Professional re-entry for foreign-trained immigrants

Existing studies have elaborated on personal and structural factors that shape the prevalent reality of occupational dislocation, underemployment, and unemployment among foreign-trained immigrant professionals. Complementing the current literature, this study explores how some immigrants manage to re-establish themselves as professionals in Canada. Drawing on in-depth interviews with six immigrant professionals from various immigrant cohorts, countries of origin, professions, and of both sexes, this study examines the professional re-entry process and describes how immigrant professionals address pre-migration preparation, postmigration individual challenges, and post-migration structural challenges. It further elaborates on factors that influence the efforts of immigrant professionals to reestablish themselves professionally in Canada. The theoretical and service and policy implications are also examined.     

PLAR in Nursing: Implications of Situated Learning, Communities of Practice and Consequential Transition Theories for Recognition

The under-utilization of recently arrived immigrants is almost an accepted fact in Canada. A persistent problem is the non-recognition of prior learning (e.g. competencies) of immigrant professionals. Based on findings of a research study, the purpose of this article is to examine possible reasons for the non-recognition of immigrant nurses' prior learning in the province of Ontario. The theoretical concepts of situated learning, communities of practice and consequential transition are explored for their relevance to the question, ‘why is recognition so difficult to achieve?’ These concepts coupled with an inductive thematic analysis of prior learning assessment and recognition (PLAR) candidates' perspectives on nursing, PLAR and their role as professionals are combined to identify possible explanations and their implications. Findings suggest that, in the absence of some form of assessment, transition and recognition process, individuals located outside the periphery of legitimate participation are powerless to negotiate the meaning of their knowledge and skills. Internationally educated nurses who bring competencies acquired in cultures and educational systems unfamiliar to Canadian authorities stand outside the periphery of the nursing community without a place or voice in the discourse. The findings also suggest that if labour force development and professional integration are public goals, the full engagement of the nursing community of practice (including internationally educated nurses and the regulatory body) is necessary for the development of a shared understanding of PLAR, its quality and its outcomes.     

Ideas and Interests Embedded in the Making of Ontario’s <Emphasis Type="Italic">Fair Access to Regulated Professions Act, 2006</Emphasis>

This paper examines the ideas-interests nexus in the making of Ontario’s Fair Access to Regulated Professions Act, 2006, designed to level the playing field for internationally trained professionals. It conceives of the legislation as the outcome of a discursive contestation between two interest-based alignments. The access coalition led by organized immigrant professionals and settlement service providers communicated a discourse around the non-recognition of foreign credentials, questioning it on moral and economic grounds. Alternatively, regulatory bodies built their discourse around the skills and experience requirements of professions, emphasizing public protection, and, as a condition of that, professional autonomy. However, despite its weaker economic base, the access coalition carried the day with the passing of the fair access legislation because it framed its ideas more effectively and thus struck a better chord with the general and policy public.     

Mentoring Nurses in Familial Cancer Risk Assessment and Counseling: Lessons Learned From a Formative Evaluation

Background. As familial cancer genetic services moves into community practice increased numbers of trained health professionals are needed to counsel individuals seeking cancer risk information. Nurses have been targeted to provide cancer risk assessment and counseling. To help prepare nurses for this role, a 5-day training in familial cancer risk assessment and counseling followed by a long-distance mentorship to support continued skill development in the work environment was conducted by Fox Chase Cancer Center, Philadelphia, PA. Methods. Four cohorts (N = 41) have completed the training and were randomized to either an immediate or delayed mentorship. A formative evaluation assessed the nurse’s ability to consult with other genetic health professionals and build self-efficacy in counseling skills via responses to questionnaire. A post-mentorship interview evaluated the usefulness, timing and length of the mentorship. Results. For both groups, there was a statistically significant improvement in self-efficacy for all skills from baseline to 6 months and an increased number of nurses consulting with genetic health professionals. All the nurses reported the value of the mentorship and those with less cancer risk counseling experience prior to the training needed support and resources for further skill and program development. Lessons learned from this formative evaluation are provided.     

