Tools for Success: Building Tools for Better Quality of Care

With 19.5% of the population being aged 65 or older, New Brunswick has the highest proportion of older adults in Canada and it is projected that by 2026 this will rise to 25.7% of the population.  In 2016, there were 67 nursing homes, and 390 special care homes providing residential care. With a large proportion of the population living in long-term care, it is important to know how to care for patients and their needs, including choices and interactions between staff and the patient.

Microethics in health and social care settings are every day, reoccurring situations that take place regularly between the provider and the individual, which can have widespread effects on the quality of life of people in long-term care facilities. Examples of microethics in long-term care facilities include how staff address residents, how staff approach and engage residents throughout the day, and may even extend into determining which decisions residents may make for themselves. Although these examples can seem very simple, microethics often have major implications for the individual’s care and can quickly become complicated. Understanding the issues, and how to make these decisions, is vital in providing exceptional quality of care in long-term care facilities.

Example of Training Module 3 - Principlism. Submitted by Jennifer Estey

Example of Training Module 3 - Principlism. Submitted by Jennifer Estey

Example of Training Module 3 - Priniciplism. Submitted by Jennifer Estey

Example of Training Module 3 - Priniciplism. Submitted by Jennifer Estey

As the first graduate of UNB’s Master’s in Interdisciplinary Studies - Aging and Dementia Pathway, Jennifer Estey, funded by Mitacs, created an interdisciplinary and wide-ranging online training program that can be used by long-term care staff members to enhance their ethical awareness and understanding of everyday ethical decision-making in the workplace. The program Estey has created is unique in that it is interdisciplinary in nature, pulling in aspects of philosophy and ethics, education, sociology, and health disciplines. The training consists of a 10-module e-learning program that can be used by long-term care staff in a non-directive way. The modules inform learners about ethical issues and decision-making, and can contribute to the overall knowledge-base of long-term care staff. Some of the material includes ethical theory, person-centered care, capacity, and decision-making ability, as well as other things such as use of language and issues regarding family. Each module builds from the previous modules, providing a cohesive training program to raise awareness of microethics and ethical decision-making. The training is not a step-by-step guide; instead it uses examples to explain the issues that all staff in long-term care facilities may face regularly.

Estey began working with Dr. Baldwin, Canada Research Chair in Narrative Studies at St Thomas University, as a research assistant undertaking interviews with long-term care staff. During this time, she developed an understanding of the issues that staff in long-term care facilities face regularly. Dr. Baldwin encouraged Estey to utilize the data they had collected for a Master’s degree. Eventually, they developed the idea into the production of Estey’s training materials. Using data from the previous research, Estey developed the training materials to aid long-term care staff in providing care. By interviewing staff, Estey better understood common situations faced by long-term care staff, and use her interdisciplinary skills to develop materials that can be used in an effective and efficient manner.

Estey’s training is currently being implemented in long-term care facilities, and it is available to be incorporated into many current training programs that are used across Atlantic Canada. Estey believes that with modification, her training modules could be applied to other areas in healthcare to improve the quality of care. Research such as Estey’s could have a major impact on the individual experience in health and social care, and findings such as this encourage further development for use within the health and social care systems.

It is important to note that this article was made possible by our partnership with the New Brunswick Health Research Foundation, the team at the ASRJ would like to thank them and Ms. Jennifer Estey for allowing our team to write this article.



  1. Your Health System in New Brunswick - CIHI. Accessed November 14, 2017.
  2. Health Spending - Nursing Homes. Canadian Institution for Healthcare Information Accessed December 21, 2017.
  3. Mandal J, Dinoop K, Parija SC. Microethics in medical education and practice. Trop Parasitol. 2015;5(2):86-87. doi:10.4103/2229-5070.162488.


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