1 of 60
Slide Notes
"A critically reflective thinking process enables you to question and unlearn old thinking habits and opens up alternative ways of interpreting and acting on social problems and structures" Campbell & Baikie, 2012, p.68-69).
My name is Laurie Chalmers. I am a married white, cissgender, heterosexual, lower-middle class woman, and I am currently studying critical social work practice at the University of Victoria.
This presentation represents the learning and work I have had the great privilege to undertake over this hot & dry 2018 summer. I have been examining my identity as a White settler Canadian, and interrogating my roles and responsibilities in regards to our history with Canada's First Peoples and reconciliation. Campbell & Baikie (2012) suggest that enhancing my capacity to understand, analyze, and respond to our institutional contexts needs to be an integral part of my personal framework for practice. Through gaining better understandings of our societal contexts, I can better recognize how my practices are shaped by them, as well as how I might act as an agent of change both within, and in relation to them (Campbell & Baikie, 2012).
"Reflecting on [my] personal frames of reference, in dialogue with others, [I] am free to imagine different ways of knowing, free to explore different worlds, and free to engage in more emancipatory practices (McKee, 2003)
My name is Laurie Chalmers. I am a married white, cissgender, heterosexual, lower-middle class woman, and I am currently studying critical social work practice at the University of Victoria.
This presentation represents the learning and work I have had the great privilege to undertake over this hot & dry 2018 summer. I have been examining my identity as a White settler Canadian, and interrogating my roles and responsibilities in regards to our history with Canada's First Peoples and reconciliation. Campbell & Baikie (2012) suggest that enhancing my capacity to understand, analyze, and respond to our institutional contexts needs to be an integral part of my personal framework for practice. Through gaining better understandings of our societal contexts, I can better recognize how my practices are shaped by them, as well as how I might act as an agent of change both within, and in relation to them (Campbell & Baikie, 2012).
"Reflecting on [my] personal frames of reference, in dialogue with others, [I] am free to imagine different ways of knowing, free to explore different worlds, and free to engage in more emancipatory practices (McKee, 2003)
IT TAKES A VILLAGE
Published on Aug 29, 2018
No Description
MORE DECKS TO EXPLORE
PRESENTATION OUTLINE
introduction
positionality
"A critically reflective thinking process enables you to question and unlearn old thinking habits and opens up alternative ways of interpreting and acting on social problems and structures" Campbell & Baikie, 2012, p.68-69).
My name is Laurie Chalmers. I am a married white, cissgender, heterosexual, lower-middle class woman, and I am currently studying critical social work practice at the University of Victoria.
This presentation represents the learning and work I have had the great privilege to undertake over this hot & dry 2018 summer. I have been examining my identity as a White settler Canadian, and interrogating my roles and responsibilities in regards to our history with Canada's First Peoples and reconciliation. Campbell & Baikie (2012) suggest that enhancing my capacity to understand, analyze, and respond to our institutional contexts needs to be an integral part of my personal framework for practice. Through gaining better understandings of our societal contexts, I can better recognize how my practices are shaped by them, as well as how I might act as an agent of change both within, and in relation to them (Campbell & Baikie, 2012).
"Reflecting on [my] personal frames of reference, in dialogue with others, [I] am free to imagine different ways of knowing, free to explore different worlds, and free to engage in more emancipatory practices (McKee, 2003)
My name is Laurie Chalmers. I am a married white, cissgender, heterosexual, lower-middle class woman, and I am currently studying critical social work practice at the University of Victoria.
This presentation represents the learning and work I have had the great privilege to undertake over this hot & dry 2018 summer. I have been examining my identity as a White settler Canadian, and interrogating my roles and responsibilities in regards to our history with Canada's First Peoples and reconciliation. Campbell & Baikie (2012) suggest that enhancing my capacity to understand, analyze, and respond to our institutional contexts needs to be an integral part of my personal framework for practice. Through gaining better understandings of our societal contexts, I can better recognize how my practices are shaped by them, as well as how I might act as an agent of change both within, and in relation to them (Campbell & Baikie, 2012).
"Reflecting on [my] personal frames of reference, in dialogue with others, [I] am free to imagine different ways of knowing, free to explore different worlds, and free to engage in more emancipatory practices (McKee, 2003)
IT TAKES A VILLAGE
- "It takes a village to raise a child"
- Spiritual, social, intellectual, relational, cultural, mental, emotional, environmental, & occupational factors
- Deeply influenced by the particular dynamics of our villages
"Our lives are not our own. We are bound to others, past and present, and by each crime and every kindness, we birth our future" ~ David Mitchell, 2004
An excess burden of ill health is carried by our most socially and economically disadvantaged community members. We now know that improving health and well-being requires intersectoral collaboration that includes all of the key sectors of society as well as working cooperatively in ways that value the knowledge and experience of service users and communities (Canadian Interprofessional Health Collaborative, 2018; CSDH, 2008; Campbell & Baikie, 2012).
"It is not our differences that divide us. It is our inability to recognize, accept & celebrate these differences" ~ AUDRE LORDE
An excess burden of ill health is carried by our most socially and economically disadvantaged community members. We now know that improving health and well-being requires intersectoral collaboration that includes all of the key sectors of society as well as working cooperatively in ways that value the knowledge and experience of service users and communities (Canadian Interprofessional Health Collaborative, 2018; CSDH, 2008; Campbell & Baikie, 2012).
"It is not our differences that divide us. It is our inability to recognize, accept & celebrate these differences" ~ AUDRE LORDE
Photo by Joshua Rawson-Harris
PATHWAYS TO HEALING PARTNERSHIP
Factors Associated with Successful Interprofessional Collaboration
"If you have come to help me, you are wasting your time. But if you have come because your liberation is bound with mine, then let us work together"
~ Lilla Watson (Aboriginal activists group, Queensland, 1970's)
The Pathways to Healing Partnership (PTHP), (funded by Children's Health Foundation of Vancouver Island & Island Health with contributions from MCFD) is a North Island trauma intervention demonstration project that utilizes an innovative attachment-neuroscience lens with mothers who are addicted and their babies, as well as families who have suffered significant adversity. While the PTHP has focused on intensive therapeutic care for parent-child dyads, they have also simultaneously endeavoured to work with community partners to promote system change.
Over its two year pilot, the Pathways to Healing Partnership has come up against barriers to functioning as a part of a collaborative village of practice. As a part of my practicum, this researcher designed a research project seeking to explore elements associated with successful collaborative practices.
Purpose (from Project Consent Form)
I am a student in the Bachelor of Social Work program at the University of Victoria. My research, entitled “Factors Associated with Successful Interprofessional Collaboration,” aims to: explore the experiences and perspectives of interprofessional collaboration of individual professionals through the lenses of their practice settings and contexts; record the factors they associate with successful interprofessional collaboration, and; validate previous research identifying the following elements as key: communication; power dynamics; decision-making; self-identity; role clarification; and, collaborative culture. My hope is that my research will strengthen the current research through the corroboration and amplification of a spectrum of professional voices from the field, therefore contributing insights for future interprofessional collaborative education, and promoting collective community initiatives.
~ Lilla Watson (Aboriginal activists group, Queensland, 1970's)
The Pathways to Healing Partnership (PTHP), (funded by Children's Health Foundation of Vancouver Island & Island Health with contributions from MCFD) is a North Island trauma intervention demonstration project that utilizes an innovative attachment-neuroscience lens with mothers who are addicted and their babies, as well as families who have suffered significant adversity. While the PTHP has focused on intensive therapeutic care for parent-child dyads, they have also simultaneously endeavoured to work with community partners to promote system change.
Over its two year pilot, the Pathways to Healing Partnership has come up against barriers to functioning as a part of a collaborative village of practice. As a part of my practicum, this researcher designed a research project seeking to explore elements associated with successful collaborative practices.
Purpose (from Project Consent Form)
I am a student in the Bachelor of Social Work program at the University of Victoria. My research, entitled “Factors Associated with Successful Interprofessional Collaboration,” aims to: explore the experiences and perspectives of interprofessional collaboration of individual professionals through the lenses of their practice settings and contexts; record the factors they associate with successful interprofessional collaboration, and; validate previous research identifying the following elements as key: communication; power dynamics; decision-making; self-identity; role clarification; and, collaborative culture. My hope is that my research will strengthen the current research through the corroboration and amplification of a spectrum of professional voices from the field, therefore contributing insights for future interprofessional collaborative education, and promoting collective community initiatives.
Photo by Johannes Plenio
CONTEXT:
- 14 social determinants of health; income most significant
- Need to mitigate excess burden of ill health, protect against ACEs, achieve health equity
- Contingent on a collaborative effort
Canada now recognizes fourteen factors that produce the conditions in which we are born, live, grow, work and age, referred to as the social determinants of health (SDOH), and income is cited as perhaps the most significant among them (Raphael, 2016). The SDOH represent the conditions in which we are born, grow, live, work, and age, and they are contingent upon the quality and quantity of resources that society makes available to its members (Mikkonen & Raphael, 2010; Raphael, 2011).
The accessibility of comprehensive and coordinated services is compromised when professionals fail to collaborate, validating the significance of interprofessional teams working well together (Glaser & Suter, 2016). In recognition of this, the World Health Organization has proposed a principled guide to coordinated action for addressing the SDOH, with the vision of achieving health equity (Moniz, 2010).
The accessibility of comprehensive and coordinated services is compromised when professionals fail to collaborate, validating the significance of interprofessional teams working well together (Glaser & Suter, 2016). In recognition of this, the World Health Organization has proposed a principled guide to coordinated action for addressing the SDOH, with the vision of achieving health equity (Moniz, 2010).
Photo by nikko macaspac
PATHWAYS TO HEALING PARTNERSHIP
Pilot Demonstration Project
PTHP represents one program with three professionals within that complex landscape network endeavouring to provide supports, services, resources to individuals, families, communities and other professionals.
12 Challenges: Grand Challenges for Social Work
The Grand Challenges for Social Work represent a dynamic social agenda, focused on improving individual and family well-being, strengthening the social fabric, and helping create a more just society:
Ensure healthy development for all youth
Close the health gap
Stop family violence
Advance long and productive lives
Eradicate social isolation
End homelessness
Create social responses to a changing environment
Harness technology for social good
Promote smart decarceration
Reduce extreme economic inequality
Build financial capability for all
Achieve equal opportunity and justice
http://aaswsw.org/grand-challenges-initiative/12-challenges/
http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSD...
https://www.canada.ca/en/public-health/services/health-promotion/population...
CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.
12 Challenges: Grand Challenges for Social Work
The Grand Challenges for Social Work represent a dynamic social agenda, focused on improving individual and family well-being, strengthening the social fabric, and helping create a more just society:
Ensure healthy development for all youth
Close the health gap
Stop family violence
Advance long and productive lives
Eradicate social isolation
End homelessness
Create social responses to a changing environment
Harness technology for social good
Promote smart decarceration
Reduce extreme economic inequality
Build financial capability for all
Achieve equal opportunity and justice
http://aaswsw.org/grand-challenges-initiative/12-challenges/
http://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSD...
https://www.canada.ca/en/public-health/services/health-promotion/population...
CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.
AIM: explore lived experiences & perspectives
of interprofessional collaboration
Aims – To explore lived experiences and personal perspectives of collaborative practices to: 1) compare them with key elements identified in the literature available on collaborative practices; and, 2) identify additional themes for further research.
ETHICS
Consent Form:
Description
Research participants are asked to complete a face-to-face research interview. If you agree, you would be asked questions concerning your professional experiences with working with other professionals in your community, with emphasis on factors such as communication; power dynamics; decision-making; self-identity; role clarification, and; collaborative culture. With your permission, the interview would be audio recorded. Your participation would require approximately one hour of your time. You have the option of participating anonymously.
Risk of harm to participants
The information collected during the interview is likely to be uncontroversial, and thus the research poses only a very small risk of harm to participants. Depending on the information you provide, and whether you choose to participate anonymously, there is a possibility that the information you provide could have professional implications, such as reputation, embarrassment, or complicating already strained relationships.
Management of Research Information/Data
If you choose to participate anonymously, all records of your participation would be confidential. Only my supervisor and I will have access to information in which you are identified. With your permission, the interview would be audio recorded and later transcribed into writing. At your request, you will be provided a copy of the transcript and invited to make changes to the transcript as you wish (e.g. if you would like withdraw a particular statement you made during an interview). Electronic data will be stored on a password-protected computer. Signed consent forms and paper copies of interview transcripts will be stored in a locked file cabinet in my home. Data will be deleted and shredded at the end of the project, approximately August 31st, 2019.
Use of Research Information
The results of this study will be written up as an article, and may also be used for conference publications, presentations, shared in inter/professional web-based forums, or used in future research.
Participation and withdrawal
Your participation is completely voluntary. You may withdraw from the study at any time where practicable, for any reason, and without explanation. If you would like to review and potentially make changes to the transcript of the interview, you may withdraw up to two weeks from the time of being provided a copy of the transcript. If you decline to review the transcript, you may withdraw up to two weeks from the date of our interview. If you choose to withdraw from the study, all information you provided during the interview would be withdrawn from the study and destroyed.
ETHICS
Consent Form:
Description
Research participants are asked to complete a face-to-face research interview. If you agree, you would be asked questions concerning your professional experiences with working with other professionals in your community, with emphasis on factors such as communication; power dynamics; decision-making; self-identity; role clarification, and; collaborative culture. With your permission, the interview would be audio recorded. Your participation would require approximately one hour of your time. You have the option of participating anonymously.
Risk of harm to participants
The information collected during the interview is likely to be uncontroversial, and thus the research poses only a very small risk of harm to participants. Depending on the information you provide, and whether you choose to participate anonymously, there is a possibility that the information you provide could have professional implications, such as reputation, embarrassment, or complicating already strained relationships.
Management of Research Information/Data
If you choose to participate anonymously, all records of your participation would be confidential. Only my supervisor and I will have access to information in which you are identified. With your permission, the interview would be audio recorded and later transcribed into writing. At your request, you will be provided a copy of the transcript and invited to make changes to the transcript as you wish (e.g. if you would like withdraw a particular statement you made during an interview). Electronic data will be stored on a password-protected computer. Signed consent forms and paper copies of interview transcripts will be stored in a locked file cabinet in my home. Data will be deleted and shredded at the end of the project, approximately August 31st, 2019.
Use of Research Information
The results of this study will be written up as an article, and may also be used for conference publications, presentations, shared in inter/professional web-based forums, or used in future research.
Participation and withdrawal
Your participation is completely voluntary. You may withdraw from the study at any time where practicable, for any reason, and without explanation. If you would like to review and potentially make changes to the transcript of the interview, you may withdraw up to two weeks from the time of being provided a copy of the transcript. If you decline to review the transcript, you may withdraw up to two weeks from the date of our interview. If you choose to withdraw from the study, all information you provided during the interview would be withdrawn from the study and destroyed.
LITERATURE REVIEW
- Interprofessional collaborative competency domains
- Determinants to interprofessional collaboration
- Elements of determinants of health frameworks
The literature search strategy included keywords such as: collaboration, collaborative practice, interdisciplinary, interprofessional, intersectoral, in combination with best practices, social determinants of health, phenomenological, phenomenographical, community, participatory, health equity, collaborative competencies, interprofessional competencies, community organizing, community building, interprofessional facilitation, collaborative leadership, communication, anti-oppressive practice, critical practice.
The interview questions were developed from the competency domains identified in the literature review. The themes identified in the interviews are captured and organized via the determinants of collaboration yielded from the literature review. They are further conceptualized with the key element of a determinants of health framework.
The interview questions were developed from the competency domains identified in the literature review. The themes identified in the interviews are captured and organized via the determinants of collaboration yielded from the literature review. They are further conceptualized with the key element of a determinants of health framework.
Photo by Janko Ferlič
key competency domains
- ROLE CLARIFICATION
- SELF-IDENTITY
- COMMUNICATION
- POWER DYNAMICS
- DECISION-MAKING
- COLLABORATIVE CULTURE
Among a number of ways in which interprofessional collaboration has been described, one is: "the process of developing and maintaining effective interprofessional working relationships with learners, practitioners, patients/clients/families and communities to enable optimal health outcomes" (National Interprofessional Competency Framework, 2010).
Regardless of the variety of ways it is defined, substantial study has identified a number of competency domains capable of organizing both the elements associated with successful interprofessional collaboration, as well as barriers to it. The interview questions were composed with guidance from six key interprofessional competency domains.
Interprofessional Education Collaborative Expert Panel (IECEP). (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C., Interprofessional Education Collaborative.
Canadian Interprofessional Health Collaborative (CIHC). (2018). [Data file]. Retrieved from: http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf
Barr, H. (1998) Competent to collaborate: towards a competency-based model for interprofessional education, Journal of Interprofessional Care, 12, 2, 181-187.
Regardless of the variety of ways it is defined, substantial study has identified a number of competency domains capable of organizing both the elements associated with successful interprofessional collaboration, as well as barriers to it. The interview questions were composed with guidance from six key interprofessional competency domains.
