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Holliday Tyson
Ryerson University International Midwifery Pre-registration Program
Plenary III: Reflections on the
Success of Transition and Bridge
Programs for IEHPs
International Midwifery
Pre-registration Program
(IMPP) 2002-2017
Best Practices and Challenges
Reasons for the IMPP
• 32% pass rate Ontario PLEA Exams – written and
OSCEs (1995-2001)
• Language and professional communication
training
• Orientation to primary care role and model,
technology, different cultural practices
• Midwifery knowledge and skills enhancement
• Ontario midwifery workplace experience and
comprehensive competency assessment
Creation of the IMPP
• 2001- Consortium: College of Midwives of
Ontario(CMO), Ryerson Con. Ed.(Chang), Ontario
Midwifery Education Program(OMEP)
• Since 2002, the IMPP has been sole third party
provider of assessment/bridging for the CMO for
all IEMs
• Funded since 2002 by the gov of Ontario, currently
MCI. Tuition charged and OBPAP supported
• Overcome barriers to registration and
employment for international midwives
• Increase diversity in the midwifery population to
better serve Ontario families
• Increase the midwifery population to address
obstetric caregiver shortage
• Create an accessible, innovative, rigorous,
competency-based bridging program for
international midwives
IMPP Objectives
IMPP Annual Admissions Cycle
• Feb 1-June 30: Admissions
• Feb-April: personal meetings, pathway counselling
• April: Orientation Weekend, to Mid in Ontario, the Program
and Admissions Assessments
• May- Phase 1 Tests: MLPT and MCQ Gen. Knowledge
(Screen of 65%)
• June-Phase 2: OSCEs, Informed Choice sim. Interview,
Oral Test, Documentation test
IMPP Annual Curriculum Cycle
July-Aug: Independent Study Modules (5 wks)
Aug-Oct: Intensive for both streams (7 wks)
• Orientation to midwifery in Ontario
• Prior learning assessment
Oct-Nov: Intensive for full prog. stream (4 wks)
• Professional communication
• Clinical knowledge and skill enhancement
Oct-April: Clinical Clerkships (14-16 weeks)
April: Exam Prep, Job App. Wkshps (2-3 days)
IMPP participants by place of
midwifery education
• To Dec. 2016:
285 participants from 38 countries
• Iran (20%)
• UK (20%)
• USA (22%
• 35 countries (each: 0.5% - 5%)
IMPP Demographics
Age range 23 – 60 yrs
(mean and
mode: 35)
Mothers of
dependent
children;
(1 male
participant, a
father)
70%
Married with
unemployed
spouse
55%
IMPP Demographics (cont`d)
Years of
midwifery experience
≤ 1 yr. – 15%
1-3 yrs. – 30%
3-5 yrs. – 25%
> 5 yrs. – 30%
Years living
in Canada
<1 yr. – 35%
1-3 yrs. – 30%
3-5 yrs. – 20%
> 5 yrs. – 15%
Primary Language other than
English
70%
IMPP Completion and Employment Data
• 78% of participants successfully completed the IMPP
• 100% of IMPP graduates have passed the CMRE
(national midwifery exam) 98% on first attempt, 2% on
second attempt
• 89% gained employment as midwives in Canada
within 4 months of completing the IMPP
Challenges and Best Practices
• Language and Communication Needs
• Difficulty Transitioning to Primary Care
• Substantive gaps between competencies and models of
practice between previous practice site and Ontario
• Enacting commitments to both clinical rigour and
inclusive, socially just policies
The IMPP’s Best Practices and learnings
have come from…
• Our commitment to solve problems by
thinking from first principles, more than by
precedent or analogy
• Eg. Practice currency for immigrating
midwives as it intersects with childrearing and
settlement in Canada
• Language learning for a workplace in a short
period of time
Guiding IMPP Values
• Fair Access – e.g. use competency assessment
rather than credential recognition as most
International Midwives don’t have degrees
• Transparency – e.g. provision of resources to
describe Canadian competencies and each step
of the pre-registration process to candidates
• Protection of Public – e.g. maintenance of
standards of clinical excellence appropriate to
primary health care professionals
Professional Midwifery Communication
- Best Practices
• Mega-simulations – complex scenarios
• Individual and Group Coaching Sessions
• Virtual Triage Placement – 3-5 Days On-call
Paging and simulated phone conversations
with clients and professionals - feedback
• Filmed presentations to group - feedback
• Embedded language and communication
training in every class + communications lab
• Communication “immersion” with preparation
for stressing situations and multi-tasking
Clinical Competency, Model and Role
Bridging Needs
• Having both accelerated and full program
streams with no national exam or employment
disadvantage from being in the full program
• Combining prior learning assessment with new
learning assessment from the admissions
process forward…
• Customizing clinical clerkships so that 14 weeks
for accel. stream and 16 for full program can be
adapted to 12-20 weeks
If you would like to talk about these
ideas…
You can find me, Holliday Tyson
at Ryerson University
htyson@ryerson.ca
Thanks.
