Appendix 2: 2023 Recommendations and Rationale
The 2023 Recommendations and Rationale: Completed Revisions to the Health Care Assistant Program Provincial Curriculum (April 2023 Summary Report) outlines the recommendations and rationale for revisions that were made to the Health Care Assistant Program Provincial Curriculum 2015 to update it to its current 2023 form.
This report was prepared for sector stakeholders by the Health Care Assistant Curriculum Revisions subject-matter expert and the BCcampus Collaborative Projects team.
Purpose
The purpose of this report is to summarize the recommended revisions to the Health Care Assistant Provincial Curriculum proposed by the Health Care Assistant Curriculum Revisions Project Steering Committee and carried out by the subject-matter expert assigned to the project. The report includes 12 recommendations, the rationale behind them, the status of completion, and a summary of the changes made for each recommendation. Details of all revisions can be found in the Revisions Manual: 2023 Revisions to the Health Care Assistant Program Provincial Curriculum in Appendix 3.
Background Information
The Ministry of Post-Secondary Education and Future Skills (PSFS) oversaw a major review of the Health Care Assistant Program Provincial Curriculum (revised 2015). PSFS engaged the BCcampus Collaborative Projects team to lead the curriculum review and collaboratively work with members of a steering committee.
This process began in spring 2022 with the formation of the HCA Curricula Revision Steering Committee, whose purpose was to provide direction and guidance on the revisions to the existing curriculum. The HCA subcommittee was comprised of key stakeholders in HCA education in B.C., including private and public post-secondary programs, practice leaders, and others involved with recognition, accreditation, or professional standards.
From March to June 2022, we conducted online meetings with the HCA subcommittee to discuss revisions to the curriculum. In April 2022 we sent a survey to 383 people in the HCA sector, including educators, administrators, employers, and professionals. The subcommittee provided contacts to BCcampus, who sent out the survey through LimeSurvey. The survey asked:
- Select which group or organization you are an employee or member of:
- Acute care
- Assisted living
- Community support
- Day home
- Government ministry
- Group home
- Health authority
- Medical facility
- Post-secondary institution
- Do you work in the private or public sector?
- What is your role?
- Think about recent B.C. HCA program graduates working as HCAs early in their career (less than two years in practice). Are there specific skills, knowledge, values, and/or attitudes identified through the B.C. Health Care Assistants Core Competency Profile (2014) they are missing or have not acquired adequately through their studies in a recognized B.C. HCA education program? (Limit of three.)
- For institutions that provide HCA training: Are there ways the Health Care Assistant Program Provincial Curriculum (2015) could be improved to facilitate a clear and consistent delivery of content that ensures HCAs have the necessary competencies?
- Do you have other suggestions or feedback for strengthening the education and training HCAs receive through a recognized program?
The survey yielded 266 responses, 93 of which provided qualitative data on questions four and five that we used in analysis. Based on the survey responses and feedback from the HCA subcommittee, and grounded in their experiences with the curriculum and/or feedback from their organizations, the group worked to determine the proposed changes.
In November 2022 we presented a draft of the HCA curriculum to the steering committee. Committee members had the opportunity to review and discuss the revisions and provide feedback. With the goal of aligning the curriculum with the role of the HCA set out by the Ministry of Health, we further revised course content, program outcomes and indicators, and course learning outcomes to reduce the amount of new content. As a result no additional program hours were required.
In March 2023 we conducted additional consultation meetings with the Ministry of Health and steering committee to review final changes before copyediting. In May 2023 PSFS reviewed the curriculum and approved it for publication in Pressbooks.
Completed Revisions
Recommendation 1
Goal: Number the program and course learning outcomes.
Rationale: To increase ease of reference in the guide and support curriculum mapping.
Status: Completed
We numbered all program learning outcomes, course learning outcomes, and performance indicators. We edited all three components to:
- Reduce repetition within and between outcomes and indicators.
- Reorder indicators so similar ones are grouped together.
- Align outcomes/indicators with current standards to ensure they are measurable and at the appropriate level for the course.
Recommendation 2
Goal: Review and update language and terminology, specifically on topics of mental health, diversity, and nutrition (e.g., “feeding”).
Rationale: To ensure terms are clear, consistent, and aligned with currently accepted definitions in health legislation and regulations such as the Health Professions Act.
Status: Completed
In consultation with the Ministry of Health, Ministry of Mental Health and Addictions, steering committee, and BCcampus, we updated language throughout the document. Details are recorded in the Revisions Manual: 2023 Revisions to the Health Care Assistant Program Curriculum (Appendix 3).
The most widespread changes were:
- “Residential care” is now “complex care.”
- “Multi-culturalism” is now “diversity.”
- All pronouns are now gender neutral (“they/them”).
- “Assess” is now “observe” or “evaluate.”
- “Nutrition/nutritional needs” is now “dietary needs.”
Recommendation 3
Goal: Review skills not included in the Personal Care and Assistance course but required for the HCA role.
Rationale: To ensure the guide is clear on the skills to be covered as part of the baseline HCA education program so HCAs can fulfill expected job duties.
Status: Completed
In consultation with the Ministry of Health, we added course content on hand and foot care and compression stockings. We did not include skills such as taking blood pressure, measuring oxygen saturation, and providing post-mortem care as they are not part of the HCA role as defined by the ministry or HCA core competency profile.
Recommendation 4
Goal: Incorporate language and learning outcomes on trauma-informed practice.
Rationale: To ensure HCAs understand the impact of trauma and can provide appropriate, person-centred, trauma-informed care to clients experiencing mental health and substance use disorders.
