An Innovative National Distance Education Initiative for
Interprofessional Practice in Psychosocial Oncology
I.
Primary Applicant Organization
Capital District Health Authority (Capital Health)
Don Ford, President & CEO, Capital Health
Suite 2142, 1796 Summer Street
Halifax, Nova Scotia
B3H 3A7
Project Lead
Deborah McLeod Ph.D., R.N.
Contact:
Clinician Scientist (Nursing),
Capital Health Cancer Care Program
Assistant Professor, School of Nursing
Dalhousie University
Canadian Association of Psychosocial Oncology
Dickson Building (1st floor)
5820 University Avenue
Halifax, NS
B3H 1V7
Phone:
902-473-2964
Facsimile:
902-473-2965
Email: deborahl.mcleod@cdha.nshealth.ca
(CAPO)
Member, Board of Directors and
Chairperson, Education Committee
Project Management Committee
Barry Bultz, Ph.D., C. Psych.
Director, Department of Psychosocial Resources
Tom Baker Cancer Centre
Adjunct Professor and Chair,
Division of Psychosocial Oncology,
Department of Oncology, Faculty of Medicine, University of
Calgary
Phone: 403-355-3205
Email: bdbultz@ucalgary.ca
Susan Cadell, Ph.D.
Assistant Professor
School of Social Work and Family Studies
University of British Columbia
Associate, SocioBehavioral Research Unit
B.C. Cancer Agency
Rm.231, 2080 West Mall
Vancouver, B.C.
V6T 1Z2
Phone: 604- 822-5302
Email: scadell@interchange.ubc.ca
Serge Dumont Ph.D. (Project Co-Lead)
Professor, School of Social Work
Université Laval, Québec City,
CAPO, Member Board of Directors
Quebec, G1K 7P4
Phone: (418) 656-2131 Ext. 7991
serge.dumont@svs.ulaval.ca
Esther Green M.Sc.(T)., R.N.
Chief Nursing Officer
Director, Health Human Resource Planning
Cancer Care Ontario
President, CAPO
620 University Avenue
Toronto, Ontario
Canada, M5G 2L7
Phone: (416) 217-1278
Email: Esther.Green@cancercare.on.ca
Grant Charles Ph.D
Assistant Professor
School of Social Work and Family Studies
University of British Columbia
Associate, SocioBehavioral Research Unit
B.C. Cancer Agency
Rm.337, 2080 West Mall
Vancouver, B.C.
V6T 1Z2
Phone: 604 822-3804
gcharles@interchange.ubc.ca
Gary Rodin M.D., FRCPC.
Head, Psychosocial Oncology and
Palliative Care Program
Princess Margaret Hospital, UHN
Professor of Psychiatry and
Head of the Behavioural Science and Health Research
Division. University of Toronto
610 University Ave. Toronto, ON,
Canada, M5G 2M9
Phone: 416-340-3044
gary.rodin@uhn.on.ca
1
Project Summary
Project title: An Innovative National Distance Education Initiative for
Interprofessional Practice in Psychosocial Oncology
Capital Health’s Mandate: Capital Health provides core health services 40 per cent of the population of
Nova Scotia, and tertiary and quaternary acute care services to residents of Atlantic Canada. Capital
Health, particularly the QEII health Sciences Centre, is a primary clinical academic and research center
for Dalhousie University. One of four strategic directions of Capital Health is to build knowledge,
through, in part, fostering interdisciplinary care teams and promoting research and education
Project Partners: The project partners include universities and clinical cancer agencies or programs in 7
provinces (NS, Nfld, NB, QC, ON, AB, BC). Each university includes 3-5 medical and health profession
faculties, with one theological school partnering. The Canadian Association of Psychosocial Oncology is
a key national partner.
Project Objectives: 1)To develop an innovative approach to interprofessional education in psychosocial
oncology at the post-licensure level in both English and French using blended, distance technologies. The
outcome will be an introductory course that can be offered as a graduate level elective at the partner
universities and adapted as a professional development option to be offered through CAPO/ACOP. 2) To
establish a Canadian network of psychosocial oncology educators and researchers committed to
enhancing the health of Canadians and their family members who are affected by cancer through
collaborative and interprofessional education initiatives.
Major activities/ Deliverables and Timelines: There are 3 phases to the project. In the first phase, a
foundation for faculty/course development will be established through focus groups, key informant
interviews, and environmental scans. In Phase 2 the two versions of the course (the graduate level,
university based, for credit option and the professional development option) in both English and French
will be developed. The course development will include the design of innovative strategies to promote
interprofessional education and practice using distance technologies. Phase 3 will involve the initial
piloting the course(s) and evaluation. Across the 3 phases, faculty development for interprofessional
education will be conducted and activities to foster the development of a network of educators/researchers
in interprofessional education will be designed.
Expected Project Results: 1) Extension of already strong interprofessional education traditions in the
partner universities to the post-licensure level of practitioner; 2) extension of professional development
options to include explicit focus on interprofessional practice; 3) enhancement of education options for
psychosocial oncology generalist and specialist students and practitioners, thus improving psychosocial
care delivered to patients and families in Canada; 4) a template for interprofessional education using
innovative distance technologies that can be applied to other specialty areas and to other health care
practitioners.; 5) development of a network of educators/ researchers that will ensure sustainable activity
in this are for psychosocial oncology.
Evaluation Methods: A formative evaluation plan will be developed as part of a participatory evaluation
approach informed by stakeholders in the project The formative evaluation design will incorporate the use
of mixed methods (quantitative and qualitative) and multiple data sources. A results-based logic model
will be used to guide the implementation of the program and subsequently inform the evaluation plan
Dissemination plan: This project is designed to provide multiple opportunities for knowledge transfer
and networking among all participants, including students, clinicians, faculty, patients/family. Knowledge
dissemination, including conference and workshop participation, and publication of research results will
begin at the end of the first phase of the project and continue throughout..
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I.
Primary Applicant: Capital District Health Authority
Organizational Overview
The Capital District Health Authority exists within the largest integrated academic health district
in Atlantic Canada, known as Capital Health. Capital Health provides core health services to
395,000 residents, or 40 per cent of the population of Nova Scotia, and tertiary and quaternary
acute care services to residents of Atlantic Canada. Specialized adult health services are provided
to a referral population from the rest of the province of 550,000, and to residents of New
Brunswick and Prince Edward Island. Some 8,500 staff are employed within Capital Health.
The Capital Health Cancer Care Program is the largest cancer program in the province, providing
primary and secondary level care to residents of Capital Health as well as tertiary level acute care
services to residents of Nova Scotia. In addition to providing cancer care in Capital Health, the
program also provides care to patients around the province via satellite clinics. The Psychosocial
Oncology Team is an interdisciplinary team of professionals providing psychosocial services to
patients and families affected by cancer. The team includes advanced practice nurses,
psychologists, social workers, a psychiatrist and spiritual care providers, all of whom will be
involved in this project. These professionals have a long history of working in interprofessional
teams, both with other psychosocial oncology practitioners and with the primary oncology teams
of oncologists and oncology nurses. Deborah McLeod is the clinical team leader for this group.
Dr. Andrew Padmos, Head of the Cancer Care Program at the QEII Health Sciences Centre, will
sit on the Project Management Committee for the project. Dr. Padmos is also Commissioner, for
Cancer Care Nova Scotia, and Associate Dean for Cancer Programs at the Dalhousie University's
Faculty of Medicine. He holds academic appointments as Professor in the Departments of
Medicine and Community Health and Epidemiology at Dalhousie. Dr. Padmos is also VicePresident Research & Academic Affairs for Capital Health and the QEII Health Sciences Centre.
As VP for this portfolio, Dr. Padmos is also responsible for the Center for Clinical Research,
which will provide necessary infrastructure for the project, including grant administration, office
space and human resource support.
Capital Health is the primary applicant leading a consortium that includes both clinical and
academic partners in 7 provinces and a national professional association, the Canadian Association
of Psychosocial Oncology/ Association Canadienne d'Oncologie Psychosociale (CAPO/ACOP). In
addition to the national scope of the project, intended to benefit Canadians broadly, there will also
be a strong Atlantic Canada collaborative partnership with Nova Scotia, New Brunswick, and
Newfoundland collaborating as a regional team for the Atlantic region. These three province have
already created a model for collaboration in graduate level education, led by Memorial University,
through the Atlantic Region Training Centre for Applied Health Research in which students from
all three universities complete their graduate education as a cohort.
Capital Health is ideally suited to be the lead organization. It is the primary teaching hospital for
Dalhousie University, with long standing affiliate agreements with the faculties of Medicine and
Health Professions. Both institutions have a long history of collaboration in clinical and
interprofessional education and strong relationships exist among the medical and health faculties
and departments based on mutual respect, trust and a spirit of collaboration.
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II.
Project Partners
The project partners include universities and clinical cancer agencies in 7 provinces: Nova Scotia,
New Brunswick and Newfoundland will form a regional team, with partners in Quebec, Ontario,
Alberta, and British Columbia. Another major partner will be a national, multidisciplinary,
professional association, CAPO/ACOP. Partner faculties and schools include medicine, nursing,
psychology, social work, and spiritual care. All of the partner universities have a strong history of
interprofessional education and experience with distance education. Each province will form a
local committee of university teachers and clinicians from 4-5 disciplines, with Atlantic Canada
forming a regional committee. Each committee will be linked to the larger project through the
Advisory Committee, described below, and through the project co-leaders and management
committee members. The project links strongly with CAPO/ACOP, particularly the Education
Committee, which provided the primary impetus for the project. The Chair of this committee,
Deborah McLeod, is the project lead and the President of CAPO (Esther Green) and other Board
members (Serge Dumont and Gary Rodin) sit on the project management committee. In addition
to being linked to these major partners, this project is also linked to the Psychosocial Oncology
Research Training Program (PORT, CIHR $1,800,000 2003-2009) with the principal investigator
with PORT, Dr. Carmen Loiselle sitting on the Advisory Committee. Deborah McLeod is also one
of the co-investigators/mentors with PORT. This project will complement the PORT agenda by
expanding educational opportunities in psychosocial oncology clinical education at the Masters
level.
