeneity and accessibility in their leadership practice. This program is intended for those who are committed to challenging the status quo, and looking to develop tools, skills, and evolving practices to positively shape our future academic health sciences system.

Registration deadline: May 16, 2024

Click here for more information

Stepping Stones: Foundations in Education

Do you have a keen interest in health professions education but don’t know where to start? Stepping Stones is a foundational two year program consisting of both workshops and a journal club. This highly-flexible interprofessional program provides support to health professionals in their multiple education roles and activities including teaching, education scholarship, advocacy and academic leadership.

Registration deadline: June 30, 2024

Click here for more information

Teaching and Learning in the Clinical Context (TLC)

Do you supervise students as part of your clinical practice? Are you looking to build your knowledge and expertise in clinical teaching?

The TLC program is a 12-week virtual program designed for supervisors/preceptors from all health disciplines to develop the foundational knowledge and skills needed to effectively teach learners in various clinical contexts.

Fall Cohort Registration is OPEN!

Click here for more information

An International Association for Health Professions Education

AMEE 2024

Develop Your Educational Career: Connect, Grow, and Inspire

August 24-28th 2024

Basel, Switzerland

AMEE 2024 will focus on how best to engage with existing knowledge to guide practice, develop new knowledge, and consider how what we do is useful for learners, patients, and society.

We will promote and inspire excellence, collaboration, and scholarship across the continuum of health professions education.

Visit the website to learn more and register online, AMEE 2024

Hosted by the National Center for Interprofessional Practice and Education, and co-hosted by the American Interprofessional Health Collaborative

Nexus Summit 2024

Navigating Complexity to Advance Outcomes

September 25, 26, 30 and October 1, 2024 Virtual

We are thrilled to announce that the annual Nexus Summit will be held this year on September 25 - 26 and September 30 - October 1! The Nexus Summit 2024 marks the ninth year of the interprofessional practice and education community coming together to learn about, from, and with each other in the Nexus of practice and education as we strive to impact health and learning outcomes that matter most to the people we serve.

This year the conference will once again be held virtually to empower the most accessible engagement from the national and global interprofessional practice and education community.

The Call for Abstracts has been released, and the submission deadline is May 24, 2024 at 11:59 p.m. ET.

See the website for updates on exciting opportunities to share your work in IPE, network and learn together with your colleagues, and discover new spaces of collaboration.

EHPIC™ 2024

Advancing the Future of Healthcare through Interprofessional Learning A Program for Healthcare Professionals, Educators & Leaders

November 6-8, 2025 | Vantage Venues, 150 King St. W, Toronto, ON

Early Bird Application Deadline: August 21, 2024

Applications Due: September 18, 2024

This competency-based program aims to develop leaders in interprofessional education and interprofessional care who have the knowledge, skills and attitudes to teach both learners and fellow colleagues the art and science of working collaboratively for patient-partnered care.

Please contact Belinda Vilhena, Program Co-Director or visit the website for more information.

Collaborative Change Leadership™ (CCL) Program

March - December 2025 | Virtual Program

Applications deadline November 27, 2024! | Early Bird Rate: Apply by October 30, 2024

This certificate Program, grounded in leadership, change and social accountability theories, processes and practices, is designed for leaders who are accountable for meaningful and sustainable change within and across complex systems. These leaders are driven to engage multiple stakeholder and community voices, build strong relationships and partnerships, work collaboratively to co-create change, and lead by example.

Program Dates:

• March 27-28, 2025

• April 24-25, 2025

• June 12-13, 2025

• September 25-26, 2025

• December 4-5, 2025

Applications deadline November 27, 2024!

Why CCL? Click the video above to learn more.

For more information visit the program website or email, belinda.vilhena@uhn.ca

VITAL: Virtual Interprofessional Teaching and Learning Program

A six-module virtual learning series covers key best practices and core competencies for interprofessional education (IPE) and virtual facilitation.

Virtual technology and virtual 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 virtual environment.

Stay Tuned for 2024/25 Program Dates

Module 1: Overview of IPE/IPC Evidence, Literature and Best Practices

Module 2: Role Clarification & Negotiation

Module 3: Team Communications and Team Disagreements Processing - Focus on Patient Safety/Quality Improvement (QI)

Module 4: Collaborative Relationship-Focused Care/ Services

For more information visit our website or email belinda.vilhena@uhn.ca

Module 5: Team Functioning - Psychological Safety and Leadership - Pulling it All Together

Module 6: Interprofessional Facilitation Simulation, Tips and Resources