Interprofessional Education Collaborative Expert Panel (IECEP). (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C., Interprofessional Education Collaborative.
Canadian Interprofessional Health Collaborative (CIHC). (2018). [Data file]. Retrieved from: http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf
Barr, H. (1998) Competent to collaborate: towards a competency-based model for interprofessional education, Journal of Interprofessional Care, 12, 2, 181-187.
Photo by Hans-Peter Gauster
DESIGN: Semi-structured qualitative interviews
PARTICIPANTS: 10 professionals representing a cross-section of sectors and levels
Using a list of prepared interview questions as a guide, 10 audio recorded interviews were conducted, each lasting between one and two hours.
COLLABORATIVE PRACTICE INTERVIEW QUESTIONS
Intro:
• Where are you on the map?
• What is your mandated role? How does that translate in your everyday practice?
• How do children and families access you?
• Do others seek you out for your expertise? Do you seek out others? (Can you tell me about that?)
• Do you collaborate with anyone else on the map? Can you tell me more about that? What is your experience of working as a part of this network around a child?
• Can you think of anyone who you would like to connect with/collaborate more with?
• Have you worked with families identified as having protection concerns? Can you tell me about that? Is the context mandated/voluntary? Any unique challenges/opportunities?
Imagine that you are sitting at a multi-disciplinary table:
• Can you tell me more about your unique contribution to the table? What do you bring?
• What contributions/philosophies do you see coming from the different agencies/professionals involved?
• In your experience, what kind of clarity do you and others have regarding each other’s roles?
• What are your personal feelings/outlook on the process of collaborating with other professionals/individuals in your community?
Practicalities:
• What is the collaborative culture in your own work environment? Or between your agency/organization/practice and others in the community?
• Can you identify any factors that you feel influence the culture around/ practice of inter-agency collaboration in your organization? (eg. lack or resources, interpretation of policy..)
• How does collaboration actually happen? ie. What methods of communication? How is information shared? Who initiates? Is there time allotted for collaborative work?
• What are the requirements of your role/position in terms of consulting with and collecting insights and expertise from other disciplines?
• In your experience, how much influence do you have on decision-making? Do you feel your voice is heard/respected? If not, which mechanisms or policies do you feel could be put in place to improve your ability to have a voice at the table?
• What is your experience of power dynamics? Do all of those involved in collaboration have an equal opportunity to participate and be considered?
• Do power differentials impact or interfere with your ability/capacity to fulfil your own role and objectives?
Conclusion:
• Can you identify any opportunities or limitations in regards to working collaboratively with/within your community? Anything else you’d like to share?
COLLABORATIVE PRACTICE INTERVIEW QUESTIONS
Intro:
• Where are you on the map?
• What is your mandated role? How does that translate in your everyday practice?
• How do children and families access you?
• Do others seek you out for your expertise? Do you seek out others? (Can you tell me about that?)
• Do you collaborate with anyone else on the map? Can you tell me more about that? What is your experience of working as a part of this network around a child?
• Can you think of anyone who you would like to connect with/collaborate more with?
• Have you worked with families identified as having protection concerns? Can you tell me about that? Is the context mandated/voluntary? Any unique challenges/opportunities?
Imagine that you are sitting at a multi-disciplinary table:
• Can you tell me more about your unique contribution to the table? What do you bring?
• What contributions/philosophies do you see coming from the different agencies/professionals involved?
• In your experience, what kind of clarity do you and others have regarding each other’s roles?
• What are your personal feelings/outlook on the process of collaborating with other professionals/individuals in your community?
Practicalities:
• What is the collaborative culture in your own work environment? Or between your agency/organization/practice and others in the community?
• Can you identify any factors that you feel influence the culture around/ practice of inter-agency collaboration in your organization? (eg. lack or resources, interpretation of policy..)
• How does collaboration actually happen? ie. What methods of communication? How is information shared? Who initiates? Is there time allotted for collaborative work?
• What are the requirements of your role/position in terms of consulting with and collecting insights and expertise from other disciplines?
• In your experience, how much influence do you have on decision-making? Do you feel your voice is heard/respected? If not, which mechanisms or policies do you feel could be put in place to improve your ability to have a voice at the table?
• What is your experience of power dynamics? Do all of those involved in collaboration have an equal opportunity to participate and be considered?
• Do power differentials impact or interfere with your ability/capacity to fulfil your own role and objectives?
Conclusion:
• Can you identify any opportunities or limitations in regards to working collaboratively with/within your community? Anything else you’d like to share?
Photo by Alejandro Escamilla
ROLE CLARIFICATION
- Mandated role & translation into everyday practice
- Sought for expertise/seek others
- Unique contribution of self/others
- Clarity of self/others' roles
Literature discusses:
* Degree of understanding of interprofessional roles and responsibilities
* Recognition and respect for the roles, responsibilities, & competencies of other professions in relation to one's own; knowledge of each other's roles, including individuals, families & communities
Deconstruction involves..."uncovering the ways we talk about & choose to label experience, and how these shape our experience" (Fook, 2016, p.290).
* Degree of understanding of interprofessional roles and responsibilities
* Recognition and respect for the roles, responsibilities, & competencies of other professions in relation to one's own; knowledge of each other's roles, including individuals, families & communities
Deconstruction involves..."uncovering the ways we talk about & choose to label experience, and how these shape our experience" (Fook, 2016, p.290).
Photo by Marcos Luiz Photograph
INTERPROFESSIONAL COMMUNICATION
- Requirements of role
- Who initiates
- Methods/time allotted for information sharing
- How does collaboration happen
Literature discusses:
* Ability to describe one's roles and responsibilities clearly to other professionals, individuals, families
* Existence of clear contexts, processes, protocols
* Collective understanding of the meanings being assigned; insurance & establishment of a common language
* Capacity to, or facilitation of interprofessional case conferences, team meetings, etc
"Language, like knowledge, is active & creative rather than static & representational" (Anderson, 2012, p.10).
* Ability to describe one's roles and responsibilities clearly to other professionals, individuals, families
* Existence of clear contexts, processes, protocols
* Collective understanding of the meanings being assigned; insurance & establishment of a common language
* Capacity to, or facilitation of interprofessional case conferences, team meetings, etc
"Language, like knowledge, is active & creative rather than static & representational" (Anderson, 2012, p.10).
Photo by Pavan Trikutam
collaborative leadership
- Who initiates/who do you collaborate with/who is missing
- Expertise of self/others
- Impact/interference of power differentials on ability/capacity to fulfill role/mandated objectives
Literature discusses:
* Ability to enter into interdependent relationships with other professionals
* Self-awareness/self-identity; level of trust related to self-competence & competence in other's abilities
* Capacity to recognize & observe the constraints of one's role, responsibilities & competence, yet perceive needs in a wider framework
* Resisting the tendency to champion the authority of one's knowledge in order to look and feel competent
"We have a remarkable ability to assimilate even the most discordant facts without altering our framing assumptions & to 'disattend' to information that would disturb our frames" (McKee, 2003, p.403).
* Ability to enter into interdependent relationships with other professionals
* Self-awareness/self-identity; level of trust related to self-competence & competence in other's abilities
* Capacity to recognize & observe the constraints of one's role, responsibilities & competence, yet perceive needs in a wider framework
* Resisting the tendency to champion the authority of one's knowledge in order to look and feel competent
"We have a remarkable ability to assimilate even the most discordant facts without altering our framing assumptions & to 'disattend' to information that would disturb our frames" (McKee, 2003, p.403).
Photo by Venessa Miemis
DECISION-MAKING
- Experience of power dynamics
- Equity of participation/consideration
- Level of influence on decision-making
- Sense of having voice heard/respected
- Mechanism/policy suggestions to improve ability to have a voice
Literature discusses:
* Degree to which interprofessional practice values and ethics are adopted
* Ability to work with others to assess, plan, provide, & review care for individuals
* Awareness, acknowledgement, and addressing of power dynamics
* Capacity to centre local knowledge, meet people where they are, foster equitable & engaged participation, commit to patient/client/family/community-centred care
"VALUES, as well as knowledge, influence our analysis and decision-making" (Campbell & Baikie, 2012, p.73).
"Depending on their view of the issue, they differ as to what facts are relevant...even when the parties in a controversy focus their attention on the same facts, they tend to give them very different interpretations" (McKee, 2003, p.402).
* Degree to which interprofessional practice values and ethics are adopted
* Ability to work with others to assess, plan, provide, & review care for individuals
* Awareness, acknowledgement, and addressing of power dynamics
* Capacity to centre local knowledge, meet people where they are, foster equitable & engaged participation, commit to patient/client/family/community-centred care
"VALUES, as well as knowledge, influence our analysis and decision-making" (Campbell & Baikie, 2012, p.73).
