Suggested Learning Strategies

Strategies that Focus on Caring

1. Qualities and Characteristics of Care Providers Discussion

Invite students to form small groups and discuss what qualities and characteristics they would want in a care provider for themselves or a family member.

Ask them to describe the “perfect” care provider in terms of:

• Personality
• Work habits
• Knowledge level
• Relationship with other health care team members
• Relationship with family members
• Other characteristics that seem important

Which qualities and characteristics would be considered most important? What does this tell you about the qualities and characteristics of an effective care provider?

2. Caring for Clients Discussion

Invite students to consider some of the key aspects of caring. Questions that could be used to elicit discussion:

• If we truly care about and for our clients, what sort of environment will we want them to live in (e.g., client-centred model of care)?
• In what ways does a team approach contribute to better care for a client?
• How are legal and ethical standards related to a philosophy of individual worth?
• How is striving for increased personal competence related to being a caring health care provider?
• How does maintaining professional boundaries by the health care provider show caring for the client?
• How does a respectful work environment among colleagues contribute to positive outcomes in client care?

3. Unfolding Case Study: Caring for Peter Schultz

As a homework assignment, have students read their textbook and other relevant course or online materials describing the role of the HCA in various health care settings, including community day programs, home care, and complex care. Ask the students to identify the positive aspects and challenges associated with working in each setting.

1. Whole Class Activity and Discussion
   • In class, briefly review the health care settings. On a whiteboard, list the positive aspects and challenges that may be experienced by the HCA working in these settings. Ask the students to consider positive aspects and challenges that might be experienced by clients and their families in these same settings and list them on the whiteboard.
2. Small Group Activity
   • Divide the class into small groups, assigning each group to one of the following health care agencies and settings that is described in the handout. After the students have read the scenario, they should work together to identify the positive aspects and challenges described and be prepared to share their observations with the larger group. See STUDENT HANDOUT 1 below.
3. Whole Class Activity Debrief
   • Come together as a class and have each group report back on the positive aspects and challenges identified. Work together to identify additional positive aspects and challenges that may be experienced by clients and families being supported in these care settings. For each setting, discuss how the HCA could provide support to address the challenges identified.

Note: Students could be instructed to add the descriptions and notes from this session to their client portfolio for Peter Schultz.

Strategies that Focus on Critical Thinking, Problem-Solving, and Decision-Making

1. Classroom Debate Activity

Invite students to engage in a debate about a topic discussed in this course. Divide the class into small groups of three to five students and assign two groups to each of the topics outlined for a debate; one group will take a pros position toward the topic and the other group will take a cons position.

Ask each group to identify two to three reasons to support the position they have been assigned. Then, with the instructor acting as the moderator, the two groups will engage in a debate using the following structure:

1. Each group provides a brief introduction to their position on the topic.
2. In alternating format, the two groups present the two or three reasons identified to support their position.
3. Each group provides a brief closing statement.

After the debate has concluded, briefly come together as a larger group and summarize the positions that were presented. Invite feedback from the students not involved in the debate and discuss further considerations. Alternate groups until each student has participated in a debate.

Debate Topics for Introduction to Practice

1. HCAs can provide better care to clients in complex care settings vs. community settings.
2. HCAs should be able to provide formal care services to their own family members.
3. An HCA has the right to refuse to provide care that makes them feel uncomfortable.
4. Health care workers should be allowed to have their phones while at work.
5. HCAs have the right to talk about their clinical experiences on social media.

2. Encouraging Reflective Practice

To develop HCA students’ ability to self-reflect and recognize and respond to their own self-development needs as care providers, consider introducing a model that can be used for reflective practice review, such as Gibbs’ Reflective Cycle.

• Description: What happened?
• Feelings: What did you think and feel about it?
• Evaluation: What were the positive and negative aspects?
• Analysis: What sense can you make of it?
• Conclusion: What else could you have done?
• Action Plan: What will you do next time?

Working together as a class, apply the Gibbs’ Reflective Cycle model to the scenarios outlined below.

