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In Canada in 2015, the pass rates on the National Council Licensure Examination (NCLEX-RN) were considerably lower than pass rates on the Canadian Registered Nurse Examination (CRNE) causing nurse educators to express concern regarding the NCLEX-RN. The purpose of this study was to examine the relationship between candidate variables (e. g. academic performance, demographics) on their NCLEX-RN outcome (pass/fail). A cross-sectional data linkage design was employed using multiple sources of data on nursing graduates who wrote the NCLEX-RN in 2015, 2016 and 2017 (n = 259). Results showed that fewer questions answered on the NCLEX-RN and higher grades in various nursing courses (e. g. Introduction to Nursing, Statistics) predicted higher odds of passing the NCLEX-RN. To improve pass rates, nurse educators must integrate diverse methods of testing into existing curricula that mimic the NCLEX-RN exam, specifically computer adaptive exams. Further research is needed to determine other possible challenges for countries considering adopting the NCLEX-RN. [ABSTRACT FROM AUTHOR]

Introduction: Faculties of Pharmacy worldwide have to adapt their curriculum to accreditation criteria. The present study explored how the Association of Faculties of Pharmacy of Canada’s (AFPC’s) 2010 Educational Outcomes are perceived and taught at the Leslie Dan Faculty of Pharmacy (LDFP). These outcomes were adapted from the CanMeds Physician Competency Framework which describes both medical expert and non-expert roles.Methods: We wondered if pharmacy would struggle, as medicine has, to integrate these roles into curricula in meaningful ways, given the absence of previous studies from Pharmacy. We conducted an exploratory interview study with 10 core faculty members in charge of courses where non-expert roles were taught. Data were analysed using conventional content analysis.Results: Faculty members understood that the AFPC Outcomes are important for students, patients, and the profession of pharmacy, and some saw the roles as knowledge-based and teachable using content from academic disciplines. However, most saw them as skills taught informally or through clinical experience. They used the roles as a framing device to legitimize their course content and relied on informal role modelling to do most of the teaching. The few faculty members who taught content related to these roles had postgraduate education in a social science or humanities discipline.Discussion: Similar to studies of Faculties of Medicine, our study highlights the difficulty of translating a role-based, competency framework into concrete, integrated curricula for students. Competency development should be explicitly embedded into the curriculum and cannot be left to individual instructors. [ABSTRACT FROM AUTHOR]

Interprofessional education (IPE) has been widely incorporated into health professional curricula and accreditation standards despite an arguably thin base of evidence regarding its clinical effects, theoretical underpinnings, and social implications. To better understand how and why IPE first took root, but failed to grow, this study examines one of the earliest documented IPE initiatives, which took place at the University of British Columbia between 1960 and 1975. We examined a subset of 110 texts (academic literature, grey literature, and unpublished records) from a larger study that uses Critical Discourse Analysis to trace the emergence of IPE in Canada. We asked how IPE was promoted and received, by whom, for what purposes, and to what effects. Our analysis demonstrates that IPE was promoted as a response to local challenges for the Faculty of Medicine as well as national challenges for Canada's emerging public healthcare system. These dual exigencies enabled the IPE initiative, but they shaped it in somewhat divergent ways: the former gave rise to its core component (a health sciences centre) and the latter its ultimate purpose (increasing the role of non-medical professions in primary care). Reception of the initiative was complicated by a further tension: nurses and allied health professionals were sometimes represented as independent experts with unique knowledge and skills, and sometimes as assistants or substitutes for medical doctors. We relate the successes and frustrations of this early initiative to particular (mis)alignments of purpose and relationships of power, some of which continue to enable and constrain IPE today. [ABSTRACT FROM AUTHOR]

Context Health professional student evaluation during experiential training is notably subjective and assessor judgements may be affected by socio-cultural influences. Objectives This study sought to explore how clinical preceptors in pharmacy conceptualise varying levels of student performance and to identify any contextual differences that may exist across different countries. Methods The qualitative research design employed semi-structured interviews. A sample of 20 clinical preceptors for post-baccalaureate Doctor of Pharmacy programmes in Canada and the Middle East gave personal accounts of how students they had supervised fell below, met or exceeded their expectations. Discussions were analysed following constructivist grounded theory principles. Results Seven major themes encompassing how clinical pharmacy preceptors categorise levels of student performance and behaviour were identified: knowledge; team interaction; motivation; skills; patient care; communication, and professionalism. Expectations were outlined using both positive and negative descriptions. Pharmacists typically described supervisory experiences representing a series of these categories, but arrived at concluding judgements in a holistic fashion: if valued traits of motivation and positive attitude were present, overall favourable impressions of a student could be maintained despite observations of a few deficiencies. Some prioritised dimensions could not be mapped to defined existing educational outcomes. There was no difference in thresholds for how student performance was distinguished by participants in the two regions. Conclusions The present research findings are congruent with current literature related to the constructs used by clinical supervisors in health professional student workplace-based assessment and provide additional insight into cross-national perspectives in pharmacy. As previously determined in social work and medicine, further study of how evaluation instruments and associated processes can integrate these judgements should be pursued in this discipline. [ABSTRACT FROM AUTHOR]

Context Predictive validity studies on the use of the multiple mini-interview ( MMI) have been primarily in medicine. Objectives This study sought to determine the predictive validity of the MMI for performance within a pharmacy programme and on the Pharmacy Examining Board of Canada ( PEBC) Qualifying Examination for licensure, and to compare the predictive validity of the MMI with that of pre-pharmacy grade point average ( GPA) and Pharmacy College Admission Test ( PCAT) score. Methods Admissions data for 223 graduates of the pharmacy programme at the University of Toronto were matched to programme and licensure outcome measures. Multiple linear regression assessed the predictive ability of the MMI, pre-pharmacy GPA, PCAT and covariates for performance in final-year experiential rotations, cumulative GPA ( cGPA) and PEBC- MCQ (multiple-choice question examination) and PEBC- OSCE (objective structured clinical examination) overall and subcomponent scores. Results The PCAT, pre-pharmacy GPA and age significantly predicted the PEBC- MCQ overall score. The MMI was the only significant predictor of overall score on the PEBC- OSCE (β = 0.17, p = 0.02); it also predicted communication and performance subscores. Scores on the PCAT and female gender predicted the communication subscore. Pre-pharmacy GPA, age and female gender significantly predicted cGPA. The MMI was the only significant predictor of institutional/ambulatory rotation score (β = 0.26, p = 0.00). Conclusions The MMI, designed to measure non-academic attributes including communication, motivation and problem-solving skills, was the only admissions tool with significant predictive validity for performance on the PEBC- OSCE national pharmacy certification examination and in an institutional/ambulatory rotation. These findings, from a single cohort of undergraduates, provide the first report of the predictive validity of the MMI for performance on pharmacy licensure examinations and thereby strengthen the evidence for its use in health professions selection. Prior university academic performance significantly predicted cGPA and performance on the PEBC- MCQ. Performance on the PCAT also predicted PEBC- MCQ results. [ABSTRACT FROM AUTHOR]

Objectives:Most medical schools using progress tests (PTs) provide feedback by utilizing a traffic-light system of green (satisfactory), yellow (borderline) and red (unsatisfactory) categories. There is little research assessing students’ perceptions or usage of this feedback. Therefore this study proposed to determine the effectiveness of formative PTs at informing and supporting student progress. Methods:A mixed methods study was performed, involving a retrospective analysis of a results database to establish the predictive validity of PT categories and 11 semi-structured interviews to explore students’ perceptions of PT feedback in a graduate entry medical programme. Results:Quantitative analysis revealed that students who always scored green performed better in their summative exams and graduated with a higher final degree than those who received a yellow or red category at least once. Qualitative analysis revealed that just over half of the interviewed students perceived the PT as having informed their progress. Most participants agreed that the current feedback is insufficient and doesn’t guide their on-going learning. Conclusion:While this study demonstrated that the PT is a useful predictive tool for informing student progress, in its current format it’s not fulfilling a truly formative role and supporting student progress sufficiently. [ABSTRACT FROM PUBLISHER]

This article discusses the process, benefits, challenges and recommendations associated with the adoption of the Problem-based Learning (PBL) approach to promote reflection for pre-service teachers. Drawing upon Schön’s concept of reflection, this article explains how a pre-service course in Canada aims to promote the participants’ ‘reflection in action’ of assessment content knowledge and professional competence through PBL. The article points out that PBL enables the pre-service teachers to critically reflect on assessment issues and make meaningful connections between their reflections and real-life teaching. The key challenges are the facilitators’ inadequate understanding of using PBL to promote reflection, as well as the pre-service teachers’ struggle with time constraint and juggling between their need for teacher guidance, group collaboration and self-directed study. To address these challenges, the article recommends formal professional development sessions for the PBL instructors, and the achievement of a balance between learner autonomy and teacher guidance. [ABSTRACT FROM PUBLISHER]

There is a growing trend toward including adults with intellectual disabilities ( ID) in further education. However, there is a lack of literature on the preparation of students with ID to attend further education. This article, by James Wintle of Queen's University, Ontario, describes how a non-profit organisation, CALC Prep, prepares adults with ID to audit university courses. Eighty hours of observations were conducted over the course of one term at this organisation. A grounded theory approach was used to identify themes within CALC Prep's curriculum. Themes within the curriculum that were considered most useful for students preparing to audit courses at the university included familiarising the students with the university, enhancing self-awareness, enhancing self-expression and building literacy skills. Additionally, recommendations for improving the transition of students with ID from the preparation programme to auditing university courses are offered. [ABSTRACT FROM AUTHOR]

Purpose -- This article aims to document the process the province of Newfoundland and Labrador used to develop an innovative Physician Management and Leadership Program (PMLP). The PMLP is a collaborative initiative among Memorial University (Faculty of Medicine and Faculty of Business), the Government of Newfoundland and Labrador, and the Regional Health Authorities. As challenges facing health-care systems become more complex there is a growing need for management and leadership training for physicians. Design/methodology/approach -- Memorial University Faculty of Medicine and the Gardiner Centre in the Faculty of Business in partnership with Regional Health Authorities and the Government of Newfoundland and Labrador identified the need for a leadership and management education program for physician leaders. A provincial needs assessment of physician leaders was conducted to identify educational needs to fill this identified gap. A Steering Committee was formed to guide the design and implementation and monitor delivery of the 10 module Physician Management and Leadership Program (PMLP). Findings -- Designing management and leadership education programs to serve physicians who practice in a large, predominately rural geographic area can be challenging and requires efficient use of available resources and technology. Originality/value -- While there are many physician management and leadership programs available in Canada and abroad, the PMLP was designed to meet the specific educational needs of physician leaders in Newfoundland and Labrador. [ABSTRACT FROM AUTHOR]

There is growing evidence that exposure to orthographic input affects second language phonological acquisition. This study examined the effects of auditory-orthographic interactions on second language assibilated/fricative rhotic productions of 20 naive English speakers of Spanish, with an acoustic-phonetic approach. The participants were assigned to two groups: auditory-only and auditory-orthographic. The results were indicative of a higher rate of both assibilated/fricative rhotics and approximant rhotics in the auditory-orthographic group. In addition, there was evidence that the acoustic input modulated the orthographic effects. However, the auditory-only group produced a higher rate of postalveolar sibilants. These results will be discussed in terms of (a) the salience-enhancing effect of the grapheme and (b) the overriding effect of orthography. [ABSTRACT FROM AUTHOR]

The article offers the author's insights on competency-based medical education (CBME) implementation in Canada and its significance. Topics discussed by the author include the concerns about CBME quality, the issue concerning the additional work and resources required by CBME, and CBME as a faith-based medical education (FBME).