"Depending on their view of the issue, they differ as to what facts are relevant...even when the parties in a controversy focus their attention on the same facts, they tend to give them very different interpretations" (McKee, 2003, p.402).
Photo by Jason Rosewell
TEAM FUNCTIONING
- Experience of being a part of network around a child
- Sense of the collaborative culture
- Perspective on factors contributing to culture of collaboration
- Feelings/outlook on process of collaboration with other community professionals/individuals
Literature discusses:
* Facilitation of teams & team work
* Capacity to tolerate differences, misunderstandings & short comings of other professions/professionals
* Degree of willingness to work together; collaborative culture
"We, as members of society, are all active participants in creating knowledge from our own social positions and perspectives, and cannot help but bring inherent value stances and biases" (Fook, 2016, p.288).
* Facilitation of teams & team work
* Capacity to tolerate differences, misunderstandings & short comings of other professions/professionals
* Degree of willingness to work together; collaborative culture
"We, as members of society, are all active participants in creating knowledge from our own social positions and perspectives, and cannot help but bring inherent value stances and biases" (Fook, 2016, p.288).
Photo by MellieRene4
INTERPROFESSIONAL CONFLICT RESOLUTION
- Mandated vs. voluntary
- Requirements of role
- Influence on decision-making
- Opportunities/limitations regarding working collaboratively within commuity
Literature discusses:
* Capacity/ability to work with other professionals to effect change & resolve conflict in the provision of care/treatment/services/resources
* Capacity/willingness to get comfortable & competent in the midst of contradiction & uncertainty
* Level of motivation, degree of investment, commitment to unified purpose over personal agendas
* Capacity/ability to work with other professionals to effect change & resolve conflict in the provision of care/treatment/services/resources
* Capacity/willingness to get comfortable & competent in the midst of contradiction & uncertainty
* Level of motivation, degree of investment, commitment to unified purpose over personal agendas
Photo by seanomatopoeia
context map
In addition to the interview questions, a visual context map of the variety of professionals, agencies & organizations within community was created.
The visual was provided to assist participants in answering the interview questions by alleviating the need to remember or recall the bigger picture and multiple factors/professionals in the network around a child.
The visual was provided to assist participants in answering the interview questions by alleviating the need to remember or recall the bigger picture and multiple factors/professionals in the network around a child.
navigating complex systems & structures
finding a compass
Participants were randomly recruited from a cross-section of professions and levels, and their experiences and perspectives provided multi-dimensional views of navigating complex systems and structures, validating both the competencies and determinants revealed in the literature review.
Researchers have now discovered what First Peoples have long known, that although the crazy intertwined root systems of trees appear a tangled mess attempting to strangle each other out, they are in fact elaborate and intricate communication systems.
http://www.ecology.com/2012/10/08/trees-communicate/
"Without equity, we've made promises we can't keep, started what we can't finish, and built a bridge that leaves us dangling between where we were (a place of prejudice and inefficiency) and where we aspire to be" ~ Natalie S. Burke
https://www.inbound.com/content/completing-the-bridge-to-nowhere-beyond-div...
Researchers have now discovered what First Peoples have long known, that although the crazy intertwined root systems of trees appear a tangled mess attempting to strangle each other out, they are in fact elaborate and intricate communication systems.
http://www.ecology.com/2012/10/08/trees-communicate/
"Without equity, we've made promises we can't keep, started what we can't finish, and built a bridge that leaves us dangling between where we were (a place of prejudice and inefficiency) and where we aspire to be" ~ Natalie S. Burke
https://www.inbound.com/content/completing-the-bridge-to-nowhere-beyond-div...
Photo by salerie
Untitled Slide
Interactional, organizational, & systemic determinants combine, overlap, and intersect to create a complex landscape consisting of a broad range of congruent/contradictory agendas/approaches, as well as an intricate tapestry of both competing and complimentary needs/priorities.
themes IDENTIFIED IN INTERVIEWS
- SYSTEMIC
- ORGANIZATIONAL
- INTERACTIONAL
As well as the six umbrella categories (used to develop the interview questions) of which most collaborative competency frameworks have incorporated, there were a number of themes expressed throughout the participant interviews.
In light of time/resource constraints, this researcher is unable to offer a more detailed breakdown by category, however, I will provide the following framework from the comprehensive research done by Martin-Robriguez, Beaulieu, D'Amour, & Ferrada-Videla (2005) to support the experiences/perspectives offered by the participants:
Interactional factors (interpersonal relationships between team members); Organizational factors (conditions within the organization); and, Systemic factors (conditions outside the organization).
In light of time/resource constraints, this researcher is unable to offer a more detailed breakdown by category, however, I will provide the following framework from the comprehensive research done by Martin-Robriguez, Beaulieu, D'Amour, & Ferrada-Videla (2005) to support the experiences/perspectives offered by the participants:
Interactional factors (interpersonal relationships between team members); Organizational factors (conditions within the organization); and, Systemic factors (conditions outside the organization).
Photo by Jeremy Bishop
SYSTEMIC
- SOCIAL
- CULTURAL
- PROFESSIONAL
- EDUCATIONAL
Systemic determinants include the social system, cultural system, professional system, & educational system.
Photo by Calsidyrose
organizational
- STRUCTURE
- PHILOSOPHY
- ADMINISTRATIVE SUPPORT
- TEAM RESOURCES
- COORDINATION & COMMUNICATION MECHANISMS
Organizational determinants include structure, philosophy, admin support, team resources, and coordination & communication mechanisms
Photo by staceyjoy
interactional
- WILLINGNESS TO COLLABORATE
- TRUST
- COMMUNICATION
- MUTUAL RESPECT
Interactional determinants include willingness, trust, communication, mutual respect
Photo by Jiuck
SOCIAL
- Binary of us/them; functioning, professional, independent, status quo versus non-functioning, lay, dependent, not knowledgeable
- Reality of life challenges acts to discredit
- "It's all about them, at them, for them"
- Need to honour/recognize insider knowledge & experience
"Collaboration happens across multiple relationships, such as worker-to-client, worker-to-colleague, worker-to-agency, agency-to-agency, and worker/agency-to-community/society" (Graham & Barter, 1999, p.1).
Photo by Sawyer Bengtson
cultural
- White Eurocentric society accustomed to not interfering
- Influences and impacts of neoliberalism, capitalism, colonialism, Protestant Work ethic & deservedness
- Hierarchical thinking, structures & systems; dominant White Western culture
- Protection offers a scapegoat/crisis that acts to motivate/mobilize
Neoliberal doctrine proposes that human well-being can best be advanced by liberating individual entrepreneurial freedoms and skills within an institutional framework characterized by private property rights, free market, and free trade (Lee & Ferrer, 2014, p.13).
"Understanding Canada as a white settler society cannot be divorced from the historical origins of colonial nation-building and development from Capitalism...it is essential to recognize the colonial continuity manifested through the intergenerational effects of the Indian residential schools, the 60's scoops, and the current child welfare system..." (Lee & Ferrer, 2014, p.4 & p.14).
"Understanding Canada as a white settler society cannot be divorced from the historical origins of colonial nation-building and development from Capitalism...it is essential to recognize the colonial continuity manifested through the intergenerational effects of the Indian residential schools, the 60's scoops, and the current child welfare system..." (Lee & Ferrer, 2014, p.4 & p.14).
Photo by Kyle Glenn
professional
- Pressure to present as a "knowledgeable" professional
- "Ability to work interdisciplinarily so impossible coming from a place of being so encouraged to exert my professionalism"
- "I felt like I needed to 'know' stuff, the lack of professional acknowledgement or recognition led to a lack of confidence & competence, to defensiveness
In addition to the infinite individual, familial, and community cultures that have, do, and will exist, each profession also has a culture of distinct values, beliefs, attitudes, customs, and behaviours (Hall, 2005). Professional socialization takes place via the isolated streams of education and training, and eventually leads to professional silos that limit the capacity of professionals, individuals, and communities to collaborate on improving the social determinants of health (Hall, 2005).
Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 1, 188–196
Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 1, 188–196
Photo by pedrosimoes7
Untitled Slide
- Experience of trying to hold space for the professionals without "dropping the baby"
- Remembering to practice "and": never instead of, always in addition to
- Hierarchical: more knowledge, more wisdom, more power
- Impact of neoliberalism: stable, consistent funding mitigates turf wars
Those in positions of power or perceived expertise are rarely challenged.
