Disclosure: This presentation has been funded by: Northern Ontario School of Medicine (NOSM)

2. 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

3. Distributed CommunityEngaged Learning:How Crazy is That? Dr Roger Strasser Dean and Professor Northern Ontario School of Medicine

4. Northern Ontario School of Medicine Faculty of Medicine of Lakehead Faculty of Medicine of Laurentian Social Accountability mandate Commitment to innovation

5. Northern Ontario Southern Ontario • Sioux Lookout In, by and for Northern Ontario

6. Recruitment Facilitators for Rural Practice • rural upbringing • positive undergraduate rural clinical experiences • targeted postgraduate training for rural practice

8. Key Academic Principles Interprofessional Integration Community Oriented Distributed community engaged learning Generalism Diversity

9. 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

10. Organization / Deliveryof NOSM Curriculum Phase 1 Phase 2 Phase 3 Residency Year 1 101 102 103 104 105 106 Year 2 107 108 109 110 111 Year 3 Comprehensive Community Clerkship Year 4 Clerkship & Electives Licensure Examination Years 5, 6 and Beyond Individual Specialty Choice Elective Case Based Modules

11. Aboriginal Community SitesIntegrated Community Experience SitesComprehensive Community Clerkship Sites Thunder Bay Sudbury All Placement Sites Toronto

12. Residency Programs • Family Medicine Residents of the Canadian Shield (RoCS) • 3rd year enhanced skills – emergency medicine, anesthesia, maternity care, etc

13. RC Specialty Programs • General Internal Medicine • General Surgery • Pediatrics • Obstetrics & Gynecology • Psychiatry • Anesthesiology • Orthopedic Surgery • Community Medicine

14. Continuing Education Professional Development • hundreds of events • many online sessions • CME/CPD • interprofessional • faculty development • leadership development

15. Health Professional Education • rehabilitation sciences • interprofessional education • - integrated clinical learning • communities of practice • dietetic internship program • physician assistants • digital library service

16. Research Programs building on existing strengths broad canvas of research approaches laboratory, clinical, community Northern Ontario research questions Northern Health Research Conferences

18. 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

19. FM RoCS Graduates

20. NOSM Charter Class NOSM

21. Benefits of NOSM • More generalist doctors • Enhanced healthcare access • Responsiveness to Aboriginal, • Francophone, rural, remote • Interprofessional cooperation • Health research • Broader academic developments • Economic development

23. Socioeconomic Impact $67-82M new economic activity 245 new jobs economic development host universities’ status raised improved HHR recruitment communities feel empowered

25. Innovative Education and Research for a Healthier North Enhanced Education Strengthened Research Quality Learning Environment Excellent Faculty Relations Community Collaboration

26. “Community” in Health Sciences Education • community oriented • - learning about the community • community based • - learning in community context • community engaged • - active community contribution

27. Community Engagement • community active participant • - interdependent partnership • ensures student “at home” • contributes to student’s • educative experience • education and research activities • community development

28. Community Engagement • individuals and organizations • partnerships and collaborations • Aboriginal and Francophone • Local NOSM Groups • education and training (DCEL) • research • community development

29. Partnerships & Relationships Communities of the North Universities and Colleges Hospitals and Health Services OTN, KOTM and Contact North Other Medical Schools

32. 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

33. 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

34. Principles for Longitudinal Integrated Curricula • comprehensive patient care over time • continuing learning relationships with clinicians • achieve core clinical competencies across multiple disciplines simultaneously

35. 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

36. Patients Health Service Community Medical Students Professional Expectations Personal Principles University Research Government Clinicians Integrity Model Worley, 2006

37. Rural Health Services • access is the major issue • “safety net” • local services preferred • limited resources • workforce shortages • different from cities

38. Rural Practitioners “Extended Generalists” • wide range of services • high level of • clinical responsibility • relative professional isolation • specific community health role

39. Rural Health Care • specialists’ support role • partnership not putdown • consultant support to local service • not assume patients will travel

40. Information Technology • greatly reduced isolation • education and information • clinical support • - Telehealth

41. Key Considerations • Context counts • Community participation • Standards and quality • Definition of success • Prevailing mindset • Vision and Mission

42. NOSM and OPOP • Collaboration to enhance care • Community engagement • Distributed learning • Telehealth • Research partnerships