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One Last Blog…A few memories and a few tears
2020-06-23 One Last Blog…A few memories and a few tears

Shortly after my arrival at Queen’s ten years ago, I brought about a dozen IT experts into my office from across campus and asked them what social media approaches I should use to stay connected with our students, staff, faculty and alumni. I was expecting the focus to be on Facebook or Twitter, but what was suggested was that I write a blog. Unknowingly, and somewhat naïve, I agreed to the suggestion, not really understanding the magnitude of the undertaking.

Well, 10 years later, 575 blogs being written and over a million blog views, I have been incredibly pleased with the suggestion I received back in 2010. It’s been amazing for me to see just how important the blog has been as vehicle to keep in touch with the many individuals who feel close to the faculty, have a strong desire hear our stories, want to learn about new developments, and appreciate the opportunity to keep current about healthcare issues that have impacted us all. Wherever I travel in the region, it always amazes me that without fail, I hear from someone about one of the blogs I have written. It has been enormously gratifying. So now, for the last time, I want to thank all of our readers for what has for me, been an amazing ten years.

With this being my last blog as dean, I want to take some time to review some of the strongest memories I will take home from my time here at Queen’s. Of course, there’s a risk that I will forget some meaningful and important event, or concentrate on one area of our faculty at the expense of another…but I know you’ll forgive me. Just assume these are the musings, or perhaps ramblings of a soon to be “has-dean”.

My strongest memories, bar none, relate to our students. Our faculty has amazing students. Their accomplishments have really moved me, both in and out of the classroom. Our 3,000 learners in FHS come from a pool of applicants where the ratios of applications to acceptances can exceed 50 to 1. Our students have excelled in just about every domain possible. They have published research in the world’s best journals, they have won national awards for academic accomplishments, and they have shown their extracurricular talents, as in this COVID-inspired rendition of Stand By Me.

Speaking of students, for Cheryl and me, our student dinners will be incredibly memorable. Shortly after I became dean, Cheryl asked me how I was going to stay connected to the students. I responded that I would do some teaching, and she shook her head and said, no, let’s have them for dinner. Well, 10 years later we’ve entertained almost all 1,000 1st year medical students at our home in small groups of 15. The dinners have been a labour of love for Cheryl, and a privilege for me. The evenings were all great, filled with wonderful food, reasonably good wine, and on occasion we broke into song 

Our faculty consists of three schools, the School of Medicine, the School of Nursing, and the School Rehabilitation Therapy. All three schools work together, with the same vision, the same values, a joint budgeting process, and joint executive decision making. This wasn’t always so, and in past years the relationships between our three schools were not always completely positive. While by no means perfect, I am 100% confident that we can now say that our faculty derives great strength from our three schools working together, and that accomplishment, which we have all worked hard to achieve, is a source of enormous pride.

Maria on stage receiving degreeBirthed out of a horrible event at Queen’s, comes a very strong and indelible memory. A few years ago, it came to University’s attention, that in 1918 the medical school at the time had taken an official policy to ban Black medical students from Queen’s. The Principal and I gave a public apology at Senate, and for that meeting we invited Daniel Bartholomew, whose father Ethelbert, in his fourth year of medical school, was asked to leave Queen’s. Ethelbert subsequently spent most of his working life as a porter on the railways. We took Daniel out for dinner, along with some family members after Senate. Over dinner, Daniel innocently asked me, “Doc, I’d like you to do one more thing. Give my father his degree.” Well, what would normally take a year to do, we had only about a month to accomplish, because convocation was just around the corner. But everybody at Queen’s jumped into action. In a very moving ceremony at the 2019 convocation, we gave Ethelbert his degree. It was a moment I will never forget. 

Some of my best memories came every fall when we welcomed Queen’s alumni back to campus for homecoming. Each year many hundreds of graduates from our three schools return to celebrate a significant anniversary. In a typical homecoming weekend, David Young from our advancement team would usher Cheryl and me to fifteen or more class events. What amazed me most, and I think a remarkable feature that characterizes Queen’s, is the affection that our alumni have for their alma mater. It’s palpable, and it’s meaningful.

Another great memory was when we hosted an incredible event in Kingston, early in my deanship. The Canadian Medical Hall of Fame gala celebrates heroes in healthcare, and once each year, there is an induction ceremony. I really wanted to host in Kingston, but the usual attendance is over 500 people, and we were challenged to find an appropriate venue. But where there’s a will, there’s a way. We transformed the K-Rock Center (now Leon’s) into an incredible event venue, and if you ask the Hall of Fame staff, they will undoubtedly tell you that the event in Kingston was the best ever, and over 600 people attended.

One of the great joys of being a dean is getting credit for all the successes that happen in the faculty. One of the successes that stands out for me, but it is really the success of Michael Adams and many others, is the development of a brand new degree program for faculty. The Bachelor of Health Sciences program grew out of a conversation in my office between Michael Kawaja, Michael Adams, Leslie Flynn and myself, and it has been a smashing success. Mike Adams took the ball and ran with it, and figuratively ran across 1,000 fields, and created what has become one of the most successful undergraduate programs in the country. It will be a lasting legacy for the Faculty of Health Sciences.

And speaking of innovative programming, the School of Nursing developed what has become the signature graduate program for the faculty, the Masters and PhD in Healthcare Quality. Similarly, the School of Rehabilitation Therapy developed new graduate programs in Aging and Health and a DSc in Rehabilitation Health Leadership in response to the needs of healthcare professionals and the populations that they serve.

Healthcare Quality class


Another program of which I’m gratified by is the Queen’s Accelerated Route to Medical School (QUARMS). Now in its seventh year, QUARMS has seen 70 exceptional high school students admitted through an accelerated pathway to medical school. And then there’s the MD/PhD program, now in its ninth year, which has approximately 20 students who are dedicated to the concept of combining careers in medicine and science. In total, over the last ten years, we have developed 15 new programs, very much expanding our offerings as a faculty. And of course I can't talk about our programs without mentioning the ground-breaking transformation that we made to our residency programs. About five years ago, our educational community in the School of Medicine took a great leap of faith and believed we could be the first program in Canada to transform all of its specialty medicine postgraduate programs to competency-based medical education. Through the hard work of an incredible CBME executive team, in concert with terrific teams in each one of the 29 programs, we launched this full-out CBME initiative in July of 2017. It can be easily said that Queen's is now considered the leading school nationally in this important new pedagogy.

One of the struggles for every health professional program administrator is dealing with the accreditation demands of organizations that sanction our schools and give it (hopefully) a stamp of approval. Over the last ten years it seems like as soon as I had finished one accreditation visit, there was another one just around the corner. One of my great joys is that as I leave the faculty, all of our programs are in really good “health”, thanks to the hard work of our staff and faculty, who at Queen’s, take their mission of educating the next generation of health professionals very seriously.

If I counted up the hours and categorized them by activity, I’m quite sure that the area I have invested the most time as a dean, has been our research mission. I am very proud of the accomplishments of our basic scientists, our clinician scientists, our public health scientists, our research centers, and our very large staff who participate in the research mission. Last year we had an all-time high in our research revenue of $134M, and together we have built a strong foundation to continue the growth of research in FHS.

I will always remember the day that Alice Aiken, now Vice President of Research at Dalhousie University, came into my office and told me about an idea she had to create a research unit dedicated to the health of our military, veterans, and their families. From that glimmer in her eye, the Canadian Institute for Military Veterans Health Research (CIMVHR) was born. The research group is going fabulously well and recently, under Dr. David Pedlar’s leadership, secured $25 million of funding from the federal government. I was the board chair of that organization for many years, and I’ll always remember that position as truly a great privilege.

I remember the day that we at Queen’s were alerted to the fact that Professor Art McDonald, in the Department of Physics, was to be awarded the Nobel prize. Even though Art is in another faculty, all Queen’s citizens, past and present, stood an inch or two taller when Art’s work was recognized as the world’s best in his field.

KHSC LogoIf I were to measure success by the height of the stack of files related to an issue that was on my desk, clearly the biggest file I worked on was the integration of Kingston General Hospital and Hotel Dieu Hospital. As my readers would know, the integration was suggested over 25 years ago, but a few years after I came to Queen’s, I was fortunate to be able to play somewhat of a catalytic role in pushing forward discussions between the two institutions. In my view, this integration has been an unqualified success, and this helped us all move forward in the mission for the best care for patients in our region. 

And speaking of hospitals, all of us at Queen’s were so proud to see the new Providence Care building open a few years ago. What a magnificent facility!