Note: This activity refers to Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Oxford Centre for Staff Development. https://stephenp.net/wp-content/uploads/2015/12/learning-by-doing-graham-gibbs.pdf

Scenario 1

Today at your annual performance review, your supervisor tells you that they have received a report from another HCA that you were impatient with a client. The HCA stated that they tried to approach you about the situation, but you would not discuss it. You remember that you had been feeling anxious that day about a personal matter and had felt bad for sighing loudly and saying, “I don’t have all day,” when your client was taking a longer time than usual to pick her outfit.

Scenario 2

Today while you are assisting a client in the dining room, you overhear two of your co-workers recalling a story about another client and laughing loudly. Taken aback by the situation, you don’t approach your co-workers, but afterwards, it bothers you and you are unsure of how to move forward.

Scenario 3

As a recent HCA graduate, you are feeling excited about your new job at a complex care home. During the orientation session, you realize that the lift equipment being used is different from what you used during your clinical placement and despite the practice you receive during training, you still feel uncomfortable with using the equipment. You don’t want to leave a negative impression on your employer, so don’t speak up when the session leader asks if anyone has any questions or concerns.

Scenario 4

You are a new HCA and are struggling to keep up with your care activities. You often ask a more experienced HCA for help and guidance. Initially, they are very supportive and patient, however, as time goes on, they begin to feel resentful of your requests for assistance. The experienced HCA begins making snide remarks about your capabilities behind your back and excludes you from team discussions and activities. You notice the change in behaviour but don’t know how to address it. You are feeling isolated and demoralized, and this is making it even harder for you to perform your job.

Scenario 5

You are a new HCA who has recently been hired at a complex care home. Today you are assigned to work with an HCA who has been employed there for 18 years. When you suggest that the two of you come up with a brief plan for how to schedule your morning, the HCA insists that you follow their regular routine. Throughout the day, they make all of the decisions and disregard any suggestions that you make, saying, “This is the way we do things here.” At the end of the day, you learn you will be working with the HCA for the rest of the week.

3. Problem-Solving and Decision-Making Process

Have students, either alone or with peers, discuss an issue that presents itself to them. One that might be appropriate is the following:

As you move towards completion of the HCA program, you will have to decide which health care context you’d like to work in and whether you would like to continue your education.

The STUDENT HANDOUT 2 below will help students analyze this problem and come to a decision that best “fits” for them at this point in time.

Strategies that Focus on Professional Approaches to Practice

1. Professional Practice Exercises

1. Invite students, as a whole class or in smaller groups, to discuss what is meant by “professional approach to practice.” Ask them to consider what sorts of behaviours reflect a “professional” approach. As the ideas are forthcoming, write them on a whiteboard or flip chart. Afterwards, encourage students to determine if there are any themes or major descriptors of professional approaches to practice. These may include:
   • Respect for the client
   • Respect for self as a health care practitioner
   • Providing safe, competent care and assistance
   • Being organized
   • Functioning within defined parameters of one’s role
   • Being dependable, reliable, and honest
   • Working collaboratively with other members of the health care team
   • Being ethical
   • Being a reflective practitioner, recognizing and seeking ways to improve competence
2. Introduce the Professional Behaviour Development Rubric from Section 5: Sample Course Assessment Tools and discuss how this type of tool could support students in their application of professionalism during the program.
3. To further extend the activity, invite students to identify what they will need to know and be able to do, to function in a professional manner as an HCA in relation to the descriptors they have identified. Ask each small group to examine one of the major elements of professional practice and discuss the learning needs related to it. They may use a graph such as the one below.

2. Exploring Workplace Policies

1. Have students work in pairs to complete online research about the work-based policies of an employer, government website, or health authority in B.C. The policies can be related to:
   • Electronic communication, including social media, the use of mobile devices, and texting
   • Respectful workplace practices, including communicating respectfully, bullying (in person or online), gossiping, and harassment
   • Privacy and confidentiality of personal information

   Students should be prepared to report back to the larger group, describing the policy, why it is important, and how it relates to the professional practice of a Health Care Assistant. After each group presents, the students could identify commonalities between various workplace policies and then draft a respectful workplace policy (classroom agreement) for their classroom or lab setting.

   Students can also share their resources by posting workplace policies, links, or documents on a physical bulletin board in the classroom or to a virtual bulletin board through imageboards and forums.

