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- Volume 8 Issue 1 - February 2022
Registrar
I would like to take this opportunity to wish each of you a bright 2022!
In this newsletter, you will find more valuable information on how to continue to keep up to date with useful and accurate resources concerning practice advice relating to the pandemic. It continues to be vitally important to stay engaged with the College. Continue to access our website’s COVID-19 Information and ‘Providing Patient Care in a Pandemic’ pages.
Also, this ex.press issue offers you important new information on a variety of topics to assist you to better serve your patients as a self-regulated health professional including:
In addition, you will find an article ‘Peer Assessments Can Now be Completed Virtually’, and ‘2022 Peer Assessment Preparation’.
Finally, also from the Conduct Department – view CASLPO’s recently published simplified complaints process infographic.
Let me again extend my thank you to all registrants for your continued outstanding service to your patients during this continuing challenging time.
As always, be sure to visit CASLPO’s website often, - it’s your main source of the latest information.
By Dana Prutschi, Director of Professional Practice & Quality Assurance
Keep up-to-date with the latest information, resources and advice during the pandemic by accessing our website’s COVID-19 Information and ‘Providing Patient Care in a Pandemic’ web pages.
In case you missed it – Health Profession Regulators Ontario published an article in Toronto Life’s latest issue. …More
Deputy Registrar
In early spring 2021, CASLPO reached out to registrants serving Indigenous communities to ask if they would participate in a Patient Outreach Group (POG). We were thrilled that 7 Speech-language pathologists and Audiologists working in Ontario’s Indigenous communities stepped up to help.
We asked them to reach out to their patients, families and the community leaders to find out what CASLPO public materials would be best to translate, and into which Indigenous languages.
Bear in mind the incredibly trying times that 2021 brought to these communities. There were several pandemic lockdowns for long stretches preventing our registrants from going into the communities. This was followed by devastating fires that ripped through some of those same Indigenous communities.
Despite these barriers, through time and patience, the Speech-language pathologists and Audiologists managed to persevere and engage with 20 respondents, who reflected the diversity of Indigenous communities in Ontario.
We now have an analysis to move forward with our translation of CASLPO’s “Trust Matters” poster in both Oji-Cree and Ojibwe along with new imagery that will reflect the Indigenous Peoples of Ontario. We were fortunate to also engage an Indigenous graphic design company, who will be working with us to modify the design and distribute these posters.
We will be distributing these posters directly to the Indigenous communities, but we also want to make them available to all our registrants. Please stay tuned for our announcements regarding their distribution in the early spring.
We would like to thank the members of the Patient Outreach Group for Indigenous Language Translation and encourage you to participate in future group work. For more information visit our Working with the College page.
By Brian O'Riordan, Registrar
Once again this year, all 26 health regulatory colleges in Ontario, including CASLPO, will be responding to the government’s annual reporting tool, the College Performance Measurement Framework (CPMF).
Last year’s reports and summary can be found on CASLPO’s website, in the Public Awareness Section:
This year’s reporting exercise will include a particular focus on college initiatives with respect to diversity, equity and inclusion, risk management, and cyber security.
Ministry staff have already begun the reporting process with meetings that took place in the fall of 2021 with all colleges, including CASLPO, relating to college collaboration with their system partners, such as patient groups, professional associations, universities, and community representatives.
CASLPO’s report to the Ministry for 2021 will be submitted by March 31, 2022 and will be available to the public and registrants on the college website.
By Dana Prutschi, Director of Professional Practice & Quality Assurance
CASLPO monitors closely the Ministry of Health’s COVID-19 related directives and disseminates and provides pandemic practice advisories as guidance. CASLPO acts as a conduit for sharing updates from the Ministry of Health, including public health directives, with registrants.
Please consult CASLPO’s COVID-19 Information Page regularly for the latest information and for revisions to the Pandemic Practice Advice documents including:
CASLPO Practice Advisors receive questions on how audiology and speech-language pathology practice can be delivered safely and effectively, whether provided in-person or virtually. The Pandemic Practice Advisories continue to inform registrants in this area. Read through the resources, use your clinical judgement, and assess your comfort level to determine best steps.
The flowchart, Providing Patient Care in a Pandemic, has been updated and guides clinical decision making on whether patients should be seen in-person or virtually.
Before any in-person intervention, the first steps are Point of Care Risk Assessment (PCRA) and COVID-19 screening. Audiologists and speech-language pathologists need to assess the task, the patient, and the environment to determine the best course of action and appropriate precautions. The PCRA is a dynamic process, where decision making can change depending on any new relevant information that comes to light. Public Health Ontario describes how to perform a Point of Care Risk Assessment. The CASLPO Standard on Infection Prevention and Control (IPAC) also refers to the Point of Care Risk Assessment. After the PCRA, registrants will determine IPAC measures, including PPE, hand-hygiene, physical distancing, adapting assessment and treatment options, and choosing virtual versus in-person care.