Providence Care Hospital


Speaking of patients, one thing I’m also very proud of is to have been the Chief Executive Officer of the Southeastern Ontario Academic Medical Organization (SEAMO). SEAMO is an organization that receives money from the government for physician compensation in an alternate funding model. But SEAMO is much more than a funding mechanism; it is a glue that binds the clinical community together, and in my opinion, is the envy of academic centers around the country. SEAMO has grown dramatically last 10 years and has facilitated bringing about 100 new doctors to our region.

One of the things I enjoy most about being a dean is being involved in all manners of philanthropy. We have a great advancement team in the faculty and they have worked hard on many projects. One of the most successful projects was a $23M partnership with the MasterCard foundation and the School Rehabilitation Therapy, to develop a collaborative relationship with the University of Gondar to have an exchange of students and teachers for the next decade, in the area of community-based rehabilitation. More than that, there are currently no schools of occupational therapy in Ethiopia, but because of this collaboration, the first school to be developed in their country will be in Gondar, thanks to this partnership with Queen’s. We have had many other successes over the last ten years, including the establishment of 17 chairs.

Queen's and Haramaya University partnershipAnd speaking of Ethiopia, another amazing project that I’ve had the privilege to be involved with has been in collaboration with Haramaya University in eastern Ethiopia. I received an email one day from a young doctor who is working as an administrator in their medical school. He said that he had heard I was interested in medical education and that they had built a new 1,000 bed hospital in their city, but didn’t have enough doctors to run the place. He wondered whether Queen’s could work with them on developing new training programs. Three years later, we are on the cusp of starting the region’s first ever training programs in anesthesia, emergency medicine and oncology. 

When I became dean, it was interesting to engage with the 16 other medical schools in the country. One of the discussions that I became involved with early on, was what role a medical school should have with industry. I must admit, I found myself at one complete end of the spectrum of opinion, feeling strongly that for our medical school to thrive it needed to have vital, ethically driven, relationships with business. This, for me, started a seven-year odyssey in developing an industry engagement strategy that in my very biased opinion has served the faculty very well through intensification of research partnerships.

Another tremendous joy of working at Queen’s has been being part of the senior administrative team Queen’s. I very much enjoyed working with the former principal Daniel Woolf, and feel the same way about working with our current principal, Patrick Deane. I have worked for five provosts, and I can truly say, one could never find a group of harder working or more dedicated individuals. We have a great group of deans here in Queen’s, and monthly dinners with the deans where we get together and complain about all manner of things at university, has indeed been a highlight. And, of course I’ve been incredibly blessed to have a wonderful team in our faculty. We have a terrific faculty and an amazing staff. And we are blessed with an incredibly strong team of leaders. Our vice deans, associate deans, assistant deans, department heads, administrative leaders, and the rest of the senior executive staff have been a joy to work with. They have been a constant source of support (of course they do all the work, and the dean gets all the credit) and I admire each and every one of them, for their enormous dedication, their skill and their friendship.  

I guess I’ll end with the thing that is most important about my time at Queen’s, and that’s the fact that we are all dedicated to improving health. I’m confident in saying that we provide an absolutely superb level of care for patients in our Kingston hospitals, throughout the region, and in our community centers. In fact, I myself been the recipient of excellent care. My favourite story about my personal healthcare involves my good friend David Pichora when he was CEO of Hotel Dieu Hospital. At the time, I needed, for short while, some treatment. The folks at Hotel Dieu, where David at the time was CEO, were very kind and obliging and often found time outside of regular hours. Well, during one of these treatments, the area where I was being cared for got a surge very sick patients. The nursing staff, somewhat sheepishly, asked if I would mind moving in to what turned out to be a closet. I will always remember the look on David’s face when he was told that the dean was being treated in the closet. I, on the other hand, was then, and remain, incredibly grateful for the care that I’ve received whenever and wherever I’ve needed it!

Well I know that my faithful readers will realize that I have just touched on a few of the highlights, and almost certainly I have forgotten to mention many memorable and significant things that have been recounted in the blog over the years. But I have a solution for you. Here’s a link to what will undoubtedly be very helpful. Click here and you will be able to re-read all blogs back to 2014. I guarantee they will be better than any pill you can buy on the market, and for those of you have trouble getting to sleep, this link will be just the ticket.

I also need to thank everyone who helped me to make this blog happen: the IT team who originally set it up (and we have an incredible IT team), the students, staff and faculty who wrote compelling pieces as guest bloggers, and the FHS marketing & communications team. Whether it was Jen Valberg ensuring that I get a blog out each week and helping me with a lot of the writing or Mike, Saif and Liz taking great photos and putting together engaging videos, I owe a lot of the dazzle on my blog to this creative team.

Of course, the biggest debt of gratitude I have for the support I have received in the last ten years, is from my family. Many of my readers have been introduced to them over the years, including my three children; Joanna and her husband Jordan, Josh and his wife Laura, and Gabriel. They have been both a source of constant joy and immense pride. And you have also met my grandson Saul, of course, the cutest two-year old in the world. You met our dog Jake, who unfortunately passed away four years ago. Jake loved our student dinners! But so does Sophie, our four-year-old Portuguese Water Dog. And you will all understand that the tear in my eye as I write this last blog, is a tear of gratitude for Cheryl, whose love and support have been unending, and for that, I will be forever grateful.

Well I normally say, please comment on the blog or better yet, please drop by the Macklem House, my door is always open. As you would all know by now, the door will still be open but Dr. Jane Philpott will be there to greet you as she starts in her new role as next dean of the Faculty of Health Sciences. Pop your head in and wish her well. And if you’d like to drop your “has-dean” a line, you’ll find me on Twitter, where my handle has changed to @RichardReznick.

It has been the privilege of a lifetime to have served as the dean here for the last 10 years, and one of the great joys has been interacting with so many of you through my Dean on Campus blog. So, for now, I will sign off, but know for sure that I will see or hear from many of you in my future travels.

I wish you all my very best.

Richard

Nursing student bridges the gap between Deaf and hearing culture
2020-06-18 Nursing student bridges the gap between Deaf and hearing culture

When Sarah Corbeil, a third-year political science student, arrived at Queen’s in 2018, she found very little in the way of American Sign Language (ASL) resources on campus. She knew this had to change. Although Sarah is a hearing person, she first became interested in learning ASL after travelling with her friend who is Hard of Hearing. During their travels, Sarah learned some ASL to communicate in tricky situations, and took her passion for the language with her back home. “I decided to create the club because there were no other opportunities to learn ASL on campus. I had intended to take an ASL class or join an ASL club when I first applied to Queen’s, but when I realized there wasn’t anything offered, I decided to create my own club!” The Queen’s American Sign Language Club (QASL) was born. Once the club was created, Sarah discovered a significant amount of interest within the Queen's student body, and quickly hired an executive team. One of those executives is a third-year nursing student, Amy Rowe.

 

 

Amy’s story is a unique one.  While not Deaf or Hard of Hearing herself, Amy came to ASL by accident. Her Toronto neighbourhood happened to be in the catchment area of a high school for Deaf and Hard of Hearing students. By virtue of her high school classmates, Amy is not only fluent in ASL, but a passionate advocate for the Deaf and Hard of Hearing community and its culture.  At Queen’s, Amy has become an ambassador for sign language. “I love ASL, I think it’s such a beautiful and expressive way to communicate.” Amy is one of the educators for QASL and has worked alongside Sarah to create a more inclusive and accessible environment for Deaf and Hard of Hearing students here at Queen’s.

ASL access is especially important in healthcare scenarios; many nursing students who attended QASL classes have learned how access to sign language skills can improve health outcomes for Deaf & Hard of Hearing patients. While some Deaf and Hard of Hearing Canadians receive speech therapy or have cochlear implants, for many their primary language is ASL.  American Sign Language uses facial expressions, body movements, and a unique grammar to communicate complex messages. Healthcare interactions without ASL for Deaf and Hard of Hearing individuals can be difficult if not impossible. Poor communication leads to inadequate health assessments, culturally inappropriate treatments, and poor clinical outcomes. In order to provide accessible healthcare – an important lesson for future nurses – understanding Deaf culture is critical.

QASL Club aims to help change this with weekly lessons and a YouTube channel for those who can’t make the lessons on campus. The channel, Queen’s American Sign Language, teaches non-medical ASL. Prior to the COVID-19 pandemic, the QASL club was meeting weekly in-person. Now, they offer Zoom lessons that are free to attend and open to anyone at Queen’s or in the Kingston community. To address medical issues specifically, Amy also created YouTube videos for the Canadian Nursing Students Association (CNSA), which provide instruction on how to do medical assessments in basic ASL.