2017 Perspectives Symposium
March 2, 2017
#Perspectives2017

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Perspectives 2017: Holliday Tyson

  • 1. Holliday Tyson Ryerson University International Midwifery Pre-registration Program Plenary III: Reflections on the Success of Transition and Bridge Programs for IEHPs
  • 2. International Midwifery Pre-registration Program (IMPP) 2002-2017 Best Practices and Challenges
  • 3.
  • 4. Reasons for the IMPP • 32% pass rate Ontario PLEA Exams – written and OSCEs (1995-2001) • Language and professional communication training • Orientation to primary care role and model, technology, different cultural practices • Midwifery knowledge and skills enhancement • Ontario midwifery workplace experience and comprehensive competency assessment
  • 5. Creation of the IMPP • 2001- Consortium: College of Midwives of Ontario(CMO), Ryerson Con. Ed.(Chang), Ontario Midwifery Education Program(OMEP) • Since 2002, the IMPP has been sole third party provider of assessment/bridging for the CMO for all IEMs • Funded since 2002 by the gov of Ontario, currently MCI. Tuition charged and OBPAP supported
  • 6. • Overcome barriers to registration and employment for international midwives • Increase diversity in the midwifery population to better serve Ontario families • Increase the midwifery population to address obstetric caregiver shortage • Create an accessible, innovative, rigorous, competency-based bridging program for international midwives IMPP Objectives
  • 7. IMPP Annual Admissions Cycle • Feb 1-June 30: Admissions • Feb-April: personal meetings, pathway counselling • April: Orientation Weekend, to Mid in Ontario, the Program and Admissions Assessments • May- Phase 1 Tests: MLPT and MCQ Gen. Knowledge (Screen of 65%) • June-Phase 2: OSCEs, Informed Choice sim. Interview, Oral Test, Documentation test
  • 8. IMPP Annual Curriculum Cycle July-Aug: Independent Study Modules (5 wks) Aug-Oct: Intensive for both streams (7 wks) • Orientation to midwifery in Ontario • Prior learning assessment Oct-Nov: Intensive for full prog. stream (4 wks) • Professional communication • Clinical knowledge and skill enhancement Oct-April: Clinical Clerkships (14-16 weeks) April: Exam Prep, Job App. Wkshps (2-3 days)
  • 9. IMPP participants by place of midwifery education • To Dec. 2016: 285 participants from 38 countries • Iran (20%) • UK (20%) • USA (22% • 35 countries (each: 0.5% - 5%)
  • 10. IMPP Demographics Age range 23 – 60 yrs (mean and mode: 35) Mothers of dependent children; (1 male participant, a father) 70% Married with unemployed spouse 55%
  • 11. IMPP Demographics (cont`d) Years of midwifery experience ≤ 1 yr. – 15% 1-3 yrs. – 30% 3-5 yrs. – 25% > 5 yrs. – 30% Years living in Canada <1 yr. – 35% 1-3 yrs. – 30% 3-5 yrs. – 20% > 5 yrs. – 15% Primary Language other than English 70%
  • 12. IMPP Completion and Employment Data • 78% of participants successfully completed the IMPP • 100% of IMPP graduates have passed the CMRE (national midwifery exam) 98% on first attempt, 2% on second attempt • 89% gained employment as midwives in Canada within 4 months of completing the IMPP
  • 13. Challenges and Best Practices • Language and Communication Needs • Difficulty Transitioning to Primary Care • Substantive gaps between competencies and models of practice between previous practice site and Ontario • Enacting commitments to both clinical rigour and inclusive, socially just policies
  • 14. The IMPP’s Best Practices and learnings have come from… • Our commitment to solve problems by thinking from first principles, more than by precedent or analogy • Eg. Practice currency for immigrating midwives as it intersects with childrearing and settlement in Canada • Language learning for a workplace in a short period of time
  • 15. Guiding IMPP Values • Fair Access – e.g. use competency assessment rather than credential recognition as most International Midwives don’t have degrees • Transparency – e.g. provision of resources to describe Canadian competencies and each step of the pre-registration process to candidates • Protection of Public – e.g. maintenance of standards of clinical excellence appropriate to primary health care professionals
  • 16. Professional Midwifery Communication - Best Practices • Mega-simulations – complex scenarios • Individual and Group Coaching Sessions • Virtual Triage Placement – 3-5 Days On-call Paging and simulated phone conversations with clients and professionals - feedback • Filmed presentations to group - feedback • Embedded language and communication training in every class + communications lab • Communication “immersion” with preparation for stressing situations and multi-tasking
  • 17. Clinical Competency, Model and Role Bridging Needs • Having both accelerated and full program streams with no national exam or employment disadvantage from being in the full program • Combining prior learning assessment with new learning assessment from the admissions process forward… • Customizing clinical clerkships so that 14 weeks for accel. stream and 16 for full program can be adapted to 12-20 weeks
  • 18. If you would like to talk about these ideas… You can find me, Holliday Tyson at Ryerson University htyson@ryerson.ca Thanks.
  • 19. 2017 Perspectives Symposium March 2, 2017 #Perspectives2017