While not dismissing standardized knowledge & practices, striving to understand "the contextual nature of practice, and varying actions, including the use of power, in relation to context" (Campbell & Baikie, 2012, p.74).
While not dismissing standardized knowledge & practices, striving to understand "the contextual nature of practice, and varying actions, including the use of power, in relation to context" (Campbell & Baikie, 2012, p.74).
Photo by Ben Rosett
educational
- Impact on service users: limit access to knowledge brokers
- Need to assert one's expertise to establish one's credibility & place on the professional playing field
- Need to define "expertise" and include collaborative process/understanding of collaborative process within that definition
Collaboration requires the creation of joint goals to guide collaborator's actions, and the shared vision of health equity provides a hoped-for outcome.
Photo by velkr0
Untitled Slide
- Thinking of "expertise" as understanding the process & helping to make that process visible
- Cross-disciplinary course instruction & delivery; cross-discipline joint mentorship/supervision
- Lack of understanding across disciplines of social/structural contexts
FURTHER READING:
Chante Stubbs, Mavis N. Schorn, Jacinta P. Leavell, Elena Wong Espiritu, Gerald Davis, Chad K. Gentry, Elisa Friedman, Traci Patton, Ali Graham, Ron Crowder & Consuelo H. Wilkins (2017) Implementing and evaluating a community-based, inter-institutional, interprofessional education pilot programme, Journal of Interprofessional Care, 31:5, 652-655, DOI: 10.1080/13561820.2017.1343808
Sandra D. Lane, Robert H. Keefe, Robert A. Rubinstein, Meghan Hall, Kathleen A. Kelly, Lynn Beth Satterly, Andrea Shaw & Julian Fisher (2018) Integrating the social determinants of health into two interprofessional courses: Findings from a pilot study, Journal of Interprofessional Care, 32:4, 505-508, DOI: 10.1080/13561820.2018.1435517
Susan McNaughton (2018) The long-term impact of undergraduate interprofessional education on graduate interprofessional practice: A scoping review, Journal of Interprofessional Care, 32:4, 426-435, DOI: 10.1080/13561820.2017.1417239
Chante Stubbs, Mavis N. Schorn, Jacinta P. Leavell, Elena Wong Espiritu, Gerald Davis, Chad K. Gentry, Elisa Friedman, Traci Patton, Ali Graham, Ron Crowder & Consuelo H. Wilkins (2017) Implementing and evaluating a community-based, inter-institutional, interprofessional education pilot programme, Journal of Interprofessional Care, 31:5, 652-655, DOI: 10.1080/13561820.2017.1343808
Sandra D. Lane, Robert H. Keefe, Robert A. Rubinstein, Meghan Hall, Kathleen A. Kelly, Lynn Beth Satterly, Andrea Shaw & Julian Fisher (2018) Integrating the social determinants of health into two interprofessional courses: Findings from a pilot study, Journal of Interprofessional Care, 32:4, 505-508, DOI: 10.1080/13561820.2018.1435517
Susan McNaughton (2018) The long-term impact of undergraduate interprofessional education on graduate interprofessional practice: A scoping review, Journal of Interprofessional Care, 32:4, 426-435, DOI: 10.1080/13561820.2017.1417239
Photo by University of the Fraser Valley
structure
- "I felt 'closed out', not a part of the collective
- "Being sought out for expertise provides me with the opportunity to share the knowledge I've accumulated"
- Clear mandates/roles actually create the capacity for more organic processes/responsiveness
"Critical reflection is an important ingredient in becoming aware of how we as individuals may create and support knowledge which excludes different (perhaps marginal) perspectives and which may therefore work to maintain social inequalities" (Fook, 2016, p.289).
Photo by Heidi Sandstrom.
Untitled Slide
- Organizational stagnation complicated and often stopped action
- Need to resist pressure to become streamlined, efficient, productive with less
- "Structure that allows principles; principles offer a framework that informs practice all the time"
- "You are holding space - but it is space - it has to be a permeable container"
"I am grateful to the many women and men who dare to create theory from the location of pain and struggle, who courageously expose wounds to give us their experience to teach and guide, as a means to chart new theoretical journeys" (hooks, 1991, p.11).
Photo by Bakar_88
philosophy
- Privileging the family voice; centring voices of whole family
- Understanding & recognition of difference
- Clearly defining what is meant by "expertise" & an equitable valuing of different kinds of expertise
- Relationally-based; person-centred; anti-oppressive; critical
"A perspective can be simply understood as an outlook...from which one views, interprets, and understands the various phenomena of everyday life" (Campbell & Baikie, 2012, p.69).
Photo by kevin dooley
Untitled Slide
- Adopting a childlike sense of curiosity
- Strong commitment to social justice
- Addressing power dynamics through agreed upon ground rules; nurturing and welcoming critical questioning & dialogue, and building solidarity through cultivating transformational conversation space
"We know things with our lives and we live that knowledge, beyond what any theory has yet theorized"
(as cited by hooks, 1991, p.12)
..."identities can change, be contradictory, and be multiple"
(Fook, 2016, p.290).
"Critical social workers understand human nature to be fluid, malleable and therefore susceptible to multiple influences" (Campbell & Baikie, 2012, p.72).
(as cited by hooks, 1991, p.12)
..."identities can change, be contradictory, and be multiple"
(Fook, 2016, p.290).
"Critical social workers understand human nature to be fluid, malleable and therefore susceptible to multiple influences" (Campbell & Baikie, 2012, p.72).
Photo by nathangibbs
administrative support
- Collaborative leadership
- "Coming alongside", power together. mentorship
- Nuanced & insightful knowledge & understanding of legislation
- Facilitation of fluid processes/measurements/outcomes
No one is truly free while others are oppressed.
Equanimity: mental calmness; composure and evenness of temper; especially in a difficult situation; sense of being held. "It is neither chasing nor avoiding but just being in the middle" ~ Amit Ray
Presence: the state or fact of being present; carriage; demeanor; aspect; something present of a visible or concrete nature; something felt.
Equanimity: mental calmness; composure and evenness of temper; especially in a difficult situation; sense of being held. "It is neither chasing nor avoiding but just being in the middle" ~ Amit Ray
Presence: the state or fact of being present; carriage; demeanor; aspect; something present of a visible or concrete nature; something felt.
Photo by Neil Thomas
Untitled Slide
- Stagnation, confusion or lack of clarity, personality issues, narcism, all mitigated by leadership with capacity to "hold space" & "trust/understand the process"
- Uphold patient/client/family/community-centred care; centre local knowledge; generate a collective expectation to commit to shared purpose
"Authenticity is not something we have or don't have. It's a practice - a conscious choice of how we want to live. Authenticity is a collection of choices that we have to make every day. It's about the choice to show up and be real. The choice to be honest. The choice to let ourselves be seen" ~ Brene Brown
team resources
- Collaboration requires an exorbitant amount of time & effort and is on-going; significant and lengthy preparation/community development work associated with any programs/initiatives - across multiple levels/sectors/networks/individuals/families
- Not simply time & space to meet - time/effort/energy to coordinate/communicate/organize meeting
Collaboration: the situation of two of more people working to create or achieve the same thing; acting, being, or existing together.
Connection: the act of joining or being joined to something else, or the part of the process that makes this possible; the state of being joined or connected in some way.
Connection: the act of joining or being joined to something else, or the part of the process that makes this possible; the state of being joined or connected in some way.
Photo by Karen Maes
Untitled Slide
- Openness & flexibility in regards to form
- "Relationship building key to any work we got done"
- Necessity of regular, mandatory, scheduled, coalitions, conferences, educational days, steering committees, Family Group Conferencing
- Practice of going once/week simply to sit in other lunchrooms
"...the privileged act of naming often affords those in power access to modes of communication that enable them to project an interpretation, a definition, a description of their work, actions, etc. that may not be accurate, that may obscure what is really taking place" (hooks, 1991, p.3).
Photo by Anna Samoylova
coordination & communication mechanisms
- Need for committed & solid routines/schedules for supervision/debriefing, as well as the ideal of having very active joint/inter-disciplinary/shared supervision
- Need to set up collaboration in ways that the system/individuals can tolerate: allow for process/relationships/reputation to evolve
"...dialoguing over debating...exploring questions over finding answers...surfacing assumptions over learning 'the facts'...searching for understanding over finding the truth..." (McKee, 2003).
Photo by yaph
Untitled Slide
- Policies/standards create atmosphere of neutrality & transparency
- Principled guidelines rather than strict boundaries; ability/capacity for flexibility, creativity, responsiveness
- How much they benefited from overall expectation of interdisciplinary supervision/accountability; valued and counted on regular reflective practice sessions
"...active creation of knowledge over the passive giving and receiving of pre-determined knowledge..." (McKee, 2003).