   The following resources may be helpful for this activity:

   • Fraser Health
   • Interior Health
   • Island Health
   • Northern Health
   • Vancouver Coastal Health

   Note: Related information may also be found in workplace collective agreements available on union websites (See Resources for website information).

2. Ethical Practice Considerations and Employer Policies Scenarios
   Invite students to form small discussion groups and discuss situations in which an HCA is confronted with a workplace dilemma. Ask them to discuss the scenarios on STUDENT HANDOUT 3 below and put forward suggestions for how each situation should be handled based on what they have learned in the course. Encourage students to check out the websites of the health authorities (links are provided above) to consider whether there is a program, workplace policy, or collective agreement that they could refer to for guidance.

3. Interprofessional Teamwork

Share the case study below with the whole class and invite students and share their responses to the discussion questions below.

Zareen is an HCA who works on an inpatient orthopaedic unit and has worked on this unit as a casual for the past three months. She is participating in a morning huddle and hears about Mrs. Nguyen, a patient who was admitted two days ago with a fractured right hip that she sustained when she slipped on an icy patch outside her church.

Mrs. Nguyen lives alone in a two-level townhome with a cat. She has one son who lives in town and he reports that his mom has lost a lot of weight since her husband passed away six months ago. The team leader reports that Mrs. Nguyen is one day post-op from a right hemiarthroplasty (partial hip replacement); she does not have hip precautions and is weight-bearing as tolerated (WBAT). Mrs. Nguyen would like to be discharged home with supports in a week.

Discussion Questions:

1. Identify four members of the health care team who may be involved with Mrs. Nguyen’s care.
2. What unique contributions might Zareen expect from the members of the interprofessional health care team that would support the goal of being discharged home?
3. What might Zareen’s role be in Mrs. Nguyen’s care?
4. How might Zareen demonstrate interprofessional communication with the team?

Note: This case study is used with permission from Island Health. (2012). Transitional Learning Continuum, Health Care Assistant in Acute Care Curriculum.

4. Understanding Workers’ Rights and Responsibilities Activity

This activity is designed to support students in better understanding HCA rights and responsibilities, the role of the supervisor and supervision, and the importance of workplace orientation and training. While some content may overlap with content in other courses, given the overall importance of occupational health and safety, it is included in this HCA Introduction to Practice course.

It is suggested that instructors:

• Invite students, as a whole class or in smaller groups, to identify the specific rights and responsibilities of workers. Elicit rights and responsibilities on the whiteboard or on a flip chart. See those listed in below as a guide or provide the STUDENT HANDOUT 4 below.
• After the brainstorming session, work with students to consider workplace safety and how rights and responsibilities can be considered specifically within the role of the HCA, using the questions and answers on the INSTRUCTOR DISCUSSION GUIDE 1, if helpful.

5. Maintaining a Respectful Workplace Scenarios

In groups of three or four, ask students to explore how to respond to challenging behaviours from classmates or co-workers and consider how different choices in verbal and non-verbal expression can change the meaning of a statement and influence the outcome of a conversation. For each scenario, students will consider the following questions:

• Is this behaviour respectful? Why or why not?
• How might you feel in this situation?
• How would you respond to this situation?

Students can incorporate knowledge from the Interpersonal Communications course to guide their responses. This means considering verbal elements such as word choice, and non-verbal elements such as tone, gestures, and facial expressions. The goal is to create a response that is most likely to result in a positive response from the other person and maintain a productive working relationship. Students will use conflict resolution skills to manage conflict effectively, incorporating the following program learning outcomes:

• 5.11 Identify problems, concerns, and conflicts within the health care team and discuss these with appropriate team members in a timely manner.
• 5.12 Approach problems or conflict in a non-threatening way.
• 5.13 Respond non-defensively to feedback, even when provided in a critical or confrontational manner.
• 6.18 Use effective approaches to conflict management.

6. The Role and Mandate of the B.C. Care Aide & Community Health Worker Registry: Search and Find Activity

This activity is designed to support students to understand the role and mandate of the B.C. Care Aide & Community Health Worker Registry. It can be designed as a follow up to the LearningHub’s Health Care Assistant Practice in B.C. online Module 4, Lesson 5 – Public Protection Mandate of B.C. Care Aide & Community Health Worker or used on its own.