Service Needs of Immigrants and Refugees

This paper evaluates the service needs of immigrants and refugees, paying special attention to their entry status, social, and human capital. Analyses are based on administrative data consisting of 2915 clients collected by the YMCA of Western Ontario, Windsor-Essex Branch (YMO). Results reveal that immigrants’ and refugees’ major service need priorities are (1) government services and language skills, (2) information about Canadian life and access to community services, (3) education and work in Canada, and (4) social and professional networks and community involvement. These service needs varied by the entry status of the immigrant as well as human and social capital. Government-assisted and sponsored refugees identified more service needs than economic immigrants relating to Canadian life, language and skill training, and social networks. Sponsored refugees also identified more needs than the economic immigrants with respect to access to community services and work. Convention refugees’ higher service needs over economic immigrants were related to language training and access to community services. Finally, the service needs of clients with higher education, English proficiency, and ethnic networks were lower than those of their counterparts.     

The Unmet Educational Agenda in Integrated Care

One of the reasons integrated care has not become a dominant service delivery model is the unmet training agenda. This article argues that the typical mental health professional is not trained to adequately address the challenges of integrated care. To insure competency both a macro and clinical training agenda are needed. At the macro-level, mental health professionals need to understand healthcare economics and basic business principles as any integrated care service delivery system is embedded and driven by economic forces. Integrated care practitioners also need some basic business skills to understand these forces and to create and manage a financially viable system, given the future flux of the system. Traditional mental health professionals also do not have the clinical skills to implement integrated care. Integrated care is not simply placing a traditionally trained mental health professional and letting them practice specialty mental health in a medical setting. Thus, the special skills needed in integrated care are enumerated and discussed. Finally, a new degree program is described as it is time given the huge need and advantages of integrated care to develop specialty training in integrated care.     

Considerations on medical training for gender-affirming care: Motivations and perspectives

Abstract

Background: Many transgender individuals lack access to needed medical care, partially due to a lack of providers with experience in gender-affirming healthcare.

Aims: The purpose of this study was to identify professional motivators for medical providers seeking out training in gender-affirming care and to define which training experiences were most beneficial to their career development. By identifying experienced providers’ recommendations on which training modalities are most relevant to their practice, we aim to suggest future directions for medical education initiatives to effectively expand the transgender care workforce.

Methods: A voluntary cross-sectional electronic survey was distributed through professional listservs and publicly-available referral lists to interdisciplinary providers who self-identified as having experience in providing care to transgender individuals.

Results: One hundred and fifty-three (n?=?153) physicians, physician assistants, or advance-practice nurses responded to the survey. The majority (96.7%) were located in the United States, representing 37 states. The two most common motivators for seeking out training in gender-affirming care were filling a need in the community (73.0%) and/or having met a transgender-identified person in a clinical setting who requested care (63.8%). While many providers gained skills independently (57.3%), the two most commonly-available training opportunities were professional conferences (57.3%) and mentorship (41.3%). Respondents were most likely to recommend that others in their field be trained via structured clinical experience (e.g., a rotation or longitudinal exposure during training), rather than additional didactic training.

Discussion: This study identifies key high-yield training methodologies which could improve access to quality gender-affirming healthcare. Through integration of structured clinical experiences during training, direct clinical mentorship, and professional development at conferences on gender-affirming care, the workforce of welcoming and prepared healthcare providers for transgender patients will increase. This will lead to a tremendous improvement on access to gender-affirming care in our communities.     

COMMUNICATION SKILLS TRAINING FOR PARENTS: EXPERIMENTAL AND SOCIAL VALIDATION

Coordination of professional services on behalf of children often hinges on the involvement of informed parents. The purposes of this study were to identify and experimentally and socially validate skills required of parents for effective communication with professionals. Target skills were identified on the basis of judges' social validation ratings of (a) sample interactions between parents and professionals and (b) the behaviors comprising a resultant task analysis. Eight parents were then trained in these skills via an instructional package. Results of a multiple baseline design across subjects and grouped skill domains showed that each parent acquired the targeted skills during simulated conferences and that correct responding usually generalized to actual conferences. Independent judges validated training outcomes, and participating parents indicated satisfaction with the curriculum.     

Suicide Intervention Skills and Related Factors in Community and Health Professionals

Health and community professionals have considerable exposure to suicidal people and need to be well skilled to deal with them. We assessed suicide intervention skills with a Dutch version of the SIRI in 980 health and community professionals and psychology students. Suicide intervention skills clearly differed among professional groups and were strongly related to experience, especially suicide‐specific experience. Some community professionals scored below acceptable levels on their ability to respond appropriately to suicidal people they encounter, and tended to overestimate their skills level. Training is therefore indicated for these groups, and may be useful to more highly experienced groups too.     

