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Interprofessional Education in Health: Challenges of
Health Inequality and Social Exclusion
Florette Giasson, Université de St. Boniface, Canada
[email protected]
and
Tuula Heinonen, University of Manitoba, Canada
[email protected]
Introduction: Social work in interprofessional
practice in health
Global Agenda for Social Work and Social
Development Commitment to Action and
IFSW Statement on Health
The Canadian and Local Context of
interprofessional health practice in Winnipeg,
Manitoba, Canada: Some examples
Conclusions, Recommendations and
Implications
Growing awareness globally that interprofessional education (IPE)
and collaborative practice (CP) can enhance health systems,
address health workforce challenges (aging workforce, job
dissatisfaction) and improve quality of service and outcomes
The foundation of IPE and CP is to ensure the health and wellbeing
of individuals, their families and communities
The World Health Organization(2010) has stated, “Interprofessional
education occurs when students from two or more professions
learn about, from and with each other to enable effective
collaboration and improve health outcomes”. The outcome is a
collaborative practice-ready workforce
IPE and CP requires that something must be exchanged that
changes how the learner perceives themselves and others
Since health systems differ internationally,
policies and strategies need to be suited to local
contexts with their own varied challenges and needs.
The Framework presents ideas for moving
forward interprofessional education and collaboration
with a range of partners and stakeholders in health
care and is essentially, “a call for action to policymakers, decision makers, educators, health workers,
community leaders and global health advocates to take
action and move towards embedding interprofessional
education and collaborative practice in all of the
services they deliver” (WHO, 2010. p. 10).
Historical aspects
Social work situation in relation to other health
professions and in the health care system
Roles and functions of social work in IPE
Challenges and potential for social work
Our local context is Winnipeg, Manitoba Canada:
Canada Health Act shapes the health system which is
mainly biomedical and serviced by doctors and
hospitals. Public health initiatives are also covered,
but they focus mainly on primary care services.
Material Well-Being
& Social and Health
Care Access and
Entitlement
Societal-,Political and
Structural Features
Biology, Genetics,
Psychology
and Identity
Behaviour
and Lifestyle
Social and Physical
Context
Health Beliefs and
Culture
Human rights
Economic disparity, poor labour standards and
conditions and lack of corporate social
responsibility leading to damaged health and
well-being of individuals and communities and
increasing inequality and poverty
Cultural diversity and right to seek redress for
better speak out for “a more satisfactory
intellectual, emotional, moral and spiritual
existence.”
Threats to community support for social development and
well-being of people
Challenges imposed on health and well-being by
unsustainable environments “related to climate change,
pollutants, war, natural disasters and violence.”
“We commit ourselves to supporting, influencing and
enabling structures and systems that positively address the
root causes of oppression and inequality… with people who
use services and with others who share our objectives and
aspirations to create a more socially-just and fair world…”
(IASSW, ICSW and ICSD, 2012, p.1)
• Health as a social work issue
• Determinants related to health
• Social work principles
• Social work roles and responsibilities
Retrieved on line, June 30, 2012 at:
www.ifsw.org
Health is multi-dimensional
Health is not just the absence of disease, also
encompassing wellness
Promotion of social work activity as essential
throughout health services
Promotion of a holistic understanding of health in
policy making and practice
Advocacy and support of efforts of individuals, families
and communities to participate in decisions affecting
their health
The University of Manitoba Interprofessional Education Initiative
was formed in 2008 by the Deans of 13 health science academic
units within the University of Manitoba (U of M);
The IPE website sets out the mission of IPE as follows: “to graduate
health professionals prepared to manage and adapt processes in
interprofessional teams necessary to achieve optimum person- and
family- centred health and wellness outcomes.”
Research indicates that IPE is most effective when:
• principles of adult learning are used. (e.g. problem-based
learning and action learning sets).
• learning methods reflect the real world practice experiences of
students
• interaction occurs between students.
