Interprofessional Education in Health: Challenges of Health Inequality and Social Exclusion Florette Giasson, Université de St. Boniface, Canada and Tuula Heinonen, University of Manitoba, Canada

Introduction: Social work in interprofessional practice in health Global Agenda for Social Work and Social Development Commitment to Action and IFSW Statement on Health The Canadian and Local Context of interprofessional health practice in Winnipeg, Manitoba, Canada: Some examples Conclusions, Recommendations and Implications

Growing awareness globally that interprofessional education (IPE) and collaborative practice (CP) can enhance health systems, address health workforce challenges (aging workforce, job dissatisfaction) and improve quality of service and outcomes The foundation of IPE and CP is to ensure the health and wellbeing of individuals, their families and communities The World Health Organization(2010) has stated, “Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes”. The outcome is a collaborative practice-ready workforce IPE and CP requires that something must be exchanged that changes how the learner perceives themselves and others

Since health systems differ internationally, policies and strategies need to be suited to local contexts with their own varied challenges and needs. The Framework presents ideas for moving forward interprofessional education and collaboration with a range of partners and stakeholders in health care and is essentially, “a call for action to policy- makers, decision makers, educators, health workers, community leaders and global health advocates to take action and move towards embedding interprofessional education and collaborative practice in all of the services they deliver” (WHO, p. 10).

Historical aspects Social work situation in relation to other health professions and in the health care system Roles and functions of social work in IPE Challenges and potential for social work Our local context is Winnipeg, Manitoba Canada: Canada Health Act shapes the health system which is mainly biomedical and serviced by doctors and hospitals. Public health initiatives are also covered, but they focus mainly on primary care services.

Material Well-Being & Social and Health Care Access and Entitlement Behaviour and Lifestyle Social and Physical Context Health Beliefs and Culture Biology, Genetics, Psychology and Identity Societal-,Political and Structural Features

Human rights Economic disparity, poor labour standards and conditions and lack of corporate social responsibility leading to damaged health and well-being of individuals and communities and increasing inequality and poverty Cultural diversity and right to seek redress for better speak out for “a more satisfactory intellectual, emotional, moral and spiritual existence.”

Threats to community support for social development and well-being of people Challenges imposed on health and well-being by unsustainable environments “related to climate change, pollutants, war, natural disasters and violence.” “We commit ourselves to supporting, influencing and enabling structures and systems that positively address the root causes of oppression and inequality… with people who use services and with others who share our objectives and aspirations to create a more socially-just and fair world…” (IASSW, ICSW and ICSD, 2012, p.1)

Health as a social work issue Determinants related to health Social work principles Social work roles and responsibilities Retrieved on line, June 30, 2012 at:

Health is multi-dimensional Health is not just the absence of disease, also encompassing wellness Promotion of social work activity as essential throughout health services Promotion of a holistic understanding of health in policy making and practice Advocacy and support of efforts of individuals, families and communities to participate in decisions affecting their health

The University of Manitoba Interprofessional Education Initiative was formed in 2008 by the Deans of 13 health science academic units within the University of Manitoba (U of M); The IPE website sets out the mission of IPE as follows: “to graduate health professionals prepared to manage and adapt processes in interprofessional teams necessary to achieve optimum person- and family- centred health and wellness outcomes.” Research indicates that IPE is most effective when: principles of adult learning are used. (e.g. problem-based learning and action learning sets). learning methods reflect the real world practice experiences of students interaction occurs between students. Faculties are presently including components of IPE in Curricula

The Faculty of Social Work was a pilot site for an interprofessional learning event that, grounded in adult learning theories, brought together small interprofessional groups of (8-10) students from social work, occupational therapy, nursing and kinesiology students to work on a health promotion case situation. The students were unanimous in recommending that this kind of interprofessional learning event be repeated in the future and with a greater number of student participants. In 2012, a large interprofessional education event was held in which over 450 students and 48 facilitators in eight professional academic units took part. After the event, students evaluated their experiences. Social work students were highly appreciative of the event and felt they had gained valuable knowledge from it.

Université de Saint-Boniface, Winnipeg, CANADA (Team: Gisèle Lapointe, Nursing, Halimatou Ba, Social Work, Florette Giasson, Social Work, Janelle de Rocquiny, Research Assistant and Emanuel Zabre, Research Assistant) Funded by Great-West Life Community Partners: Centre Flavie Laurent: reduce poverty by offering support and physical goods (clothes, furniture, household items) to people in need Accueil francophone: services for French-speaking new comers (immigrants & refugees) Youville Centre : services focused on healthy living – from health care and wellness education to counselling and support Centre de santé de Saint-Boniface : primary healthcare clinic that offers services in both French and English – offers community health programming outside the clinical setting

Students to transcend their ideas – draw on team members’ best skills/assets – develop a new way of thinking as a group Students to change their perceptions, attitudes and behaviours about transdisciplinary work Tackle social inequalities at the prevention/community level Focus on “transdisciplinarity” & “community health” : Collaborative practice works best when it is organized around the needs of the population being served (Framework for Action on Interprofessional Education & Collaborative Practice, p. 28 ). CommunityPrimary Tertiary HealthCareCare TrandisciplinaryMulti or Interdisciplinary

The WISH Clinic is an interprofessional, student-run clinic It provides non-judgmental, socially responsible, holistic health care to a population that struggles with poorer health than the rest of the city. Health and social care is provided by university students and licensed professional mentors from a broad range of disciplines that includes Dental Hygiene, Dentistry, Dietetics, Medical Rehabilitation, Medicine, Nursing, Pharmacy, Psychology, Social Work, and Spiritual Care. The WISH clinic is open on Sundays and offers not only care services for clients, but also food for those who come to use its services.

Interprofessional health care practice is here to stay In Canada, intersectoral interprofessional strategies (beyond hospital care) in promoting health and preventing health problems can be further developed (e.g., housing, child care, education and action to address violence, poverty and addictions and social exclusion) Social work contributions in health care can be highlighted and promoted through interprofessional relationships and in practice settings Social work roles in social advocacy and action can enhance interprofessional practice collaboration and health outcomes for clients Social workers can play a greater role by researching and writing on interprofessional practice processes and outcomes It is time to treat the client as a true partner in a system where the client is encouraged to take more responsibility for his or her health and where professionals are encouraged to practice in a collaborative process.

the-interprofessional-way the-interprofessional-way World Health Organization (WHO) (2010). Framework for action on interprofessional education & collaborative practice. Geneva: WHO. Heinonen, T., Metteri, A. & Leach, J. (2009). Applying health determinants and dimensions in social work practice. European Journal of Social Work, 12(2), WHO (2010). Framework for Action on Interprofessional Education & Collaborative Practice (WHO/HRH/HPN/10.3). Geneva: author. Sargent, J. (2009). Theories to aid understanding and Implementation of Interprofessional education. Journal of Continuing Education in the Health Professions, 29(3), D’Amour, D., Ferrada-Videla, M., Rodriguez, L., & Beaulieu, M-D. (2005). The conceptual basis for interprofessional collaboration: Core concepts and theoretical frameworks. Journal of Interprofessional Care, 1,