Labour market outcomes of immigrant and racial minority university graduates in Canada

Between 1986 and 1996 there has been a significant increase in the racial minority and immigrant populations of Canada and a very significant proportion of racial minorities are of immigrant origin. With the aging of the Canadian population and its persistently low fertility rates the success of the Knowledge Based Economy (KBE) is expected to depend on the economic integration of immigrant racial minorities. In this paper, we frame the discussion of economic integration from a social inequality perspective, and examine how fields of study (FOS) and education credentials impact the earnings of immigrant racial minorities. Our analysis indicates that, in all fields of study, the earnings of immigrant visible minorities, especially those who migrated at an older age to Canada with foreign credentials, are not commensurate with their education level. This suggests that the adjustment mechanisms that have been introduced to recognize the credentials of young adult racial minority immigrants and smooth their entry into the work force have been inadequate and/or ineffective.     

The short-term, medium-term, and long-term economic performance of immigrant women in Canada and the United States

This paper identifies and compares the factors that influence the short-term, medium-term, and long-term employment income of immigrant women in Canada and the United States. It is widely documented that immigrant women in both countries face barriers to employment, high status occupational attainment, and reasonable economic returns to their education, but studies typically fail to consider the various stages of integration. By examining the short-term (less than three years), medium-term (3 to 10 years), and long-term (more than ten years) stages of economic integration, we can identify factors that influence their employment income at varying stages of settlement. Results from the analysis of the Censuses of the United States and Canada reveal that the short-term stages of integration markedly affect the employment income of immigrant women in the medium- and long-term in both countries.     

Development of the “Mentorship in Clinical Training Scale” (MiCTS)

Using an online survey, the researchers examined new family therapists’ experiences of four types of professional mentoring during their most recently completed family therapy training programs. The sample of 223 was mostly white, North American, female, and trained in master’s level graduate programs within the United States. Mentorship experiences were assessed with a new scale of quantitative items aimed to represent the four most common types of mentorship: psychosocial mentorship, career mentorship, clinical mentorship, and research mentorship. Exploratory and confirmatory factor analyses identified and supported a four-factor model of mentorship and an assessment scale of 26 items. Characteristics of the students, their mentors, and the programs, as well as the four mentoring factors were used in structural equation modeling to predict student satisfaction with their primary mentoring relationships. Suggestions are made for future research using the “Mentorship in Clinical Training Scale” (MiCTS). In addition, the MiCTS can be useful for measuring student and faculty outcomes with respect to training programs’ mentorship goals.     

A Bourdieuian Analysis of Job Search Experiences of Immigrants in Canada

Drawing on qualitative interviews, this paper examines the labour market integration experiences of immigrants from Turkey to Canada. Analysis is framed in the context of Bourdieu’s theoretical framework in order to understand the ways in which members of certain immigrant groups follow varied integration trajectories. This paper contributes to the literature by first focusing on the experiences of immigrants who arrived with varied levels of education and under different immigration classes, settling in diverse segments of the labour market and, second, by exploring strategies developed to deal with job search challenges. The findings show that capital and habitus travelled with participants from Turkey and that the intersection of their immigration status with the set of written and unwritten rules of the Canadian labour market and its subfields (both professional and non-professional) shaped their integration experiences.     

Dynamiques représentationnelles et identitaires au cours de la socialisation professionnelle de jeunes recrues LGBT

This article examines the ways in which representational and identity transformations work during the socialization in the workplace of young LGBT hires, linked to discrimination perceived in their workplace environment as well as their impact on professional goals. Working within the theoretical framework of active socialization, the study is based on the IMIS method and proposes a detailed analysis of two cases recently entering the transportation workplace. The results show that, depending on how severe the perceived discrimination is in the workplace, previous experiences of homophobia encountered in other environments and already built self-image are reactivated in different ways, leading to a more or less important reconstruction of professional and identity representations, as well as the future goals of the individual. These elements are discussed from the point of view of interactions between environments and possible interventions by valuing diversity and accompanying the integration of young hires into organizations.     