• In class, invite students to work in pairs or small groups to visit the B.C. Care Aide & Community Health Worker Registry website to answer the questions outlined in the STUDENT HANDOUT 5 below.
• After students have completed the activity, come together as a class, and ask students to report back on what they have learned. An INSTRUCTOR DISCUSSION GUIDE 2 with links to the relevant web pages is provided below.

Suggested Course Assessments

The course learning outcomes may be assessed by the following tasks:

1. One or more quizzes or examinations that pertain to knowledge of the British Columbia health care system, workplace settings, roles and responsibilities of health care team members, respectful workplace, legal and ethical aspects of caregiver practice, and human rights (Learning Outcomes 1, 2, and 3).
2. An assignment in which students analyze one or more scenarios taken from practice situations. Students discuss the role of the HCA, rights and responsibilities, legal and ethical implications, and appropriate caring (person-centred) approaches (Learning Outcomes 1 and 3).
3. A written assignment in which students describe the qualities and characteristics of an “ideal” care provider, with emphasis on how an “ideal” HCA works both independently and collaboratively. Each student will compare themselves to this ideal and use this comparison to delineate self-development needs (Learning Outcomes 1, 3, and 4).
4. A written assignment in which students develop a personal mission statement related to their work as HCAs and career goals, both short and long term. The students should then search online to look up the mission and value statements of various employers. Using this information and their knowledge of the challenges and rewards of various workplace settings (community, complex, acute care), the students will describe where they would like to work and why and how this fits with their own beliefs, values, goals, and interests (Learning Outcome 5). Refer to HCA Workplace Settings Assignment in Section 5: Sample Course Assessment Tools.
5. The LearningHub modules included in the Online Learning Resource section can also be included as graded activities, as certificates are provided for completion. These modules include the HCA Practice in B.C. module (required by the B.C. Care Aide & Community Health Worker Registry) and two modules on the topic of respectful workplaces.

Resources for Introduction to Practice

Online Resources

Adult Guardianship Act. RSBC 1996, c. 6. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96006_01

Alberta Health Services. (n.d). Respectful workplaces: Resource guide. https://www.ualberta.ca/anesthesiology-pain-medicine/media-library/eliassons-wellness-docs/hr-respectful-workplaces-resource-guide-copy.pdf

B.C. Care Aide & Community Health Worker Registry. (2024). https://www.cachwr.bc.ca/

B.C. Care Providers Association. (2022). http://bccare.ca/

B.C. Centre for Disease Control. (2020). Ethics. http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/ethics

B.C. Government and Service Employees’ Union. http://www.bcgeu.ca/

Bright Knowledge from Brightside. (2017). What is reflective practice? https://brightknowledge.org/medicine-and-healthcare/what-is-reflective-practice

British Columbia College of Nurses and Midwives. (2021). Licenced practice nurses-practice standards-working with health care assistants. https://www.bccnm.ca/LPN/ PracticeStandards/Pages/WorkingwithHealthCareAssistants.aspx

Canadian Human Rights Commission. https://www.chrc-ccdp.gc.ca/en

Canadian Interprofessional Health Collaborative. (2010). A national interprofessional competency framework. https://drive.google.com/file/d/1Des_mznc7Rr8stsEhHxl8XMjgiYWzRIn/view

Canadian Network for the Prevention of Elder Abuse. http://www.cnpea.ca/en/

Canadian Nurses Association. (2018). Interprofessional collaboration. https://www.cna-aiic.ca/en/nursing/nursing-tools-and-resources/interprofessional-collaboration

Community Care and Assisted Living Act, SBC 2002 c. 75. https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/00_02075_01

Community Care and Assisted Living Act. Residential Care Regulation. [B.C. Reg. 96/2009.] https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/96_2009

Continuing Studies University of Victoria. (2021). Skills to support independent living. https://continuingstudies.uvic.ca/health-wellness-and-safety/programs/strategies-and-actions-for-independent-living-sail/

First Nations Health Authority. http://www.fnha.ca/

Fraser Health Authority. http://www.fraserhealth.ca

Government of British Columbia, (n.d.). About B.C.’s health care system. https://www2.gov.bc.ca/ gov/content/health/about-bc-s-health-care-system