1.
Atlantic Canada
Nova Scotia
In addition to Capital Health, project partners in Nova Scotia include Dalhousie University
(Faculties of Medicine, and Health Professions, principally the Schools of Nursing and Social
Work), the Atlantic School of Theology, and Cancer Care Nova Scotia.
Dalhousie University is the largest post-secondary institution in the Maritimes. Particular
strengths of the partnering Faculties and Schools include considerable experience in distance
education and well-established relationships with Capital Health. The Faculty of Medicine has
over 1300 faculty, 360 medical students and 450 post-graduate physicians. There is already a
partnership in place between the Faculty of Medicine, Cancer Care Nova Scotia and Capital
Health to strengthen the cancer care system and to collaborate on education opportunities for
cancer health care professionals. There is a large continuing medical education department, which
is experienced in the provision of distance education to physicians in Nova Scotia. Dalhousie
University Continuing Medical Education, Dalhousie University Continuing Pharmacy Education
and the Registered Nurses Professional Development Centre recently collaborated with Cancer
Care Nova Scotia in creating interprofessional modules for interactive, case based education for
cancer care.
The School of Nursing is renowned both nationally and internationally for its education programs,
which have been offered since 1949, and the quality of faculty research. The School offers a
Bachelor of Science in Nursing program, a post-baccalaureate primary health care nurse
practitioner program, a master of nursing (MN) program, a joint master of nursing and health
services administration (MN/MHSA) and a PhD (Nursing) program to more than 600 students.
The School of Nursing is one of nine units within the Faculty of Health Professions (FHP) at
Dalhousie and is a key participant in providing interprofessional education at the undergraduate
level.
4
The Maritime School of Social Work offers Bachelors and Masters degrees in Social Work, both
accredited by the Canadian Association of Schools of Social Work. The School also offers a
diversified Continuing Education program. In 2001, the School launched a National Distance
Delivery Mode for both the BSW and MSW degrees, the only distance education Masters of
Social Work program in Canada. A number of faculty members are recognized as experts in
distance education.
Dalhousie has a strong history of interprofessional education that includes mandatory
undergraduate modules in sexuality, disability, palliative care, family violence and 2 modules
focused on working in interprofessional teams. is by The Tri-Faculty interprofessional Academic
Advisory Committee (Tri-IPAAC) administers the interprofessional education program.
Approximately 900 students who attend each module work together in randomly assigned
interprofessional teams. More than 3900 students from the first to third years of their programs
attend the interprofessional modules. These modules are supported by over 60 faculty and many
more volunteers who are trained as facilitators. The tradition of interprofessional education at
Dalhousie provides a strong community to support new interprofessional education initiatives. The
proposed project builds on these traditions and initiatives in interprofessional education at the
undergraduate level and extends it to post-licensure professionals and graduate students.
The Atlantic School of Theology (AST) is an ecumenical university committed to excellence in
graduate level theological education and research and in formation for professional ministries in
churches, health care settings and the wider society. The two primary graduate programs offered
by AST are the Master of Divinity and a Master of Theological Studies Degrees. AST offers
courses in dying, death and bereavement, trauma studies, ethics, sexuality and narrative theology.
In 2003 AST introduced a new curriculum, the focus of which is transformational leadership.
Students are encouraged to be both creative and innovative throughout their time of study. At the
heart of the curriculum is the belief that graduates can and indeed must be agents of spiritual and
social transformation.
Atlantic School of Theology in conjunction with the Institute of Pastoral Training (IPT) offers
Clinical Pastoral Education (CPE) programs within a variety of health care setting throughout the
Maritimes. IPT is affiliated with the Canadian Association for Pastoral Practice and Education
(CAPPE). Both IPT and CAPPE are broadly ecumenical and support the work of all faith groups.
They also provide spiritual and professional programming and certification to those who are
interested in professional graduate education.
Cancer Care Nova Scotia
Cancer Care Nova Scotia's (CCNS) mandate is to coordinate, strengthen, and evaluate cancer
services in Nova Scotia. CCNS programs include prevention, screening, education, treatment,
follow-up care and palliation. Through the development of clinical guidelines and professional
education, CCNS contributes to the standardization of cancer services across the province.
CCNS develops and implements educational programs for health professionals based on
recommendations from the Education Advisory Group. With representatives from across the
province, the Advisory Group includes cancer specialists, health professionals and educational
experts. The group provides advice and leadership on the development of evidence- and best
practice-based educational programs for health professionals, which help to ensure a quality
cancer care system. CCNS is also the lead agency in proposing an initiative in the area of
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interdisciplinary education in cancer care. While it is expected that one project will inform the
other, the two projects differ in substantial ways. The target audience in the CCNS project is
community based generalist practitioners who wish to develop better knowledge in cancer care
generally, whereas this project targets those with specialized interest in oncology and psychosocial
oncology. The content of the course produced in our proposed project will provide much more indepth focus on a specialized area. However, it is expected that knowledge generated from both
projects will inform and strengthen the outcomes of each. Furthermore, the synergy in focus on
interprofessional education and practice in cancer care for both specialists and community based
generalists across both projects, at least at the local Nova Scotia level, can be expected to
contribute to more significant change in practice than either project on its own.
Cancer Care Nova Scotia established the Cancer Patient Family Network in 2001, as a formal
communication channel for cancer patients, survivors and family members. This network
facilitates the sharing of information, fosters and promotes grassroots support for cancer patients
and offers its members a collective voice to ultimately enhance the cancer system across the
province. The Network will provide a primary link to patients and families for this project. A
representative of the network will serve on the Advisory Committee.
New Brunswick and Newfoundland
It is anticipated that partnerships will be developed with interprofessional teams in cancer
programs in New Brunswick and Newfoundland as well as with the University of New Brunswick
(UNB) and Memorial University (MUN). The Schools of Nursing at UNB and MUN have agreed
to facilitate the development of partner teams of clinicians and faculty in their provinces. This will
allow an Atlantic Regional collaboration in interprofessional, distance based education at the
graduate level.
2.
Quebec
In Quebec, the partner organizations will be Laval University and the Centre de Recherche de
l’Hôtel-Dieu de Québec, a cancer research center with a strong basic and clinical research
program, which was recently awarded a grant by the Canadian Foundation for Innovation (CFI) to
build a new Clinical and Evaluative Research Center. This university research centre hosts one of
the largest interdisciplinary team of research in psycho-oncology in Canada. Six clinicianresearchers with full time position in Laval Universty (medicine, pharmacy, nursing, social work,
nursing, psychology) play an important role in teaching and research in North American and
European French-speaking communities. As an outpatient center, it captures patients early in the
course of their cancer trajectory from the diagnostic to the curative and the palliative phase which
include all critical periods for psychosocial adjustment. This centre is becoming progressively a
major referral center for the entire eastern part of the Province of Quebec, thereby providing
access to a large number of patients for student clinical training. The professors currently
supervise more than 15 graduate students in psycho-oncology.
3.
Ontario
The University of Toronto, founded in 1827, is Canada’s largest university. It is consistently
ranked as one of Canada’s top research intensive universities. There are teaching programs in 17
academic divisions with educational programs offered across three campuses. There are nine fully
affiliated teaching hospitals and over 67,692 students, most of whom are full-time. There are over
11,635 faculty and staff. The library is rated as one of the four top research libraries in North
America with over 15 million holdings.
6
The Faculty of Nursing (FON) at the University of Toronto is renowned nationally and
internationally for its educational programs and nursing research conducted by its faculty
members. The faculty offers a Baccalaureate in Nursing Science, a Masters of Nursing with
options for a combined Masters in Business Administration and a Clinical Focused Masters in four
specialty areas, collaborative and practitioner programs, and a PhD program. Across all levels
there are over 600 students. In 1994, the FON offered the only distance education program for
preparing Acute Care Nurse Practitioners. In 2004, a specialty clinical track in oncology was
developed. Psychosocial oncology is an important dimension of this program that needs further
development. The FON is currently examining a specialty focus in oncology as one of the clinical
streams in the Masters of Nursing program.
The Princess Margaret Hospital (PMH), is the Oncology Division of the University Health
Network, which is a large quaternary acute care hospital located in Toronto, Ontario. Princess
Margaret Hospital is a world renowned comprehensive cancer centre. The program is comprised of
114 in-patient beds, with programs and clinics across all cancer sites including transplant. The
program served over 38,525 patients in 2003/2004. Psychosocial oncology and palliative care is a
very prominent department at PMH, comprised of a multidisciplinary palliative and pain care
team, advanced practice nurses, psychiatrists, psychologists and social workers. A research
division for psychosocial oncology and palliative care is currently in development.