Photo by Vincent Camacho
willingness to collaborate
- Distinguish that collaboration is an invitation to collectivity NOT conflict resolution
- Willingness/capacity to get comfortable & competent in the midst of contradiction & uncertainty
- Focus on the process, recognize/understand motivations for engagement/participation & differing agendas behind individual investment
"...staying with discomfort over seeking comfort..." (McKee, 2003).
Photo by Jitabebe
Untitled Slide
- Balancing/negotiating phenomenon of "crisis" being the motivator
- Coordinating a negotiated process; balancing legislated presence/key decision-makers
- Humility: recognize limits of one's role, need to access contributions of others, accept overlap/blurriness of roles
- Engage in repair/reconciliation congruent to expectations of service users
Humility: a disposition to be humble; a lack of false pride.
Humility ensures the wise and appropriate use of power. It is the act of being modest, reverential, even politely submissive. It is the opposite of aggression, arrogance, pride, and vanity. It reminds us of our limitations. On the surface it may appear to empty its holder of power, but on the contrary, it grants enormous power to its owner.
Humility ensures the wise and appropriate use of power. It is the act of being modest, reverential, even politely submissive. It is the opposite of aggression, arrogance, pride, and vanity. It reminds us of our limitations. On the surface it may appear to empty its holder of power, but on the contrary, it grants enormous power to its owner.
Photo by Venessa Miemis
trust
- Dependent upon competence - skills & knowledge - and on experience
- Vulnerability = intimacy = trust
- Required in order to tolerate differences, misunderstandings & shortcomings of other professions/professionals
- Need to adopt values/ethics of interprofessional practice
"Honesty and transparency make you vulnerable. Be honest and transparent anyway" ~ Mother Teresa
Integrity: adherence to moral and ethical principles; soundness of moral character; the state of being whole, entire, undiminished.
Integrity: adherence to moral and ethical principles; soundness of moral character; the state of being whole, entire, undiminished.
Photo by Cristina Gottardi
communication
- Necessity of being able to describe one's role & responsibilities clearly
- Understand collective meanings; establish a common language
- Understand and accept ambiguity, uncertainty, discomfort
- Nuts & bolts/tool for working with other professional to effect change & resolve conflict
"Knowledge...is actively and socially constructed and interpreted..." (Campbell & Baikie, 2012, p.72).
We are meaning-making machines; we need to recognize and embrace diverse and multiple ways of MEANING MAKING, and replace "dogmatic insistence on the facts" with curiosity (McKee, 2003, p.403).
We are meaning-making machines; we need to recognize and embrace diverse and multiple ways of MEANING MAKING, and replace "dogmatic insistence on the facts" with curiosity (McKee, 2003, p.403).
Photo by Mark Fischer
Untitled Slide
- Need for expert facilitation of open/active communication, active listening & opportunity to improve sharing processes
- Engaged, expert facilitation of mutual knowledge sharing supports joint knowledge creation
Margaret McKee (2003) suggests that "our multiple ways of looking are not a problem needing a solution, but rather the very condition for dialogue and creative collaboration" (p.405).
Photo by Anne Worner
mutual respect
- Need to recognize and respect the roles, responsibilities & competencies of others in relation to one's own
- Understanding of the social determinants, oppression, and that conditions do not exist in isolation
- Need to consciously choose to forfeit professional identity/reputation in favour of collaboration
"Establish and maintain ethical relationships that respect the uniqueness of individuals, groups, and communities" (Campbell & Baikie, 2012, p.74).
Empathy: the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another without having the feelings, thoughts and experience fully communicated in an explicit manner.
Compassion: sympathetic consciousness of others' distress with a desire to alleviate it.
Empathy: the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another without having the feelings, thoughts and experience fully communicated in an explicit manner.
Compassion: sympathetic consciousness of others' distress with a desire to alleviate it.
Photo by saxarocks
conclusions
interface with elements of SDOH
Collaborative processes can empower individuals and communities to take control of their own lives & environments, strengthen community capacity & enable them to identify their own needs and problems.
Power: the ability of capacity to do something or act in a particular way; the capacity or ability to direct or influence the behaviour of others or in the course of events; a person or organization that is strong or influential within a particular context; used in the names of movements aiming to enhance the status of a specified group; physical strength and force exerted by something or someone.
Power: the ability of capacity to do something or act in a particular way; the capacity or ability to direct or influence the behaviour of others or in the course of events; a person or organization that is strong or influential within a particular context; used in the names of movements aiming to enhance the status of a specified group; physical strength and force exerted by something or someone.
SDOH frameworks
six key elements
The World Health Organization (WHO) defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity” (2018). The complex interactions between factors such as: income and social status; social support networks; education and literacy; employment/working conditions; social environments; physical environments; personal health practices and coping skills; healthy child development; biology and genetic endowment; health services; gender; and culture, combine to produce the conditions that influence and determine our health status (Brunner & Marmot, 2006).
Canadian Council on Social Determinants of Health (2015). A Review of Frameworks on the Determinants of Health. [Data file]. Retrieved from: http://ccsdh.ca/images/uploads/Frameworks_Report_English.pdf
Canadian Council on Social Determinants of Health (2015). A Review of Frameworks on the Determinants of Health. [Data file]. Retrieved from: http://ccsdh.ca/images/uploads/Frameworks_Report_English.pdf
elements 1 & 2
USE OF A HOLISTIC & INTERSECTORAL APPROACH
Elements of frameworks on the determinants of health
Elements 1 & 2: Use of a Holistic & Intersectoral Approach
Elements 1 & 2: Use of a Holistic & Intersectoral Approach
elements 1 & 2
a holistic & intersectoral approach
"Action is the natural antidote to despair" ~ Patricia Romney
elements 3 & 4
- Recognition of Social Exclusion
- Understanding the Role of Individuals & Communities
Element 3 & 4:
* Recognition of Social Exclusion * Understanding the Role of Individuals & Communities
* Recognition of Social Exclusion * Understanding the Role of Individuals & Communities
element 5
recognizing the importance of upstream action
Element 5: Recognizing the Importance of Upstream Action
element 6
identification of interactions between determinants
https://www.unicef.ca/sites/default/files/legacy/imce_uploads/images/advoca...
Element 6: Identification of Interactions between Determinants
Element 6: Identification of Interactions between Determinants
connections
disconnections
"TRANSFORMATIVE EDUCATION ...an emotional and spiritual process that calls for active dialogical engagement... [in order to] ...achieve congruency among our assumptions, values, theories, concepts, principles, and practices" (Campbell & Baikie, 2012, pp. 78 & 74).
interprofessional
collaboration
"...our multiple ways of looking are not a problem needing solution, but rather the very condition for dialogue and creative collaboration" (McKee, 2003, p.403).
interprofessional education
integrating education & practice
CRITICAL INQUIRY (McKee, 2003)
* Greet your discomfort with a gentle smile & a friendly hello.
* How do I know what I know?
* Why did I do it this way?
* What feelings am I aware of in this situation?
* Are my feelings constraining my perceptions in this situation?
* Does this situation remind me of one in my past?
* Have I been recruited to a view that is suppressing information that might help me change my frame of mind?
http://www.cihc.ca/files/CIHC_IPCompetenciesShort_Feb1210.pdf
* Greet your discomfort with a gentle smile & a friendly hello.
* How do I know what I know?
* Why did I do it this way?
* What feelings am I aware of in this situation?
* Are my feelings constraining my perceptions in this situation?
* Does this situation remind me of one in my past?
* Have I been recruited to a view that is suppressing information that might help me change my frame of mind?
http://www.cihc.ca/files/CIHC_IPCompetenciesShort_Feb1210.pdf
professionalization
building in bridges
Allen, A., Kelly, B. (2015). Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation. Committee on the Science of Children Birth to Age 8: Deepening and Broadening the Foundation for Success, Washington, DC, THE NATIONAL ACADEMIES PRESS.
Interprofessional education for Patient-centred practice
IECPCP
IECPCP: Interprofessional Education for Patient-centred Practice; An evolving framework
https://members.aamc.org/eweb/upload/Core%20Competencies%20for%20Interprofe...
https://members.aamc.org/eweb/upload/Core%20Competencies%20for%20Interprofe...
Social determinants of health
collaborative practice compass
* The social determinants of health provide a unifying purpose for organizing principled guidance for developing fluid & responsive frameworks, flexible & permeable boundaries for collaboratively achieving equitable health & well-being, as well as collective motivation & buy-in.