Their work is making a difference. In February 2020, the club was awarded the Equity, Diversity and Inclusivity Impact Award. This award is presented to individuals or groups who have contributed to making Queen’s a more inclusive space and who have, “…demonstrated contributions to furthering an understanding of the interplay and intersections among different identities on campus and their work will show that diversity strengthens the Queen’s community.”  Amy's thank you video is posted above. In addition, in March 2020, it was announced that QASL has been named Queen’s Club of the Year for 2019-2020.

Amy and the rest of her nursing student colleagues realize this is only just the beginning of their work. How can healthcare become more accessible for Deaf and Hard of Hearing people? One answer is training more Deaf and Hard of Hearing nurses and doctors. In the meantime, Amy and her nursing student colleagues want to make it easier for Deaf and Hard of Hearing people to work in health care, and that means more people with sign language skills. “It is not the responsibility of Deaf and Hard of Hearing students alone to advocate for inclusivity on campus. We all play a part in making Queen’s and our health care system accessible for everyone.”

If you are interested in learning ASL, visit the QASL YouTube channel and Facebook page  or email them at qasl@clubs.queensu.ca.

Interested in learning some ASL during Pride month? QASL held a free online Pride ASL signs lesson this week which you can see on their YouTube Page.

2020-06-10 How FHS researchers are pushing for solutions to COVID-19

The impact of the COVID-19 coronavirus has been felt around the globe and a race to find a vaccine is on. Moreover, the safety and health of our communities have been pushed to the forefront, with our healthcare leaders being the public face of the pandemic.

Here at Queen's Faculty of Health Sciences, students, staff, and faculty are navigating through this new normal, and leaders are emerging at every corner – especially in research. Our team of clinician scientists are working around the clock on a variety of research projects to help combat and find rapid solutions in response to COVID-19.

As readers would know, the Southeastern Ontario Academic Medical Organization (SEAMO) supports both the clinical and academic missions of the School of Medicine.  As part of a funding program from the Province of Ontario, SEAMO has established a COVID-19 Research Fund to accelerate academic, clinical, and basic science research projects, expand the infrastructure required to perform critical research and enable research into innovative solutions to maximize the use and reuse of personal protective equipment (PPE). We had 37 submisssions and through a competitive process, chose six projects for funding.

 

Stephen Vanner 

COVID-19 testing of health professional students: Informing testing and public policy for Universities and Society
Collaborators: Dr. Snelgrove-Clarke, Dr. Marcia Findlayson, Dr. Tony Sanfilippo, Dr. Leslie Flynn, Dr. Gerald Evans, Dr. Keiran Moore, Dr. Azim Kasmani, Dr. Kathie Deliszny, Dr. David Walker, Dr. Stephen Archer, Dr. Dean Tripp

 

How FHS researchers are pushing for solutions to COVID-19

 

One COVID-19 centric research project that is underway involves students from our Schools of Nursing, Rehabilitation Therapy and Medicine here at Queen’s. The project is being led by Dr. Stephen Vanner, pictured above, the Director of our Gastrointestinal Disease Research Unit.

Worldwide experience with the rapidly evolving COVID-19 pandemic has highlighted the urgent need for expanded testing, and critical unanswered questions highlight that a rigorous approach is required. To understand the evolutionary epidemiology of COVID-19 and the usefulness of tests evaluating its circulation within defined populations’ longitudinal studies on well-defined cohorts are needed. These answers are also critical to inform policy decisions regarding the movement of segments of our community, particularly from regions where COVID-19 infection has been highly prevalent. This is especially true for post-secondary institutions grappling with decisions about when students can be safely returned to campus, protecting both their physical and mental wellbeing.

Queen's University is in a unique position to address these questions because a large cohort of health professional students are returning to our campus in either June or September. Dr. Vanner’s study aims to determine whether testing from asymptomatic individuals identifies carriers on arrival at Queen’s University at six weeks, three and eight months, and also determine what percentage have antibodies to COVID-19.

Read more below about the other projects funded by SEAMO’s COVID-19 Innovation Fund:

Stephen Archer & Victor Snieckus - Synthesis and preclinical testing of novel small molecule therapies for COVID-19

Currently, no drugs have been proven effective in a randomized clinical trial for treating the severe respiratory effects of COVID-19. Drs. Archer and Snieckus are confronting this challenge on two fronts. They will modify existing antiviral drugs to improve their metabolism and efficiency and reduce their toxic side effects. On a second front, they have identified that this virus kills cells, and may impair oxygen sensing by damaging mitochondria in lung cells. They will explore a novel mitochondrial pathway to combat the “happy hypoxemia” (low oxygen without appropriate shortness of breath), which characterizes COVID-19 pneumonia, and to prevent cell death by protecting mitochondria from SARS-CoV-2. Sussex Research Inc. (Ottawa) is collaborating in the antiviral drug synthetic work and dissemination of the results. 

Paula James and David Lillicrap - Coagulopathy: Understanding and Treating a Novel Entity

Drs. James and Lillicrap (Clinical and Molecular Hemostasis Research Group), leading researchers in hemostasis, are studying the links between COVID-19 Coagulopathy, an unexplained and potentially fatal blood-clotting syndrome associated with this virus, and von Willebrand Factor (VWF), a blood-clotting protein. They are collaborating with researchers at St. Michael’s Hospital (Toronto) and Vermont Medical Center who are studying the effects of the blood thinner heparin on COVID-19 patients, which has been shown in preliminary research to help these patients. The role of VWF in this disorder has not yet been studied, and the Queen’s/KHSC researchers aim to gain a better understanding of the mechanisms of VWF in COVID-19 Coagulopathy, potentially leading to the development of new treatments.  

David Maslove and Michael Rauh - COVID-19 and the Genetics of Mortality in Critical Care (GenOMICC)

Drs. Maslove (Critical Care) and Rauh (Pathology and Molecular Medicine) are part of an international genetics study on why some patients are affected more severely by COVID-19 than others. They will be looking at the DNA of patients admitted to intensive care units across Ontario and compare them to those of a healthy control population. Using advanced computing, they will be able to look at hundreds of thousands of subtle genetic variations across the population, to determine which of these are associated with outcomes. Knowing more about these variations will lead to new strategies for fighting the virus.

Martin Petkovich, Jacob Rullo & Martin ten Hove  - Coronavirus infection of the ocular mucosa to model infection and systemic immunity

Drs. Martin Petkovich, Jacob Rullo, and Martin ten Hove will study local and systemic immune responses to COVID-19 infection using a non-human model that will examine how the virus infects the mucosal layer of the eyes. They will also determine the efficacy of administering a vaccination via this route to see if it generates systemic immunity against coronaviruses, and then use these results to study how the disease progresses in vaccinated and non-vaccinated models.   

Robert Siemens & Charles Graham - The Role of BCG-induced innate immune memory in the protection against coronavirus 

Countries that use the vaccine Bacillus Calmette Guerin (BCG) to prevent tuberculosis show lower rates of coronavirus infection than those that do not. Intriguingly, this vaccine has also been used to successfully treat bladder cancer. Drs. Siemens and Graham believe that BCG enhances the body’s innate immune system. Their research aims to understand the immune-system mechanisms that lead to these protective benefits, and whether this vaccine could be used to protect against SARS-CoV-2, the coronavirus that causes COVID-19.  

In parallel, the Vice-Principal (Research) launched an internal initiative fund to support research projects that will contribute to the development, testing, and implementation of medical or social countermeasures to mitigate the rapid spread of the virus and its negative consequences on global communities. Five of the 13 projects at Queen's receiving funding are supporting the work of researchers in the Faculty of Health Sciences and are listed below. The full Queen’s list can be viewed here.

We are optimistic about the potential impact of these new research projects as we work to battle COVID-19. I encourage you to comment on the blog below to share your thoughts, and if you would like more information, please contact Emily Rees from the Advancement team at e.rees@queensu.ca.

2020-06-04 Taking action against anti-Black racism

I want to start this week’s blog by letting you know that I am spending a lot of time listening right now. Since the Faculty of Health Sciences posted a 4-part statement on Twitter condemning racism and violence against Black people and voicing our solidary with the Black community, I have heard from our community. I have received tweets and emails, and I have watched conversations unfold on social media.

Our community has voiced concerns. I have heard concern for our colleagues in FHS who are Black, and who may be feeling sadness, anger or despair right now. I have heard concern about our curricula, and whether it does enough to equip our students to challenge the systems that perpetuate anti-Black racism. I have heard concern about representation of racialized groups amongst our faculty members. I have heard concern for our staff, who also need to be supported in becoming allies. And I have heard concern that staying silent will not move us forward.