As a provincial cancer agency, Cancer Care Ontario (CCO) is a specialized, knowledge-driven,
evidence-based organization that uses data to plan, fund, and report on performance of the cancer
system in Ontario. CCO in its relationship with 11 Integrated Cancer Programs in 11 regions of
the province, influences the delivery of a broader range of cancer services spanning the entire
continuum of care. There is a strong emphasis on prevention and screening, diagnostic services,
surgery, supportive and psychosocial oncology and palliative care across the entire system, as well
as the traditional treatment aspects of radiation and chemotherapy. Princess Margaret Hospital has
a formal affiliation agreement with CCO, as part of the unification of the cancer system. The
Cancer Quality Council of Ontario (CQCO) was created with a mandate to publicly report on the
quality of cancer services. In partnership with CQCO, CCO has produced several important
reports, such as Strengthening the Quality of Cancer Services in Ontario, and the Four-Point
Strategy to Reduce Waiting Times in Ontario. In 2005, CCO produced the first-ever Ontario
Cancer Plan that provides a new and expanded profile of cancer services within the entire system,
identifies the gaps and outlines specific strategies to improve care for people at risk for cancer and
those living with cancer.
In partnership with the University of Toronto, Faculty of Nursing, CCO is supporting the
development of a Master’s program in oncology advanced practice nursing. CCO has guided the
development of programs for other disciplines in oncology, and through the Integrated Cancer
Programs located in academic health science settings, supports the clinical development of
oncologists, social workers, psychologists, radiation therapists and nurses. As a provincial cancer
agency and prime advisor to the government on the cancer system, CCO, in partnership with the
Program in Evidence-based Care (PEBC) develops clinical practice guidelines in all domains of
the continuum, including supportive care and psychosocial oncology. CCO supports research
from bench to bedside and health services research. As an example of the latter, CCO has
undertaken an evaluation of the integration of the cancer programs, funded by CIHR and CHSRF.
7
4.
Alberta
In Alberta, the partner organizations are the University of Calgary (U of C) and the Tom Baker
Cancer Centre, Alberta Cancer Board. The Alberta Cancer Board is mandated under the
Alberta Government, within the Cancer Program Act to coordinate all cancer research, prevention
and treatment programs. The board operates 17 cancer treatment facilities, including the Tom
Baker Cancer Centre (TBCC) in Calgary and four associate cancer centers in Red Deer, Grande
Prairie, Lethbridge and Medicine Hat.
The Department of Oncology at the U of C and the Department of Psychosocial Resources, TBCC
are well positioned to partner in this project. Most of the staff members at the Department of
Psychosocial Resources are cross-appointed as adjunct faculty at the U of C, while the Director of
the Department of Psychosocial Resources (Barry Bultz) is also Chair of the Division of
Psychosocial Oncology, Faculty of Medicine. The U of C has offered a course in Psychosocial
Oncology (MDSC 635) for more than 8 years, the first of its kind in Canada. The course is taught
by TBCC clinical staff, which includes psychologists, clinical social workers, and psychiatrists. In
addition, the Department of Psychosocial Resources offers the only clinical training program in
psychosocial oncology accredited by the Canadian Psychological Association.
Other partner faculties include the Faculty of Social Work, which is recognized nationally for its
excellence in education and research. In May 2005, the Faculties of Nursing and Social Work
joined with Kinesiology, Medicine, Social Work and Veterinary Medicine to create a Division of
Health Sciences. This represents a commitment and emphasis on an inter-professional and
integrated approach to educating health professionals.
5.
British Columbia
The major partners in British Columbia include both campuses of the University of British
Columbia (UBC Vancouver and UBC Okanagan) and the British Columbia Cancer Agency.
These two institutions have many links but the most pertinent to this proposal is the course SOWK
570C Psychosocial Oncology: Grief, Loss and Survival, a graduate level course offered in the
School of Social Work and Family Studies at UBC in conjunction with the B.C. Cancer Agency
Patient and Family Counselling staff. The course, which has been offered since 2002, is housed in
Social Work but is open to all disciplines.
The University of British Columbia Vancouver
Since opening in 1915, the University of British Columbia (UBC) has developed a reputation for
innovation and excellence in both teaching and research, and has become a leader in higher
education in Canada. The School of School Work and Family Studies at UBCV is a unique
institution of higher education and professional learning in B.C. and Canada. Building on over
seventy years of social work education and a quarter of a century of family studies education at
UBCV, the recently merged School (1999), the only such institution in Canada, draws on its twin
disciplines in education and preparing students as critically aware and reflective citizens, as family
practitioners in the human services and for entry level and advanced professional social work
practice. The School offers BSW and MSW degrees, both accredited by the Canadian Association
of Schools of Social Work, majors in Family Studies at the BA and MA level, and has just started
the first PhD program in Social Work and Family Studies in North America.
The Faculty of Medicine at UBCV is a dynamic component of one of Canada's most exciting,
innovative public universities, and the only medical school in the province of British Columbia.
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Faculty members from 15 academic departments and 2 schools - Audiology & Speech Sciences,
and Rehabilitation Sciences - are actively engaged in leading-edge research, education and
community service on university and hospital campuses across the province.
The College of Health Disciplines is a unique part of the interprofessional educational leadership
at UBCV. The College leads the university's 15 health and human service programs in
interprofessional education and research. For example, the College focuses on complex problems
like patient safety, HIV/AIDS, family violence, palliative care and many others that demand a
collaborative and or team approach.
The University of British Columbia Okanagan
The University of British Columbia Okanagan (UBCO), formerly Okanagan University College,
opened its doors July 1, 2005. Its new Faculty of Health Sciences is comprised of the well
established Schools of Nursing and Social Work. The vision for the Faculty is one of
interdisciplinary and interprofessional teaching/learning in the context of strong, complex
relationships with community partners that involves innovative educational strategies and the
widest possible access for students. This will build upon currently existing links to the community,
including the British Columbia Cancer Agency Centre for the Southern Interior, and an effective
working relationship between the Schools of Nursing and Social Work.
Rapid growth of the Faculty to include pharmacy, dentistry, medicine, rehabilitation sciences, and
human kinetics is anticipated. A core of interdisciplinary/interprofessional courses is planned and
will encompass interprofessional teamwork. Graduate programs in Nursing and Social Work will
be launched in September 2006. An interdisciplinary centre focused on population and health
services research is established and an interdisciplinary community based research unit focused on
chronic illness is being developed. Further, an interprofessional clinical teaching and research unit
has been proposed.
The British Columbia Cancer Agency
The mission of the BC Cancer Agency is to reduce the incidence of cancer; to reduce the mortality
rate of people with cancer; and to improve the quality of life of people living with cancer. This
mission is achieved by a system that links prevention, early detection, diagnosis and treatment,
supportive care, rehabilitation, palliative care, education, research, and support for community
programs. This system links research and treatment, leading to new solutions for treating cancer.
This is achieved through four regional cancer centres in Vancouver, Vancouver Island (Victoria),
the Southern Interior (Kelowna) and the Fraser Valley (Surrey). Each cancer centre provides
patient services including assessment & diagnosis, chemotherapy and radiation therapy,
counseling services and follow-up care. In addition there are provincial networks in cancer
rehabilitation and palliative care. The B.C. Cancer Research Centre is part of the Agency and
allows scientists, clinicians, students, and technicians to work to discover what causes cancer,
ways to improve treatment and, in future, how to predict its occurrence or prevent it entirely. The
BC Cancer Agency also has a SocioBehavioral Research Centre.
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Canadian Association of Psychosocial Oncology/ Association Canadienne d'Oncologie
Psychosociale
A key partner and initiator of this proposal is the Canadian Association of Psychosocial
Oncology/ Association Canadienne d'Oncologie Psychosociale (CAPO/ACOP). CAPO/ACOP
is a multidisciplinary association that was established in 1985, incorporated in 1987, and achieved
charitable status in 2003. The purpose of the Association is to foster and encourage
interdisciplinary excellence in psychosocial research, education and clinical practice in oncology.
The objectives of the Corporation are: To educate and disseminate information on all aspects of
psychosocial oncology including promoting the efficiency and effectiveness of registered charities
as recognized by Canada Customs and Revenue Agency regarding psychosocial oncology, by:
a) conducting conferences and workshops educating professionals, health personnel and
the public in clinical skills and theoretical concepts in psychosocial oncology;
b) preparing and disseminating educational material to the public and health care
professionals across Canada on all aspects of psychosocial oncology;
c) providing a national network for the exchange of ideas; and
d) establishing a library of educational materials concerning all aspects of psychosocial
oncology.
CAPO/ACOP was a partner in developing the Centre for Behavioural Research and Program
Evaluation of the National Cancer Institute, is a member of the Board of the National Cancer
Institute, and in 1999 drafted and adopted a set of Canadian standards for psychosocial oncology.
CAPO/ACOP members (approximately 200) are involved in all levels of clinical care, planning,
research, and education in cancer care and are regular participants on local, provincial, regional,
national, and international planning groups.
The CAPO/ACOP Education Committee mandate is twofold, namely to support patient/family
education and to foster professional education in psychosocial oncology. Members of the
committee represent a number of disciplines (nursing, medicine, psychology, social work, spiritual
care and rehabilitation specialists) and all regions of Canada, with the exception of the territories.
CAPO/ACOP has a 20-year history of fostering interprofessional and interagency collaboration, as
well as collaboration across all levels of government. All major cancer agencies in Canada are
represented in the CAPO/ACOP membership. CAPO/ACOP works in collaboration with, or has
representation on the following national organizations: the Canadian Strategy for Cancer Control,
National Cancer Institute, Canada (NCIC), the Canadian Institute for Health Research (CIHR), and
the Canadian Association of Provincial Cancer Agencies. The membership of CAPO includes
practitioners, educators, administrators and researchers in psychosocial oncology. CAPO is a
respected member of the American Psychosocial Oncology Society (APOS) and the International
Psychosocial Oncology Society (IPOS), leading North American and international organizations in
the areas of practice, education and research. CAPO/ACOP is recognized not only by the formal
cancer system but also by hospitals where systemic care is provided. Many members are faculty
or adjunct faculty at leading universities in Canada.
