Brief Report: Preliminary Course Impact Evaluation

J. Craig Phillips, Carrie De Palma, R. Paul Kerston, Todd Sakakibara, William Booth, Mary Petty, Linda Akagi, Meaghan Thumath

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Interprofessional Health and Human Service (IHHS) 402–HIV Prevention and Care

EXECUTIVE SUMMARY In response to a request by the British Columbia Centre for Excellence in HIV/AIDS (BC CfE), this report summarizes the impact of the IHHS 402 course on the education of future health care providers in relation to providing effective care for persons living with HIV in British Columbia. The IHHS 402 model of interprofessional education (IPE) in HIV care and prevention is described in the context of the broader international and national movements for IPE and collaborative healthcare. A brief history of the course and future directions are considered in light of current recommendations by a global independent health commission1 on the education of health professionals for the 21st century. A search of the electronic databases and the literature has provided evidence that demonstrates that former IHHS 402 students’:

Continue to contribute to addressing the healthcare needs of British Columbians living with HIV;

Enhance the body of knowledge of HIV prevention, care, treatment, and management; and

Become better interprofessional (IP) and collaborative practitioners. IHHS 402 is taught by an interprofessional team of health and social service professionals in a partnership between the College of Health Disciplines, UBC School of Nursing, Providence Health Care, Vancouver Coastal Health and BC CfE. The course adopts an IP competency-based curriculum and provides opportunities to break down professional silos through positive well-supervised experiences of collaborative practice. The goal of the course is to prepare a new generation of HIV health care providers competent to respond to the complex nature of HIV disease and its prevention, care, treatment, and management. Future directions for IHHS 402 include strategies to:

1. Enhance partnership activity and joint planning between pre-qualifying professional programs, service providers, and ministries to advance interprofessional learning opportunities and overcome fragmentation of care;

2. Expand pre-qualifying HIV healthcare education to academic systems that integrate the discovery- care-education continuum in schools, primary care settings, hospitals and communities; and

3. Motivate practitioners to lead collaborative endeavours.

1 The Lancet Commission 2010

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Brief Report: Preliminary Course Impact Evaluation

Subject: Interprofessional Health and Human Service (IHHS) 402–HIV Prevention and Care Introduction This brief report describes this course’s impact on future HIV health care providers and as a consequence, healthcare for persons living with HIV. A preliminary assessment of the course demonstrates that former IHHS 402 students’: (1) continue to contribute to the healthcare needs of British Columbians living with HIV; (2) enhance the body of knowledge of HIV prevention and care; and (3) become better interprofessional and collaborative practitioners.

The course exemplifies a contemporary and collaborative approach to interprofessional education as a means to prepare a new generation of HIV health care providers competent to respond to complex nature of HIV disease and its prevention, care, and management. Rational for interprofessional education for collaborative practice Our health care environment is faced with patient safety issues, health and human resource shortages, increasing chronic disease and an aging population with complex health care needs. The literature suggests that interprofessional collaboration (IPC) is a necessary strategy to manage the increasingly

complex demands of today’s health care environment[1]. “Interprofessional approaches are [also] seen

as key to more effective patient-centred HIV care[2].”. In response to numerous government reports on patient safety and adverse events, Health Canada proposed that successful health care relies on collaborative care, which requires a broad network of collaborative interactions among a variety of health service providers, patients, their families and caregivers, and the community [1,3,4,5]. In 2002, the Romanow Commission stated that “in view of …changing trends, corresponding changes must be made in the way health care providers are educated and trained. If health care providers are expected to work together and share expertise in a team environment, it makes sense that their education and training should prepare them for this type of working arrangement.” Interprofessional education (IPE) provides students from different health professions with opportunities to “learn with, from and about each other to improve collaboration and the quality of care [6].” The challenges inherent in the provision of coordinated interprofessional HIV prevention and care provide a contextual opportunity to integrate interprofessional education (IPE) into the health professional curriculum. Course Overview - IHHS 402 as a model of interprofessional education for collaborative practice IHHS 402 is an interprofessional course originally designed to prepare senior students in the health and human service professions to respond effectively, as individuals and members of a team, to the HIV epidemic and its consequences, both biological and social. IHHS 402 has had a long and solid history as an enhanced educational experience at UBC. Under the exceptional initial direction of Anne Wyness (UBC, School of Nursing), Irene Goldstone (BC CfE), Sharon McKinnon (UBC, Pharmaceutical Sciences) and Dr Andrew Chalmers (Associate Dean of Undergraduate Medicine, UBC) and currently, Dr. J. Craig Phillips, the HIV prevention and care course has been offered at UBC since 1997. Current course planning team member biographies are listed in Appendix 2. Originally offered under the auspices of the School of Nursing and by the College of Health Disciplines since its formation in 2002,

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more than 400 students2 have enrolled and completed the course. For more than 14 years, students, preceptors, and institutions caring for persons with HIV continue to praise the course and attest to its value [7, 8]. It is a highly specialized course, taught by an interprofessional team of health and social service professionals (Appendix 2). This course is designed for upper-level undergraduate students, health and human service graduate students, and practicing public health and human service professionals. Students from medicine, nursing, social work, pharmacy, nutrition and interdisciplinary students (e.g. international relations, psychology and biological sciences) form the interprofessional teams which assist to broaden discussions and horizons for learning HIV prevention, care, treatment, and management. The theoretical component of the course is presented through patient-centered problem-based learning (PBL) scenarios, presentations and workshops. The presenters include a full range of health and human service professionals, patients and families, who are engaged in the access, delivery, treatment, prevention and support of persons living with HIV. Individuals who work within Vancouver’s HIV service organizations not only participate in the planning and delivery of the course, but have taken the course. The knowledge, skills and abilities required for interprofessional and discipline-specific work in HIV prevention, care, treatment, and management are emphasized. Clinical practice experiences occur in institutional and community settings, with health and human service professionals who have expertise in HIV prevention, care, treatment, and management. Fundamental skills and abilities for working in partnership with patients/clients, families and community agencies to address the complex issues that influence health are explored. The course allows each student to experience being part of an interprofessional team of fellow classmates by engaging in HIV/AIDS patient-centred learning activities. Preliminary Assessment of IHHS 402 Impact on HIV Prevention and Care Results

1. Contribution to the healthcare needs of British Columbians living with HIV - Former students as current HIV health care providers

Our search of electronic databases3 revealed that more than 15% of students (n > 40), who have completed IHHS 402, have continued to contribute to the healthcare needs of British Columbians living with HIV. These students include physicians who work for specialty care clinics (e.g., psychiatry,

2 This figure is based on UBC SIS database information

3 Databases Searched included the general search engines Google, Yahoo, and Dogpile to identify former student’s

contributions and locations. Additional searches for former student community and professional involvement was carried out using social networking sites (e.g., Facebook, LinkedIn). Based on general web-based search strategy findings, a search of publication databases included PubMed, CINAHL, Academic Search Complete, and Medline. Many former students may choose to not make public information regarding their HIV work or are not highlighted in public databases for the following reasons: (1) have not or no longer work in HIV care, (2) HIV is not a main focus of their work, (3) may not be tech savvy enough to include HIV related details in public forums that would be accessed by search engines, and/or (4) are concerned about stigma by association & potential discomfort with disclosure of working in the field of HIV. Each of these reasons would require a more thorough and formalized course evaluation process with continued research to more fully understand the influence each reason or factor would have on being able to evaluate a posteriori, the efficacy of a course such as IHHS 402.

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internal medicine) in the Metro Vancouver area and have been involved in establishing programs for vulnerable populations in the Downtown Eastside and transgender health programs in the downtown core. Others now work in multiple practice settings across BC and Canada in many specialties that address HIV: nursing, research, biological and laboratory sciences, pharmacy, social work, and advocacy. In addition to evidence that former students have made major substantive contributions within BC and across Canada, many students have worked in Africa and other international locations (Table 1). Table 1. Former IHHS 402 Students’ Clinical Practice Contributions (2001-2010)

Discipline

Students Work Status post-Training HIV work,

British Columbia

HIV work,

National or Global

Other work or Unknown*

Total

Medicine 3 1 38 42 Nursing 7 – 44 51 Pharmacy 2 1 47 50 Social Work 8 2 41 51 Nutrition 2 1 35 38 Interdisciplinary 6 5 25 36

Total 28 10 230 268** Note: *no public information about HIV care was available, however, it cannot be assumed that they do not use the knowledge gained in the course to shape their practice with PLWH they may encounter; **does not include 2 students who audited the course in 2010 from BCPWA (Positive Living Society of British Columbia).

2. Enhancing the body of knowledge of HIV prevention and care – Former students as

contributors to the body of knowledge of HIV Prevention and Care

In the academic setting, a measure of a person’s impact on their field is whether they have a publication record. Former IHHS 402 students that continue to work in HIV and other health and human services related positions, have contributed to the body of knowledge related to HIV care and interprofessional education (Table 2). We cannot directly assess the impact the work of these students has had on the health of Persons living with HIV in British Columbia. However, the publication record of former students highlights their contributions to interprofessional education and HIV care at local, provincial, and national levels (Appendix 1). Our search of electronic databases revealed more than 30 publications by former students, with eleven works directly related to HIV prevention, care, treatment, and management (Appendix 1).

3. Providing better interprofessional and collaborative practitioners - Former students as knowledgeable and collaborative practitioners

Exploring the perceived impact of and ability of students to change clinical practice based on learning experiences from a course is another strategy to measure the efficacy of the IHHS 402 course. Previous work conducted with this particular interprofessional course has suggested that students highly valued the learning experiences [9]. Jason Nickerson, a former IHHS student, sought to understand the effectiveness of the learning experiences and interprofessional education by exploring the experiences of IHHS 402 students as they transitioned from the classroom to the workplace. He reported that former students greatly appreciated learning from patients and clients as these opportunities provided additional insight into the perspectives and contexts of patients with complex

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medical needs. Former students valued the opportunity to further explore interprofessional care in the practice settings that exemplified a collaborative model of care. He also identified that “no single discipline has all the knowledge required to support patients whose needs span physical, psycho-social and spiritual domains” and the benefits of interprofessional care remained with the learners as they

entered professional practice [8]. Nickerson and others suggested that many practice environments

have yet to adopt a culture of interprofessional collaboration and it is beneficial to start interprofessional acculturation early in the professionalization of health and social science students [8,10]. The nature of IHHS 402 demands an intensive one-month commitment to learning and an opportunity for socialization among students of the various professions. The positive effects of interprofessional socialization have been established in the literature [9,11]. Ongoing IHHS 402 course evaluations reveal consistent favorable feedback from students for the opportunities to work with other students, persons living with HIV, and professionals from other health disciplines on: identifying and defining problems, planning joint solutions, illuminating multiple perspectives and exploring roles and responsibilities in the management of HIV. Furthermore, positive role modeling is an important strategy for developing a culture of interprofessional care [12].The IHHS 402 instructors, from various health professions, model positive collaborative working relationships for effective navigation of systems of care. This approach facilitates addressing the challenges faced by practicing professionals and patients alike in HIV prevention and care. The literature supports that practice-based interprofessional collaboration (IPC) interventions can lead to positive changes in health care but further studies are needed to have a broader understanding of possible interventions and their effectiveness [11]. Future directions for HIV prevention and care

Organizational structure, context and process can benefit or create barriers to interprofessional

collaboration [8]. Nickerson illuminated that a lack of coordination of health and social care services for

HIV prevention, care, treatment, and management may alter students’ perceptions towards the

organization and delivery of care and their ability to practice collaboratively. To educate health

professionals for the 21st century, Barr et [al], and the Lancet Commission (2010) articulated the need

for the following:

1. Promotion of IPE and trans-professional education into culture and curricula throughout pre-qualifying professional programs as a way to break down professional silos while enhancing collaborative and non-hierarchical relationships

2. Adoption of IP competency-based curricula as a foundation, transforming present professional silos, for preparation of a new generation of health care workers to complement their various areas of expertise and ability to work in effective teams.

3. Positive and well-supervised experiences of collaborative practice for students during their formative years of professional education and opportunities to test and reinforce their interprofessional learning

4. Enhance partnership activity and joint planning between pre-qualifying professional programs, service providers, ministries of education and health and professional associations to further and advance interprofessional learning opportunities and overcome fragmentation of care

5. Expand pre-qualifying healthcare education to academic systems that integrate the discovery- care-education continuum in schools and hospitals into primary care settings and communities.

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6. Motivate practitioners to lead collaborative endeavours to improve interprofessional learning, effect change, incorporate patient-centred approaches, and improve systems.

The literature suggests that interprofessional education models that include partnerships between

educational institutions and health professionals leads to improved collaboration [10, 13, 14, 15, 16]. The complex nature of HIV disease and its prevention, care, treatment and management requires intersectoral and interprofessional collaboration. Similarly, the training of health care and social services providers who are competent to care for persons living with HIV and the communities where they live also requires intersectoral and interprofessional collaboration. IHHS 402 has long ago adopted the first three aforementioned recommendations. In order to accomplish the last three goals, continued collaboration, commitment and support from the academia, practice, and community partners is required.

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References

1. Romanow R. Building on values: The future of Health Care in Canada. 2002; Available at:

http://dsp-psd.pwsc.gc.ca/Collection/CP32-85-2002E.pdf. Accessed 5/16/2011, 2011. 2. D’Eon M, Proctor P, Cassidy J, McKee N, Trinder K. Evaluation of an Interprofessional

Problem-based Learning Module on Care of Persons Living with HIV/AIDS. Available at: http://jripe.org/index.php/journal/article/viewFile/28/28. Accessed 5/25/2011, 2011 (http://jripe.org/index.php/journal/article/viewFile/28/28)

3. Stelfox HT, Palmisani S, Scurlock C, Orav EJ, Bates DW. The “To Err is Human” report and the patient safety literature. Qual Saf Health Care 2006;15:174-178 doi:10.1136/qshc.2006.017947 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464859/

4. Province of British Columbia. Health Professions Act. Available at: http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_96183_01. Accessed 5/16/2011, 2011.

