Jan 14, 2016
Disclosure:This presentation has been funded by:
• Northern Ontario School of Medicine (NOSM)
which is funded by the Government of Ontario
I sit on the board of directors for the following organizations:
• NOSM (CEO of NOSM Corporation)
• Sudbury Regional Hospital
• Thunder Bay Regional Health Sciences Centre
Distributed Community
Engaged Learning:How Crazy is That?
Dr Roger Strasser Dean and Professor
Northern Ontario School of Medicine
Northern Ontario School of Medicine
• Faculty of Medicine of Lakehead • Faculty of Medicine of Laurentian • Social Accountability mandate• Commitment to innovation
In, by and for Northern Ontario
Northern Ontario
Southern Ontario
• Sioux Lookout
Recruitment Facilitators
for Rural Practice
• rural upbringing• positive undergraduate rural clinical
experiences• targeted postgraduate training for rural practice
Key Academic Principles
• Interprofessional• Integration• Community Oriented• Distributed community engaged learning• Generalism• Diversity
Distributed CommunityEngaged Learning
An instructional model that allows widely distributed human and instructional resources to be utilized independent of time and place in community partner locations across the North
Organization / Deliveryof NOSM Curriculum
Phase 1 Phase 3
Year 1
101102103104105106
Residency
Year 2
107108109110111
Year 3
Comprehensive Community Clerkship
Year 4
Clerkship&
Electives
Licensure Examination
Years 5, 6and Beyond
IndividualSpecialtyChoice
Case Based Modules
Phase 2
Elective
All Placement Sites
Thunder Bay Sudbury
Toronto
Aboriginal Community SitesIntegrated Community Experience SitesComprehensive Community Clerkship Sites
Residency Programs
• Family Medicine Residents of the Canadian Shield (RoCS)
• 3rd year enhanced skills – emergency medicine, anesthesia, maternity care, etc
RC Specialty Programs
• General Internal Medicine• General Surgery• Pediatrics• Obstetrics & Gynecology• Psychiatry• Anesthesiology• Orthopedic Surgery• Community Medicine
Continuing Education Professional
Development• hundreds of events• many online sessions• CME/CPD• interprofessional• faculty development• leadership development
Health Professional Education
• rehabilitation sciences• interprofessional education - integrated clinical learning• communities of practice• dietetic internship program• physician assistants • digital library service
Research Programs
• building on existing strengths• broad canvas of research approaches• laboratory, clinical, community• Northern Ontario research questions• Northern Health Research Conferences
NOSM Charter Class
• CaRMS - 100% matched 1st round• 70% rural family medicine• 30% general specialties• 11 medical schools (of 17)• 40% residency with NOSM• “deep roots” in Northern Ontario• >60% of NOSM residents stay
FM RoCS Graduates
NOSM Charter Class
NOSM
Benefits of NOSM
• More generalist doctors• Enhanced healthcare access• Responsiveness to Aboriginal, Francophone, rural, remote• Interprofessional cooperation• Health research• Broader academic developments• Economic development
Socioeconomic Impact
• $67-82M new economic activity• 245 new jobs• economic development
• host universities’ status raised• improved HHR recruitment• communities feel empowered
Innovative Education and Research
for a Healthier North • Enhanced Education
• Strengthened Research
• Quality Learning Environment
• Excellent Faculty Relations
• Community Collaboration
“Community” inHealth Sciences
Education• community oriented - learning about the community• community based - learning in community context• community engaged - active community contribution
Community Engagement
• community active participant - interdependent partnership• ensures student “at home”• contributes to student’s educative experience• education and research activities• community development
Community Engagement
• individuals and organizations• partnerships and collaborations• Aboriginal and Francophone• Local NOSM Groups• education and training (DCEL)• research• community development
Partnerships & Relationships
• Communities of the North• Universities and Colleges• Hospitals and Health Services• OTN, KOTM and Contact North• Other Medical Schools
Membership of LNGs
• Faculty Members from community
• Community leaders
• Non-academic NOSM personnel
• Local academic and health service providers (i.e. Hospitals)
• Local Group Leader
Comprehensive Community Clerkship
• 30 weeks in large rural and small urban communities• Based in Family Practice • Learn clinical disciplines in parallel• Students learn and live in community
Principles for Longitudinal
Integrated Curricula• comprehensive patient care over time• continuing learning relationships with clinicians• achieve core clinical competencies across multiple disciplines simultaneously
Importance of Relationships
• student-teacher/student-student/ student-community• four levels: clinical, institutional, social and personal (Worley)• paying attention as part of curriculum improves learning
Clinicians
Patients
Personal Principles
ProfessionalExpectations
UniversityResearch
Health Service
Government
Community
MedicalStudents
Worley, 2006
Integrity Model
Rural Health Services
• access is the major issue• “safety net”• local services preferred• limited resources• workforce shortages• different from cities
Rural Practitioners
• wide range of services• high level of clinical
responsibility• relative professional
isolation• specific community health
role
“Extended Generalists”
Rural Health Care
• specialists’ support role• partnership not putdown • consultant support to local
service• not assume patients will
travel
Information Technology
• greatly reduced isolation• education and information• clinical support - Telehealth
Key Considerations
• Context counts• Community participation• Standards and quality• Definition of success • Prevailing mindset• Vision and Mission
NOSM and OPOP
• Collaboration to enhance care
• Community engagement• Distributed learning• Telehealth• Research partnerships