Due to its strong history of interprofessional collaboration and commitment to practice standards
and education, CAPO/ACOP is ideally suited as a partner in this initiative. A number of CAPO
representatives are project leads or co-leads for the project, including the President, Esther Green,
the Chairperson of the Education Committee, Deborah McLeod and members of the Board of
Directors, Serge Dumont and Gary Rodin.
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III.
Patients/Families and Learners
The target audience for the distance course includes graduate students in medicine (including
oncology, palliative care, family medicine and psychiatry residents) and the health professions,
including nursing, psychology, social work, and spiritual care. The target audience for the
professional development version of the course is clinicians who are new to cancer care and
psychosocial oncology and who have not had previous education in this specialty area, as well as
other clinicians who wish to increase or update their knowledge. The latter group might include
oncology nurses, oncologists, family physicians and other community based professionals for
whom psychosocial oncology is not a specialty practice but is of interest by virtue of their contact
with cancer patients and families as part of their professional practice. The professional
development option is expected to be particularly valuable to clinicians working in rural and
remote areas where there are few resources and perhaps no psychosocial oncology specialists
available. Surveys of the CAPO/ACOP membership have identified that the provision of
educational opportunities through CAPO/ACOP is a high priority for them and have endorsed
distance education as a key national priority.
IV.
Project Management, Advisory and Regional/Provincial Committees
The Project Management Committee, will provide accountability and overall direction for the
project. A larger Advisory Committee will function as an advisory group, providing input and
direction for the project. Provincial/Regional Committees will be formed to include academic,
clinical, patient/family & learner representatives, with the Atlantic provinces (NS, NB, NFLD)
forming a regional committee. The provincial/regional committees will be responsible for ushering
the syllabus through appropriate approval channels in their respective universities, gaining ethical
approval for project evaluation components where necessary and providing opportunities for both
clinicians and faculty to develop working relationships, knowledge, and skill in interprofessional
education. Members of each provincial group will function as academic and clinical mentors to
students in both the university course as well as in the professional development course. The
budget has included costs for faculty members in each of the provinces to lead the universitybased course for the first offering, as well as stipends for other academic and clinical mentors to
participate, thus ensuring meaningful involvement of 4-5 disciplines. See Appendix B for the list
of participants for each province.
Regional/Provincial Committees:
Each regional/provincial committee will consist of the members of the advisory committee from
that region or province plus additional clinical staff from the partner clinical agency psychosocial
team/department as necessary. At least one of the members of the project management team will
sit one each provincial/regional committee. In addition, 2 graduate students and 2-3 health
professional members (oncology or community based professionals) will be appointed. The intent
is to have good representation both from the university partner and the clinical agency partner,
with at least 3, and preferably 5 health disciplines represented (medicine, nursing, psychology,
social work and spiritual care). The provincial groups will work together to develop both academic
faculty and clinical mentor knowledge and skill in interprofessional education. These educators
will participate in the course offerings in Phase 3 of the project, functioning as mentors both
locally and nationally.
11
V.
Project Objectives
The objectives of the project are:
1) To develop an innovative approach to interprofessional education in psychosocial oncology at
the post-licensure level in both English and French using blended, distance technologies. The
outcome will be an introductory course that can be offered as a graduate level elective at the
partner universities and adapted as a professional development option to be offered through
CAPO/ACOP.
2) Within the CAPO/ACOP Education Committee mandate, to establish a Canadian network of
psychosocial oncology educators and researchers committed to enhancing the health of Canadians
and their family members who are affected by cancer through collaborative and interprofessional
education initiatives.
VI.
Project Description
Psychosocial Oncology is an interprofessional sub-specialty in oncology for a variety of health
professionals, including medicine, nursing, pastoral/spiritual care, psychology and social work.
Psychosocial oncology programs and services in Canadian cancer care settings are always
interprofessional in focus, including at a minimum social work, nursing and medicine. While the
Canadian Association of Psychosocial Oncology (CAPO/ACOP) Standards of Practice (CAPO,
1999) identify the need for practitioners to be educated at a graduate level (Master’s, Ph.D, or
post-graduate medical specialties), there are extremely few formal educational opportunities
available for such education in Canada. Therefore, many health professionals employed with
psychosocial oncology programs, departments or teams have no formal education in
interprofessional, psychosocial oncology practice. The lack of such educational opportunities
limits the availability of qualified psychosocial oncology specialists and, by extension, access of
patients and families to adequately educated care providers.
This project addresses these gaps through the development of an interprofessional, distance course,
utilizing blended learning strategies, for graduate students in selected Canadian universities. The
course will also be adapted and provided as a web-based professional development course for
practicing professionals. It will provide students with opportunities to examine theory and research
in psychosocial oncology and gain experience in interprofessional education for collaborative
patient centered practice (IECPCP). The course(s) will be informed by, and linked to, existing or
emerging courses and faculty members at the partner universities. There are important differences
between the proposed course(s) and others that are available in Canada or via the internet,
including current courses offered at UBC and U of C, as well as online education offered through
the American Psychosocial Oncology Association. Strengths of the proposed course include the
breadth and depth of the content, the sophistication of the distance, web based and other learning
components, the possibility of university credit (adding credibility and rigor) and, most
importantly, the emphasis on education specifically for interprofessional practice. No other course
offering in the field in North America has emphasized the need, nor created specific educational
strategies for psychosocial oncology practitioners to develop specific knowledge and skill in
interprofessional team practice.
This project will serve as an important catalyst to build knowledge and skill in interprofessional
education strategies at the graduate and post-licensure level. It expands the focus on
interprofessional education at the partner universities from undergraduate education to graduate
12
level, post-licensure education and will contribute to the development of innovative strategies for
interprofessional education using distance technologies. Although this project will develop one
course, it will provide a template for the development of future graduate level interprofessional
and multi-site/sectoral courses, both within and beyond a psychosocial oncology focus. It also
provides a template for other professions who might wish to develop educational initiatives
specific to their discipline, extending the impact of this one project far beyond psychosocial
oncology and its member disciplines.
The project will be guided by an interprofessional advisory committee, representing 7 provinces
(Nova Scotia, New Brunswick, Newfoundland, Quebec, Ontario, Alberta, & British Columbia)
and both clinical and academic agencies, learners, patients/families, and representatives of related
professional and health associations. The key product of the project will be the development of a
unique inter-professional and multi-site blended learning, psychosocial oncology focused course,
which will include innovative, distance-based opportunities for mentoring in interprofessional
psychosocial oncology teams.
The initial phase (0-9 months) of the project will involve environmental scans and national level
focus groups. Environmental scans will consist of accepted literature and internet based search
strategies. The interviews and focus groups will target the following: 1) psychosocial oncology
practitioners (new and experienced) and administrators; 2) graduate student learners, including
graduate students in medicine (principally oncology, palliative care, and psychiatry) and health
professions (nursing, psychology, social work, and spiritual care); 3) practicing professionals who
might be users of the professional development option (e.g. oncologists, oncology nurses, social
workers, family physicians and other community based health professionals; and 4) patients and
families. The key informant interviews and focus groups will include both urban and rural
practitioners. A key benefit of distance-based education is the potential to support health
professional working in rural communities. While a great deal of cancer care occurs in large
centers, psychosocial oncology care needs often continue or develop closer to home. Since health
professionals in rural and even small urban areas are not usually specialists, professional
development options that are relevant and accessible are critically important to ensure Canadians
receive the care they require. Accessible education is also a factor in support and retention of
health professionals in rural and isolated communities.
Focus groups with psychosocial oncology team members from clinical agencies partnered with
this project will be conducted to explore questions such as: What knowledge/skills/attitudes do
health professionals need in order to function well in an interprofessional, collaborative practice?
What gaps in knowledge/skills/attitude are evident in practitioners new to this area of practice?
What educational strategies would help to overcome these gaps? Focus groups with graduate
student learners will explore questions such as: What attributes do you identify as important in a
graduate level course focusing on psychosocial aspects of cancer? What knowledge and skills do
you identify as essential for working with individuals and families experiencing cancer? Could
you suggest some teaching approaches that enhance your learning? What experiences have you
had in interprofessional education and what made these good (bad) learning experiences?
Focus groups will also be conducted with members of the target audiences for the professional
development course including oncology nurses, oncologists, rural practitioners providing support
services to cancer patients/families, and family physicians. The question explored with this group
is: How do professionals in this area of practice work together? The patient/family focus groups
13
will explore the question: What do health professionals need to know to meet the psychosocial
needs of patients and families living with cancer?
The second phase of the project (10-20 months) will involve the development of the graduate
level, interprofessional psychosocial oncology course. Given the characteristics of the Canadian
health care system, as rapidly changing and more certainly focused on community-based care, a
call for change in the way that health professionals practice, and consequently in the way that they
are taught to practice, is what this graduate level inter-professional course appeals to. These
realities highlight the need for courses constituted by a sound educational pedagogy, reflecting
narrative, cooperative, case-based teaching and learning strategies to complement current health
reform and conventional educational approaches.
Members of the Advisory committee and CAPO/ACOP will collaborate to consolidate
pedagogical directions and content priorities, while acknowledging and incorporating the findings
from the national environmental scans and focus groups. Instructional experts in inter-professional
and blended distance learning education strategies, as well as web and graphic designers will be
contracted to develop innovative inter-professional teaching and learning strategies with the
required flexibility in delivery and content. The inter-professional course we create will immerse
learners across Canada, into the realities of Canadians living with a challenging health diagnosis
by utilizing a platform of blended learning strategies such as on-line or video-conferencing, casesstudies, and faculty/clinical mentors enriched by discipline decision making and narrative
pedagogies. The third phase of the project (21-27 months) will involve the launch of both the
university based elective option and the professional development option, as well as the initial
evaluations of both.
A faculty development/curriculum specialist will be hired as part of the project staff to develop
education for faculty and clinical mentors. Local workshops will be offered in each province in
Phases 2 and 3 of the project to prepare faculty and clinical mentors for interprofessional
education. A national educator/researcher network will be developed and maintained through
various CAPO/ACOP activities, including meetings and educational offerings in conjunction with
CAPO/ACOP’s annual conference.
Significance of the Project
There is now good evidence that psychosocial oncology care contributes to a variety of important
outcomes for cancer patients and families, including such things as alleviating distress, enhancing
quality of life and supporting cancer rehabilitation (e.g. Blake-Mortimer, Gore-Felton, Kimerling,
Turner-Cobb, & Spiegel, 1999; Bottomley, 1997; Fawzy, 1999; Meyer & Mark, 1995). There is
also good evidence that there is substantial cost savings to be realized by the health care system
when patients and families with medical illnesses including cancer receive adequate psychosocial
care (Lane, 1998; Lechnyr, 1993; Simpson, Carlson, & Trew, 2001; Sobel, 2000). Provision of
educational opportunities for psychosocial oncology clinicians that emphasize interprofessional,
collaborative, patient/family-centered activities is essential if patients and families are to receive
14
sound, cost-effective care. Consequently, the need to rebalance care to ensure that psychosocial
and supportive care issues are addressed is a strategic direction of the Canadian Strategy for
Cancer Control. In order to realize this pan-Canadian approach to transforming the cancer care
system to ensure a focus on psychosocial and supportive care as fundamental service elements in
all cancer care settings education of all providers will be critical.
The Education Committee and the Board of Directors of CAPO/ACOP have clearly identified the
need to create, implement and evaluate interprofessional, graduate level psychosocial oncology
education opportunities in Canada. The need for a consorted approach to workforce planning and
training for interprofessional teamwork has been clearly mandated by the Canadian Health
Services Research Foundation and Institute of Health Services and Policy Research (CIHR). In
addition, professionals currently employed or new to the field of psychosocial oncology need to be
supported and sustained in this challenging area of practice, particularly in rural or isolated areas.
This proposal is reflective of a collegial and collaborative national commitment by health
professionals, university faculty and researchers across Canada. The objectives of this proposal
effectively address national concerns around workforce planning and interprofessional teamwork,
contributing to excellence in psychosocial oncology care. The members of the advisory committee
and institutional and professional affiliates represented within this initiative offer theoretical,
practical and experiential knowledge essential to developing, delivering and evaluating
interprofessional courses which clarify the scope of practice for health professionals employed in
the specialty area of psychosocial oncology. This project not only appeals to the current and
projected needs within the specialty of psychosocial oncology, but also to the challenges around
interprofessional teamwork, with the plan to create a template that is generalizable to broader
health care settings and learners.
Conceptual Framework: Interprofessional Education
The investigators of this project are cognizant of the concerns expressed within the health care
system, by policy makers and educators to respond to the demand to ensure that the best health
opportunities for all Canadians prevail. The current status of graduate level curricula continues to
reflect the segregated discipline specific assumptions of a health care system that is predominately
hospital or institutionally based. Yet, health care reform is clearly directed towards a community
focused and family centred approach. This project is a response to the call for change in the way
that health care professionals practice, recognition of what scope of practice means for each
discipline and an acknowledgement of how disciplines work together in teams to meet the needs of
Canadians safely. In order to offer Canadians safe and appropriate care, health professionals need
to learn together in order to practice together.
Through inter-professional education, members of each discipline gather together to teach and
learn about their practice by utilizing narrative strategies to reflect, think about, decipher and
analyze patient care situations with the purpose of identifying actions, accountabilities and
responsibilities of each discipline. The focus of interprofessional team learning is on positive
patient/family outcomes through discipline specific understandings. Discipline specific
understandings are created as individuals of each discipline learn together, through patient care
situations with the goal of understanding patients, their families and their contexts and how best to
accommodate patient care responses to a complex health diagnosis. Members of each discipline
negotiate, with the educator and mentors, specific actions, expectations and responsibilities.
Hence, an inter-professional approach to education creates opportunities for individuals of
15
disciplines to understand the meaning of scope of practice and collaborative teamwork as a
respectful and accountable taken for granted activity within patient/family centred practice.
Narrative pedagogy
Clarity within scope of practice and safe clinical decision-making has become a growing
expectation within our rapidly changing health system. Insight into the decision-making challenges
that health professionals make in practice is essential learning and expected knowing for members
of all disciplines. This knowledge is beyond empirical understanding; more aptly this knowledge
is more clearly represented through contextual analysis. Stories of Canadians being diagnosed and
responding to complex health care issues, such as cancer, enables learners to be reminded of not
only empirical knowledge, but also practical, ethical, social-political and personal knowledge. In
understanding and exploring what another health professional thinks, deciphers and does within
particular situations, students learn about discipline specific decision-making and scope of
practice. This contextual mode of knowledge creation is identified by Diekelmann (2001) as
narrative pedagogy.
Narrative pedagogy (Diekelmann, 2001) has arisen out of interpretive studies of the practices of
nursing students and educators. The emphasis in this pedagogy is on the creation of learning
communities in which the practices of community hold issues of concern open and problematic.
Narrative pedagogy does not supplant, but rather incorporates in conversation, more conventional
pedagogies, such as outcomes and competency-based education, and alternative pedagogies such
as critical or feminist approaches. In narrative pedagogy, the “concerns focus on presenting
multiple epistemologies, exploring ways of knowing and practices of thinking” (Diekelmann, p.
54) as central to learning. With the emphasis within narrative pedagogy on locally generated
communities of learning, in which multiple ways of thinking and interpreting are valued, narrative
pedagogy offers a way of thinking about meaningful engagement with interprofessional learners
and learning. Educators, students, clinicians and perhaps individuals and families living with
cancer gather to collectively share and interpret situations in health care and foster understandings
and consolidate knowing around practice responsibilities and accountabilities.
The philosophical assumptions of narrative pedagogy, guide learners to explicate knowing through
sharing, thinking, probing and analyzing situations. Learning in teams is facilitated when learners
are able to engage in mastery of cases of increasing complexity in several domains. One type of
cooperative learning is “case-based learning” in which interprofessional teams engage in
consideration of life like “cases” of increasing complexity. Such learning is experiential, clinically
based and addresses real patient/family situations, which are important elements for effective
interprofessional learning and practice (D’Eon, 2004). D’Eon offers a hierarchical framework
describing the nature of “cases” in ascending difficulty, with simple paper cases with two
disciplines at one end of the spectrum, progressing to very complex cases in realistic or real-life
settings with many disciplines. This framework provides a foundation for considering the
development of cases for the course. “Cases” will include opportunities to consider both
patient/family situations, as well as team process. Within the course there will be a strong
emphasis on team process, increasing the learner’s awareness of how to contribute to highly
functioning teams as well as possible solutions to areas of difficulty.
16
Inter-professional education strategies offer health professionals an understanding of practice that
is based on a philosophy of inclusiveness, acknowledging the contributions of each discipline as
equally relevant, non-hierarchical and complementary. In contrast to conventional and fragmented
approaches which have traditionally been represented in discipline specific education, interprofessional teaching and learning strategies strive to engender consensus, mutual respect and a
shared vision that is essential to ensure a synergistically relevant plan of care for Canadians living
with cancer (Boon, Verhoef, O’Hara & Findlay, 2004).
17
VII
Work Plan and Timelines
Project Activities
Timeline
(month)
Responsibility
Outcomes
Phase1 (0-9 months): Foundation and environmental scan
Initial teleconference with Project management committee –
monthly or bi-monthly for duration of project
Press releases
Initial teleconference with Advisory Committee – Project start up
and review of project plan (thereafter at least quarterly
teleconferences with two in-person meetings during the project in
conjunction with the CAPO Annual Conference).
