As noted in the IEHPs experiences in the barriers section above and in the reviewed policy literature , comfort and ease with English or French is critical. But it was not just any kind of language assistance that the IEHPs we interviewed suggested was needed, but rather that which was specific to the health care domain and the practice of their particular profession:

Definitely a language course with specific terminology would help a lot. And it's not just medical terminology because a lot of these words are new but there are other terms that are specific to this country that could mean something different in the States and something that again, it's not the only thing that immigrants have to learn so it could be very overwhelming to have to deal with this language barrier [Ontario IEN #1, practicing].

Some of the IENs we interviewed in Manitoba recounted how they lobbied for just such a course and were successful in having one created:

These students I think will benefit from giving them a course which is specifically dedicated to nursing only, like terminologies, you know, the languages. What are the common terms that the patients are using inside the hospital? So that's what they did. They opened this English for nursing purposes here in Manitoba. So before you can go for a refresher course you have to pass that course first and then you go to the refresher course. But that is after we have talked to politicians. But before that, there is nothing. [Manitoba IEN #1, practicing]

Another promising practice, highlighted by one of our participants, is avoiding the use of acronyms so as to better enable the integration of those educated outside of Canada:

We don't abbreviate stuff. So you know, you'll hear a lot of people within the work force talking about certain abbreviations and you're kind of like 'Well what does that mean?' So that was one of the things. [Manitoba ITM #1, practicing]

Several of the bridging programs, like CARE in Ontario, incorporate elements of profession-specific language training which our participants noted as being important. Keatings (2006, p. 64S) also describes how independently, the College Nurses of Ontario (CNO) has developed a program that "focuses on helping internationally educated nurses understand specific health care terminology." Such programs, as we have already noted, are few and far between, making this a critical area for which to scale up services and benefit from lessons learned.