Leading the Way: Multi-Stakeholder Work Groups

Overview

• The Multi-stakeholder Work Group model is unique to Nova Scotia, recognized nationally as a best practice to address international qualifications recognition (IQR)
• This model originated in the settlement sector in response to barriers facing clients in regulated occupations
• The model recognizes that IQR is a complex problem; responsibility for finding solutions is not held by regulatory bodies alone but shared amongst key stakeholders
• This model takes a collaborative approach to making systemic change and developing innovative solutions
• Profession-specific work groups (13) aim to ensure fair, transparent, and equitable pathways to licensure, and develop practical, sustainable programs to help newcomers become qualified and integrated into the provincial workforce in their chosen fields
• This model supports the goals of the provincial Fair Registration Practices Act (FRPA) and the Pan-Canadian Framework for the Assessment & Recognition of International Credentials
• Indicators of impact include: internationally educated individuals in Nova Scotia perform significantly better on national examinations than those in other provinces, 70% of settlement association clients find work in their field, increased immigrant retention rate
• An external evaluation was conducted in 2013

Background

International qualifications recognition (IQR) is complex: to tackle IQR challenges effectively, all key stakeholders in a profession need to be at the table. Significant differences across occupations require that multi-stakeholder tables be profession-specific. Collaborating to make systemic change takes time, but once mutual trust and respect is established, a collective vision develops and synergy is created, leading to critical thinking & innovation.

The Multi-stakeholder Work Groups project is a collaborative approach to developing practical and sustainable solutions. The project was initiated by a member of ISANS staff because they recognized that providing employment services is not enough to ensure workforce integration for clients in regulated occupations. Fair and transparent pathways to licensure, and new pathways and competency assessment methods were needed. Unnecessary barriers had to be removed, and programs and supports were needed to provide orientation, address skill or knowledge gaps, and promote effective workforce integration.

Work groups were established in Engineering and Pharmacy in 2005, Medicine in 2006, and Law in 2009, but momentum increased substantially in 2011. At this time, a special project was initiated to support a member of ISANS staff to work within the Nova Scotia Department of Labour & Advanced Education as Consultant, International Labour Mobility.  This special project provided dedicated leadership for the work group project.

Description

There are currently thirteen Multi-stakeholder Work Groups that cover the following regulated occupations:

• Accountants/finance professionals
• Architects
• Dental professionals (dentists, hygienists, dental assistants, dental technologists)
• Dietitians
• Early childhood educators
• Engineers & engineering technicians/technologists
• Lawyers
• Nurses (RNs and LPNs)
• Medical laboratory technologists
• Pharmacists & pharmacy technicians
• Physicians
• Social workers
• Teachers

Each work group meets quarterly or as needed and is co-chaired by a high-profile member of the profession, together with the Consultant, International Labour Mobility.  While the primary focus is provincial, the groups may include Pan-Canadian representatives and/or representatives from other provinces in the Atlantic region.

Key stakeholders vary amongst professions but generally include:

• Regulatory authorities
• Professional associations
• Educational institutions
• NGO, immigrant-serving organizations
• Representatives of internationally educated professionals
• Employers and employer organizations
• Unions
• Sector Councils
• Government departments
• Community champions

Purpose & Function

Members report back to their organizations, and every member is there because they share some responsibility for addressing IQR and experience benefit from membership. The functions of each work group are to:

• Provide a forum for information sharing
• Review and confirm pathways to licensure
• Develop new pathways or routes to licensure
• Eliminate unnecessary barriers and make process changes to improve equity
• Liaise and cooperate with national, regional and other provincial partners
• Identify critical issues, engage in informed dialogue, and problem-solve
• Identify and pursue opportunities for partnership
• Develop collaborative programs and supports
• Act in an advisory capacity and/or as a steering group for programs
• Sustain the momentum for change