Development of job descriptions for project coordinator; research
assistants (RAs), curriculum/faculty development consultant
Advertise/hire staff/set up staff offices
Co-Chairs
1
1
2
2-3
Development of focus group/key informant interview matrix and
guides for all constituent groups
Prepare ethics submissions for each province
3
Design project webpage – contracted
3
Survey of existing courses
First newsletter (every 3-4 months thereafter)
Conduct focus groups
Develop & release RFPs for web designer & graphic artist
Data analysis & report – focus groups and key informant
interviews
Dissemination of focus group findings & consensus building
(ongoing) – CAPO Board, membership, all constituents/partner
organizations
Development of curriculum templates:
 university based course
 professional development course
Identification of content experts
(CAPO Education committee; CAPO members)
3
3-4
4
4-7
7
8-9
9&
ongo
ing
7-9
8-9
Co-Chairs
Advisory
Committee
Management
Committee
Management
Committee
Project
coordinator
Project
coordinator
Project
coordinator
Project
coordinator &
RAs
Project
coordinator
RAs
Project
coordinator &
RAs
Management
Committee
Project
Coordinator
RAs
Members of
Advisory
Committee;
Project
coordinator
Job descriptions
Curriculum
consultant
Advisory
Committee
Curriculum
templates
Experts
identified
Interview guides
Submissions
REB
Web-page
Survey report
Newsletter
RFP
Report
18
Phase 2 (Months 10-20): Development of course, consensus building, formation of educators’
network
Hire web/graphics designer
10
Develop course development plan outlining roles, timelines and
pilot testing junctures with curriculum consultant, web designer,
graphic artist
Development course content, syllabus, curriculum resources and
teacher manual
10-11
Identification of small group (learners, experts, faculty) for pilot
testing of web-based course at key junctures
10
Design and testing of web-based components
Consensus Building (ongoing)
- Presentation of Draft Course syllabus CAPO Scientific Meeting
& AGM
In conjunction with CAPO Annual Scientific Meeting:
 initial meeting of psychosocial oncology educators
 formation of network
 pre-conference workshop offered on interprofessional
education for patient-centered practice (invited speaker)
Submission of course syllabus to curriculum committees at
partner universities
First faculty development workshop in each province – 1 day
Finalize web/graphics & distance aspects
10-14
11-18
13
13
16
18
20
Management
committee
Project Coordinator
Content experts
Curriculum
consultant
Advisory/
Provincial
Committees
Project
Coordinator +
Advisory
Committee
Web designer
Curriculum
consultant +
pilot test group
Management
committee
Management
committee +
faculty
development
(FD) consultant
Provincial
Committee
FD consultant
and provincial
committees
Web/graphics
designer
Syllabus &
teacher manual
Formation of
network of
educators
committed to
IECPCP
19
Phase 3 (Months 21-27): Initial Course Offerings and evaluation
Pilot test final course versions, including expert psychosocial
oncology educators as one constituent group of evaluators. Make
revisions.
21
Second faculty development workshop in each province
22
Launch graduate elective course in selected universities (3-5) and
as professional development option though CAPO
23
Educators’ Network
 2nd meeting in conjunction with annual scientific meeting
CAPO
 Pre-conference workshop offered on IECPCP (invited
speaker)
 Evaluation of educators network
Evaluation of courses:
focus groups and key informant interviews
24
Final project report
26-27
27
Project
coordinator
Curriculum
consultant
FD consultant
and provincial
committees
University
Faculty
members of
Provincial
Committee &
partner schools
CAPO Board
CAPO
Education
Committee &
Advisory
Committee
Project
coordinator
Curriculum
consultant
Management
Committee
Network
meeting
Data collection
Report
VII. Evaluation Plan
The evaluation of the impact of interprofessional education and practice is rift with
methodological and measurement difficulties (Freeth, Hammick, Koppel, Reeves, & Barr, 2002).
While there have been numerous attempts at measuring changes in interprofessional learner
attitudes, values and skills there is not yet common agreement on universal measurement tools
despite a great deal of effort in this area (Geller, Rhyne, Hansbarger, Borrego, VanLeit & Scaletti,
2002; Krist-Janson, Dudgeon, Nelson, Hentelff & Balneaves, 1997; Glennie & Cosier,1994;
Freeth, Hammick, Koppel, Reeves, & Barr, 2002). Much of the problem involves attempting to
isolate the impact of certain variables that come into play when dealing with complex health and
human resource situations. These include learners’ reactions, modification of learners’ attitudes
and perceptions, acquisition of knowledge or skills, behavioural changes within professional
practice, and changes in the organization and delivery of care and improvements in the health of
patients (Freeth et al., 2002). Clearly interprofessional education and practice has a number of
dimensions, each of which needs to be accessed in order to determine their impact and
contribution to the interprofessional learning and collaboration process (Barr, 1996).
It is our intention to evaluate each of these areas as they pertain to our project as part of a
formative evaluation approach. The formative evaluation plan will be developed as part of a
participatory evaluation approach informed by stakeholders in the project. This approach has been
shown to be successful when various stakeholder groups are involved in the development of an
20
initiative and is an essential element in the uptake of innovation and implementation of change. A
formative evaluation will allow the program to be refined as it is being developed and will provide
the data to inform program change. The formative evaluation design will incorporate the use of
mixed methods (quantitative and qualitative) and multiple data sources. Focus groups will be
conducted initially to ensure the program implementation is informed by stakeholder needs and to
ensure the rigorous development of a relevant and appropriate program given the interprofessional
diversity and environmental context across provinces and universities. A results-based logic
model will be used to guide the implementation of the program and subsequently inform the
evaluation plan. Program logic models have been found to be effective in planning and evaluating
projects throughout the healthcare field especially in the promotion of results based performance
in multi-stakeholder collaborations. This fits well with the national and complex multi-partner
nature of our program. The inputs required in program implementation will be described and the
outputs in the form of process indicators and outcomes will be captured. Short and intermediate
term outcomes will be identified emphasizing the uptake of the program in various universities in
addition to the satisfaction and impact of the program on participants. Long-term outcomes will be
identified in relationship to the impact on patients and families and will inform future evaluation
and research initiatives.
The following is a proposed, preliminary format of the first three steps of a results based logic
model to be used to guide the implementation of the educational program and the development of
the evaluation framework and evaluation questions. The development of the logic model will be
achieved through consensus processes with the stakeholders involved in the project during which
time short, intermediate and longer term outcomes will also be formulated.
Inputs: This will include all human, financial and material contributions through IECPCP and the
project partners including Capital Health, Cancer Care Nova Scotia, CAPO, Princess Margaret
Hospital, Alberta Cancer Board, BC Cancer Agency and the partner post-secondary institutions
including Dalhousie University, McGill, the University of Toronto, the University of Calgary and
the University of British Columbia. Outputs: This will include the development of the partnership
process, development and delivery of an online curricula, the number of participants in the
development and delivery process, the number of practitioners and students trained in
interprofessional practice specific to psychosocial oncology and the increased number of
interprofessional collaborations. Short-term Outcomes: These will include improved
collaboration between health and education sectors, improved collaboration between professions,
sustained national and local partnerships and related initiatives, increased capacity for specialized
practitioner and student education and increased patient/community involvement. In addition,
satisfaction with course content from participants enrolled will be evaluated as one of the short
term outcomes. An intermediate outcome will include the uptake of the course as an accepted
elective credit course in various faculties across Canada.
It is our intention to establish an evaluation team comprised of representatives from the partners as
well as patients and families. Expertise in measurement and evaluation will be accessed through
the various community and post-secondary partners. The team will develop a range of
measurement tools and methods associated with interprofessional education and collaborative
practice specific to our project and to each of the project objectives. The following preliminary
plan has been developed as a first step in the evaluation process.
21
The project objectives are:
1) To develop an innovative approach to interprofessional education in psychosocial oncology at the post-licensure level in both English and
French using blended, distance technologies. The outcome will be an introductory course that can be offered as a graduate level elective at the
partner universities and adapted as a professional development option to be offered through CAPO/ACOP.
2) Within the CAPO/ACOP Education Committee mandate, to establish a Canadian network of psychosocial oncology educators and
researchers committed to enhancing the health of Canadians and their family members who are affected by cancer through collaborative and
interprofessional education initiatives.
Objective
1
1, 2
Focus of
evaluation
Gaps in
knowledge,
skills &
attitudes:
IECPCP
/psycho-social
oncology
Course
development
& consensus
building
Method/Data
Focus groups/ key informant interviews in 5
regions with:
 psychosocial practitioners (experts &
entry level)
 health professionals (nurses, oncologists,
family physicians)
 graduate students
 patients/families
 faculty currently teaching PS Oncology
At key junctures (e.g. at the end of each
lesson or phase) of the development of the
online course, key informants will pilot test
the course for
Partners/
constituents involved
CAPO membership
Responsibility
When
Project coordinator
Phase 1
(Months 4-7)
 Project coordinator
 curriculum
consultant
Begin at first
key juncture
–(Phase 2,
month 11) &
Universities
(Dalhousie, Laval,
U of T, UBC, U of C,)
Clinical Agencies:
 BC Cancer Agency
 TBCC, Alberta Cancer Board
 Princess Margaret Hospital (ON)
 (Quebec)
 Cancer Care Nova Scotia
 & Capital Health (NS)
Professional Associations:
(College of Family Medicine; Canadian
Association of Nurses in Oncology; Canadian
Association of Social Work; Canadian
Psychological Association; Canadian
Association of Pastoral Practice Education)
Key informants include:
1.University faculty with expertise in
psychosocial oncology and interprofessional
education
22





1, 2
Development
teacher’s
manual
2
Inaugural
meeting –
formation of
educator’s
network to
foster
knowledge,
skill and
research
- Invited
speaker/
presenter
(IECPCP
expert)
ease of use of the web design
satisfaction with content, graphics
degree of interactive features
congruence with established
distance/web adult education principles
congruence with principles of
interprofessional education
2.Students
3.Practicing professionals
 expert
 new
 urban
 rural
4. Patients/families
Key informants:
 University faculty with expertise in
psychosocial oncology and interprofessional
education
As each section in the teacher’s manual is
written pilot testing with key informants
will be done to evaluate:
 adequacy of direction for faculty, with
regard to both psychosocial content and
principles of interprofessional education  PS Oncology specialists
 clarity
 ease of use
Key informants:
 Attendance at educational event
 Attendees at the educator’s network
 Pre/post tests of IECPCP (new
meeting
knowledge, theory, models)
 university faculty
 Participant satisfaction
 psychosocial oncology specialists
Key informant interviews ( 3) months after
the meeting to evaluate:
Key partners involved:
 knowledge retention
 universities
 change in teaching or practice;
 clinical agencies & PS oncology teams
or departments
 intention to conduct research
 CAPO
 web/graphic
designers
on going
until
course(s) are
complete
Project cocoordinator with
support from
curriculum
consultant
Phase 2
Months 1014
Project coordinator
CAPO
Annual
Scientific
Conference
Members of the
Advisory Committee
Phase 2,
Month 13
23
2
2nd Annual
networking
meeting and
IECPCP
Education al
Event for PS
Oncology
Educators
- Invited
speaker/
presenter
(IECPCP
expert)
1
Course
evaluation
(knowledge,
skill, course
process):
elective option
 Attendance at educational event
 Pre/post tests of IECPCP (new
knowledge, theory, models)
 Participant satisfaction
Key informants:
 Attendees at the educator’s network
meeting
 university faculty
 psychosocial oncology specialists
Project coordinator
Members of the
Advisory Committee
Key informant interviews (3) months after
the meeting to evaluate:
 knowledge retention;
 change in teaching or practice;
 intention to conduct research;
 formation of research teams
Key partners involved:
 universities
 clinical agencies & PS oncology teams
or departments
 CAPO
Pre/Post tests of knowledge, attitudes –
congruence with IECPCP
Course participants
Project co-ordinator
Course faculty
Education consultant
Course process – written and key informant
interviews:
 ease of use
 interactive design
 graphics
CAPO
Annual
Scientific
Conference
Phase 3
(month 24)
Phase 3
(month 2627)
professional
development
option
24
IX.