5. Baker, R. G., Norton, P. G., Flintoft, V., Blais, R., Brown, A., Cox, J., …Tamblyn, R. (2004). The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. Canadian Medical Association Journal, 170 (11), 1678-1686. doi:10.1503/cmaj.1040498. Retrieved January 8, 2011, from http://www.cmaj.ca/cgi/reprint/170/11/1678

6. CAIPE. 1997 & 2006. Interprofessional Education – a definition (London CIPE). Retrieved from http://www.caipe.org.uk/about-us/defining-ipe/

7. Kerston, R. P. (2009). The next generation of experts: An excellent HIV course for professionals at UBC is at risk of being cut. Living Positive Magazine, 62, 5. Vancouver: British Columbia Persons With AIDS Society. Retrieved January 10, 2011, from http://www.bcpwa.org/content/living_positive/Issue62/Issue62.pdf

8. Nickerson, J. (2009). From classroom to workplace: How effective is interprofessional education? (Unpublished master’s thesis). The University of British Columbia, Vancouver, Canada. Retrieved January 10, 2011, from https://circle.ubc.ca/handle/2429/11761

9. Barr H, Freeth D, Hammick M, Koppel I, & Reeves S. The evidence base and recommendations for interprofessional education in health and social care. J Interprof Care. 2006 Jan;20(1):75-8. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16581641

10. O’Neill BJ, Wyness MA. Student voices on an interprofessional course. Med Teach. 2005

Aug;27(5):433-8. http://www.ncbi.nlm.nih.gov/pubmed/16147797

11. Zwarenstein M, Goldman J, Reeves S. Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD000072. doi: 10.1002/14651858.CD000072.pub2. Retrieved January 8, 2011, from http://www2.cochrane.org/reviews/en/ab000072.html

12. Cruess, R. L. & Cruess, S. R. (2006). Teaching professionalism: general principles. Medical Teacher, 28(3), 205-208. Retrieved November, 24 2010, from http://informahealthcare.com/doi/pdf/10.1080/01421590600643653

13. Frenk J, Bhutta ZA, Chen L, Cohen J, Crisp N, Evans T, Fineberg H, et al. Education of health professionals for the 21st century: a global independent Commission. The Lancet 2010 Dec 4/9;376(9756):1923-1958. DOI: 10.1016/S0140-6736(10)61854-5 Retrieved from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2960450-3/fulltext

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14. Hughes, L. (2007) Creating an Interprofessional Workforce: An Education and Training Framework for Health and Social Care in England. CAIPE. Retrieved from http://www.caipe.org.uk/silo/files/cipw-fw-doc.pdf

15. Dix L, Steggles E, Baptiste S, Risdon C. A process-oriented approach to enhancing interprofessional education and collaborative relationship-centered care: the PIER project J Interprof Care 2008 Jun;22(3):321-324. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18569418 or http://www.cihc.ca/library/bitstream/10296/186/1/Ontario_PIER_FinalReport_2008.pdf

16. Barrett J, Curran V, Glynn L, Godwin M. CHSRF synthesis: Interprofessional collaboration and quality primary healthcare. Ottawa, Ontario: Canadian Health Services Research Foundation; 2007. Retrieved from http://www.chsrf.ca/Migrated/PDF/SynthesisReport_E_FINAL.pdf

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Appendix 1

Publications by Former IHHS 402 Students

NAME PUBLICATIONS

GREATER VANCOUVER AREA

Mathias,

Steve

Oliffe, J., Roots, J., Goldstone, I., Granger, P., & Mathias, S. (2005). Integrating problem-based learning to interprofessional education curricula using the Corbin and Strauss’ illness trajectory model: Student evaluations and faculty experiences. Journal of Interprofessional Care, 19, 172-173. doi: 10.1080/13561820500081109

Hides, L., Elkins, K., Catania, L.S., Mathias, S., Kay-Lambkin, F., & Lubman, D.I. (2007). Feasibility and outcome of an innovative cognitive-behavioural skill training program for co-occurring disorders in the youth alcohol and other drug (AOD) sector. Drug and Alcohol Review, 26, 517-523. doi: 10.1080/09595230701499134

Carroll, S., Hides, L., Catania, L., Mathias, S., Greenwood-Smith, C., & Lubman, D. (2009). Integrated cognitive behaviour therapy for co-occurring substance misuse and major depression: lessons from a youth mental health service. Australasian Psychiatry: Bulletin of the Royal Australian and New Zealand College of Psychiatrist, 17, 365-370. doi: 10.1080/10398560902912544

Berkhout,

Suze Gillian

Berkhout, S.G. (2010). Social identity, agency and the politics of adherence to antiretroviral therapy in HIV/AIDS care [Doctoral dissertation]. Circle: UBC's Digital Repository: Electronic Theses and Dissertations (ETDs) 2008+. Retrieved from http://hdl.handle.net.ezproxy.library.ubc.ca/2429/25158

PROVINCIAL – BRITISH COLUMBIA

Fielden,

Sarah

Jennifer

Fielden, S.J., Chapman, G.E., & Cadell, S. (2010). Managing stigma in adolescent HIV: silence, secrets and sanctioned spaces. Culture, Health &Sexuality, 13, 267-281. doi: 10.1080/13691058.2010.525665

Fielden, S.J., Rusch, M.L., Yip, B., Wood, E., Shannon, K., Levy, A.R., et al. (2008). Nonadherence increases the risk of hospitalization among HIV-infected antiretroviral naïve patients started on HAART. Journal of the International Association of Physicians in AIDS Care, 7, 238-244. doi: 10.1177/1545109708323132