Our students have also been active on this. I have seen many of our students taking to social media to raise their voices. Just last night the Aesculapian Society published a letter denouncing anti-Black racism and laying out concrete actions that they will take as student leaders.

The current protests in defiance of anti-Black racism underscore the need for a commitment from institutions like the Faculty of Health Sciences to not simply stand in solidarity with the Black community, but to actively work to dismantle systemic racism. This is particularly important in a health and healthcare context. Our primary job, as a Faculty, is to train the next generation of healthcare professionals. And as such, we must prepare our learners to be leaders and advocates who are equipped to challenge racism in all of its forms, who understand that even today the colour of one’s skin can dramatically impact one’s health outcomes and who are motivated to work for change.

In the Faculty of Health Sciences, we take this responsibility seriously. And we have made some progress. 18 months ago, I struck a Commission on Black Medical Students to address the ban on Black medical students at Queen’s in 1918. The commission is chaired by our Director of Diversity, Dr. Mala Joneja, and its members include a diverse range of stakeholders that include staff, students and faculty members from across the university. The commission’s work has led to several initiatives beyond our public apology last April. Some have been actioned and some are on the way. They all aim to support our Black students and to bolster equity and inclusion within the School of Medicine. You can read more about what has been accomplished so far, and what is in progress here. As a dean, this has been the most meaningful work that I have participated in during my 10 years at Queen’s. It was an incredible honour when three representatives from the commission, Dr. Joneja, Mr. Edward Thomas and myself, were awarded the university’s Human Rights Initiatives Award in recognition of this work.

I know that there is more to be done. Here in the Faculty of Health Sciences, we have only just begun, but I can tell you that our three schools – Medicine, Nursing and Rehabilitation Therapy – are committed eliminating structural and institutional racism, and instead, building anti-racist structures within our institution. 

As we continue to engage in discussion and move forward with action, I would encourage you to continue to bring your ideas forward. Please continue to support one another, please continue to speak out against racism and please continue hold us accountable to our work in building a Faculty that prioritizes inclusivity, dignity and respect.

As a Faculty, we stand in solidarity with Black students, trainees, faculty members, staff, alumni, partners and the entire Black community to promote a Faculty, university and world that is equitable. A world where Black voices are heard and Black lives matter.

Occupational Therapy Students Make the Most of Online Learning
2020-05-28 Occupational Therapy Students Make the Most of Online Learning

I am pleased to share a guest blog with you today, written by Megan Edgelow, an Assistant Professor in the School of Rehabilitation Therapy. She is an occupational therapist and an educational researcher.

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The Spring has unfolded in some unexpected ways for first-year students of the MSc in Occupational Therapy (OT) Program. Students returned to campus in early March, fresh from their first two-month clinical placements across the province, and the country, ready to dig into a Spring term of learning while applying their recently expanded clinical skills. Just one week of face-to-face learning took place before students left campus and courses moved online due to Covid-19, and students once again found themselves scattered across the country when learning resumed online late-March.

For my teaching, the move online presented some challenges in OT852 “Group Theory and Process”. This course traditionally blends group theory and practical group leadership experiences, with teams of OT students designing and leading health-oriented groups for community volunteers in the Faculty of Health Science’s Clinical Education Centre. While theory may lend itself to online lectures and textbook readings, the applied learning activities in the course were more difficult to reconceptualize. Thankfully, with some creative thinking, and the flexibility of the OT students, all the learning objectives could be met remotely.

Occupational Therapy Students Make the Most of Online LearningMy course team and the students turned our usual face-to-face class times into regular Zoom sessions covering the necessary group theory, and then used the “breakout rooms” feature of Zoom to allow the students to work in teams. These smaller online rooms provided the students with a virtual environment where they could effectively engage in group collaboration, including the designing and planning of OT group sessions, while continuing to receive essential formative feedback from instructors.

To replace the in-person Clinical Education Centre experience, further creativity was needed. This year, the OT students designed “Healthy Aging” groups, creating content to address the physical, emotional, social and spiritual factors that influence the aging process, responding to the performance and engagement issues that the aging process can bring. Teams of students designed online group sessions around a variety of topics, including falls prevention, physical activity, leisure activity, time use and routines, spirituality, and coping skills for use in daily life and with the stress of Covid-19. Students then recruited adults and older adults from their own lives, including parents, grandparents, aunts, uncles, family friends and neighbours to volunteer as their group participants.

Occupational Therapy Students Make the Most of Online LearningOver the course of two weeks in May, 10 teams led and recorded three group sessions each, for a total of 30 “Healthy Aging” group sessions, with over 50 community participants.

Feedback from the participants was overwhelmingly positive. They learned new things about staying healthy later in life, as well as ways to cope in daily life and during the global pandemic, and they appreciated the opportunity to connect remotely with the OT students and other participants during a particularly isolated time. Some participants even asked to keep in touch with each other to keep applying their learning and supporting one other.

For myself and my co-instructors, who had the pleasure of watching the recorded group sessions and providing the OT students with feedback on their leadership skills, the learning was clear. Our students designed creative, engaging and supportive sessions for their participants, learning about leadership in a new way during an unprecedented time in health care.

Given the ongoing need for flexibility in health service delivery, and the expanding nature of telehealth and remote health care, this learning experience sows the seeds for these OT students as future action-oriented, responsive and adaptive leaders. This evolving health care environment continues to provide opportunities for Occupational Therapists to lead in health systems adaptations, addressing issues of performance and engagement, and focusing on meaning, purpose and connection with patients and clients as their health journeys unfold in real time.

A call to action from Global Health leaders at Queen's
2020-05-12 A call to action from Global Health leaders at Queen's

I am pleased to share a guest blog with you today, written by the COVID-19 Pandemic Working Group of Global Health at OPDES. This group of faculty and staff members within the Faculty of Health Sciences endeavours to:

  • Advocate for health equity to be considered in all aspects of the Faculty of Health Science and Queen’s University’s response to the pandemic;
  • Raise the health concerns of and challenges faced by marginalized patients and populations in our community;
  • Support global health and equity-focused practitioners, researchers and learners in local and international communities; and
  • Support community partners who are already engaged in equity focused work
  • Support and advance the work of the Director of Global Health at OPDES.

As with Dr. Fayed’s blog published last week, the COVID-19 Pandemic Working Group of Global Health highlights a critical issue, and asks us to consider the fulsome impact of the crisis that we find ourselves in today. I invite you to share your thoughts by commenting below.

Richard

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It is becoming increasingly clear that within countries, cities and communities, we are witnessing vast disparities in outcomes as a result of the SARS-CoV-2 pandemic. Across our country, vulnerable populations with chronic illnesses and disabilities, those incarcerated, those in poverty, and those living in long-term care homes, have borne the brunt of this disease. We also know that the health impacts of this pandemic go far beyond the direct morbidity and mortality related to SARS-CoV-2. Social distancing and the economic standstill will affect us differently as social determinants of health continue to dictate different outcomes in the same city, county, province or state. The pandemic has revealed disparities related to access to technology, connectivity and transportation, geographic distance to health centers, and basic shelter.

As the pandemic unfolds in Canada and in different countries, it has become clear that there are grave health equity considerations that academic institutions such as the Faculty of Health Sciences (FHS) at Queen’s University have an obligation to address. Our commitment to health equity requires us to work to reduce and eliminate disparities in health outcomes—to ensure social justice in health. Disparities are avoidable adverse health outcomes caused by structural factors and social determinants of health that affect people experiencing homelessness, mental health or substance use concerns, racialized people and Indigenous persons, those experiencing family violence, and people living with disabilities, among others. 

In addition to being at the frontline of the immediate medical and public health response, FHS faculty members must engage with our communities locally and globally to address the pandemic using a robust health equity lens. We call upon all members of the Faculty to consider health equity in the way we educate, the types of research questions we choose to ask, and how we advocate for patients and populations during and after the pandemic.

If you are a faculty member or a learner who is doing an equity-related activity, if you want to raise awareness about an equity-related issue associated with the pandemic, if you have questions and need to be connected to experts or resources, or if you have ideas for optimizing the way in which health equity and disparities are addressed in the FHS, please comment on the blog, or better yet, reach out to us at Global.Health@queensu.ca.  We are aiming to encourage dialogue, bring resources, facilitate partnerships and highlight advocacy, education, and research in health equity at FHS

For more information, please visit our webpage.