Knowledge transfer, Networking, and Dissemination
The following strategies will support knowledge transfer, networking, and dissemination:
 A project website will be developed containing information about the project background and
design, project updates, as well as links to information about IECPCP and psychosocial
oncology.
 At each major juncture of the project, the CAPO Board and membership and other key partners
will be informed and input solicited.
 Formal opportunities for knowledge transfer, networking and dissemination will be created in
conjunction with at the annual CAPO scientific conference with CAPO members (who
represent all regions and partner organizations) and conference attendees. Two such meeting
swill be held during the tenure of this project, with ongoing meetings thereafter planned and
supported by CAPO.
 Workshops with invited IECPCP expert speakers will be organized for Phase 2 and Phase 3 of
the project and will be held annually thereafter in conjunction with the CAPO conference.
 The Advisory Committee and partners will seek opportunities for presentation of the project,
project findings and IECPCP (using psychosocial oncology as an example) at international,
national, regional and local meetings and conferences. In addition, members of the Advisory
Committee will attend national networking meetings to disseminate the results of this project.
Partner organizations that will be particularly targeted for dissemination include the clinical
agencies, university faculties and professional organizations such as the College of Family
Medicine, the Canadian Association of Nurses in Oncology, the Canadian Association of
Social Work, the Canadian Psychological Association and the Canadian Association of
Pastoral Practice Education.
 A quarterly project newsletter will be created and disseminated both electronically and in hard
copy to project partners.
 Publication in peer-reviewed journals.
 Presentation of the process, outcome and evaluation of this course is intended at national and
international educational and inter-professional forums/conferences.
25
X.
Sustainability Plan
Sustainable activities: 1. Sustain faculty commitment to offering elective graduate course
using principles and strategies of IEPCPC
Barriers and
challenges
Methods and
support to
overcome barriers
Factors favouring
sustainability
Prior and project
activities to
increase chances
of sustainability
Stakeholders involved
in sustaining activities
 University
program resources
variable and
dependent on
student interest
Commitment from
Deans, Directors,
and/or Coordinators of
Graduate Programs
will be enhanced
by including them
in the project from
the outset.
 Existing
psychosocial
oncology courses
(UBC & U of C)
demonstrate the
viability of such
courses.
 Regular
Advisory
Committee
meetings will be
held to ensure
quality of
stakeholders
involvement.
 Deans, Associate
Deans and Coordinators of graduate
programs.
 Evidence
 Heads, Psychosocial
 Time/workload
pressures on
faculty
 Many schools are
small and have
limited elective
courses to offer
students. Sharing
a course may be
seen as viable
way to enrich
programs.
 Curriculum
development
costs are
extremely high,
particularly for
high quality
distance
education
courses. Sharing
the costs through
a national project
is a reasonable
way for all
partners to gain
something for
students with low
direct cost.
 Case based,
interprofessional
learning requires
greater resources
than traditional
courses; requires
both faculty and
clinical mentors in
several disciplines
 Stipends will be
provided to
support the
involvement of
faculty/clinical
mentors in initial
course offerings
 Involvement of
university
administrators
and clinical
agency CEOs is
expected to
increase
commitment.
There is a high
commitment of
clinical agencies
already to such
courses, with
significant numbers
of clinical mentors
sharing teaching
responsibilities
with faculty (e.g.
UBC & U of C).
Clinical agencies
are already
engaged in
considerable
education of new
staff due to the
 CEOs, Cancer Care
Agencies.
generated by the
project,
including the
initial results of
focus groups and
evaluation of
course
outcomes, is
expected to
support ongoing
commitment.
Oncology/Supportive
Care clinical
programs
 The project will
incur the cost of
the initial course
development, a
significant factor
in sustainability
will be the
availability of
the course itself..
 Deans, Associate
Deans and Coordinators of graduate
programs.
 The
development of
the educator’s
network will
ensure there are
faculty and
 CEOs, Cancer Care
Agencies.
 Heads, Psychosocial
Oncology/Supportive
Care clinical
programs.
26
limited number of
formal courses
available in
universities.
clinicians with a
high level of
commitment to
sustaining such a
course.
Sustainable activities: 1. (cont’d) Sustain faculty commitment to offering elective graduate
course using principles and strategies of IEPCPC
Barriers and
challenges
Possible lack of
support for the
principles of
IECPCP
Methods and
support to
overcome
barriers
Evidence
generated by the
project is
expected to
demonstrate the
benefits of
IECPCP
Factors favouring
sustainability
Partner universities
were largely
selected because
they have a
tradition and history
of commitment to
interprofessional
education
Prior and project
activities to increase
chances of
sustainability
The development of
the educator’s network
will ensure there are
faculty and clinicians
with a high level of
commitment to
sustaining such a
course
Stakeholders involved
in sustaining activities
 Deans, Associate
Deans and Coordinators of
graduate programs.
 CEOs, Cancer Care
Agencies.
 Heads, Psychosocial
Oncology/Supportive
Care clinical
programs.
Sustainable activity: 2. Sustain the ongoing revision and updating of professional development
course through the CAPO/ACOP website
Financial
resources of
CAPO/ACOP
may vary as may
commitment of
any given Board
of Directors
Involvement of
several members
of the Board of
Directors, with
participation
based on position
rather than
individuals
should help
sustainability.
Currently the
President, Chair
of the Education
Committee and 2
additional Board
members are
involved in the
project.
CAPO/ACOP has a
long history of
commitment to
professional
education
Development of
educator/researchers’
network will generate
interest and enhance
sustainability.
Establishment of a
forum for this network
as an integral part of
the CAPO/ACOP
annual scientific
conference and
meeting will also
contribute to
sustainability
 CAPO President and
the Chairperson of
the Education
Committee
27
References
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and Teaching Support Network for Health Sciences and Practice from the UK Centre for the
Advancement of Interprofessional Education.
Blake-Mortimer, J., Gore-Felton, C., Kimerling, R., Turner-Cobb, J. M., & Spiegel, D. (1999).
Improving the quality and quantity of life among patients with cancer: a review of the
effectiveness of group psychotherapy. European Journal of Cancer, 35(11), 1581-1586.
Bottomley, A. (1997). Where are we now? Evaluating two decades of group interventions with adult
cancer patients. Journal of Psychiatric & Mental Health Nursing, 4(4), 251-265.
Diekelmann, N. L. (2001). Narrative pedagogy: Heideggerian hermeneutical analysis of lived
experiences of students, teachers and clinicians. Advances in Nursing Science, 23(3), 53-71.
Fawzy,F.I. (1999). Psychosocial interventions for patients with cancer: what works and what doesn't.
European Journal of Cancer, 35(11), 1559-1564.
Freeth, D., Hammick, M., Koppel, I., Revves, S. & Barr, H. (2002). A critical review of evaluations of
interprofessional education. London: Learning and Teaching Support Network.
Glennie, S. & Cosier, J. (1994). Collaborative inquiry: Developing multidisciplinary learning and
action. Journal of Interprofessional Care, 8(3), 255-263.
Krist-Janson, L., Dudgeon, D., Nelson, F., Hentelff, P. & Balneaves, L. (1997). Evaluation of an
interdisciplinary program in palliative care: addressing the needs of rural and northern
communities. Journal of Palliative Care, 13(3), 5-12.
Lane, J. S. (1998). Medical cost offset: A review of current research and practices. Preferred Mental
Health Management.
Lechnyr, R. (1993). The cost savings of mental health services. EAP Digest, 22.
Meyer, T. J., & Mark, M. M. (1995). Effects of psychosocial interventions with adult cancer patients: A
meta-analysis of randomized experiments. Health Psychology, 14, 101-108.
Simpson, J. S. A., Carlson, L E., & Trew, M. (2001). Impact of a group psychosocial intervention on
health care utilization by breast cancer patients. Cancer Practice, 9(1), 19-26.
Sobel, D. S. (2000). The cost-effectiveness of mind-body medicine interventions. Progress in Brain
Research, 122, 393-412.
28
Appendix A
List of Individuals Providing Endorsement
(Letters enclosed)
Name
Mr. Don Ford
Dr. Peter Vaughan
Glenn Davis (for Pam Trainor &
Susan Graham)
Dr. Barbara Downe-Wamboldt
Dr. Wanda Thomas Bernard
Dr. Eric Beresford
Dr. Cheryl Gibson
Dr.Vernon Curran
Dr. Sandra LeFort
Drs. Luc Belanger & Pierre
Gagnon
Dr. Robert Bell
Ms. Sue Mathews
Dr. Diane Doran
Dr. Terrence Sullivan
Dr. Bill DuPerron
Dr. Gayla Rogers
Dr. George Browman
Ms. Marlene Mysak
Mr. Craig Knight
Dr.Simon Sutcliffe
Dr. Patricia Boston
Dr.Graham Riches
Dr. Marvin Krank
Dr. Joan Bassett-Smith
Dr. Daniel Salhani
Ms. Pamela Faulkner Baker
Ms. Eugenia Repetur Moreno
Organization & Province
CEO, Capital District Health Association-Queen Elizabeth II Health
Sciences Centre, Nova Scotia
Chief Health Human Resource Officer, Department of Health, Nova
Scotia
Co-Chairs, Atlantic Advisory Committee, on health Human Resources,
Nova Scotia
Director, School of Nursing, Dalhousie University, Nova Scotia
Director, School of Social Work, Dalhousie University, Nova Scotia
President, Atlantic School of Theology, Halifax, Nova Scotia
Dean, Faculty of Nursing, UNB, Fredericton, New Brunswick
Co-Director, Centre for Collaborative Health professional Education,
Faculty of Medicine, MUN, St. John’s, Newfoundland
Director, School of Nursing, MUN, St. John’s, Newfoundland
Director, L’Hotel-Dieu de Quebec Research Center, Laval, Quebec &
Director Research Team in palliative care.
President & CEO, University Health Network, Toronto General Hospital,
Toronto, Ontario
Provincial Chief Nursing Officer, Ontario Ministry of Health and Long
Term Care
Interim Dean, Faculty of Nursing, University of Toronto, Ontario
President & CEO, Cancer Care Ontario, Toronto, Ontario
Director, Education & Immigration, Workforce Policy and Planning,
Alberta Health and Wellness, Edmonton, Alberta
Dean, Faculty of Social Work, University of Calgary, Alberta
Director, Tom Baker Cancer Centre, Calgary, Alberta & Vice-President,
Alberta Cancer Board
Senior Leader, Clinical Services & Nursing Practice, Tom Baker Cancer
Centre, Calgary, Alberta
ADM, Strategic Policy, Legislation and Intergovernmental Relations, BC
Ministry of Health.
President, British Columbia Cancer Agency, Vancouver, BC
Faculty of Medicine, University of British Columbia, Vancouver, British
Columbia
Director, School of Social Work, University of British Columbia,
Vancouver, British Columbia
Dean, Graduate Studies, University of British Columbia, Okanagan, BC
Dean, Faculty of Health and Social Development, University of British
Columbia, Kelowna, BC
Acting Dean, Faculty of Health and Social Development, University of
British Columbia, Kelowna, BC
President, Canadian Association of Nurses in Oncology , Vancouver, BC
President,Canadian Association of Social Workers, Ottawa, Ontario
(original sent separately)
29
Appendix B
Project Management Committee Members
Dr. Deborah McLeod (Project Co-Lead), Capital Health Cancer Care Program,
Dalhousie University, CAPO Board of Directors (Chairperson, CAPO Education
Committee)
Dr. Barry Bultz Director, Department of Psychosocial Resources, Tom Baker Cancer
Centre
Adjunct Professor and Chair, Division of Psychosocial Oncology, Department of
Oncology, Faculty of Medicine, University of Calgary.
Dr. Susan Cadell, Assistant Professor, School of Social Work and Family Studies, The
University of British Columbia
Dr. Serge Dumont (Project Co-Lead),, Professor, School of Social Work, Université
Laval and CAPO Board of Directors (member)
Ms. Esther Green, Chief Nursing Officer and Director of Health Human Resource
Planning, Cancer Care Ontario, Toronto. Adjunct Faculty, University of Toronto and
McMaster University. President of CAPO.
Dr. Andrew Padmos, Head, Capital Health Cancer Care Program, Commissioner Cancer
Care Nova Scotia, Vice-President, Research and Academic Affairs, Capital Health,
Associate Dean, Cancer Care programs, Faculty of Medicine, Dalhousie University.
Dr. Gary Rodin, Professor of Psychiatry, University of Toronto, Head of the Behavioural
Science and Health Research Division. Head, Psychosocial Oncology and Palliative Care
Program at the University Health Network (Princess Margaret Hospital).
Expert Panel
Nova Scotia
Brenda Richard, Ph.D., Director (acting), Maritime School of Social Work, Dalhousie
University.
Jody Clarke, Ph.D. Professor of Pastoral Studies and Director of Supervised Field
Education, Atlantic School of Theology, Halifax, Nova Scotia.
Janice Howes, Ph.D., Psychologist, Department of Psychology, QEII Health Sciences
Centre and Assistant Adjunct Professor, Department of Psychology, Dalhousie
University.
Emmie Luther-Hiltz, Co-ordinator Patient Family Network, Cancer care Nova Scotia.
30
Deborah McLeod, Ph.D., R.N., Clinician Scientist (Nursing), Capital Health Cancer Care
Program, Assistant Professor, School of Nursing, Dalhousie University, CAPO Board of
Directors (Chairperson, CAPO Education Committee)
Ruth Martin Misener, M.N., Ph.D.(c), DOCHN, RN. Associate Director, Graduate
Programs, School of Nursing, Dalhousie University.
Douglas Sinclair, MD, CCFP [EM], FRCPC. Associate Dean, Continuing Medical
Education, Faculty of Medicine, Dalhousie University. Chief of Pediatric Emergency
Medicine at the IWK Health Centre.
New Brunswick
Karen Tamlyn, Professor & Assistant Dean, Undergraduate programs, Faculty of
Nursing
Newfoundland
Pamela Faulkner Baker, B.N., M.N., R.N. President, Canadian Association of Nurses in
Oncology. Health Services Consultant, Canadian Council on Health Services
Accreditation, (CCHSA), Surveyor.
Sandra Lefort, Ph.D., R.N., Associate Professor and Director, School of Nursing,
Memorial University.
Quebec
Michele Aubin, MD, FRCPC. Professor, Faculty of Medicine, Laval University.
Serge Dumont, Ph.D., Professor, Faculty of Social Work, Laval University
Lise Fillion, Ph.D., Professor, Faculty of Nursing, Laval University
Pierre Gagnon, MD, FRCPC. Psychiatrist, L'Hotel-Dieu-de-Quebec and Professor,
Faculty oif Pharmacy, Laval University.
Josée Savard, Ph.D. Professor, School of Psyhcology, Laval University
Carmen Loiselle, Ph.D., Assistant Professor, School of Nursing, McGill University
Ontario
Mary Elliott, MD, FRCPC, Staff Psychiatrist and Head of Resident Training, Department
of Psychosocial Resources and Palliative Care, Princess Margaret Hospital.
Esther Green, M.Sc.(T), R.N., Chief Nursing Officer, and Director of Health Human
Resource Planning, Cancer Care Ontario. Adjunct Faculty, University of Toronto and
McMaster University. President of CAPO.
31
Doris Howell, Ph.D., R.N., Assistant Professor, Faculty of Nursing, University of
Toronto and Oncology Clinical Track Leader in the ACNP program, RBC Financial
Group Chair, Oncology Nursing Research, University Health Network (Oncology and
Hematology Divisions of PMH), Toronto, Ontario.
Gary Rodin, MD, FRCPC, Professor of Psychiatry, University of Toronto, Head of the
Behavioural Science and Health Research Division. Head, Psychosocial Oncology and
Palliative Care Program at the University Health Network (Princess Margaret Hospital).
Alberta
Barry Bultz Ph.D., C.Psych., Director of the Department of Psychosocial Resources at the
Tom Baker Cancer Centre of the Alberta Cancer Board. Adjunct professor in the
Departments of Surgery and Psychiatry, Faculty of Medicine, University of Calgary;
adjunct professor and chair of the Division of Psychosocial Oncology, Department of
Oncology, University of Calgary.
Jeannette Waegemakers Schiff, Ph.D., Associate Professo, Faculty of Social Work,
University of Calgary
Helen MacRae, Ph.D., Clinical Psychologist, Tom Baker Cancer Centre, Dept. of
Psychosocial Resources and Adjunct Assistant Professor Faculty of Medicine. Calgary,
Alberta
Guy Pelletier, Ph.D., Clinical Psychologist, Tom Baker Cancer Centre, Dept. of
Psychosocial Resources and Adjunct Assistant Professor, Faculty of Medicine, Calgary,
Alberta.
British Columbia
Susan Cadell Ph.D. Assistant Professor, School of Social Work and Family Studies, The
University of British Columbia
Grant Charles, Ph.D., Assistant Professor, School of Social Work and Family Studies,
University of British Columbia, Vancouver
Gina MacKenzie, MSW, Professional Practice Leader, Patient and Family Counselling,
Lower Mainland Cancer Centres, BC Cancer Agency.
Carole Robinson, Ph.D., R.N., Associate Professor, Faculty of Health & Social
Development (Nursing), University of British Columbia, Okanagan.
Daniel Salhani, Ph.D., R.N. Acting Dean, Faculty of Health and Social Development and
Director, School of Social Work, University of British Columbia Okanagan.
Patient/Family Representatives: (4 from different provinces)
32
Learner Representatives:
2 graduate students (nursing/ psychology/social work/pastoral care)
1 representative from each group of the following professionals: family medicine,
oncology, oncology nursing, social work.
Professional Representatives
1 Representative from:
Canadian Association of Pastoral Care and Pastoral Education
Canadian Association of Nurses in Oncology
College of Family Physicians of Canada
Canadian Psychological Association
Canadian Association of Social Work
33