Fielden, S.J., Rusch, M.L., Masinda, M.T., Sands, J., Frankish, J., & Evoy, B. (2007). Key considerations for logic model development in research partnerships: a Canadian case study. Evaluation and Program Planning, 30, 115-124. doi:10.1016/j.evalprogplan.2007.01.002

Fielden, S.J., Sheckter, L., Chapman, G.E., Alimenti, Al., Forbes, J.C., Sheps, S., et al. (2006). Growing up: perspectives of children, families and service providers regarding the needs of older children with perinatally-acquired HIV. AIDS Care, 18, 1050-1053. doi: 10.1080/09540120600581460

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Fielden, S.J., Sheckter, L., Forbes, J., Alimenti, A., Burdge, D., Sheps, S., et al. (2004). Exploring the needs of older children who are growing up with perinatally-acquired HIV in British Columbia [Abstract]. Canadian Association for HIV Research: 2004 Annual Canadian Conference on HIV/AIDS Research in Montreal. Retrieved from http://cahr-acrv.ca/english/resources/abstracts_2004/abs/abs406.htm

NATIONAL

Bullock,

Lana

Bullock, L. (2009). AIDS therapy [Book review of AIDS therapy, by R. Dolin, H. Masur, & M. Saag]. International Journal of Infectious Disease, 13, e14. doi: 10.1016/j.ijid.2008.01.013

Nickerson,

Jason

Willard

Nickerson, J. (2009). From classroom to workplace: How effective is interprofessional education? (Unpublished master’s thesis). The University of British Columbia, Vancouver, Canada. Retrieved January 10, 2011, from https://circle.ubc.ca/handle/2429/11761

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Appendix 2

2011 IHHS 402 Working Group Biographies

__________________________________________________________________________________

J. Craig Phillips, PhD, LLM, RN, PMHCNS-BC, ARNP (USA), PMHCNS-BC, ACRN, Assistant

Professor, School of Nursing & Member College of Health Disciplines, University of British

Columbia

Dr. Phillips is a Tenure-Track Assistant Professor of Nursing at the University of British Columbia

(UBC). He has a Master of Laws (LLM) in Intercultural Human Rights Law with a concentration on

health as a human right and was the first PhD in Nursing graduate from Florida International University

(Miami, Florida). From 2003 to 2007 he Co-Chaired the task force to develop the Scope and Standards

of HIV Nursing Practice and is currently Co-Chair of the task force to revise this document that is

published jointly by the American Nurses Association (ANA) and the Association of Nurses in AIDS

Care (ANAC). He has extensive research and clinical experience in acute care and community settings

in Florida, Botswana, and British Columbia. He has worked as a staff nurse on dedicated HIV units in

Miami Beach and Inner-City Miami. He has also worked as a mental health clinical nurse specialist and

nurse practitioner in Miami. He has served as a research consultant to Mercy Hospital, an American

Nurses Credentialing Center (ANCC) Magnet facility in Miami. His program of research explores the

ecosocial context of health as a human right. He is the Vancouver PI for an international nursing

research collaborative study to explore the effects of self-concept on managing HIV symptoms and

antiretroviral therapy adherence. His research efforts to document tobacco use among HIV+ persons in

BC has been funded by a CIHR Catalyst Grant (2010) from the HIV/AIDS Community-based Research

Program–Federal Initiative to Address HIV/AIDS in Canada and an Operating Grant – PA (2012):

HIV/AIDS Bridge Funding – Health Services/Population Health Stream of the Institute of Infection and

Immunology. His teaching responsibilities in addition to IHHS 402, include mental health nursing and

statistical literacy in nursing in the undergraduate and graduate programs in nursing at UBC. He is

president-elect, Xi Eta Chapter of Sigma Theta Tau International and Chair of the national Bylaws

Committee of ANAC. He is a member of the Canadian Association of Nurses in AIDS Care (CANAC),

and a member of the Board of Directors of the Community Based Research Centre (CBRC) in

Vancouver and ANAC in the United States. He is the President-Elect of Xi Eta chapter of Sigma Theta

Tau International. He was the recipient of the 2010 Journal of the Association of Nurses in AIDS Care

(JANAC) Editor’s Award for excellence as a reviewer, guest editor, and contributor to the journal.

__________________________________________________________________________________

R. Paul Kerston, Program Coordinator: Treatment Outreach + Community Representation &

Engagement, Positive Living Society of British Columbia, & Member College of Health

Disciplines, University of British Columbia

Paul Kerston has been a full-time staff member of the province-wide, non-profit AIDS service

organization, The Positive Living Society of BC (formerly British Columbia Persons with AIDS Society

[BCPWA]), for over three-and-a-half years. His role, there, is as the HIV-treatment information and

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outreach coordinator, in addition to duties supporting the Society’s collective advocacy standing

committee of the member-driven governance structure of Positive Living Society of BC. Regularly

attending scientific conferences, forums and workshops, Paul is responsible for knowledge transfer via

outreach activities he conducts for Positive Living Society of BC members and their caregivers. This is

in addition to regular articles written in the Positive Living Society of BC bi-monthly magazine Positive

Living and participation on a number of committees and advisory boards. In addition to the IHHS 402

course, Paul also has teaching duties for the CIHR-funded Universities Without Walls, operated from

the Ontario HIV Treatment Network, and he serves on the REACH and Universities Without Walls

Executive Committee. He has been a part- and full-time instructor since 1982, in private schools as well

as in colleges and universities in four countries (Vancouver Community College, Douglas College,

Seneca College, Algonquin College to name a few). He volunteered in several capacities between 2000

and 2007 for both Positive Living Society of BC and local health board committees. In his background,

he includes past work as a political aide and continuing time as a theatrical performer and director.