Director of Registration Services
CASLPO’s new registration examination requirement has been put in place to meet the College’s mandate to protect the public. It exists for important safety reasons and has been undertaken with a great deal of research, consultation, and consideration. Below are answers to frequently asked questions.
On December 2, 2021, 194 individuals wrote the Canadian Entry to Practice (CETP) Exam, with 171 of the Exam writers being applicants for registration in Ontario. 135 people wrote the Speech-Language Pathology Exam and 36 people wrote the Audiology Exam.
We are excited to see how well the entire group performed!
94% of CASLPO’s initial registrants who wrote the Speech-language pathology Exam passed, while 92% of those who wrote the Audiology Exam passed. We are optimistic that these pass rates will remain consistent as Speech-Language and Audiology Canada (SAC) continues to deliver the CETP Exam!
Successful completion of the CETP Exam, a critical entry to practice requirement, is one way for a new registrant to demonstrate to employers and peers that they have the knowledge, skills, and judgement necessary to practice safely as an audiologist or a speech-language pathologist.
Beginning in 2008, the Canadian regulators for the 2 professions, in collaboration with Speech-Language and Audiology Canada (SAC), Canadian Academy of Audiology (CAA) and the 12 university programs in the country, worked to enhance and harmonize the evaluation of competence across Canada. It was collectively recognized that academic credentials, course work hours and clinical practicum hours alone do not fully or adequately assess competence within the context of inter-provincial labour mobility.
The purpose of the Exams is to provide a consistent and fair assessment of competency for entry into the professions for applicants educated both inside and outside of Canada. Of the 37 health professions in Canada, 33 now have in place, entry to practice exams. A vast majority of them have been in operation for at least 20 – 30 years.
An exam candidate who has the requisite knowledge, skills and judgement should be able to pass an examination that assesses job-related tasks and knowledge. CETP Exam questions were created based on the national competencies and learning outcomes identified in the National Competency Profiles. These were developed based on an extensive job analysis of the professions of audiology and speech-language pathology. The Profiles have been in place since 2018 and were created through a multi-year process involving universities, professional associations, and the regulators in all 9 provinces where the professions are regulated. It is expected that all applicants who wish to work in Canada understand these competencies and can readily apply them in either theoretical or real-life scenarios. Exam questions were developed to assess an applicant’s knowledge, skills, critical thinking, and judgement with respect to providing patient-centered care. The CETP Exams Blueprint outlines the major content areas of the exam and provides a structural map indicating the relative distribution of the exam questions.
Speech-Language and Audiology Canada (SAC) has been chosen by the regulators to administer the CETP Exam based on their 35-year history in providing the previous national certification exams for both professions.
CASLPO has developed a Memorandum of Understanding with SAC who administers the CETP Exams. SAC collaborated with a team of psychometricians at Meazure Learning to develop a fair, reliable, valid, and secure examination.
The CETP Exams have been administered by SAC three times since 2020. The pass/fail results have been consistent across each Exam sitting. This gives CASLPO confidence in the reliability and validity of the CETP Exams as a measure of professional competence.
Yes. An applicant may begin to practice as an initial practice registrant (IPR) while they wait to take the CETP Exam for their profession.
When an IPR fails the CETP Exam, the IPR has 30 days to transfer or discharge their patients before their Initial certificate expires.
Once the IPR’s Initial certificate has expired, the individual may not practice in Ontario as an audiologist or a speech-language pathologist until after they have passed the CETP Exam, and their Initial certificate has been reinstated.
CASLPO has a mentorship requirement for initial practice registrants which places clinical responsibilities on mentees rather than on their mentors. Therefore, mentees in the Ontario context are directly responsible for the care they directly provide to patients, unlike supervision whereby the supervisor takes clinical responsibility for those they supervise.
Failure to successfully complete the CETP Exam, raises significant public interest concerns as to whether an initial registrant can practise safely. It is not in the best interest of the public to permit registrants who fail the examination to continue to practice. Therefore, CASLPO mitigates such risk by requiring the IPR to cease practice resulting in the expiration of their certificate until they can demonstrate they possess all entry-to-practice competencies. The Registrar does not have the discretion to waive the requirement for successful exam completion.
An individual who has failed the CETP Exam must wait to retake the Exam and if the individual passes their next attempt, they may reapply for registration with CASLPO.