Sample of Current Activities

• Conducting information sessions for internationally educated professionals, including recent sessions for international medical graduates and internationally educated nurses, with plans to host sessions for internationally educated engineers, teachers, and lawyers in the spring of 2020.
• Interaction and consultation with national organizations including the National Dental Examining Board, the National Committee on Accreditation ( LAW), and the Canadian Association of Social Workers (CASW).
• Supporting and providing feedback on the launch of the new Practice-Ready Assessment program for Family Physicians, working to expand opportunities for clinical assistants as an alternative career for international medical graduates.
• Advising on the finalization of a “Bridge to Social Work” initiative, a partnership between Dalhousie School of Social Work and the Nova Scotia College of Social Workers (NSCSW) that aims to fundamentally expand the certification process so that gap filling is possible.
• Working with Engineers Nova Scotia (ENS) to develop an online orientation for internationally educated engineers, a profession-specific job-search program, and the development of a module to assist internationally educated engineers in writing their experience records, which is required for licensure.
• Revision of a Communications for Healthcare Professionals program with profession-specific content for internationally educated nurses, pharmacists, and physicians, and an additional focus on inter-professional communications in a Canadian healthcare context.
• Development of a Canadian English Language Benchmark Assessment for Nurses (CELBAN) preparation course to prepare internationally educated nurses for success on this profession-specific language assessment.
• Advocating for designated seats for internationally educated professionals in the Medical Laboratory Technology program at NSCC.
• Revision and translation of profession-specific documents designed to standardize information provided by stakeholders for internationally educated professionals.

Sample Accomplishments & Results

Each of the following is a result of one of the multi-stakeholder work groups and affects the success of immigrants to the province.

Process Changes, New Pathways, Improving Access & Advocacy:

• Engineers Nova Scotia credits the orientation/communication skills program delivered by ISANS for credit toward the required one year of Canadian experience.
• Internationally educated engineers with over ten years of experience may be assessed through a structured competency interview rather than compensatory exams.
• The incubation and implementation of the International Medical Graduate (IMG) Med III Clerkship, a unique program for immigrant physicians, has put 24 IMGs on a pathway to licensure and employment in the province.
• The expansion of the clinical assistant role in Nova Scotia has provided many international medical graduates with satisfying alternative careers. The clinical assistant role has recently been successfully piloted in rural areas of Nova Scotia.
• The addition of the clinical assistant membership category by Doctors Nova Scotia provides advocacy, support, and networking opportunities for international medical graduates who have chosen this alternative career.
• The College of Pharmacists of Nova Scotia eliminated the requirement for part of internship to be in hospital environment; instead, it can be done entirely in the community thereby overcoming a significant barrier in the process.
• The Pharmacy Association of Nova Scotia created a special membership for immigrant pharmacists which includes access to professional practice insurance.
• College of Physicians & Surgeons ceased requiring the MCC Qualifying Part II exam as a requirement for a Clinical Assistant license; the National Assessment Collaboration (NAC) Objective Structured Clinical Examination (OSCE) is accepted instead.

Program Development & Enhancement:

• An open access, online orientation module was developed to provide contextual awareness for internationally educated teachers to prepare for certification, to increase success on the job and/or to assist with alternative career exploration. This resource is available both pre- and post-arrival and is looked at as a model for other regulated professions in Nova Scotia.
• An observership program for internationally educated dental professionals (using previously developed models in Law and Medicine) was launched.
• Development of resource guides/compendiums in a number of fields inspired by the one developed for internationally educated nurses in Nova Scotia.
• A worksite-based competency assessment program for internationally educated engineers was developed and implemented as a collaboration amongst Engineers Nova Scotia, Engineers Canada, ISANS, and local employers.
• A workplace-based assessment for architecture, using profession-specific competencies adapted from the Engineers model, has increased employer engagement in supporting internationally educated architects to demonstrate competency.
• An observership program was developed to introduce internationally trained lawyers to Canadian legal practice. This program is run by the Barristers’ Society of Nova Scotia.
• Online orientation programs specific to the profession have been developed in pharmacy and medicine, available to immigrants both pre- and post-arrival.
• An orientation to canadian dental practice workshop was developed and piloted to enthusiastic response, under the leadership of the Nova Scotia Dental Association.  The workshop included a “Day in the Life” video funded by the province.
• A hands-on practice program (HOPP) to assist internationally educated dentists to prepare for the clinical skills assessment was developed in collaboration with Dalhousie Faculty of Dentistry, experienced faculty facilitators, and ISANS.