__________________________________________________________________________________

Willliam Booth, MS, Member-at-Large, Adjunct Professor Department of Family Medicine &

Member College of Health Disciplines, University of British Columbia

William Booth joined the HIV Legal Network's Board of Directors in 2006 (www.aidslaw.ca).

Currently, he holds an appointment as Adjunct Professor in HIV/AIDS Prevention and Care at the

University of British Columbia's College of Health Disciplines; at Simon Fraser University he is Manager

of Literacy Lives an applied community-based literacy, HIV/AIDS and health ally support program for

HIV+ populations who experience difficulty accessing primary health care.

At present William is an Associate of Panos Canada (www.panoscanada.ca) with a focus on HIV-AIDS

(www.1001aidsstories.org) and is a member of the Board of Directors of Africa’s Children, Africa’s

Future.

Prior to this, he was Executive Director of AIDS Vancouver, and an associate of Keeping the Door

Open an active participant in local and global harm reduction initiatives.

William has been an instructor of HIV/AIDS with the United Nations Development Program Virtual

Development Academy. He was also Deputy Director of the UN Non-Governmental Liaison Service.

He has a long history of working with bi- and multi-lateral organizations, and numerous not-for-profit

international organizations. Among other activities, he drafted a regional strategy for HIV/AIDS

prevention and treatment in collaboration with UN country offices in Eastern Europe and the Newly

Independent States. More recently he worked in Mongolia with UNAIDS and UNDP to assist local HIV

organizations to design strategic plans.

__________________________________________________________________________________

Linda Akagi, BSc (Pharm), Coordinator, Outreach Pharmacy, B.C. Centre for Excellence in

HIV/AIDS, St. Paul’s Hospital Providence Health Care, & Member College of Health Disciplines,

University of British Columbia

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Linda Akagi is a clinical pharmacist at St. Paul’s Hospital and has been the Outreach Pharmacy

Coordinator for the BC Centre for Excellence in HIV/AIDS (BC CfE) – Drug Treatment Program (DTP)

since September, 2001. Her function in this position is as an external resource, educator and consultant

for health care providers and other users of the DTP.

Linda reviews new drug requests that are sent to the DTP for appropriateness and safety (e.g. drug

resistance, interactions with other medications, consistency with current treatment guidelines). She also

is a member of several committees that develop HIV-related guidelines, including those for HIV

treatment, primary care and prophylaxis (accidental exposure, including sexual assault.)

Linda is the pharmacy faculty advisor for IHHS 402, an interdisciplinary HIV/AIDS Prevention & Care

course, which is provided through the College of Health Disciplines (UBC) and is also a clinical

instructor for the Faculty of Pharmaceutical Sciences at UBC.

__________________________________________________________________________________

Meaghan Thumath, BScN, MPH; Adjunct Professor, UBC Faculty of Nursing, & Member of

College of Health Disciplines, University of British Columbia

Meaghan Thumath has been involved in HIV/AIDS, Harm Reduction and Aboriginal Health projects

since 1994 with an expertise in public health. After completing a Bachelor of Science in Nursing at the

University of British Columbia (UBC), she held a variety of positions as a registered nurse at St Paul’s

Hospital HIV Ward 10C, as a community health nurse for new moms and babies, at North America’s

first heroin prescription trial, NAOMI, and the outreach project for pregnant and parenting women with

addiction, Sheway.

After completing a Master of Science in Public Health at the London School of Hygiene and Tropical

Medicine in the UK she took a leadership role as the Clinical Coordinator for Insite, North America’s first

supervised injection facility. Meaghan was promoted to Clinical Practice Leader for HIV/AIDS and Harm

Reduction for the Vancouver Coastal Health (VCH) region. In this role she provides HIV testing and

treatment clinical practice leadership including the provincial Seek and Treat to Optimally Prevent

HIV/AIDS project and maintains a casual practice as an outreach nurse with the BC Centre for Disease

Control.

Meaghan is currently an adjunct professor at the University of British Columbia and also works as an

international HIV consultant in Haiti, Ukraine, Uruguay, Thailand and North Africa for organizations

such as UNAIDS, The British Red Cross, the World Bank and the International HIV/AIDS Alliance.

__________________________________________________________________________________

Cheryl Collier, BSc, RD; Oak Tree Clinic, Children’s & Women’s Health Centre of British

Columbia; Adjunct Instructor, College of Health Disciplines, University of British Columbia

Cheryl Collier is the dietitian at the Oak Tree Clinic, an HIV clinic specializing in care for women and

families. She completed her undergraduate degree in Biological Science in 2001 and a Master of

Science in Human Biology and Nutritional Science in 2004, both at the University of Guelph in Ontario.