Yours sincerely,

Drs. Nazik Hammad, Eva Purkey, Colleen Davison, Heather Aldersey, Faizal Haji, Susan Bartels, Rosemary Wilson and Eleftherios Soleas on behalf of the Pandemic working group of Global Health at the Office of Professional Development and Education Scholarship (OPDES), FHS.

Resources

  1. Armitage, R., Nellums. The COVID-19 response must be disability inclusive, Lancet Public Health, Published Online March 27, 2020 DOI: https://doi.org/10.1016/S2468-2667(20)30076-1
  2. Dorn, A. et al. COVID-19 exacerbating inequalities in the US. The Lancet, Volume 395, Issue 10232, 1243 – 1244 DOI: https://doi.org/10.1016/S0140-6736(20)30893-X
  3. Hall, K et al. Centring sexual and reproductive health and justice in the global COVID-19 response. The Lancet, Volume 395, Issue 10231, 1175 – 1177 DOI: https://doi.org/10.1016/S0140-6736(20)30801-1
  4. Owen WF, Carmona R, Pomeroy C. Failing Another National Stress Test on Health Disparities. JAMA. Published online April 15, 2020. DOI: https://doi:10.1001/jama.2020.6547   
  5. Paakkari, Leena et al. COVID-19: health literacy is an underestimated problem. The Lancet Public Health, Volume 0, Issue 0 DOI: https://doi.org/10.1016/S2468-2667(20)30086-4
  6. Wang, Z., Tang, K. Combating COVID-19: health equity matters. Nat Med, 26458. DOI: https://doi.org/10.1038/s41591-020-0823-6
  7. Wurcel et al. Spotlight on Jails: COVID-19 Mitigation Policies Needed Now, Clinical Infectious Diseases. DOI:https://doi.org/10.1093/cid/ciaa346
  8. https://disabilitydebrief.substack.com/p/where-we-are-now-disability-in-the
  9. http://globalaccessibilitynews.com/2020/04/14/advisory-group-to-help-canadians-with-disabilities-during-covid-19/
We can’t forget community-based care during the pandemic
2020-04-29 We can’t forget community-based care during the pandemic

I am pleased to share a guest blog with you today, written by Dr. Nora Fayed. Dr. Fayed is an Assistant Professor in the School of Rehabilitation Therapy. She is an occupational therapist and a health services and systems researcher.

Dr. Fayed has touched on an important issue and I hope that, after reading the blog, you will share your thoughts by commenting below.

Richard

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COVID-19 surprised us all. Canadian providers and policy-makers quickly mobilized to create a response aimed at protecting the health of our population. The responses included repurposing factories for medical equipment, flatten-the-curve media campaigns, and a deeper public understanding of the importance of emergency room access, intensive care service, and personal protective equipment for hospital workers.  

There is a concomitant cost to focusing on hospital-based healthcare at the expense of other areas of the system. In this first wave of the pandemic, COVID-19 has claimed higher infection and mortality where skilled healthcare is less visible and understood by the public such as long-term care and residential care. Now that we are aware of this oversight, it is time to prevent more of them.

Specifically, we need to talk about community-based care.

The consequences of averting the public, policy, and provider gaze away from community-based care is costly to us all. What informs this perspective? My research focuses on evaluation of a Ministry of Health funded coordinated-care intervention dedicated to children with high levels of medical complexity, complex disabilities, and their families. Depending on how you define them, they represent only 0.5-2% of children but require 1/3 of all Ontario health spending for kids. This phenomena of a small group of complex patients requiring the bulk of health spending occurs across the lifespan in Canada.

Lately, some events have me concerned.

All of these concerns fall under the umbrella of small gaps in community-based care that might result in avoidable care urgencies for the most complex patients and people with disabilities. Inclusion and foresight of community care at all levels will prevent us from overwhelming hospitals downstream..

Firstly, complex patients, their families, and people with disabilities are scared. Preliminary data I have begun collecting on children and families in pediatric complex community-based care suggests they are actively declining or reducing home care. This could be because of caregivers’ worries that their children are more vulnerable to viral attack than the general public, perceptions that home health workers may transmit the virus, or beliefs that workers lack the proper precautions or equipment to prevent disease spread. The extent to which complex patients at home are being exposed, is one worthy of discussion by the appropriate experts, but not the issue I am raising here. My concern is the preventable mental and physical health burden taken on by caregivers and the lack of patient monitoring that can result in illness and hospital admissions. For example, if caregivers can’t get the sleep they need, they can make mistakes with their child’s medications, their medical technology, or end up at the hospital with general burnout or inability to cope. Our caregivers are a precious resource in the effort to maintain community-based health. As providers, we need to take actions that help them maintain their health and that of their children at home. Luckily, community-based care strategies have been considered in our region, and there are indications that we are faring comparatively well. However, attention to community-based health care is not universal in all regions.

What can providers do? Talk to your clients and patients and begin to learn what is needed to maintain their trust in home care. If the issue is family perception of infection control, 1) stay informed about the latest evidence on what it would take to control exposure, 2) provide access to webinars or infographics that help everyone stay informed, and 3) if needed, walk families through best procedures, step by step, to help them feel trust in their home health supports. Discuss the benefits and challenges of receiving home care with each individual family.

What can policymakers do? During decision-making, consider if/how many services that are being delivered in the community are essential even if they are not hospital-based. In Ontario, a highly essential reimbursement for health service has been suspended in the form of the closure of the Ontario Assistive Device Program (ADP) office. The ADP program funds over 8,000 types of medical technology and assistive devices such as insulin pumps and supplies, respiratory equipment, pressure modification devices wheelchairs, enteral feeding supplies, and home oxygen. These devices and technologies are not the bells and whistles of health care; they are essential. They allow children and adults with complex illness and disability to survive and thrive in their communities and prevent the need for hospital emergencies.

The issue of the ADP office closure was raised by the Ontario Society of Occupational Therapists in conjunction with many Ontario tertiary care centres. The government response was that applications will continue to be processed, but only for patients who require equipment to be discharged from hospital to home. This leaves a gap, in that applications for new or existing equipment - that keeps children from going to hospitals in the first place – are not currently considered. This means that children with medical equipment needs they can’t afford will need to go to the hospital to get them. This is not an efficient use of our healthcare system.

The Ontario government also clarified that the ADP office will continue to make transfer payments to device and equipment suppliers (based on past claims) to keep the supply chain afloat. This practice seems like a solution, except it places the burden on suppliers to fill orders in advance, not knowing for certain whether the orders are for the appropriate equipment, or whether they will receive reimbursement. Essentially, suppliers are being asked to take on liability for the appropriate equipment and the expense for it. At the same time, low income families might not be able to pay the costs up front. It is time to close this gap in essential service.

A final note to my fellow therapists and health care professionals. If you are an ADP authorizer, I encourage you to take into account the pressures and demands of COVID-19 and consider the consequences to individuals on your caseloads of not conducting assessments for ADP eligibility. Make those consequences known to your employers and your community. A broader understanding of the issue will encourage policy-makers to be aware and inclusive of patients who need this service.

The progress we have made in Ontario with our pandemic response is laudable. But it has only begun. My message as an occupational therapist and a health services and systems researcher is that we need to remember community-based healthcare so we can continue to maintain our progress in supporting some of the populations who need it most. In doing so, we will all benefit.

How FHS students are volunteering with seniors in our community
2020-04-24 How FHS students are volunteering with seniors in our community

As social distancing measures continue across Canada, I have been astounded at the ways in which students within the Faculty of Health Sciences have stepped forward in a volunteer capacity. Our students are astute; in just a few weeks they have identified several areas of need and quickly organized themselves to provide much needed support. I detailed some of these initiatives in my blog in late March.

This week, I learned that some of our students, independent of the university and curricular activities, have created a program to support seniors in the Kingston community. The students were inspired by the University Hospital Network’s OpenLab Friendly Neighbour Hotline in Toronto, where volunteers deliver groceries to seniors. They named this program the ‘Student-run Community Support Program’ (SCSP) and it was formally launched in early April. The organizing team includes students from across four programs (medicine, nursing, occupational therapy and physical therapy): Valera Castanov, Vanessa Giuliano, Nia King, Ruchit Patel, Daniel Shi, Jenn Campbell, Kathryn McGuire, Justin Achat, Theresa Fraser, Grace Manalili, Michaela Patterson and Cici Sij.

“During the COVID-19 crisis, it has become increasingly difficult for seniors to obtain groceries, especially with the risk of going out to large crowds. We thought it would be great if seniors and other vulnerable populations in Kingston had the support that UHN is offering in Toronto,” says Daniel Shi, who is a medical student. “As Queen's medical students we all followed a member of the Kingston community with a chronic illness as part of the First Patient program in first year. Hence, we began to recruit volunteer students to reach out to our former patients and offer support.”

The support comes in the form of either grocery shopping with contactless deliveries or weekly phone calls, with an aim to prevent senior isolation. The students have organized this on their own as volunteers, without involvement from the Faculty of Health Sciences.

"Community is imperative during a time like this. We have built a community of health professions students who are eager to pool their talents to benefit the wider Kingston community,” says Theresa Fraser, who is an Occupational Therapy student. “Our ultimate goal is improved health, well-being, and quality of life of individuals and populations in the community." Having developed a system for the logistics and accepting reimbursement for groceries, there are now over 40 student volunteers using their own vehicles and bicycles to do grocery shopping and delivery for those who request it. They are delivering to seniors who live within a 30-minute drive from downtown.

We all have relatives who we are worrying about during this pandemic. And what I love most about this initiative is that it provides a way for both seniors and students to build connections in the community when they may not have family nearby.

"Speaking with individuals and families on the phone has allowed me to feel more connected to my community, even in a time of social distancing,” says Alanna Jane, a medical student who has been having weekly phone calls with local seniors. “I have really enjoyed my volunteering experience so far.”

I am in awe of our students’ willingness and ability to serve others during this challenging time. But they tell me that this isn’t a one-shot deal.  After the COVID-19 pandemic ends, the students have a plan to expand the program to include in-person visits. The students envision going on walks, playing cards, and engaging in other activities that would provide ongoing emotional support and physical activity for the people they have met through the program. What a beautiful image to have to focus on right now.

To learn more about the SCSP program or to sign up to receive support, click here.

Please share your thoughts by commenting on the blog, better yet, let’s set up a Zoom call….my virtual door is always open.

Richard

How I discovered a new talent through social distancing
2020-04-08 How I discovered a new talent through social distancing

I remember 10 years ago, when I had just started as dean, gathering a group of communications experts and IT specialists in my office to strategize about social media. I wanted to get connected and stay engaged with alumni, faculty, staff and students, and social media seemed like a great tool to do so.

I started my twitter account, @DeanOnCampus in July 2010, and have been tweeting somewhat regularly ever since. I got the occasional spike in interest, but nothing to write home about.

So who would have imagined that of all the messages I sent out over a decade, that by far and away the most popular tweet would be an attempt to add a little humour to a time of unprecedented seriousness and fundamental change to all of our lives.

The tweet in question - that received 80,000 impressions and more than 18,000 engagements – is about me dyeing my wife Cheryl’s hair.

Last week Cheryl reached out to our favourite hair stylist, Fletcher Nelson of Chic Kingston (if you are a dedicated reader, you have heard me rave about him before). Practicing appropriate social distancing, Fletcher left a package for Cheryl on the doorstep. In it was her colour mixture, an application comb, an instruction sheet and a plastic smock.

With all the supplies in hand, Cheryl then needed someone to apply it. Of course, you know who she asked. The procedure, which I took very seriously, went smoothly. My son who was in the house at the time, documented the event by taking a photo. I decided why the heck not, and tweeted it out.

To my surprise – because I don’t spend a lot of time on Twitter, let alone obsess about it – my notifications started lighting up. Opening up the app, I saw that the likes, retweets and replies were accumulating quickly. And almost all of it was in good fun:

View the full conversation on Twitter
View the full conversation on Twitter
View the full conversation on Twitter
View the full conversation on Twitter
View the full conversations on Twitter
View the full conversation on Twitter
View the full conversation on Twitter
View the full conversation on Twitter
View the full conversation on Twitter
View the full conversation on Twitter

 

I’m flabbergasted that in ten years of tweeting, this by far and away got the most attention. But I think in some way, the tweet struck a chord.

Our circumstances are deeply unusual given the COVID-19 crisis. I think the tweet reflected a combination of the adjustment to our new reality and the desperation for a laugh during a time when things are so serious, and the challenges seemingly insurmountable.

As we persevere through these unprecedented times, I would love to hear your thoughts. Please share them by commenting on the blog, or better yet, let’s set up a Zoom call….my virtual door is always open.

Richard

Look for the helpers
2020-03-26 Look for the helpers

The world has changed dramatically in the past two weeks.

I never would have imagined a time where 90% of our workforce is working remotely; a time where you only leave home to get essentials like groceries, or a time where the only way to see loved ones is through a computer screen. And yet in a very short time, we have reached this place, and come to accept it as our new - albeit temporary - normal.

If you listen to the radio, scroll through social media or read the newspaper, COVID-19 has quickly become the one and only thing we’re talking about. Many are scared, and there is good reason to feel this way. As I write this, we sit at the precipice. We could see the virus overwhelm our healthcare system, with a disastrous impact on our population. Or, together (but apart), we could flatten the curve and see the virus progress in such a way that we can manage the impact of its spread.

And with the high levels of fear and uncertainty that now characterize our day to day, I am reminded of a quote from Fred Rogers from the TV show Mister Rogers Neighbourhood:

“When I was a boy and I would see scary things in the news, my mother would say to me, 'Look for the helpers. You will always find people who are helping.'”

Over the past week I have been struggling with what to write on my blog. The precautions that we’re taking, what we know about the virus, how we’re shifting our operations within the Faculty of Health Sciences; all of these things have been changing at such a steady pace that I figured whatever I might put down on paper would be out of date by the time it published.

So today, I am going to heed the advice of Fred Rogers’ mother, Nancy Rogers, and use my blog as a forum to point out some of the many helpers in our community who are responding to the COVID-19 pandemic.

Last week, knowing that the closure of schools and daycares would put a strain on the healthcare workforce, a group of medical students quickly organized a system where healthcare staff could request help with childcare, grocery pick-up and other services, and paired them with medical, nursing, OT and PT students who would volunteer to do it. Shikha Patel, one of the lead organizers from the Aesculapian Society, told me that to date, 73 students have signed up and 90 requests from healthcare providers have been received. From this, they have been able to pair students with 35 families to provide support that is allowing our healthcare professionals to continue to work on the frontlines.

Erna Snelgrove-Clarke, our Director of Nursing, put a call out on Twitter this week for acts of #intentionalkindness. Many of our staff, faculty and students responded with small but meaningful acts of kindness. Picking up groceries for others who are in quarantine, cards and gifts to acknowledge the hard work of colleagues, supportive calls to friends through virtual means and picking up litter in the neighbourhood are just a few of the things that Erna’s callout inspired.

Responding to the need for more personal protective equipment (PPE) in hospitals, Dr. Hailey Hobbs found 3D printer plans online and worked with Jeremy Babcock, in our Clinical Simulation Centre, to start printing masks and other PPE. The initiative has now grown to include some of our medical students, residents, members of the Faculty of Engineering and Applied Science and St. Lawrence College. The group is now the recipient of several 3D printers that have been lent by the Kingston Frontenac Public Library, and Dr. Hobbs reported to me yesterday that they are now able to produce up to 500 masks and 100 face shields per week. Pictured at the top (from left to right) are Megan Singh; Zuhaib Mir; Jeremy Babcock; Matthew Snow; and Cesia Quintero who are all involved in the project.

Addressing another shortage, Queen’s scientists have started investigating the possibility of producing hand sanitizer with potential application in a healthcare setting.

A group of our medical students are working with KFLA Public Health on screening individuals, including recent travelers.

At a time when the most marginalized people in our community need more support than ever, Tom Heneghan and Jon Dunning, Occupational Therapy students in the class of 2020 are collecting donations for Home Base Housing, and coordinating the delivery and drop off of food donations.

And on the side, some of our very busy staff and faculty members, like Dr. Michelle Gibson, are addressing the need for a steady supply of blood by donating their own, and encouraging others to do the same.

Southeastern Ontario Academic Medical Organization (SEAMO) has pulled together 400 care packages for their member physicians to let them know that they are being thought of during this challenging time. 

Our clinical departments have sprung to action, preparing for COVID-19 patients in the coming weeks. Departments such as emergency medicine, critical care, family medicine, medicine and psychiatry are all going to great lengths to ensure that they are well prepared for all scenarios. Many of our staff and faculty members are already working on the frontlines, keeping our healthcare system running while putting their own wellbeing at risk. And many of those of our faculty members who are not clinically active are putting themselves on the list to be redeployed should the need for additional healthcare support arise.