Participation of Canadian licensed professionals:

• Twelve active Canadian licensed physicians have volunteered their time to teach IMGs at evening clinical skills review sessions conducted at ISANS.
• A new award (2020) will be presented annually at the annual general meeting of Engineers Nova Scotia, recognizing the efforts of a Nova Scotian engineer in welcoming international colleagues.
• Eleven Canadian licensed pharmacists participate in and promote the Communications Skills Labs coordinated by ISANS with provincial funding.
• Continuing education credits are awarded to pharmacists who take part in preparatory or assessment programs for professional immigrants in these fields.
• An information session conducted for internationally educated architects at the Nova Scotia Architects’ Association included local architectural firms and assessors. Information sessions for other internationally educated professionals are ongoing.
• Local engineering firms participate in the workplace-based competency assessment.
• Dental professionals are speakers at the orientation workshop and appear in the video.

Communications & Advising:

• Website reviews and improvements made; ongoing efforts to integrate electronic information amongst stakeholders; articles published on profession-specific sites and journals.
• Internationally Educated Nurses Work Group is an advisory committee for the IEN Bridging and Re-entry Program delivered by the Registered Nurses Professional Development Centre.
• Work groups are advisory committees for bridging programs in dentistry, medicine, engineering, pharmacy, dietetics, and social work. The Sustainable Bridging Process for Internationally Educated Dietitians has been nationally recognized as a best practice by the International Qualifications Network.

Regional and Pan-Canadian Participation:

• Work groups are forums for providing updates and feedback on Pan-Canadian initiatives – e.g. National Nursing Assessment Service, Gateway to Pharmacy, Canadian Technology Information Network and others.
• National regulators have made presentations at work group tables including Social Work, Dental Professionals, Medical Lab Technology, Law, and Architecture. They continue to follow our work through receiving all meeting minutes and correspondence.
• The Managing Director of the National Committee on Accreditation for Law actively participates on an ITL work group.
• The IMG Work Group includes a stakeholder who provides regular updates and information about the Medical Council of Canada.
• The Dietitians Work Group includes regulatory bodies and settlement association representatives from all Atlantic provinces.
• The Medical Lab Technologists Work Group includes active participation from the New Brunswick regulatory body.
• Whenever practical, access to programs is opened to internationally educated individuals across the Maritimes.

Measures of Impact and Indicators of Success:

• Continuous, demonstrated commitment of stakeholders to working in collaboration to ensure fairness for internationally educated professionals in regulated professions
• Increased retention of immigrants in Nova Scotia (74%)
• Improved labour force attachment of immigrants in field of practice:
  • 982 clients secured employment in the past year, 83% in their field or a related field (ISANS data)
• Positive results on national qualifications assessments – internationally educated immigrants in Nova Scotia perform significantly better on national exams
• Increase in employer uptake for Internationally Educated Engineers Work-based Competency Assessment Program:
  • 3 month on-the-job competency assessment
  • 132 engineers completed the program, 90% secured jobs in engineering
• Other provinces have replicated or are exploring the Multi-stakeholder Work Group model including NB, PEI, Manitoba, BC, and Ontario
• Successful launch of Atlantic IQR network
• Outcomes for Immigrants in Regulated Occupations, October 2017, ISANS
• Gardener Pinfold Consultant evaluation report, 2013

 

Debra Johns, Consultant, International Labour Mobility

Debra.Johns@novascotia.ca

djohns@old.isans.ca

902-424-4637

Updated May 2020