Status: Completed
Content on trauma informed practice was added to the Cognitive and/or Mental Health Challenges course.
Specific learning outcomes were not added as the provision of trauma informed care falls under the principle of person-centered care and therefore is captured by existing person-centered learning outcomes in the theory and application courses.
Recommendation 5
Goal: Consider where content and concepts addressed in more than one course could be streamlined or included in multiple courses.
Rationale: To ensure appropriate scaffolding of concepts and, where appropriate, to streamline the curriculum and reduce redundancy.
Status: Completed
Most duplication was levelling rather than redundant. The concepts of emergencies, delegation, and reporting are introduced in theory courses and revisited in the lab course for application. For example, the learning outcome for emergencies in the theory course uses the verb identify, while the learning outcome in the lab course uses recognize and respond to. This kind of levelling is appropriate. Programs need to ensure these concepts are not reintroduced in the lab course but incorporated for practice and evaluation.
The exceptions were critical thinking and problem solving, which were introduced in the Concepts for Practice and again in Common Health Challenges courses before being applied in the lab and practice education courses. To make room for added content on communicable diseases and to address redundancy, we removed this topic from the Common Health Challenges course.
Recommendation 6
Goal: Ensure there is current and relevant content on dementia and best practices for providing person-centred care to clients with dementia.
Rationale: To make the curriculum guide current and relevant to the complex and changing health care practice settings where HCAs work.
Status: Completed
We edited the course learning outcomes for dementia in the Cognitive and Mental Health Challenges course. The original course learning outcomes used application verbs and were identical to the program learning outcomes in the practice education courses. Cognitive and Mental Health Challenges is a theory course, so verbs should reflect the level of evaluation that would take place in a classroom before the application of learning in the practice education courses. We also edited the course content section to improve concept delivery.
After consultation with the Ministry of Mental Health and Addictions, the Alzheimer’s Society, and the steering committee, we made additional language changes. This included adjusting language around disruptive behaviours to make it more patient positive, including stigma under cognitive challenges and replacing “mental challenges” with “mental health challenges.” We separated the topic of abuse from the topic of disruptive behaviours and established it as a new course learning outcome.
References to commonly available person-centred care training programs and models were originally included as examples in the discussion of person-centred care at the request of external stakeholders. We later removed them due to concerns about the potential lack of permanency of these training models.
Recommendation 7
Goal: Review guidance related to documentation with the guide.
Rationale: To make the guide current and relevant to the complex and changing health care practice settings where HCAs work and to provide specific direction to educators on learning outcomes related to documentation.
Status: Completed
We added more guidance on electronic documentation to the Concepts for Practice course. This addition does not require institutions to purchase and train HCA students in specific software for electronic documentation. The theory course introduces the concept, and students will practice using the software available in their practice education courses.
Recommendation 8
Goal: Incorporate language and learning outcomes for Indigenous content.
Rationale: To ensure HCAs are able to provide appropriate and respectful person-centred care to Indigenous clients and their families.
Status: Completed
We added content on cultural safety and humility, culturally safe and sensitive care, and the impact of inequity and discrimination to the diversity section of Concepts for Practice. We also enhanced language on respecting diversity throughout the curriculum. We added performance indicators for providing culturally sensitive care to multiple program and course learning outcomes, and we added Indigenous references for cultural safety to program learning outcome 1.11 and Concepts for Practice course learning outcome 3.6 to 3.9.
Recommendation 9
Goal: Incorporate more content on building and maintaining a respectful workplace with a focus on preventing bullying and harassment.
Rationale: To increase HCA preparation for the workforce and to make the guide current and relevant to the complex health care practice settings where HCAs work.
Status: Completed
We added enhanced language and guidelines for content to the Introduction to Practice course under the heading “Teamwork in Health Care Settings.”
Recommendation 10
Goal: Enhance language and expectations around health promotion and well-being across the lifespan and with different populations.
Rationale: To make the guide current and relevant to the diverse, complex, and changing health care practice settings where HCAs work.
Status: Completed
We added language throughout the curriculum to enhance the focus on person-centred care and health promotion across the lifespan. We also added content on the development stages of infancy to middle adulthood to the Concepts for Practice course.
Recommendation 11
Goal: Review language and expectations around medication assistance.
Rationale: To ensure the knowledge and skills taught in the curriculum align with the HCA role as set by the Ministry of Health.
Status: Completed
In consultation with the Ministry of Health and the steering committee, we revised learning outcomes and course content on medication assistance to align the curriculum with legislation and address discrepancies between the parameters established by the curriculum and those expected in practice. The enhanced language supports post-secondary institutions by providing more clarity about HCAs’ participation in restricted activities and the regulatory requirements for delegation. Details are outlined in the Revisions Manual: 2023 Revisions to the Health Care Assistant Program Curriculum (Appendix 3).
Recommendation 12
Goal: Ensure the B.C. HCA curriculum aligns with the National Occupational Standards for personal care providers as appropriate for B.C.
Rationale: To support consistency in the HCA role across Canada.
Status: Completed
Through consultation with the Ministry of Health, we determined the HCA provincial curriculum aligns with the National Occupational Standards to a degree appropriate for the B.C. context. No further alignment is required.
We adopted language from the National Occupational Standards on Indigenous content when we updated program learning outcome 1.10 and Concepts for Practice course learning outcome 3.10.
Project Conclusion Summary
The revisions to the HCA provincial curriculum are complete and aligned with the 12 recommendations established by the HCA curriculum project steering committee.
A comprehensive list of all revisions can be found in the Revisions Manual: 2023 Revisions to the Health Care Assistant Program Curriculum (Appendix 3).
