Holliday TysonRyerson University International Midwifery Pre-registration Program

Plenary III: Reflections on the Success of Transition and Bridge Programs for IEHPs

International Midwifery Pre-registration Program

(IMPP) 2002-2017Best Practices and Challenges

Reasons for the IMPP• 32% pass rate Ontario PLEA Exams – written and

OSCEs (1995-2001)• Language and professional communication

training• Orientation to primary care role and model,

technology, different cultural practices• Midwifery knowledge and skills enhancement• Ontario midwifery workplace experience and

comprehensive competency assessment

Creation of the IMPP

• 2001- Consortium: College of Midwives of Ontario(CMO), Ryerson Con. Ed.(Chang), Ontario Midwifery Education Program(OMEP)

• Since 2002, the IMPP has been sole third party provider of assessment/bridging for the CMO for all IEMs

• Funded since 2002 by the gov of Ontario, currently MCI. Tuition charged and OBPAP supported

• Overcome barriers to registration and employment for international midwives

• Increase diversity in the midwifery population to better serve Ontario families

• Increase the midwifery population to address obstetric caregiver shortage

• Create an accessible, innovative, rigorous, competency-based bridging program for international midwives

IMPP Objectives

IMPP Annual Admissions Cycle• Feb 1-June 30: Admissions

• Feb-April: personal meetings, pathway counselling

• April: Orientation Weekend, to Mid in Ontario, the Program and Admissions Assessments

• May- Phase 1 Tests: MLPT and MCQ Gen. Knowledge (Screen of 65%)

• June-Phase 2: OSCEs, Informed Choice sim. Interview, Oral Test, Documentation test

IMPP Annual Curriculum Cycle

July-Aug: Independent Study Modules (5 wks) Aug-Oct: Intensive for both streams (7 wks)• Orientation to midwifery in Ontario• Prior learning assessmentOct-Nov: Intensive for full prog. stream (4 wks) • Professional communication• Clinical knowledge and skill enhancementOct-April: Clinical Clerkships (14-16 weeks)April: Exam Prep, Job App. Wkshps (2-3 days)

IMPP participants by place of midwifery education• To Dec. 2016: 285 participants from 38 countries

• Iran (20%)• UK (20%)• USA (22%• 35 countries (each: 0.5% - 5%)

IMPP Demographics

Age range 23 – 60 yrs(mean and mode: 35)

Mothers of dependent children; (1 male participant, a father)

70%

Married with unemployed spouse

55%

IMPP Demographics (cont`d)Years of midwifery experience

≤ 1 yr. – 15%1-3 yrs. – 30%3-5 yrs. – 25%> 5 yrs. – 30%

Years living in Canada

<1 yr. – 35%1-3 yrs. – 30%3-5 yrs. – 20%> 5 yrs. – 15%

Primary Language other than English

70%

IMPP Completion and Employment Data

• 78% of participants successfully completed the IMPP

• 100% of IMPP graduates have passed the CMRE (national midwifery exam) 98% on first attempt, 2% on second attempt

• 89% gained employment as midwives in Canada within 4 months of completing the IMPP

Challenges and Best Practices

• Language and Communication Needs

• Difficulty Transitioning to Primary Care

• Substantive gaps between competencies and models of practice between previous practice site and Ontario

• Enacting commitments to both clinical rigour and inclusive, socially just policies

The IMPP’s Best Practices and learnings have come from…

• Our commitment to solve problems by thinking from first principles, more than by precedent or analogy

• Eg. Practice currency for immigrating midwives as it intersects with childrearing and settlement in Canada

• Language learning for a workplace in a short period of time

Guiding IMPP Values• Fair Access – e.g. use competency assessment

rather than credential recognition as most International Midwives don’t have degrees

• Transparency – e.g. provision of resources to describe Canadian competencies and each step of the pre-registration process to candidates

• Protection of Public – e.g. maintenance of standards of clinical excellence appropriate to primary health care professionals

Professional Midwifery Communication - Best Practices

• Mega-simulations – complex scenarios• Individual and Group Coaching Sessions• Virtual Triage Placement – 3-5 Days On-call

Paging and simulated phone conversations with clients and professionals - feedback

• Filmed presentations to group - feedback• Embedded language and communication

training in every class + communications lab• Communication “immersion” with preparation

for stressing situations and multi-tasking

Clinical Competency, Model and Role Bridging Needs

• Having both accelerated and full program streams with no national exam or employment disadvantage from being in the full program

• Combining prior learning assessment with new learning assessment from the admissions process forward…

• Customizing clinical clerkships so that 14 weeks for accel. stream and 16 for full program can be adapted to 12-20 weeks

If you would like to talk about these ideas…

You can find me, Holliday Tyson at Ryerson University

htyson@ryerson.ca

Thanks.

2017 Perspectives SymposiumMarch 2, 2017

#Perspectives2017