Although the individual cannot practice audiology or speech-language pathology, an individual who has failed the CETP Exam may continue to work as a support personnel.
An individual who has failed the CETP Exam can review their results and see what areas of the exam they need to concentrate on. The individual should review the National Competency Profiles for their profession and focus their studies also on the sub-competencies identified in the areas where they did not do well.
SAC has also made the following resources available:
The next sitting of the CETP Exams will occur on March 7, 2022. As with the December 2, 2021 sitting, applicants may write the exam in person or virtually.
By Colleen Myrie, Director of Registration Services
The Health Professions Procedural Code of the Regulated Health Professions Act, 1991 requires information about suspended registrants to be made available to the public by each regulatory college. The reason for this is to ensure that the public knows that they should not be receiving services from these suspended registrants, nor should they be using the protected titles.
The following individuals are currently under suspension for failing to pay their annual fees for 2021/2022 in accordance with section 24 of the Code:
Name |
Registration Number |
---|---|
Helena Szybalski |
2375 |
Illana Gurevitch Morton |
2821 |
Gilbert Alex Rondeau |
4382 |
Sara Epstein |
6638 |
Taelor Elizabeth Smith |
7301 |
Kathryn Zirk |
7653 |
While under suspension:
In addition, the following certificates were revoked for failing to pay the annual fees for 2020/2021 in accordance with section 26 of Ontario Regulation 21/12:
Name |
Registration Number |
---|---|
Agnes Miller |
1937 |
Name |
Registration Number |
---|---|
Linda Buskin |
1193 |
Susan Jane Honeyman |
1603 |
Laurie Patricia Light |
1780 |
Marlene Bedzow |
2483 |
Christy Lorraine Bates |
7595 |
Melissa E. Willis-Erickson |
7597 |
After a certificate has been revoked:
Audiology Advisor and Manager of Mentorship
The positive impact that mentors have is clearly measurable through analysis of the mentorship reports that the College receives through the Mentorship Self-Assessment Tool (MSAT). It is evident from these reports that the guidance provided by mentors makes a significant contribution in helping Initial Practice Registrants (IPRs, i.e., mentees). The reports help mentees to address any improvements needed in meeting the College’s standards of practice. This is an important feature of self-regulation that contributes to public protection.
A review of mentorship reports submitted between June 2019 and October 2021 provides insight into how identified gaps in a mentee’s ability to meet standards are addressed through mentoring. Here’s what the last 2 years of data tell us:
June 2019 to October 2021
Completed Mentorship Periods = 421
Speech-Language Pathologists |
334 |
Audiologists |
87 |
Standards Rated as “Needs Work” by the Mentor at Midterm
Of the 421 mentorships completed between June 2019 and October 2021, 8.5% of mentees (36 out of 421) received a “needs work to meet the standard” rating at midterm in one or more of the following “Red Flag” areas:
Speech-Language Pathologists
|
Audiologists
|
||
Record Keeping |
11 |
Record Keeping |
4 |
Hearing Aid Prescription |
N/A |
Hearing Aid Prescription |
3 |
Health & Safety |
7 |
Health & Safety |
2 |
Informed Consent |
7 |
Informed Consent |
2 |
PHIPA Consent |
5 |
PHIPA Consent |
2 |
Confidentiality |
1 |
Confidentiality |
3 |
Clinical Reasoning |
7 |
Clinical Reasoning |
4 |
Red flag standards are highlighted at the midterm and must be addressed by mentees through their learning goals. The reports show that all mentees in this group met the standards above by the end of their mentorship period according to both their own as well as their mentor’s assessment.
This doesn’t mean mentees recommended for a General Certificate have no areas for improvement. The following indicators (i.e., standards) were identified by mentors as areas for continuing improvement following mentorship. The right-hand column is the frequency a mentor marked the indicator as an area for continuing improvement for a mentee. (out of the sample of 421 completed mentorship periods.)
I am knowledgeable about mandatory reports outlined in the Regulated Health Professions Act |
7 |
I use intervention procedures based on current knowledge incorporating evidence-based research and advances in technology |
4 |
I use intervention procedures that are responsive to the cultural and linguistic background of the patient or substitute decision maker (SDM) |
4 |
I set intervention goals that describe realistic outcomes for the patient. |
6 |
I communicate in a manner that is responsive to the cultural and linguistic background of the patient. |
5 |
I have reviewed in detail, specific documents that relate to my current practice |
7 |
This information helps the College to determine which standards commonly need more attention during the initial practice period. It also gives the College insight into whether mentees can demonstrate that they can meet the standards by the end of their 6-month mentorship period.