Faculties are presently including components of IPE in Curricula
The Faculty of Social Work was a pilot site for an
interprofessional learning event that, grounded in adult
learning theories, brought together small interprofessional
groups of (8-10) students from social work, occupational
therapy, nursing and kinesiology students to work on a
health promotion case situation. The students were
unanimous in recommending that this kind of
interprofessional learning event be repeated in the future and
with a greater number of student participants.
In 2012, a large interprofessional education event was held in
which over 450 students and 48 facilitators in eight
professional academic units took part. After the event,
students evaluated their experiences. Social work students
were highly appreciative of the event and felt they had gained
valuable knowledge from it.
Université de Saint-Boniface, Winnipeg, CANADA
(Team: Gisèle Lapointe, Nursing, Halimatou Ba, Social Work, Florette Giasson,
Social Work, Janelle de Rocquiny, Research Assistant and Emanuel Zabre,
Research Assistant)
Funded by Great-West Life
Community Partners:
Centre Flavie Laurent: reduce poverty by offering support and physical
goods (clothes, furniture, household items) to people in need
Accueil francophone: services for French-speaking new comers
(immigrants & refugees)
Youville Centre: services focused on healthy living – from health care
and wellness education to counselling and support
Centre de santé de Saint-Boniface: primary healthcare clinic that
offers services in both French and English – offers community health
programming outside the clinical setting
Students to transcend their ideas – draw on team members’ best
skills/assets – develop a new way of thinking as a group
Students to change their perceptions, attitudes and behaviours
about transdisciplinary work
Tackle social inequalities at the prevention/community level
Focus on “transdisciplinarity” & “community health”:
Collaborative practice works best when it is organized around the
needs of the population being served (Framework for Action on
Interprofessional Education & Collaborative Practice, p. 28).
Community
Health
Primary
Care
Tertiary
Care
Trandisciplinary
Multi or Interdisciplinary
The WISH Clinic is an interprofessional, student-run
clinic
It provides non-judgmental, socially responsible,
holistic health care to a population that struggles with
poorer health than the rest of the city.
Health and social care is provided by university
students and licensed professional mentors from a
broad range of disciplines that includes Dental
Hygiene, Dentistry, Dietetics, Medical Rehabilitation,
Medicine, Nursing, Pharmacy, Psychology, Social Work,
and Spiritual Care.
The WISH clinic is open on Sundays and offers not only
care services for clients, but also food for those who
come to use its services.
Interprofessional health care practice is here to stay
In Canada, intersectoral interprofessional strategies (beyond hospital
care) in promoting health and preventing health problems can be
further developed (e.g., housing, child care, education and action to
address violence, poverty and addictions and social exclusion)
Social work contributions in health care can be highlighted and
promoted through interprofessional relationships and in practice
settings
Social work roles in social advocacy and action can enhance
interprofessional practice collaboration and health outcomes for clients
Social workers can play a greater role by researching and writing on
interprofessional practice processes and outcomes
It is time to treat the client as a true partner in a system where the client
is encouraged to take more responsibility for his or her health and
where professionals are encouraged to practice in a collaborative
process.
http://umanitoba.ca/programs/interprofessional/
http://umanitoba.ca/programs/interprofessional/about_us/media/
www.umanitoba.ca/news/blogs/blog/improving-health-promotion-and-carethe-interprofessional-way
http://www.cihc.ca/
World Health Organization (WHO) (2010). Framework for action on
interprofessional education & collaborative practice. Geneva: WHO. Heinonen,
T., Metteri, A. & Leach, J. (2009). Applying health determinants and
dimensions in social work practice. European Journal of Social Work, 12(2),
139-153.
WHO (2010). Framework for Action on Interprofessional Education &
Collaborative Practice (WHO/HRH/HPN/10.3). Geneva: author.
Sargent, J. (2009). Theories to aid understanding and Implementation of
Interprofessional education. Journal of Continuing Education in the Health
Professions, 29(3), 178-184.
D’Amour, D., Ferrada-Videla, M., Rodriguez, L., & Beaulieu, M-D. (2005). The
conceptual basis for interprofessional collaboration: Core concepts and
theoretical frameworks. Journal of Interprofessional Care, 1, 116-131.