Cheryl moved to Vancouver for the dietetic internship program with Providence Health Care. As a

casual dietitian at St Paul's Hospital, she gained experience in many clinical areas of dietetics. Cheryl

was fortunate to work as the dietitian with the HIV Program at St Paul's Hospital for two and a half

15

years. In this position she covered on the inpatient HIV ward and the outpatient HIV clinic. Cheryl has a

strong interest in research and worked as a research dietitian for three years with a multi-centre trial on

diet and cholesterol management based out of St Michael’s Hospital in Toronto, Ontario. In March

2010, Cheryl joined the Oak Tree Clinic’s HIV program and has participated as the dietitian faculty

member for IHHS 402 since this time. Cheryl enjoys sharing information about HIV nutrition. She is

involved with training dietetic interns and orienting dietitians new to HIV, has written nutrition articles for

Living Positive, and is a member of Vancouver Dietitians in HIV Care group.

__________________________________________________________________________________

Mary Petty, MSW, PhD; Social Work Department, St. Paul’s Hospital, Providence Health Care,

Sessional Instructor, School of Social Work & Member College of Health Disciplines, University

of British Columbia

Mary Petty has worked in the HIV/AIDS epidemic since the early 1980s when she was a graduate

social work student in the U.S. Like many activists in the women’s health movement at the time, she

began working with gay men in communities facing the AIDS crisis. She went on to receive her MSW

from Dalhousie University in 1985 and began her professional social work career in a psychiatric

rehabilitation program in Halifax. Continuing to work in the community, organizing around gay and

lesbian health issues and the HIV/AIDS crisis, she worked to incorporate HIV prevention education into

services for patients with psychiatric illnesses. She began doctoral studies at the University of

Pennsylvania in 1994, studying cultural and policy aspects of the AIDS epidemic through ethnographic

research with ACT UP Philadelphia. She received her Ph.D. in Social Welfare in 2000 and moved to

Vancouver where she began working in St. Paul’s Hospital HIV program. She has collaborated

extensively with community groups and is currently working with Positive Living Society of BC (formerly

BCPWA) to develop a peer navigation program as part of the HIV primary care program in the

Immunodeficiency Clinic. She started a support group for HIV positive people working and re-entering

the work force and has been instrumental in developing counseling and advocacy services for long

term survivors of HIV. She teaches in the UBC College of Health Disciplines Interprofessional HIV/AIDS

course and is an adjunct professor of social work at Dalhousie University where she developed an HIV

and social work course for the distance graduate program. She has published on criminalization of HIV,

self-help groups, aging with HIV and community based qualitative research methods.

__________________________________________________________________________________

Todd Sakakibara, MD, CCFP, ASAM; Assistant Director, Inner City Medicine, Assistant Clinical

Professor, Department of Family Practice, Faculty of Medicine, & Member College of Health

Disciplines, University of British Columbia

Dr. Sakakibara is a specialist in Family Medicine and is now a practitioner and the Associate

Director of the Division of Inner City Medicine with Vancouver Coastal Health. Dr. Sakakibara is also

an Assistant Clinical Professor in the Department of Family Practice at the UBC Faculty of Medicine.

He practices Family Medicine at Three Bridges Community Health Clinic and at the Raven Song

Community Health Clinic in Vancouver and is certified in Addiction Medicine. He has done volunteer

work in several international locations. Dr. Sakakibara is also actively involved in several

professional and community organizations. His service activities include among others membership

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on the boards of directors for the Shooting Stars Foundation, and the Community Based Research

Centre.

__________________________________________________________________________________

Carrie De Palma, RDH, DipDH, BScD, MEd, Curriculum Coordinator, College of Health

Disciplines, Instructor, Dental Hygiene, Faculty of Dentistry, University of British Columbia

Carrie is the Curriculum Coordinator for the College of Health Disciplines and works very closely with

the IHHS 402 teaching team. Carrie De Palma has also continued to work as a clinical dental hygienist

in a variety of practice settings for 22 years. Carrie taught within the Dental Hygiene program at the

College of New Caledonia from 2002- 2008 and currently teaches as a part-time clinical instructor in the

Faculty of Dentistry, UBC. Carrie completed her diploma of Dental Hygiene at the College of New

Caledonia (1990). After graduation, she worked in several rural communities, general practice, long-

term care facilities and specialty care practice. She completed her undergraduate degree in Dental

Science at UBC and also completed a Masters of Education from Simon Fraser University.

Carrie is actively involved in several professional, community and student organizations. She currently

serves on the Board of Directors for the College of Dental Hygienists of BC and participates on the

working group for the BC Quality Assurance program for registered Dental Hygienists. She also serves

as a mentor to students involved with the Community Health Initiative for University Students and the

Health Science Student Association. Carrie has a strong interest in the enhancement of health and

human services through innovative collaborations in interprofessional education, practice, and

research.

