In anticipation of our 2004 annual meeting, which will have an international focus, we are pleased to feature another one of our international members. The CCPH Featured Member is the Drug Use Management and Policy Research Residency Program at Dalhousie University in Nova Scotia, Canada, represented by Patricia Conrad. The Canadian Health Services Research Foundation/Canadian Health Institutes of Health Research/Nova Scotia Health Research Foundation are partners in the funding of this program. The Canadian Health Research Foundation was established in 1997 to facilitate evidence-based decision-making throughout Canada’s health care system. Under the leadership of Chair Ingrid Sketris, Patricia explains how this unique community-university partnership sharpens the skills of residents while improving drug use policy at various levels of decision-making. This is particularly important because pharmaceuticals are one the fastest growing components of health sector expenditures in Canada. Continued growth is anticipated due to the aging of Canada’s population and the advent of new genetic technologies. Their model brings a unique perspective to service-learning because the focus of the program is on health policy (as compared with providing clinical services or community-based programs).
what is the mission of your organization?
A: The Canadian Health Services Research Foundation was established in 1997 to facilitate evidence-based decision-making throughout Canada’s health care system. The Chair Awards Program is one of the key initiatives that has been developed to build capacity using an evidence-based approach. This program funds twelve research chairs, who are national and international leaders in health services and nursing research, for up to 10 years. Chair holders focus on mentoring less experienced health services researchers, training graduate students, and building national, regional, and local applied health research networks in addition to continuing their individual programs of research.
Under the leadership of Chair Dr. Ingrid Sketris, The Drug Use Management and Policy Research Residency (a four month paid summer residency) helps bridge education, research, and knowledge use in decision-making. We focus on drug use management and policy, including educational, mentoring, and research initiatives for improving drug use policy at various levels of decision-making. A critical element of this program is developing and maintaining links with decision-makers to increase the use of research in policy-making.
The goals of the Residency Program are to:
A: Residents are challenged to work on “real life” drug policy and practice issues. This work is completed during a four month time period and becomes one of the critical inputs considered in finding and formulating policy solutions. This paid summer residency enables decision-makers to benefit from “just in time” research skills of the residents and their faculty supervisors.
A: Pharmaceuticals are one of
the fastest growing components of health sector expenditures. Continued
growth is anticipated due to our aging population, the advent of new genetic
technologies and other factors. A key policy challenge is how to continue
providing access to drug therapies while managing these rising expenditures.
Here at Dalhousie we have been steadily building significant interdisciplinary
expertise in drug use management and policy that is devoted to assisting
decision-makers evaluate solutions for this complex health policy issue.
Our community-university partnerships are an opportunity that enables
our residents to put theory into practice. The completed projects create
a “stock” of policy relevant knowledge for use by decision-makers
as needs and issues arise and/or resurface.
A: Our Canadian health case system is grappling with
complex issues related to health system sustainability, resource allocation
decisions, and effective and efficient delivery of quality health services.
In the future we would like to create a better working environment where
representatives of numerous disciplines such as ethics, law, political
science, sociology, economics, and anthropology in addition to pharmacists,
work as a team to find meaningful solutions. Currently we are setting
the stage for future interdisciplinary initiatives by accepting residents
beyond pharmacy, including disciplines such as marketing/business, health
informatics, and epidemiology and population health.
A: Ongoing communication is central to the success of our residency program. The scope of the policy projects must be carefully managed since the time frame the residents have to complete their research is limited to four months. Another critical success factor is building relationships and trust. We also spend time “upfront” in matching preceptors and residents in conjunction with a comprehensive application and admission process. Orientation plays a critical role in developing an understanding of expectations and deliverables.
A: One of the biggest challenges is the cultural and value differences exhibited by universities and decision-making organizations. These incongruities, coupled with different views about endpoints and the use of research evidence, are a source of tension between the academic environment and the policy world. We spend a lot of time mediating “one on one” between the need for methodological rigor and precision, while taking into account that the decision-making environment operates on “immediacy of knowledge needs” which is not always conducive to the detailed study of policy options. Our strategy centers around continually refining our program, an approach based on the feedback we receive from participants. We also include government representatives in our skill building seminars to assist in establishing connections that we hope will lead to an in depth understanding of how to work within the constraints these cultural differences impose.
A: In order to work successfully with university-based researchers, policymakers must see the value of investing their time even though the payback may not be immediate. In other words, there can be some “quick wins” in the short term, but policymakers need to be cognizant that this is not always the case. The key is making a commitment and taking initiative to build ongoing relationships which are critical building blocks for a successful partnership and the conduct of an ongoing program of policy-relevant research activity.
A: We joined so we could quickly
become informed about the research and best practices for community-campus
partnerships. We also wanted to learn about the “state of the art”
evidence that exists with respect to service-learning. CCPH provides members
with access to a network of individuals who have expertise that others
in the early stages of program development can quickly learn from.
A: It’s a partnership whereby the community
becomes an active and engaged partner that provides an environment where
learning “comes alive” for university-based participants as
they experience the application of theory to practice. In our partnership,
our drug policy residents are engaged in conducting policy-relevant research
to solve “real life” issues and problems.
A: Our ongoing funding is contingent upon us demonstrating
the value of the Drug Use Management and Policy Research Residency Program
to both graduate students and the decision-maker partners who are involved
in our program. Demonstrating that the research created by the residents
during their placement was actually used is a key challenge for me as
a program evaluator. I am looking to CCPH to learn about new ideas that
can assist me in this undertaking. So far, CCPH has helped most by providing
comprehensive knowledge on the application of the logic model to evaluate
service-learning. I attended the CCPH
Advanced Service-Learning Institute in January 2003. It was an invigorating
experience. Because of it we very quickly “came up to speed”
and were able to grasp the major concepts and approaches that underpin
service-learning as a pedagogy.
A: We provide an international perspective on the application
of the service-learning. We are engaged in an ongoing formative and evolving
summative evaluation of the Drug Use Management and Policy Research Residency
Program. Our findings will advance service-learning in the context of
the particular interpretation that is applied to our program. Lastly,
we bring a unique perspective to service-learning because the focus of
our program is on health policy (compared with providing clinical services
or community-based programs). Plus, the intensity of our program is different
since our participants complete a four month in-depth residency located
in various decision-making environments.
For more information please contact: