Health Services Management students solve problems, broaden horizons in an international collaborative online learning program

Emergency room wait times and bed blocking are global problems in healthcare, but students in Ted Rogers School of Health Services have been collaborating with students around the world on developing solutions.

Over the last two semesters, Dr. Pria Nippak, Dr. Housne Begum and students in Ted Rogers School’s School of Health Services Management participated in a four-month Collaborative Online International Learning (COIL) (external link)  program with students and professors from universities in the United Kingdom, Finland and India. Student groups discussed the challenges faced in Emergency departments in each country and their differences in approach to these challenges. 

Nippak, an associate professor in Health Services Management, first participated in the project in the fall of 2022, as a coordinator. The COIL program runs for four months during the semester and was based out of Coventry University (external link)  in the United Kingdom. There was no cost to the Canadian students. The COIL program gave Ted Rogers School’s Master of Science in Management (MScM) students an opportunity to explore cross-cultural comparisons, Nippak explained. 

“For us to have this capacity to be able to collaborate with other universities and particularly with students from those universities and have our students interact with them, was exciting,” she said. “The goal of this particular exercise was for them to troubleshoot or solve a particular healthcare problem that plagues all of us.”

In the fall semester, the program focused on exploring how to reduce emergency department wait times, which is a problem that occurs in every single country, even though each has independently operating healthcare systems, Nippak explained. 

Students were put into approximately 15 groups of six to eight students each. Twenty of the students were from India, 10 were based in Finland and approximately 50 students were from the UK. Student groups met 10 times to discuss the wait time problem and solutions. 

The biggest challenge for both Nippak and her students were the differences in time zones.  Canadian students took part in the early hours of the morning. “The participants in the UK had to start really early, and then we were starting really, really late,” Nippak said. “That was a huge barrier to the participation component.”

Nevertheless, the students who took part in the COIL project were excited about participating. 

Devi Santhikumar, a Master of Science in Management student, jumped on the opportunity to learn with an international cohort of fellow health sciences students with different backgrounds. Her team members came from Coventry University, and their project was to create a proposal to resolve the early retirement of nurses in Ontario. “And because I was in Canada, I was able to share my lived experiences here in Canada and about our health system,” she explained. “I thought it was a great opportunity.” 

Working through the COIL program gave Santhikumar a shared understanding of global health issues. Issues like staff turnover and emergency wait times weren’t limited to Canada. “We understood that we weren’t the only ones experiencing certain issues. Those issues occur the world over, and we were able to devise solutions to the problems as a team,” she said. 

“I found that, with all of the global health issues we have, working collaboratively with other healthcare providers and policy makers was exciting,” she said. “We were able to learn from our challenges and what works in other countries, and we could implement it in our Canadian context. Using technology and social media to share our expertise and information was a very effective way to work collaboratively with other teams regardless of borders.”

In the winter 2023 semester, the COIL program participants focused on bed blockages that happen in hospitals. Groups discussed potential solutions in which healthcare can move people out of the hospital once they've been admitted quicker.

“We came to find, I think, one of the most interesting results,” Nippak said. “Despite the fact that we have different health care models, there were quite a few similarities from one country to another, because we're dealing with people. Transportation was an issue across the board. It was an issue we saw independent of healthcare setting or delivery style. We saw that some of the human factors crossed all of the different cultures.”

At the same time, some things were culturally-specific. For example, in terms of times of the day where they saw the greatest amount of lag in emergency wait times was quite different based on country. In India, they had a certain break time each day, and so patient flow didn't stop during those break times.

“The program provided students an opportunity to learn about each other's individual goals in health care once they finish,” Nippak said. “It was an opportunity for them to learn about what other students were doing in each of their countries, what facets of healthcare they would be working in.”

Additionally, the program broadened students’ understanding of the health care systems in each of the other countries. While healthcare delivery models in Finland and the United Kingdom are similar to Canada’s, their salary grading system is different, as are their resources and staffing. However, in the latter, there are some differences. In India, shifts don’t exceed eight hours, while in Finland, they don’t set a specific shift time, Nippak said. 

“It was really interesting because when students tried to think about solutions, they had to know that information, which only became apparent by working with other students who actually live in those countries,” she said. 

Nippak will definitely participate in the COIL program again in Fall 2023. 

“Honest to goodness, I've been teaching for 20 years, and I've never seen anything so awesome,” she said. “I've never seen something that worked that had so many moving parts.”

The program also offered her an opportunity to collaborate with international faculty. To meet the requirements for the schools, she ended up using a lot of readings that focused on the emergency room wait time problem to help build their understanding, which her students were able to use as part of their MScM coursework. The readings from Nippak’s syllabus were shared with the Coventry University COIL coordinator, who shared UK-based citations that Nippak could use to build her students’ understanding of the healthcare system in the United Kingdom.

“In the end, it just ended up working out to be something so fantastic,” Nippak said. “The students were enjoying themselves so much, and they got a certificate of completion from Coventry University they could add to their CVs.”