The emergence over the past 20 years of health promotion discourse poses a specific challenge to public health professionals, who must come to terms with new roles and new intervention strategies. Professional development is, among other things, a lever for action to be emphasized in order to meet these challenges. To respond to the specific training needs of public health professionals, a team from the Direction de santé publique de Montréal (Montreal Public Health Department) in Quebec, Canada, established in 2009 the Health Promotion Laboratory, an innovative professional development project. An evaluative component, which supports the project’s implementation by providing feedback, is also integrated into the project. This article seeks to demonstrate that it is possible to integrate the basic principles of health promotion into a professional development program and its evaluation. To this end, it presents an analytical reading of both the intervention and its evaluation component in light of the cardinal principles in this field. Initiatives such as the Health Promotion Laboratory and its evaluation are essential to consolidate the foundations of professional development and its assessment by concretely integrating health promotion discourse into these practices. [ABSTRACT FROM PUBLISHER]

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Objectives: The purpose of this article is to share the details, outcomes and deliverables from an international workshop on work transitions in London, Ontario, Canada. Participants: Researchers, graduate students, and community group members met to identity ways to advance the knowledge base of strategies to enhance work participation for those in the most disadvantaged groups within society. Methods: A participatory approach was used in this workshop with presentations by researchers and graduate students. This approach included dialogue and discussion with community members. In addition, small group dialogue and debate, world cafe discussions, written summaries of group discussion and reflection boards were used to bring new ideas to the discussion and to build upon what we know. Findings: Two research imperatives and six research recommendations were identified to advance global dialogue on work transitions and to advance the knowledge base. Occupational justice can be used to support future research directions in the study of work transitions. Conclusions: Moving forward requires a commitment of community of researchers, clinicians and stakeholders to address work disparities and implement solutions to promote participation in work. [ABSTRACT FROM AUTHOR]

This study uses data from the child and adult components of the 2001 Canadian Aboriginal Peoples Survey to examine what factors are related to speaking an Aboriginal language and how speaking an Aboriginal language is related to school outcomes. Even after controlling for child and family factors (age, sex, health status, household income, number of people living in the household, and living in an urban or rural area), speaking an Aboriginal language was associated with positive school outcomes for young children aged 6–14 years old if they learned the language in school, but a lower likelihood of having completed high school for 20–34-year olds. Possible reasons for this difference between child and adult results are discussed. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the modular continuing health education (CHE) programme for family doctors, known as "Working with Depression", developed by the Canadian Network for Mood and Anxiety Treatments (CANMAT) to reduce patients with depression disability. It notes that the programme, using chronic disease management (CDM) strategies, explores the impact of depression in the work place. It also enhances clinical approaches to depression, and pharmacotherapy advises.

Experts estimate that the prevalence of antibiotics use exceeds the prevalence of bacterial acute respiratory infections (ARIs). To develop, adapt and validate DECISION+ and estimate its impact on the decision of family physicians (FPs) and their patients on whether to use antibiotics for ARIs. Two-arm parallel clustered pilot randomized controlled trial. Four family medicine groups were randomized to immediate DECISION+ participation (the experimental group) or delayed DECISION+ participation (the control group). Thirty-three FPs and 459 patients participated. DECISION+ is a multiple-component, continuing professional development program in shared decision making that addresses the use of antibiotics for ARIs. Throughout the pilot trial, DECISION+ was adapted in response to participant feedback. After the consultation, patients and FPs independently self-reported the decision (immediate use, delayed use, or no use of antibiotics) and its quality. Agreement between their decisional conflict was assessed. Two weeks later, patients assessed their decisional regret and health status. Compared to the control group, the experimental group reduced its immediate use of antibiotics (49 vs. 33% absolute difference = 16%; P = 0.08). Decisional conflict agreement was stronger in the experimental group (absolute difference of Pearson's r = 0.26; P = 0.06). Decisional regret and perceptions of the quality of the decision and of health status in the two groups were similar. DECISION+ was developed successfully and appears to reduce the use of antibiotics for ARIs without affecting patients' outcomes. A larger trial is needed to confirm this observation. [ABSTRACT FROM AUTHOR]

As the demand for cultural awareness in the provision of nursing care continues to increase, nursing programs must develop creative and effective teaching strategies and curricula to address this need. The evaluation of a five year, funded, North American nursing exchange project developed and implemented by six partner universities in Canada, Mexico and the United States of America is described in this article. The project was designed to enable nursing students to increase cultural awareness, redefine their role relationships with nurses from the partner countries, and increase knowledge regarding the health care systems and role of the nurse in those countries. Findings provide evidence that teaching nursing through a prism of cultural awareness, using both a jointly taught online course and student and faculty exchanges across the three countries is an effective strategy to increase the level of cultural awareness in nursing students. [ABSTRACT FROM AUTHOR]

While Canada is often described as the most and France as one of the least successful countries in the realm of immigrant incorporation, the question remains unresolved of how to evaluate a country's policies for dealing with immigration and incorporation relative to that of others. Our strategy is to examine the relationships among (1) countries' policies and practices with regard to admitting immigrants, (2) their educational policies for incorporating first- and second-generation immigrants, and (3) the educational achievement of immigrants and their children. We compare eight western industrialized countries. We find that immigration regimes, educational regimes, and schooling outcomes are linked distinctively in each country. States that are liberal, or effective, on one dimension may be relatively conservative, or ineffective, on another, and countries vary in their willingness and ability to help disadvantaged people achieve upward mobility through immigration and schooling. We conclude that, by some normative standards, France has a better immigration regime than Canada does. Overall, this study points to new ways to study immigration and new normative standards for judging states' policies of incorporation. [ABSTRACT FROM AUTHOR]

Traditional models of educational outcomes relate academic achievement to university experiences controlling for background characteristics, like former levels of achievement. In these models, most of the variance in the outcome under consideration is explained not by experiences inside the university but by background characteristics, such as prior levels of academic achievement. In many instances the contribution of institutional experiences to outcomes under consideration is small. To date, researchers have not included sense of coherence (SOC) among background characteristics. In the current study traditional models are modified to include SOC as a possible contributor to first year academic achievement among domestic and international students with English and other first languages at four Canadian universities. It is found that a model including SOC better fits data for commuter and residence students than a model in which SOC is omitted. Although the effect of SOC on first year academic achievement is small, it is larger than the effects of some institutional experiences. As a result, SOC should be included in attempts to explain first year academic achievement. [ABSTRACT FROM AUTHOR]

This article describes the formation of the International Pharmacists-as-Immunizers Partnership (IPIP), an international network of pharmacy practice researchers with an interest in pharmacist-administered immunizations. Using funds obtained from a university-sponsored grant, a two-day meeting was held at the University of Waterloo in Canada to discuss published and in-progress research on the topic, identify gaps and priorities for future research, and share implementation strategies used in different jurisdictions. Twelve researchers from five countries attended this initial meeting, identified from both personal networks and from authorship lists from published research. Small- and large-group discussions addressed a number of themes, including: clinical, economic and educational outcomes of the service; the perspectives of pharmacists, patients, and other health professionals; operational and policy factors influencing uptake; safety; and the immunizing pharmacist's role in disaster preparedness. Feedback on our first meeting and outcomes achieved were evaluated on the basis of participant feedback. Key components of the meeting that were considered successful and important lessons learned are summarized, so that other like-minded researchers with a shared pharmacy practice research interest could consider leveraging funding opportunities to establish other international pharmacy practice research networks. [ABSTRACT FROM AUTHOR]