And I would be remiss if I didn’t mention the unsung heroes of our Faculty. There are countless staff members who are helping in the background. Whether it is Peter MacNeil who, along with his team, who is supporting the technology for the delivery of our programming online as we deliver 50+ classes online just this week. Or Klodiana Kolomitro, who, along with her team in the Office of Professional Development and Educational Scholarship, has dropped everything to support our faculty members and students as we deliver curriculum fully online for the first time. Or our clinical secretaries, who are continuing to work with our patients on a day to day basis. Or Kevin McKegney and his team, who are keeping everyone safe by managing our facilities and ensuring that all runs smoothly as our research labs and facilities are put on pause, and our workforce largely shifts to working at home.

All of these people – and many many more who I haven’t named – are allowing our faculty to continue to put our mission into action as we train the next generation of healthcare professionals in unprecedented circumstances. But beyond that, they are supporting what I believe to be the biggest asset that Canada has: our public healthcare system. Each and every act of help is preparing us to handle what could be the biggest public health emergency of our lifetime.

So, thank you to all of the helpers who I have mentioned, and to everyone else out there who is making a difference. You are reminding us that when scary things happen, we can always look for the helpers.

Please share your stories of helpers – big acts or small – by commenting on the blog. I would usually say, stop by the Macklem House, my door is always open; but actually, since we are all working remotely for the next two weeks at least, my virtual door is always open…. you can drop by anytime by emailing me at Richard.reznick@queensu.ca.

 

Richard

Not Your Average Lasagna
2020-03-11 Not Your Average Lasagna

Not your average lasagna As I reflect back on the last 10 years as dean of this remarkable faculty and school of medicine, without a doubt, some of my fondest memories will be our student dinners. Back in 2010, as I was preparing to become the “new dean at Queen’s” my wife Cheryl asked me a simple, yet profound question. She said, “how are you going to keep in touch with the students?” Innocent enough, but complex and challenging. I replied I would do a bit of teaching, meet with student leaders, and keep in touch with weekly blogs. Cheryl responded, not bad…but let’s have them over for dinner.

Well, 10 years later, and 1,000 students fed, the student dinners have become a real joy for both Cheryl and I.

Although we have had several menus, Cheryl’s gourmet lasagna was the most common main course. In fact, I think, in the last 10 years, Cheryl and I have cooked over 200 of them. I stand corrected, Cheryl cooked all of them and occasionally I was the sous chef, relegated for the most part to chopping vegetables.

So, of all of my memories as dean, why the dinners? That’s an easy question to answer. Through the dinners, even in some small way, we were able to have a conversation with 1000 remarkable students. Over lasagna, we heard of the incredible array of experiences our students brought to Queen’s. Over a glass of wine or Perrier, we heard about their aspirations, their excitement at being at Queen’s, their initial guesses at career choice, and often, about their upbringing and families. And on more than one occasion, we broke out into song, and I somehow got myself coerced into doing a number for the annual Medical Variety Night!

Like Cheryl’s not-so-average lasagna, the classes of 2014-2023 have been extraordinary. Like the best lasagnas, our students started at Queen’s with a great foundation, sort of like simmering Vidalia onions and fresh minced garlic cooked in extra virgin first cold pressed olive oil. They have a richness to them, like the luxurious béchamel sauce that is secret ingredient of this great lasagna. And none of them are unidimensional, no, like the lasagnas that have three different types of cheeses, they too, bring diversity and complexity to our medical school. And no doubt, just like the home-made lasagnas, they too, all 1,000 of them, are “self-made”. They in year one from scratch, and in a non-compromising process, they matured, became fully baked and ready to start the next phase of their careers.

Our dinners represented what is best about Queen’s Meds: a feeling of family. Having had dinner together, students frequently stopped Cheryl and I on the street to say hello and pet the dog. Having had dinner together, students would wave as I walked into the medical school building. Having had dinner together, students had no hesitation in coming to my office when I advertised that “my door is always open”. And having had dinner together, in a small way, but a very special way for Cheryl and I, we achieved the original goal of staying connected to what is our biggest asset in the medical school…our students.

After 10 years of this great tradition, last night we held the final student dinner at our house. It was a bittersweet evening, but as with every dinner, I have come away feeling energized and proud of the fantastic students we have here in the School of Medicine.

Why cancer care isn’t ‘one-size-fits-all’ from one country to another
2020-03-03 Why cancer care isn’t ‘one-size-fits-all’ from one country to another

Six years ago, when Dr. Fabio Ynoe de Moraes was a resident in radiation oncology in São Paulo, he began to ask questions about cancer patients’ access to radiation in Brazil. How many LINAC systems (linear accelerator radiation machines) were there in the country? Where were they?

His mentor agreed that he could devote time to researching this question. He spent almost a year developing a map of every machine in Brazil, a country of more than 212 million people that’s geographically almost as large as the United States. And then he studied statistics about cancer rates.

“We calculated that only 45 to 47 per cent of those who would need radiation in their lifetime had access, and that 53% of cancer patients die without access to basic treatment.” 

When Dr. Ynoe de Moreas published his findings, they caught the attention of the country’s Ministry of Health, and the government fostered the development of a plan to increase capacity and access to radiation treatment. The government is now implementing, over five years, a program to purchase 100 machines so that 95 per cent of cancer patients will have access to radiotherapy. The plan includes training people to use and maintain the machines.

 “One of the biggest challenges is we do research but it rarely has an immediate impact on populations,” Dr. Ynoe de Moreas says. “I started to understand more about policy and got really excited. When you do policy and population research, you can improve care for thousands or more people.”

Dr. Ynoe de Moreas, who joined the Department of Oncology at Queen’s last year, now divides his time between clinical work and research/policy work and this year he is defending his PhD on Innovation in Health Care in Brazil. A former tennis pro, he applies the discipline and focus from that experience. Before heading to his clinical work at Queen’s, he spends his early morning hours doing policy work and global oncology research.

A major endeavour has been his international work completing a checklist for National Cancer Control Plans (NCCPs) with colleagues on the Union for International Cancer Control, Australia and World Health Organization. The biggest challenge in developing the list was “the amount of information and finding consensus among peers,” he says.

Dr. Ynoe de Moreas was a co-lead author of a policy review of this research that was published in Lancet Oncology last November.

The checklist, which consists of more than 100 core elements of a plan, builds on previous work by the World Health Organization. Most countries already have a national non-communicable disease plans, and a large proportion of those also have NCCPs. But these plans don’t always have common elements and most have not been implemented or even assessed for its quality.

Dr. Ynoe de Moraes and his colleagues discovered that a large number of previous plans did not specifically acknowledge childhood cancer — a major cause of mortality in lower income countries —nor the need for sustainable plans for machine maintenance. This new developed checklist takes both of those, and other factors, into account.

Similarly, strategies to actively encourage access to care for underserved populations had not been stressed. Dr. Ynoe de Moraes contributed to research that promoted this approach after establishing that a high proportion of men in Nigeria, a country with a high rate of prostate cancer mortality, believe they are immune to cancer. “Some believed breast cancer was the only cancer possible,” he says. “Or that cancer only happens to women.”

The checklist is designed to allow countries to establish a baseline of existing cancer prevention, diagnosis, and treatment resources. They can then implement a plan that is based on the resources that they have, and measure progress towards reducing the burden of cancer and improving the quality of life of patients. Dr. Ynoe de Moraes hopes to see more and more countries taking this kind of action.

With regional leaders at the helm, he believes that we will see real progress towards improving cancer control, and a reduction in the gaps in cancer care – the very gaps that first caught his attention when he was completing his residency in Brazil.

I swore I would never do this…but
2020-02-18 I swore I would never do this…but

I promised myself never to think about the end of my deanship, but the events of the last few weeks have made me break my promise. Just as we passed the new year, I became increasingly conscious of the fact that this truly is the last lap of what has been a privilege for the last nine and half years.

Last week, my successor, the Hon. Jane Philpott was announced as Queen’s next dean. Jane will be starting on July 1, and I know the entire Queen’s community wishes her well and is excited about her arrival. Here is a link to the announcement, which shares some of the details and the skills that Dr. Philpott will bring to Queen’s. 

This past week, I was at my last Faculty Board meeting. At that meeting I gave a state of the faculty address, that was somewhat emotional, as it will be my last formal speech in my capacity as dean. I must say, I’m very proud of all that we have collectively accomplished in the last nine and a half years, and I am very confident that there is a strong foundation on which Dr. Philpott can build; a foundation for success.