We are very thankful to our mentors for their generous contributions and commitment to supporting their newly practicing peers.
Visit the Mentorship Program web page for training webinars, information and resources. To learn if you are eligible to be a mentor, review the Mentor Criteria.
Director of Professional
Practice & Quality Assurance
Advisor, Professional Practice and Quality Assurance
Here’s what happened in 2021. Last year for the first time all peer assessments were conducted virtually. (Please see ex.press Volume 7, Issue 2 for survey feedback from registrants and peer assessors.)
79 peer assessments were completed by December 2021. 67 registrants, through their Self-Assessment Tool (SAT) and virtual interviews, demonstrated knowledge, skills and judgement. All met the standards for Management Practice, Clinical Practice, Patient Centred Practice, Communication and Professional Accountability. The remaining 12 registrants were provided remediation virtually, which they all completed successfully
There were 9 SAT indicators that were targeted in remediation. The most common indicators were:
Congratulations to all who completed their 2021 peer assessments! The College also recognizes and is grateful to all peer assessors, especially those who provided service for the first time.
By Dana Prutschi, Director of Professional Practice & Quality Assurance
Each year, as part of CASLPO’s Quality Assurance program, a number of audiologists and speech-language pathologists are randomly selected for peer assessment.
Even with the large number (90) of peer assessments CASLPO will conduct this year, we continue to offer individualized support to everyone who has been selected. Here’s what we offer to support those being peer assessed.
Peer assessments are an integral part of the Quality Assurance program, as outlined in the Regulated Health Professions Act. CASLPO recently presented two live webinars on peer assessments to support registrants. If you were not able to attend, the recording and slides are available. You can also access both clinical and non-clinical peer assessment guides for additional information.
Peer assessments are comprised of:
If you have any questions, please contact Practice Advice. You can also request to speak to a registrant who was previously peer assessed.
By Dana Prutschi, Director of Professional Practice & Quality Assurance
The e-Forums for Code of Ethics and the Audiological Assessment Standards took place in December 2021 and January 2022. Recordings and slides can be accessed under the Events tab.
What is coming in 2022?
Preeya Singh
Director of Professional Conduct
Receiving a notice of complaint can be a very daunting, and frankly, scary thing. But, it does not mean that you will lose your CASLPO certificate of registration immediately. It is important to understand that, under the law, anyone has the right to make a complaint to the College about a registrant. For example, complaints can be received from patients, substitute decision makers, coworkers or anyone who may have concerns about your advertising or your use of a professional title. There is also no screening option for the College, but rather a legal obligation to investigate any complaint received.
Once a complaint is received, the College has an obligation to provide the audiologist or speech-language pathologist (registrant) who is the subject of a complaint with notice of that fact. The College must provide the registrant with a copy of the complaint. Usually, the registrant is also provided with a signed Areas of Concern form, which is a form signed by the complainant that outlines all the concerns that have been raised. In high risk cases, such as allegations of sexual abuse, the College may appoint an investigator immediately upon receipt of a complaint. This may be done to assist the complainant in making a statement as it may be difficult for the complainant to record details that are traumatic in nature.
The registrant is then given an opportunity to respond. Some registrants, at this stage, may choose to obtain legal counsel. Upon receipt of the response, the file is screened by College staff to determine if any further information is needed. Additional information can include: patient records, witness statements, billing records, and/or site visits.
Once all the relevant information has been collected, the documents are presented to a panel of individuals drawn from the Inquiries, Complaints and Reports Committee (ICRC). The panels will be made up of both members of the public, and registrants. The ICRC is a screening committee, which means that it does not meet with either the complainant or the registrant, but rather relies upon the documents that have been submitted. Based on that information, the ICRC determines whether:
When a decision is made, the ICRC is required to provide it in writing, including reasons for the decision. Both the registrant and the complainant receive a copy. Should either party be unhappy with the outcome, they have the option of requesting a review of the decision by the Health Professions Appeal and Review Board (unless the decision was to refer to the Discipline Committee or for incapacity proceedings). This Board is completely independent of the College and is directly accountable to the Ministry of Health. The Board receives appeals of decisions involving all 26 regulated health professional colleges in Ontario.
It is important for any CASLPO registrant who becomes the subject of a complaint to understand their rights, their role in the process, and their obligation to fully participate in the process. Further, there are many options open to the ICRC and they have the responsibility to issue a decision that aligns with any risk of harm that may impact the public.
For more information, please refer to the College’s complaints information page and the new complaints process infographic outlining the College’s complaint process. The College’s Alternative Dispute Resolution (ADR) process also allows for informal case management of complaints. Please refer to CASLPO’s ADR web page for more information.