The Integration of Immigrant Teachers in Manitoba, Canada: Critical Issues and Perspectives

This article considers programming and policy debates pertaining to the integration of immigrant teachers in Manitoba, Canada, situating the discussion in critical theory that promotes ethnocultural and employment equity for immigrant professionals and advocates for a more diverse teaching force in newcomer-receiving contexts. Exploring recent immigration trends, the changing demographics of the teaching profession, and new certification requirements for Manitoban teachers, the authors share insights from a pilot bridging program for Internationally Educated Teachers (IETs) at the University of Manitoba. Policy implications for immigrant teacher related initiatives, both in Canada and beyond, are addressed.     

Tracking the Emotional Cost of Immigration: Ethno-religious Differences and Women’s Mental Health

The challenges of the settlement process can at times give way to persistent feelings of sadness, loneliness, and despair for immigrant women. Based on analysis of the Longitudinal Survey of Immigrants to Canada, this article shows that immigrant women’s self-reported experiences of mental health vary at arrival and over the course of the settlement process because of the intersection of pre- and post-migration factors. The results show how ethnic origins and religious differences intersect with women’s main activities in Canada and influence multiple mental health trajectories. Immigrant women strategically pursue different post-migration pathways because some are more likely to find the social interactions of employment contexts emotionally distressing while for others shouldering responsibilities for full-time care work in the home leads to mental health problems. Still others who study to retrain or get a Canadian degree find the experience detrimental to their emotional health. However, these very same activities can be conducive to mental well-being for women with different ethno-religious backgrounds. The results illustrate that the intersection of ethnicity, religion, and gender in a stratified Canadian society is complex and produces a range of mental health outcomes. Concerns are raised about the high emotional toll of racialized Canadian workplaces and the stress that some employed Muslim women report. An awareness of influences on immigrant women’s mental health can assist employers and public service providers as well as members of cultural associations and religious groups in providing appropriate social support for them in the early months and years after arrival.     

Integrating Immigrants into the Life of Canadian Urban Christian Congregations: Findings from a National Survey

In just one generation the cultural face of Canadian society has been transformed. The relative level of immigration has increased rapidly as has diversity among those immigrants. This article reports on the findings of a national survey that offers a baseline of how and to what extent local Canadian Christian congregations are responding to this cultural diversity. In particular, it explores how churches are integrating immigrants within the life of their local congregations. This article uses a systems change perspective to frame immigrant integration. This perspective emphasizes three requirements for change: vision, structure and processes that promote immigrant integration. Data was collected using an online survey of urban congregations in the nine urban Canadian communities having an immigrant population above the national average (20% foreign-born). Using these data this article explores the full range of immigrant integration efforts from the initial welcome to inclusion into congregational life. It describes the present status of immigrant integration, details reported successes and challenges and notes respondent suggestions for better integration. Results of this survey provide first-time baseline insights into how a range of urban Christian congregations from across Canada are presently responding to the Canadian immigrant reality.     

Promoting responsible conduct in research through “survival skills” workshops: Some mentoring is best done in a crowd

For graduate students to succeed as professionals, they must develop a set of general "survival skills". These include writing research articles, making oral presentations, obtaining employment and funding, supervising, and teaching. Traditionally, graduate programs have offered little training in many of these skills. Our educational model provides individuals with formal instruction in each area, including their ethical dimensions. Infusion of research ethics throughout a professional skills curriculum helps to emphasize that responsible conduct is integral to succeeding as a researcher. It also leads to the consideration of ethical dimensions of professional life not covered in traditional ethics courses.     

医患关系中医生沟通能力培训模式的研究进展

从医生沟通能力的视角出发，改善医患关系的相关促进技术主要包括线下课程培训和计算机网络技术的实时交互式模拟训练等形式。其中，线下课程培训是当前医生沟通能力提升的主要促进技术，分别以沟通技能培训Comskil模型和真实工作场所中的医生沟通能力培训周期模型作为理论支撑，形成了针对特殊领域的“告知坏消息”沟通培训课程和处方对话培训课程。线下的课程培训因其在培训时间和培训师能力要求方面的局限性，促使了计算机模拟在医生沟通能力训练上的运用，从而形成了基于计算机的实时交互式模拟训练系统。随着科学技术的发展，未来将会有更多的新技术加入到实时交互式模拟训练中来。