Government of British Columbia. (n.d.). Accessing health care. https://www2.gov.bc.ca/gov/ content/health/accessing-health-care

Government of British Columbia. (n.d.). Assisted living in B.C. https://www2.gov.bc.ca/gov/ content/health/assisted-living-in-bc

Government of British Columbia. (2023). B.C. health care assistants core competency profile. https://www.health.gov.bc.ca/library/publications/year/2023/hca-core-competency-profile-april-2023.pdf

Government of British Columbia. (2022). Building a respectful workplace: Checklist for employees. https://www2.gov.bc.ca/assets/gov/careers/all-employees/working-with-others/building_a_respectful_workplace_checklist_for_employees.pdf

Government of British Columbia. (2024) Define discrimination, bullying and harassment. https://www2.gov.bc.ca/gov/content/careers-myhr/all-employees/working-with-others/address-a-respectful-workplace-issue/define-discrimination-bullying-harassment

Government of British Columbia. (2021). Health authorities. https://www2.gov.bc.ca/gov/ content/health/about-bc-s-health-care-system/partners/health-authorities

Government of British Columbia. (2019). Home and community care. https://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care

Government of British Columbia. (n.d.). Human rights in British Columbia. What you need to know. [Fact sheet]. https://www2.gov.bc.ca/assets/gov/law-crime-and-justice/human-rights/ human-rights-protection/what-you-need-to-know.pdf

Government of British Columbia. (2022) Human Resources Policy 11 – Discrimination, Bullying and Harassment in the Workplace. https://www2.gov.bc.ca/assets/gov/careers/managers-supervisors/managing-employee-labour-relations/hr-policy-pdf-documents/11_discrimination_harassment_workplace_policy.pdf

Government of British Columbia. (2024). Long-term care services. https://www2.gov.bc.ca/gov/ content/health/accessing-health-care/home-community-care/care-options-and-cost/ long-term-care-services

Government of British Columbia. (2024). Professional regulation. https://www2.gov.bc.ca/gov/ content/health/practitioner-professional-resources/professional-regulation

Government of British Columbia. (2016). Protecting personal information. https://www2.gov.bc.ca/gov/content/employment-business/business/managing-a- business/protect-personal-information

Government of British Columbia. (2023). Protection from elder abuse and neglect. https://www2.gov.bc.ca/gov/content/family-social-supports/seniors/health-safety/ protection-from-elder-abuse-and-neglect

Government of British Columbia. (2022). Resident’s rights. https://www2.gov.bc.ca/gov/content/health/assisted-living-in-bc/operating-an-assisted-living-residence/operator-responsibilities/residents-rights

Government of British Columbia. (2022). Medical Services Plan of B.C. https://www2.gov.bc.ca/ gov/content/health/health-drug-coverage/msp

Government of British Columbia. (2024). Ministry of Health. https://www2.gov.bc.ca/gov/content/governments/organizational-structure/ministries-organizations/ministries/health

Government of Canada. (2019). Canada’s health care system. https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html

Government of Canada. (2012). It’s not right: What you can do when abuse or neglect is happening to an older adult in your life. https://www.canada.ca/content/dam/phac-aspc/documents/ services/publications/health-risks-safety/what-you-can-do-elder-abuse/pub1-eng.pdf

Health Employers Association of B.C. (n.d.). Collective agreements. https://www.heabc.bc.ca/ Page20.aspx#.YLEo5KhKjIV

Health Employers Association of B.C. (n.d.). Labour relations. https://www.heabc.bc.ca/Page11.aspx

Hospital Employees’ Union. http://www.heu.org/

• Facilities collective agreement. https://heu.org/collective-agreements/facilities
• Community health collective agreement. https://heu.org/collective-agreements/community-health
• Independent collective agreement. https://www.heu.org/collective-agreements/independent
• Community Social Services. https://www.heu.org/collective-agreements/community-social-services

Interior Health. http://www.interiorhealth.ca

InterRAI. http://www.interrai.org

Island Health. https://www.islandhealth.ca/

Master Class. (2022). How to recognize the five stages of group development. https://www.masterclass.com/articles/how-to-recognize-the-5-stages-of-group-development

