Download - Disclosure: This presentation has been funded by: Northern Ontario School of Medicine (NOSM)
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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
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Distributed Community
Engaged Learning:How Crazy is That?
Dr Roger Strasser Dean and Professor
Northern Ontario School of Medicine
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Northern Ontario School of Medicine
• Faculty of Medicine of Lakehead • Faculty of Medicine of Laurentian • Social Accountability mandate• Commitment to innovation
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In, by and for Northern Ontario
Northern Ontario
Southern Ontario
• Sioux Lookout
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Recruitment Facilitators
for Rural Practice
• rural upbringing• positive undergraduate rural clinical
experiences• targeted postgraduate training for rural practice
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Key Academic Principles
• Interprofessional• Integration• Community Oriented• Distributed community engaged learning• Generalism• Diversity
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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
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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
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All Placement Sites
Thunder Bay Sudbury
Toronto
Aboriginal Community SitesIntegrated Community Experience SitesComprehensive Community Clerkship Sites
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Residency Programs
• Family Medicine Residents of the Canadian Shield (RoCS)
• 3rd year enhanced skills – emergency medicine, anesthesia, maternity care, etc
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RC Specialty Programs
• General Internal Medicine• General Surgery• Pediatrics• Obstetrics & Gynecology• Psychiatry• Anesthesiology• Orthopedic Surgery• Community Medicine
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Continuing Education Professional
Development• hundreds of events• many online sessions• CME/CPD• interprofessional• faculty development• leadership development
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Health Professional Education
• rehabilitation sciences• interprofessional education - integrated clinical learning• communities of practice• dietetic internship program• physician assistants • digital library service
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Research Programs
• building on existing strengths• broad canvas of research approaches• laboratory, clinical, community• Northern Ontario research questions• Northern Health Research Conferences
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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
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FM RoCS Graduates
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NOSM Charter Class
NOSM
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Benefits of NOSM
• More generalist doctors• Enhanced healthcare access• Responsiveness to Aboriginal, Francophone, rural, remote• Interprofessional cooperation• Health research• Broader academic developments• Economic development
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Socioeconomic Impact
• $67-82M new economic activity• 245 new jobs• economic development
• host universities’ status raised• improved HHR recruitment• communities feel empowered
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Innovative Education and Research
for a Healthier North • Enhanced Education
• Strengthened Research
• Quality Learning Environment
• Excellent Faculty Relations
• Community Collaboration
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“Community” inHealth Sciences
Education• community oriented - learning about the community• community based - learning in community context• community engaged - active community contribution
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Community Engagement
• community active participant - interdependent partnership• ensures student “at home”• contributes to student’s educative experience• education and research activities• community development
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Community Engagement
• individuals and organizations• partnerships and collaborations• Aboriginal and Francophone• Local NOSM Groups• education and training (DCEL)• research• community development
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Partnerships & Relationships
• Communities of the North• Universities and Colleges• Hospitals and Health Services• OTN, KOTM and Contact North• Other Medical Schools
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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
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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
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Principles for Longitudinal
Integrated Curricula• comprehensive patient care over time• continuing learning relationships with clinicians• achieve core clinical competencies across multiple disciplines simultaneously
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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
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Clinicians
Patients
Personal Principles
ProfessionalExpectations
UniversityResearch
Health Service
Government
Community
MedicalStudents
Worley, 2006
Integrity Model
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Rural Health Services
• access is the major issue• “safety net”• local services preferred• limited resources• workforce shortages• different from cities
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Rural Practitioners
• wide range of services• high level of clinical
responsibility• relative professional
isolation• specific community health
role
“Extended Generalists”
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Rural Health Care
• specialists’ support role• partnership not putdown • consultant support to local
service• not assume patients will
travel
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Information Technology
• greatly reduced isolation• education and information• clinical support - Telehealth
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Key Considerations
• Context counts• Community participation• Standards and quality• Definition of success • Prevailing mindset• Vision and Mission
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NOSM and OPOP
• Collaboration to enhance care
• Community engagement• Distributed learning• Telehealth• Research partnerships
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