* Improving health outcomes has become the collective goal of establishing collaboration, and pursuing health equity is contingent upon our ability and willingness to connect the dots across and through all of these silos, and to "relinquishing some professional autonomy in order to work closely with others" (IECEP, 2011, p.24).
Rather than static prescriptions, collaborative frameworks are designed to facilitate our "ability to integrate knowledge, skills, attitudes, and values in arriving at judgments" (CIHC, 2010).
* Improving health outcomes has become the collective goal of establishing collaboration, and pursuing health equity is contingent upon our ability and willingness to connect the dots across and through all of these silos, and to "relinquishing some professional autonomy in order to work closely with others" (IECEP, 2011, p.24).
Rather than static prescriptions, collaborative frameworks are designed to facilitate our "ability to integrate knowledge, skills, attitudes, and values in arriving at judgments" (CIHC, 2010).
CRITICAL PROCESSES OF DECONSTRUCTION
COLLABORATIVE PROCESSES OF RECONSTRUCTION
"It is important that we all become skilled at recognizing and working within these contradictions in the best interests of our service users" (Campbell & Baikie, 2012, p.79).
"We always act within an inherited, historical context that structures our experiences for us..." (McKee, 2003, p.403).
"We always act within an inherited, historical context that structures our experiences for us..." (McKee, 2003, p.403).
it takes a village
community collaboration
"In the beginner's mind there are many possibilities, but in the expert's there are few" ~ Suzuki Roshi, 1972
The ideal of a village connotes an interconnected web of responsive and respectful relationships; recognition of the inherent value of all human beings; deep acknowledgement of the reciprocal design of humanity and the Earth; and, sustainable access to, and equitable distribution of resources.
Intersectoral collaboration includes all of the key sectors of society, not just the health sector.
People cannot achieve their fullest health potential without a secure foundation, a supportive environment, access to information, life skills, and opportunities for making healthy choices, and this requires us to "work cooperatively in ways that value the knowledge and experience of service users and communities" (Campbell & Baikie, 2012, p.74).
The ideal of a village connotes an interconnected web of responsive and respectful relationships; recognition of the inherent value of all human beings; deep acknowledgement of the reciprocal design of humanity and the Earth; and, sustainable access to, and equitable distribution of resources.
Intersectoral collaboration includes all of the key sectors of society, not just the health sector.
People cannot achieve their fullest health potential without a secure foundation, a supportive environment, access to information, life skills, and opportunities for making healthy choices, and this requires us to "work cooperatively in ways that value the knowledge and experience of service users and communities" (Campbell & Baikie, 2012, p.74).
thank you
- Jan Ference, the Pathways to Healing Partnership Team & the CVDCA
- All of the interviewees for the generous sharing of their time, experience & perspectives
- The many sources I have referenced throughout my research and presentation
- UVIC: Shawn Hoey, Marion Selfridge & Bruce Wallace for answering my questions
- Comox Valley Healthy Families Program
Presentation References
Allen, A., Kelly, B. (2015). Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation. Committee on the Science of Children Birth to Age 8: Deepening and Broadening the Foundation for Success, Washington, DC, THE NATIONAL ACADEMIES PRESS.
Anderson, H. (2012). Collaborative relationships and dialogic conversations: Ideas for a relationally responsive practice. Family Process, 51, 1, 8-24.
Barr, H. (1998) Competent to collaborate: towards a competency-based model for interprofessional education, Journal of Interprofessional Care, 12, 2, 181-187.
Brady, C. & Johnson, F. Matern Child Health J (2014) 18: 380. https://doi-org.ezproxy.library.uvic.ca/10.1007/s10995-013-1242-9
Brunner, E., Marmot, M.G. (2006). Social Organization, Stress, and Health. In M.G. Marmot & R.G. Wilkinson (Eds.), Social Determinants of Health. Oxford, Oxford University Press, 2.2, 9.
Campbell, C & Baikie, G. (2012). Beginning at the Beginning: An Exploration of Critical Social Work. Critical Social Work, 13, 1.
Canadian Interprofessional Health Collaborative (CIHC). (2018). [Data file]. Retrieved from: http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf
Stubbs, C., Schorn, M., Leavell, J., Wong Espiritu, E., Davis, G., Gentry, C., Friedman, E., Patton, T., Graham, A., Crowder, R., Wilkins, C. (2017). Implementing and evaluating a community-based, inter-institutional, interprofessional education pilot programme. Journal of Interprofessional Care, 31, 5.
CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.
D'Amour, D., & Oandasan, I. (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: an emerging concept. Journal Of Interprofessional Care, 19, 18-20.
Fook, J. (2016). The Critical Tradition of Social Work (Chapter 1). Social Work: A critical approach to practice, 3-24, London, Sage Publishing.
Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers.
Journal of Interprofessional Care, 1, 188–196
hooks, b. (1991) Theory as Liberatory Practice. Yale Journal of Law & Feminisim, 4, 1.
Hovey, R. Delormier, T., McComber, A. (2014). Social-relational understandings of health and well-being from an Indigenous perspective. International Journal of Indigenous Health, 10, 1, 35-54.
Interprofessional Education Collaborative Expert Panel (IECEP). (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C., Interprofessional Education Collaborative.
Lane, S., Keefe, R., Rubinstein, R., Hall, M., Kelly, K., Satterly, L.B., Shaw, A., Fisher, J. (2018). Integrating the social determinants of health into two interprofessional courses: Findings from a pilot study. Journal of Interprofessional Care, 32, 4
Lee, E.O.J., Ferrer, I. (2014) Examining Social Work as a Canadian Settler Colonial Project: Colonial Continuities of Circles of Reform, Civilization and In/visibility. Journal of Critical Anti-Oppressive Social Inquiry, 1, 1, 1-20.
McKee, M. (2003). Excavating our frames of mind: The key to dialogue and collaboration. Social Work, 3, 401-408.
McNaughton, S. (2018) The long-term impact of undergraduate interprofessional education on graduate interprofessional practice: A scoping review. Journal of Interprofessional Care, 32, 4
Mikkonen, J., Raphael, D. (2010). Social Determinants of Health: The Canadian Facts. Toronto, York University School of Health Policy and Management.
Minkler, M. , Wallerstein, N. (2012). Improving health through community organization and community Building: perspectives from health education and social work. In M. Minkler (Ed.). Community Organizing and Community Building for Health and Welfare (pp.37-58). Retrieved from https://ebookcentral.proquest.com
Mitchell, D. (2004). Cloud Atlas. NY, Random House Trade Paperbacks.
Oandasan, I., Reeves, S. (2005). Key elements for interprofessional education. Part 1: the learner, the educator and the learning context. Journal of Interprofessional Care, 1, 21-38.
Potts, K., & Brown, L. (2005). Becoming an anti-oppressive researcher. In Brown, L., & Strega, S. (Eds.), Research as Resistance (pp. 255-285). Toronto, ON: Canadian Scholar’s Press.
Raphael, D. (2016). Social determinants of health: a quick guide for social workers. Perspectives, BCASW. [Data file]. Retrieved from: http://www.bcasw.org/wp-content/uploads/2016/04/UPLOAD-Raphael-Social-Deter...
Oandasan, I., Reeves, S. (2005). Key elements for interprofessional education. Part 1: the learner, the educator and the learning context. Journal of Interprofessional Care, 1, 21-38.
Potts, K., & Brown, L. (2005). Becoming an anti-oppressive researcher. In Brown, L., & Strega, S. (Eds.), Research as Resistance (pp. 255-285). Toronto, ON: Canadian Scholar’s Press.
Raphael, D. (Ed.). (2009). Social Determinants of Health: Canadian Perspectives. 2nd edition. Toronto, Canadian Scholars’ Press Incorporated.
Raphael, D. (Sept., 2010). About Canada: Health and Illness. Halifax, Fernwood Publishers.
Raphael, D. (2016). Social determinants of health: a quick guide for social workers. Perspectives, BCASW. [Data file]. Retrieved from: http://www.bcasw.org/wp-content/uploads/2016/04/UPLOAD-Raphael-Social-Deter...
Renedo, A., Marston, C. (2015). Developing patient-centred care: an ethnographic study of patient perceptions and influence on quality improvement. BMC Health Services Research, 15, 122.
Rine, C. (2016). Social determinants of health: grand challenges in social work’s future. Health Social Work, 41, 3, 143-145.
Rossiter, A. (1993). Teaching social work skills from a critical perspective. Canadian Social Work Review, 10, 1, 76-90.
Rosenberg, G. (2008). Social Determinants of Health: Twenty‐First‐Century Social Work Priorities. In Comprehensive Handbook of Social Work and Social Welfare (eds K. M. Sowers, C. N. Dulmus and I. C. Colby).