__________________________________________________________________________________

Silvia Guillemi, MD, Director of Clinical Education, BC Centre for Excellence in HIV-AIDS; IDC

Clinical Coordinator, St. Paul’s Hospital, Providence Health Care; Clinical Supervisor,

Department of Family Practice, Faculty of Medicine, University of British Columbia

Dr. Silvia Guillemi is the Director of the Clinical Education and Training program at the BC Centre for Excellence in HIV/AIDS. She also works as the Clinical Coordinator in the John Ruedy Immunodeficiency Clinic (IDC), collaboration between the BC Centre for Excellence and Providence Health Care. __________________________________________________________________________________

Leslie Soon, Senior Program Assistant, College of Health Disciplines, University of British

Columbia

Leslie is greatly appreciated for her administrative support for the IHHS 402 course, students and teaching team.

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Acknowledgements

The authors of this report and current members of the IHHS 402 course planning team are forever grateful to the following people for their contributions to this important course. We would like to thank the persons living in British Columbia who are living with or at risk for acquiring HIV. By sharing your lived experience with students in classroom and clinical environments, you facilitate development of patient-centred approaches to health care early in the career of our future health care professionals. Your experiences and perspectives are invaluable to guide student learning and build the understanding that patients are a critical element of every interprofessional health care team.

The ongoing collaboration among key individuals from The University of British Columbia, the British Columbia Centre for Excellence in HIV/AIDS, Providence Health Care, Vancouver Coastal Health, BC Women’s and Children’s Hospital, Positive Living Society of British Columbia and Panos Canada have made this course a dynamic and robust learning experience for our students over the past 14 years. We would also like to thank the previous members of the course planning team. Anne Wyness, Irene Goldstone, Sharon McKinnon, Andrew Chalmers, Peter Granger, Paul Perchel, Terry Trussler, Carl Bognar, Diana Johansen, Glenda MacDonald, Steve Mathias, Ryna Levy Milne, John Oliffe, Brian O’Neill, and Wallace Robinson. Your contributions have set the standard for teaching interprofessional HIV care and the delivery of interprofessional health care throughout British Columbia and beyond. We are indebted to the countless hours you have each contributed to making the course a success since it began in 1997. We would like to thank the many guest lecturers who have shared their expertise in topics relevant to the management of persons living with HIV and the struggles they have faced throughout the course of the epidemic. We apologize for not listing each of you by name.

We would like to thank the numerous community partners that have made essential contributions to the development and delivery of the course over the years in both classroom and clinical settings to provide students with an understanding of multiple perspectives and specific needs of persons living with and most at risk for acquiring HIV. These partners include, Providence Health Care: Saint Paul’s Hospital, John Ruedy Infectious Diseases Clinic, 10C AIDS Unit, Centre for Practitioner Renewal, Pharmacy Department; Vancouver Coastal Health: Three Bridges Clinic, North Health Unit Home Care Nurses, Pacific Spirit Community Health Centre, Pender Clinic, Downtown Community Health Centre, Life Skills Centre; Provincial Health Services Authority: British Columbia Centre For Disease Control, Street Nurse Program, Bute Street Clinic, TB Outreach Program; British Columbia Women’s and Children’s Hospital and Health Centre: Oak Tree Clinic, Fir Square; First Nations and Inuit Health, Spectrum Health Care, AIDS Vancouver, Positive Women’s Network, Dr Peter AIDS Foundation; Vancouver Native Health Society, Vancouver Area Network of Drug Users, YouthCo, Vancouver Police Department; City of Vancouver; Canadian Drug Policy Consortium; Heart of Richmond Society; Sheway; WISH; Portland Hotel Society: Insite/Onsite; Rain City Housing, McLaren Housing Society; Health Initiative for Men (HIM), Pivot Legal Society; ,British Columbia Civil Liberties Association; A Lovingspoonful; Eastside Pharmacy; Howe Street Pharmacy; Lookout Housing Society; and The Living Room.

The course would not have been possible without the generous funding support from The Association of Canadian Medical Colleges and Health Canada (1996; PIs Andrew Chalmers, Anne Wyness, Irene Goldstone) and The British Columbia Medical Services Foundation (1997; PI Gordon Page) for Evaluating an Interprofessional Elective in HIV/AIDS Care. We are grateful for unconditional educational grants from Merck Frosst (2000-2008), GlaxoSmithKline in partnership with Shire Canada, HIV/AIDS Community Innovation Program (2009), and ViiV-Shire Community Innovation Program (2010).

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We thank the teaching assistants who have contributed to the successful delivery of the course over the years and to the research assistants who conducted the database searches to identify the achievements of previous students. We would also like to thank all our former students for moving forward and making us proud of the accomplishments they have made as health care professionals. Your efforts drive the change we hoped to create when you were in the class. If we have overlooked a specific individual or organization, the oversight has been purely unintentional and does not diminish our gratitude for the contributions of all persons and organizations who have participated in the development, implementation, evaluation, and overall success of IHHS 402.