1. Report to NARTRB PLA Process and Outcomes in Ontario CRTO Algonquin College The Michener

2. Objectives Identify statistics of candidates – Algonquin/Michener Discuss challenges Discuss lessons learned Celebrate successes

3. B E S T E X P E R I E N C E B E S T E D U C A T I O N The Michener’s Experience Andrea White Markham, RRT, CRE, MAS(RS)c PLA Coordinator

4. T H E M I C H E N E R I N S T I T U T E PLA at Michener Michener has partnered with CRTO on PLA since 2002 Total 91 candidates completed Stage One to date –10 dropped out after Stage One London, ON; Saskatchewan; Alberta; GTA –31 no contact with Michener after applied to CRTO (not including those in Ottawa catchment) GTA; Brantford; Kitchener; Montreal

5. T H E M I C H E N E R I N S T I T U T E Professions challenging PLA Stage One at Michener (n=88)

6. T H E M I C H E N E R I N S T I T U T E

7. Feedback after Stage One Recommend continue with PLA –Admit to Access and Options Program for faculty advisement –Courses available with full time program –On line learning available through Blackboard platform –CE available on week-ends –Introduction to Healthcare in Canada –Practice exams

8. T H E M I C H E N E R I N S T I T U T E Feedback after Stage One Not Recommended to continue with PLA –e.g. OBGYN, Pathologist, RT with no clinical experience No option at this point to “close the door” –CE available on week-ends –Introduction to Healthcare in Canada –Suggestions for other avenues including: Full time program at a CRTO recognized school of RT Sleep medicine Physician Assistant program PFT/Cardiology Tech

9. T H E M I C H E N E R I N S T I T U T E PLA Stage Two Challenges at Michener (n=27) SuccessfulUnsuccessful 200419 2005220 (14) 200611 200742 20082(1)7 (1) NOTES Numbers in brackets are additional numbers due to rewrite

10. T H E M I C H E N E R I N S T I T U T E Feedback Stage Two Written report to CRTO and candidate –Requires 60% to pass –Identify areas of strength and gaps/weakness –Pass Begin to prepare for Stage Three –Fail 1 st attempt – prepare for 2 nd attempt or withdraw 2 nd attempt – no longer eligible for PLA

11. T H E M I C H E N E R I N S T I T U T E PLA Stage Three Challenges at Michener (n=12) Average ~24 weeks Successful Unsuccessf ul In progress 20041 (FP) 2005 20062 (AN) 20072¹ (AA/RT) 20081 (AN)1² (RS)5³ (4AN/RT) NOTES ¹ waited 1 yr for placement ² waited >1yr for placement ³ 1 in clinical; 1 placed for Feb start; 1 >1yr wait /LOA; 2 passed June 08 & awaiting placement FP – family practitioner AN – anaesthesiologist AA – anaesthesia ass’t RT – resp therapist

12. T H E M I C H E N E R I N S T I T U T E Feedback for Stage Three Clinical checklist completed and signed off to CRTO Congratulatory note to candidate Find work and STUDY for the CBRC exam!! OR Report to CRTO of inability to achieve mastery –CRTO Registration Committee makes final determination

13. T H E M I C H E N E R I N S T I T U T E Challenges to successful navigation of PLA Individuals are often unable to “hear” message not to proceed Support for the candidates with “rigor” may meet with more success There is a large challenge re: clinical assessment –Placement –Learning curve in clinical re: RT and culture

14. T H E M I C H E N E R I N S T I T U T E Lessons learned Individualized learning plans essential with support RT curriculum and scope of practice varies greatly in Philippines RT curriculum in India based on US model US RTs not successful without support

15. T H E M I C H E N E R I N S T I T U T E More lessons Some MDs make great RTs!! Every successful PLA candidate has been hired by their clinical assessor

16. Anita Gallant, RRT Experience with PLA

17. ALGONQUIN COLLEGE has offered this process in a contractual agreement with the CRTO for approximately 2 years. Candidates enrolled….2, anesthesiologists –Level completed… stage 1, withdrew

18. –Completion of Stage ONE Feedback to applicant and report to CRTO. Provide information to foster improvement in areas where knowledge and skills should be improved for a better chance of successful completion of the subsequent stages of PLA.

19. Feedback options: –Algonquin College offers online and onsite remedial courses. (pass/fail credit courses) –Registration as an audit student for courses in the RT program. –Identification of resources for self study –Referral to other resources for course registration, such as the Michener Institute for Applied Health Sciences or Thompson River University. –Referral for general assistance. (college and community partners) English remedial courses, may be specified for health care. Exam writing skills. Clinical simulation of skills.

20. Feedback after Stage TWO: –Successful completion… identify areas where improvement is required. –Completion of first attempt is not successful… MAY elect to do subject specific testing for more detailed feedback prior to last attempt at written challenge.

21. SUMMARY Since 2002 almost 100 individuals have challenged PLA Stage Onealmost 100 individuals have challenged PLA Stage One –40% MD Majority anaesthetistsMajority anaesthetists Other specialties include general practitioner, Obstetrician, Pathologist, Cardiologist, InternistOther specialties include general practitioner, Obstetrician, Pathologist, Cardiologist, Internist –62% RTs Majority from PhilippinesMajority from Philippines Other countries include USA, Columbia, IndiaOther countries include USA, Columbia, India –3% AA All from IranAll from Iran 11 have successfully challenged Stage Two11 have successfully challenged Stage Two 6 have successfully challenged Stage Three 6 have successfully challenged Stage Three

22. CONCLUSION There are major barriers to successfully challenging the PLA process that relate to: –Structure –Process –Individual Characteristics Programs are required to facilitate success