San Martín-Rodríguez, L., Beaulieu, M., D'Amour, D., & Ferrada-Videla, M. (2005). The determinants of successful collaboration: a review of theoretical and empirical studies. Journal Of Interprofessional Care, 19, 1132-147.
Strozzi-Heckler, R. (2018). The Trauma Therapist Project. [Blog]. Retrieved from: https://www.thetraumatherapistproject.com/category/blog/
Suzuki, S. (1972). Zen Mind, Beginner’s Mind. Boston, Massachusetts, Shambhala.
The Ottawa Charter for Health Promotion. (2008). First International Conference on Health Promotion. [Website]. Retrieved from: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
Watson, L. (1985). Lilla Watson, activist, academic and artist says that this quote is a collective belief born from the activist groups she was a part of, and she is "not comfortable being credited for something that had been born of a collective process" and prefers that it be credited to "Aboriginal activists group, Queensland, 1970s”.
Wong, Y.R. (2004). Knowing through discomfort: A mindfulness-based critical social work pedagogy. Critical Social Work, 5, 1, 1-9.
World Health Organization. (2008). Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Geneva: World Health Organization.
World Health Organization. (2018). Commission on Social Determinants of Health 2005-2008. [Website]. Retrieved from: http://www.who.int/social_determinants/thecommission/countrywork/within/soc...
Allen, A., Kelly, B. (2015). Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation. Committee on the Science of Children Birth to Age 8: Deepening and Broadening the Foundation for Success, Washington, DC, THE NATIONAL ACADEMIES PRESS.
Anderson, H. (2012). Collaborative relationships and dialogic conversations: Ideas for a relationally responsive practice. Family Process, 51, 1, 8-24.
Barr, H. (1998) Competent to collaborate: towards a competency-based model for interprofessional education, Journal of Interprofessional Care, 12, 2, 181-187.
Brady, C. & Johnson, F. Matern Child Health J (2014) 18: 380. https://doi-org.ezproxy.library.uvic.ca/10.1007/s10995-013-1242-9
Brunner, E., Marmot, M.G. (2006). Social Organization, Stress, and Health. In M.G. Marmot & R.G. Wilkinson (Eds.), Social Determinants of Health. Oxford, Oxford University Press, 2.2, 9.
Campbell, C & Baikie, G. (2012). Beginning at the Beginning: An Exploration of Critical Social Work. Critical Social Work, 13, 1.
Canadian Interprofessional Health Collaborative (CIHC). (2018). [Data file]. Retrieved from: http://www.cihc.ca/files/CIHC_IPCompetencies_Feb1210.pdf
Stubbs, C., Schorn, M., Leavell, J., Wong Espiritu, E., Davis, G., Gentry, C., Friedman, E., Patton, T., Graham, A., Crowder, R., Wilkins, C. (2017). Implementing and evaluating a community-based, inter-institutional, interprofessional education pilot programme. Journal of Interprofessional Care, 31, 5.
CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.
D'Amour, D., & Oandasan, I. (2005). Interprofessionality as the field of interprofessional practice and interprofessional education: an emerging concept. Journal Of Interprofessional Care, 19, 18-20.
Fook, J. (2016). The Critical Tradition of Social Work (Chapter 1). Social Work: A critical approach to practice, 3-24, London, Sage Publishing.
Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers.
Journal of Interprofessional Care, 1, 188–196
hooks, b. (1991) Theory as Liberatory Practice. Yale Journal of Law & Feminisim, 4, 1.
Hovey, R. Delormier, T., McComber, A. (2014). Social-relational understandings of health and well-being from an Indigenous perspective. International Journal of Indigenous Health, 10, 1, 35-54.
Interprofessional Education Collaborative Expert Panel (IECEP). (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C., Interprofessional Education Collaborative.
Lane, S., Keefe, R., Rubinstein, R., Hall, M., Kelly, K., Satterly, L.B., Shaw, A., Fisher, J. (2018). Integrating the social determinants of health into two interprofessional courses: Findings from a pilot study. Journal of Interprofessional Care, 32, 4
Lee, E.O.J., Ferrer, I. (2014) Examining Social Work as a Canadian Settler Colonial Project: Colonial Continuities of Circles of Reform, Civilization and In/visibility. Journal of Critical Anti-Oppressive Social Inquiry, 1, 1, 1-20.
McKee, M. (2003). Excavating our frames of mind: The key to dialogue and collaboration. Social Work, 3, 401-408.
McNaughton, S. (2018) The long-term impact of undergraduate interprofessional education on graduate interprofessional practice: A scoping review. Journal of Interprofessional Care, 32, 4
Mikkonen, J., Raphael, D. (2010). Social Determinants of Health: The Canadian Facts. Toronto, York University School of Health Policy and Management.
Minkler, M. , Wallerstein, N. (2012). Improving health through community organization and community Building: perspectives from health education and social work. In M. Minkler (Ed.). Community Organizing and Community Building for Health and Welfare (pp.37-58). Retrieved from https://ebookcentral.proquest.com
Mitchell, D. (2004). Cloud Atlas. NY, Random House Trade Paperbacks.
Oandasan, I., Reeves, S. (2005). Key elements for interprofessional education. Part 1: the learner, the educator and the learning context. Journal of Interprofessional Care, 1, 21-38.
Potts, K., & Brown, L. (2005). Becoming an anti-oppressive researcher. In Brown, L., & Strega, S. (Eds.), Research as Resistance (pp. 255-285). Toronto, ON: Canadian Scholar’s Press.
Raphael, D. (2016). Social determinants of health: a quick guide for social workers. Perspectives, BCASW. [Data file]. Retrieved from: http://www.bcasw.org/wp-content/uploads/2016/04/UPLOAD-Raphael-Social-Deter...
Oandasan, I., Reeves, S. (2005). Key elements for interprofessional education. Part 1: the learner, the educator and the learning context. Journal of Interprofessional Care, 1, 21-38.
Potts, K., & Brown, L. (2005). Becoming an anti-oppressive researcher. In Brown, L., & Strega, S. (Eds.), Research as Resistance (pp. 255-285). Toronto, ON: Canadian Scholar’s Press.
Raphael, D. (Ed.). (2009). Social Determinants of Health: Canadian Perspectives. 2nd edition. Toronto, Canadian Scholars’ Press Incorporated.
Raphael, D. (Sept., 2010). About Canada: Health and Illness. Halifax, Fernwood Publishers.
Raphael, D. (2016). Social determinants of health: a quick guide for social workers. Perspectives, BCASW. [Data file]. Retrieved from: http://www.bcasw.org/wp-content/uploads/2016/04/UPLOAD-Raphael-Social-Deter...
Renedo, A., Marston, C. (2015). Developing patient-centred care: an ethnographic study of patient perceptions and influence on quality improvement. BMC Health Services Research, 15, 122.
Rine, C. (2016). Social determinants of health: grand challenges in social work’s future. Health Social Work, 41, 3, 143-145.
Rossiter, A. (1993). Teaching social work skills from a critical perspective. Canadian Social Work Review, 10, 1, 76-90.
Rosenberg, G. (2008). Social Determinants of Health: Twenty‐First‐Century Social Work Priorities. In Comprehensive Handbook of Social Work and Social Welfare (eds K. M. Sowers, C. N. Dulmus and I. C. Colby).
San Martín-Rodríguez, L., Beaulieu, M., D'Amour, D., & Ferrada-Videla, M. (2005). The determinants of successful collaboration: a review of theoretical and empirical studies. Journal Of Interprofessional Care, 19, 1132-147.
Strozzi-Heckler, R. (2018). The Trauma Therapist Project. [Blog]. Retrieved from: https://www.thetraumatherapistproject.com/category/blog/
Suzuki, S. (1972). Zen Mind, Beginner’s Mind. Boston, Massachusetts, Shambhala.
The Ottawa Charter for Health Promotion. (2008). First International Conference on Health Promotion. [Website]. Retrieved from: http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
Watson, L. (1985). Lilla Watson, activist, academic and artist says that this quote is a collective belief born from the activist groups she was a part of, and she is "not comfortable being credited for something that had been born of a collective process" and prefers that it be credited to "Aboriginal activists group, Queensland, 1970s”.
Wong, Y.R. (2004). Knowing through discomfort: A mindfulness-based critical social work pedagogy. Critical Social Work, 5, 1, 1-9.
World Health Organization. (2008). Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Geneva: World Health Organization.
World Health Organization. (2018). Commission on Social Determinants of Health 2005-2008. [Website]. Retrieved from: http://www.who.int/social_determinants/thecommission/countrywork/within/soc...
Photo by Andrea Reiman
