My patient/client

speaks French, and I

don’t

Northern Health Research Conference

June 6, 2014

Lee Rysdale, MEd, RD

Assistant Professor, Clinical Sciences, NOSM

Danielle Barbeau-Rodrigue, Director

Francophone Affairs Unit, NOSM

Conflict Disclosure Information:

Presenters: Lee Rysdale and Danielle Barbeau-

Rodrigue

Title of Presentation: My patient/client speaks French,

and I don’t: Evaluation of a NOSM Preceptor Training

Series

We have no financial or personal relationships to

disclose

Francophone

Competency

• 22% of Franco-Ontarians in Northern

Ontario

• Ensure all NOSM activities

– sensitive to cultural and linguistic

needs

• All NOSM learners

– develop knowledge and

understanding

– history, tradition and culture

– health concerns and needs

Needs Assessment

• Non-medical preceptors from NW and NE ON (RD, OT, PT, SLP, Audiology) – To gauge attitudes, perceived

importance and professional development needs

– As a practitioner and as a preceptor

• 43-item online survey (Fluid Surveys©) during March 2013

• Approval from Lakehead & Laurentian University REBs

Results

• ≥ 50% ill-prepared to integrate

– as a practitioner and as a preceptor

• Top barriers

– lack of exposure to Francophones

– insufficient language skills

– insufficient training opportunities

• Many interested in further training

– in person

– distance education • workshops and/or lunch and learns

Webinar Series

• Thursday, January 23, 2014

– Francophone Context in Northern Ontario

• Thursday, February 27, 2014

– The Health Status of Francophones

• Thursday, March 27, 2014

– Francophone Stakeholders in Northern Ontario

• Thursday, April 24, 2014

– Tools for Making it Work

http://www.nosm.ca/education/general.aspx?id=17825

Promotion

• NOSM CEPD and Faculty Affairs

– Faculty, students and staff

• NOSM Francophone Affairs

– Community Partners

– Facebook

– NOSM Pulse weekly newsletter

• NOSM Health Sciences Unit

– 500+ preceptors

Study Objectives

• To formally evaluate the series and

inform the design and

implementation of curriculum,

resources and processes towards

the integration of these

competencies within the Health

Sciences Unit for all present and

future preceptors and learners.

Methods

• 22-item online survey (Qualtrics™)– overall webinar content, facilitation,

delivery mode, etc.

– pre and post training knowledge and skills

– level of agreement with the proposed learning outcomes of each webinar.

• Data analysis using Microsoft® Excel®

and frequencies

• Webinar polls

• Approval from Lakehead & Laurentian University REBs

Results-Participation

Webinar Registration Webinar

Participation*

Survey

Participation**

Webinar #1 53 31

(58.5%)

21

(67.7%)

Webinar #2 53 23

(43.4%)

7

(30.4%)

Webinar #3 50 14

(28.0%)

7

(50.0%)

Webinar #4 55 21

(38.2%)

8

(38.1%)

Average 52.8 22.3

(42.1%)

43

(46.6%)

*May include multiple participants, including those not registered from one site

**Unregistered participants may have completed the survey

Results-Demographics

Discipline* Responses (%)

Webinar Poll

(n=63)

Online

Survey

(n= 42)

Total

(n= 105)

OT 6 (9.5%) 3 (7.4%) 9 (8.6%)

PT 5 (7.9%) 6 (14.3%) 11 (10.5%)

RD 10 (15.9%) 8 (19.0%) 18 (17.1%)

SLP 8 (12.7%) 3 (7.4%) 11 (10.5%)

Audiology -- -- --

MD -- -- --

RN 3 (4.5%) 1 (2.4%) 4 (3.8%)

Other 31 (49.2%) 21 (50.0%) 52 (49.5%)

*Polling question in 4 webinars

Results-Demographics

Characteristic (%)

Age (years) (n=43) 20-39 34.9

40-49 30.2

50-69 34.8

Years of Practice (n=41) 1-2 years 26.8

3-5 years 14.6

6-15 years 12.2

16-25 years 22.0

26 + years 24.4

Practice Setting (n=42) Hospital inpatients/outpatients 11.9

CCAC 9.5

CHC, including First Nation 7.1

Public Health Unit 9.5

Education 21.4

Private Practice 7.1

Research 4.8

Other, please specify 28.6

Results-Demographics

*Polling question in 3 of 4 webinars **Polling question in 4 webinars

Level of French*

Work with Francophones**

0 5 10 15 20 25 30 35 40

Total n=84

Bilingual

Speak/understandcomfortably

Speak/understand alittle

None

0 10 20 30 40 50 60 70

Total n=107

Always

Often

Sometimes

Never

Results-AwarenessFranco-Ontarians

(Webinar #1)

Health Status (Webinar #2)

0 5 10 15 20 25

Total n=45

Very aware

Aware

Somewhat aware

Not aware

0 2 4 6 8 10 12 14

Total n=24

Very aware

Aware

Somewhat aware

Not aware

Results-Awareness

Stakeholders(Webinar #3)

Tools(Webinar #4)

0 1 2 3 4 5 6 7

Total n=17Very aware

Aware

Somewhat aware

Not aware

0 1 2 3 4 5 6 7 8 9

Total n=22Very aware

Aware

Somewhat aware

Not aware

Post Knowledge & Skills

QuestionAgree/Strongly

agree (%)

Provided ideas, tools, techniques,

resources (n= 41)87.8

Provided better awareness/ knowledge of

issues (n=43)97.7

Increased confidence (n=36) 80.6

Increased awareness of connections and/

or organizations (n=41)85.4

Confirmed/ reaffirmed work (n=37) 89.2

Learning Outcomes

Webinar Outcomes Good/Excellent

Webinar #1 (n= 22)Historical milestonesSocio-demographic profilesLiving in minority situation

90.7%

Webinar #2 (n=7)Health status factorsHealth status differencesImpact on health service delivery

100.0%

Webinar #3 (n= 7)Elements to engage Francophones

Key FLS organizations/agenciesWays to improve regardless of first language

83.3%

Webinar #4 (n=8)HEIA ToolNOSM HS Competency ChecklistIncorporate into practice and teaching

83.3%

Overall Impressions

Question Agree/Strongly Agree

Clear objectives (n=43) 92.9%

Met objectives (n=43) 90.7%

Excellent facilitation (n=42) 97.6%

25% interactive (n=41) 85.4%

Webinar appropriate (n= 42) 95.2%

Convenient date & time (n=42) 97.6%

Recommend to others (n=43) 95.3%

Limitations

• Small sample size

– Variety of disciplines participated

• Low response rate

– Survey overload?

• Survey functionality and confidentiality

– Challenges with question and response design of program

– REB issues re: US provider

Implications

• Use polling surveys with webinars/online learning

• Reaching our target audience?– Majority bilingual

• Other cultural competency training strategies that are more effective?– Reach and impact

• Continue to evaluate progress with measurable indicators– Education content and commitment

• A process to track and report what is working and not working

Acknowledgements

• NOSM CEPD and Communications

• NOSM Francophone PPC

• Health Nexus

– Estelle Duchon, Andrea Bodkin , Gillian Kranias

• Webinar Speakers

– Alain Gauthier, Patrick Timony, Cindy Davis-Maille, Renée St Onge, Angèle Brunelle, Suzanne Davidson-Noël, Stéfanie Middleton, and Christiane Fontaine

• Webinar Participants