National Healthcareer Association. (n.d.). Healthcare job interview questions (and how to answer them). https://info.nhanow.com/blog/healthcare-job-interview-questions-and-how-to- answer-them

Nidus. (2024). Your Choice. Your Plan. Your Life. https://nidus.ca/

Northern Health. http://www.northernhealth.ca

Office of the Seniors Advocate British Columbia. http://www.seniorsadvocatebc.ca/

Provincial Health Services Authority. http://www.phsa.ca/

Providence Healthcare. https://www.providencehealthcare.org/en

Public Guardian and Trustee of British Columbia. (2014). Protecting adults from abuse, neglect, and self-neglect: Supporting self-determination for adults in British Columbia. https://www.trustee.bc.ca/Documents/adult-guardianship/Protecting%20Adults%20from%20Abuse,%20Neglect%20and%20Self%20Neglect.pdf

SafeCare BC (2020). Civility matters: An online toolkit for long-term care staff. https://www.safecarebc.ca/civilitymatters/

Truth and Reconciliation Commission of Canada. ( n.d.). https://www.rcaanc-cirnac.gc.ca/eng/1450124405592/1529106060525

WorkSafeBC. (2020). Back talk for workers. https://www.worksafebc.com/en/resources/health-safety/interactive-tools/back-talk-for-workers

WorkSafeBC. (n.d.). Bullying and harassment. https://www.worksafebc.com/en/health-safety/hazards-exposures/bullying-harassment

WorkSafeBC. (2023). Communicating risk information to prevent violence-related injuries to workers. https://www.worksafebc.com/en/resources/health-safety/information-sheets/communicating-risk-information-prevent-violence-injuries-workers?lang=en

WorkSafeBC. (2023). Industry claims analysis: Time-loss claims in B.C. https://public.tableau.com/app/profile/worksafebc/viz/IndustryclaimsanalysisTime- lossclaimsinB_C_/Didyouknow

WorkSafeBC. (2020). Occupational health and safety regulation. https://www.worksafebc.com/en/law-policy/occupational-health-safety/occupational-health-safety-regulation

WorkSafeBC. (2018). Point-of-care risk assessments in long-term care [Videos].https://www.worksafebc.com/en/resources/health-safety/videos/point-of-care-risk-assessments-in-long-term-care/full-video

WorkSafeBC. (2013). Student WorkSafe Infosheet: Workplace rights and responsibilities. https://www.worksafebc.com/en/resources/health-safety/information-sheets/student-worksafe-infosheet-workplace-rights-and-responsibilities

WorkSafeBC. (2013). Toward a respectful workplace: A handbook on addressing and preventing workplace bullying and harassment. http://www.worksafebc.com/en/resources/health-safety/books-guides/a-handbook-on-preventing-and-addressing-workplace-bullying-and-harassment?lang=en

WorkSafeBC. (2016). Worker orientation checklist for health care. https://www.worksafebc.com/en/resources/health-safety/checklist/worker-orientation-checklist-health-care

Young, J. M. & Everett, B. (2018). When patients choose to live at risk: What is an ethical approach to intervention? BCMJ, 60(6), 314–318. https://bcmj.org/articles/when-patients-choose-live-risk-what-ethical-approach-intervention

Online Videos

Alberta Health Services. (2016, July 26). Patient and family centered care: Moments that make all the difference [Video]. YouTube. https://www.youtube.com/watch?v=Tej5g6w34BA&feature=youtu.be

City News 1130. (2020, December 8). Elder abuse calls increase [Video]. YouTube. https://www.youtube.com/watch?v=iYOCT8N9lwg

CLPNA. (2020). Respectful Workplaces; Building Healthy Working Relationships [Video]. YouTube. https://www.youtube.com/watch?v=ca94a0UnOyc

Indeed. (2020, January 3). Top interview tips: Common questions, body language and more [Video]. YouTube. https://youtu.be/HG68Ymazo18

McGill Caps. (n.d.). Writing a cover letter. https://www.mcgill.ca/careers4engineers/files/careers4engineers/guide_coverletter.pdf

University of British Columbia. (2012, September 17). Resumes 101: Accomplishment statements [Video]. YouTube. https://www.youtube.com/watch?v=bOSKynkOgQE&t=2s

Online Learning Tools