Royal College of Physicians LogoThis week, I was very privileged to have been elected as the President-Elect for the Royal College of Physicians and Surgeons of Canada. This is an organization I’ve been involved with for over 30 years. The President-Elect job lasts for one year, followed by two years as President and then one year has past president. So, my 30 years of engagement with the College will now be extended by four years of very active work for an organization that I know brings great pride to our medical community here in Canada.

The college has a new CEO, Dr. Susan Moffat Bruce, and I’m very much looking forward to working with her as well as the entire Council as we further the goals and ambitions of what is a rather unique organization around the world; an institution that has such a broad mandate for specialty medicine. You may know that we are one of the few colleges in the world that encompasses over 60 medical specialties. We are also rather unique in that we oversee the standards of training, accredit programs, set the final examinations, and oversee the maintenance of competence for practice.

Closer to the end of my tenure, I’ll fill you in on the extent of my planned activities for what will initially be an administrative leave for the next 15 months.

So, much too much work in the next four and a half months for me to become either too reflective or emotional, but I guess human nature is human nature, and it’s hard for me to divorce myself from the fact that not only will this be the end of my tenure as dean, but that I will be heading into semi-retirement.

However, there is still lots to look forward to, and more about this to come in future blogs.

If you have yet to take me up on my offer of stopping by the Macklem House, my door is (still) always open, but you better make an appointment soon!

Richard

Remembering Black Medical Alumni
2020-02-12 Before the ban: Remembering Black Medical Alumni

If you have been following my blog for the last year, you may be aware that in 2018, it was brought to light that the Queen’s School of Medicine (then Faculty of Medicine) banned Black students in 1918. And while the ban had not been enforced since 1965, it remained on the University’s books as an official policy. So in October 2018, the Queen’s University Senate formally repealed the ban on black medical students. But I knew that we needed to do more. In April 2019, then Principal Daniel Woolf and I issued a formal apology to those who had been affected by the ban.

Ethelbert Bartholomew was one of the Black students enrolled at the time of the ban, and he had completed nearly all of the necessary work to earn his MD. But because of this policy, he had to leave the school before graduating. Unable to secure a spot at another medical school, he supported himself and his family working as a sleeping car porter for the Canadian Pacific Railway.

Ethelbert’s son, Daniel Bartholomew, attended the public apology in April 2019. And while he was touched by this action, he requested the University take another symbolic step to address a historical injustice. And so, at the 2019 Spring Convocation, Queen’s presented Ethelbert D. J. Bartholomew with a posthumous MD, 101 years after he was pressured to withdraw from the Faculty of Medicine.

There were fifteen black students enrolled in the Queen’s Faculty of Medicine at the time of the ban with fourteen physically present on campus. Half of these students left shortly after the ban was introduced. Despite the promise of continuing their education elsewhere, the University did not help them secure spots at other Canadian schools. Most of these students completed their medical education in the United Kingdom. The other half fought to continue their education at Queen’s, despite constant pressure from the Faculty to transfer elsewhere. The last of these enrolled students graduated from Queen’s in 1922.

One of the most damaging consequences of the ban was that the Faculty of Medicine failed to acknowledge the accomplishments of those black alumni who graduated during the early twentieth century.

Today, in honour of Black History Month, I want to share with you the names of four students; three are alumni who graduated from the Faculty of Medicine. These stories are but a small sample of the illustrious careers of black alumni who received their MDs from Queen’s before the ban was enacted.

 

Dr. Courtney Clement Ligoure (Meds 1916)

Dr. Ligoure graduated from Queen’s before the ban and established his practice in Halifax, N.S. Unable to secure hospital privileges, he set up an independent surgery at his home in the city’s north end. He became the publisher of the Atlantic Advocate and used this position to advocate for the formation of the No. 2 Construction Battalion. In 1917 when the Halifax Explosion killed 2,000 and injured 9,000 people, he set off to tend the injured, using his home as a local dressing station where he successfully treated hundreds of injured persons over the next several days.


Dr. Hugh Gordon H. Cummins (Meds 1919)

Dr. Cummings rose to prominence as a co-founder of the Barbados Labour Party in partnership with Sir Grantley Adams. He became the second premier of Barbados and played an instrumental role in revoking the Island’s predatory Located Labourers Act.

 
Dr. Curtis Theopolis Skeete (Tufts 1925)
 

Dr. Skeete left Queen’s immediately after the 1918 ban. He would eventually graduate from Tufts University and establish his medical practice in Nassau County, N.Y. In the 1940s, he became the first president of a local chapter of the National Association for the Advancement of Colored People, which played a pivotal role in confronting Long Island’s infamous regime of racial segregation. 

John Wiseman Eve (Meds 1917)
Pictured above

John was born in Bremuda and attended the Bertley Institute, graduating with a Senior Cambridge Certificate. He joined Queen’s Faculty of Medicine in 1913, in the class of 1917. Jack was an excellent violinist and an enthusiastic member of his class. He was a member of the Freshman Year Executive. John died in a canoeing accident on August 12, 1916, just on year before completing his MD.

 

There are many more stories that I have not included here, but I hope that in reading this blog, you have taken a moment to reflect on these four students who walked through our doors over 100 years ago. Nelson Mandela once said, “Education is the most powerful weapon which you can use to change the world.” And Drs. Ligoure, Cummins and Skeete did just that.

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

Child being held by a woman while the child looks over her shoulder
2020-02-04 Uncovering a human rights crisis in Haiti – what happens next?

Since the beginning of her career as a physician, Susan Bartels has felt a pull toward social justice, and to addressing the broader issues of health care inequity around the world.

It’s no surprise, then, that her latest research into the impact of the long-standing UN peacekeeping presence in Haiti follows that same trajectory.

Uncovering a human rights crisis in Haiti – what happens next?
Dr. Susan Bartels (right) with Luissa Vahedi (left) who
graduated in 2019 and Samantha Gray (middle) 2nd year
masters student

The study, conducted with Sabine Lee, Professor of Modern History at the University of Birmingham, and published in The Conversation, details how girls as young as 11 are being sexually abused and impregnated by UN peacekeepers and left, often in extreme poverty and disadvantage, to raise children alone and, in most cases, with no assistance from the fathers. The research has garnered significant attention around the world, and is steadily creating awareness and change around a very troubling issue.

Dr. Bartels – who is an associate professor in the Department of Emergency Medicine, a clinician scientist with research support from SEAMO and a practicing emergency room physician – became interested in Haiti, particularly because it presented an interesting case example. While there has been a peacekeeping mission in Haiti for many years due to political instability and the 2004 coup, there has been no actual armed conflict in the country. Severe natural disasters, including the 2010 earthquake and Hurricane Matthew in 2016, have made the situation even more complex.

“Because the peacekeepers have been there for nearly two decades, we knew there were likely interactions that had happened and lived experience we could document, with children born and paternity claims made,” she says.

Dr. Bartels explains that she and her team were fairly certain the sexual abuse by UN peacekeepers was happening in Haiti, but interestingly, she was surprised to learn that the story was more nuanced than she had thought.

Luissa Vahedi

GRAD CHAT Luissa Vahedi, MSc in Epidemiology, supervised by Dr Susan Bartels and Dr Heather Stuart.

Topic: Even Peacekeepers Expect Something in Return’: An Exploratory Cross-Sectional Analysis of Sexual Interactions Between UN Peacekeepers and Haitian Citizens.

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“There was much more transactional sex happening than I expected, arising from the poverty and social situation in the country,” she says. “Overall, what troubled me the most was how normalized it was in Haitian society. For many there was an acceptance that ‘this is how it is.’”

Dr. Bartels’ research was published late last fall in the International Peacekeeping journal, and media interest was strong early on, with an article first in the Times of London, and then in the New York Times as well as other major media outlets.

“The attention was somewhat uncomfortable at first, mostly because my previous work has not been publicized to this extent,” she says. “But it has made me feel hopeful that the results of our study will make a difference and that with this exposure the information will fall on the right ears and have some impact.” 

Indeed, the research seems to be falling on the right ears. Representatives from the UN have been in touch with Dr. Bartels – an unprecedented move – and her team looks forward to engaging with them. She is also in the final stages of editing a policy brief that will be shared with various UN offices. The study has also created a stir in many of the peacekeepers’ home countries. Notably, the Chilean government has already commissioned an inquiry into the issue. And locally, Dr. Bartels hopes to work with the Peace Support Training Centre in Kingston to incorporate her research into pre-deployment training programs for peacekeepers.

In the near future, she hopes to go back to Haiti to host a multi-stakeholder conference with the UN, the Haitian government, various NGOs, and women and girls with lived experience. But the current security situation in Haiti, with repeated lockdowns, has made it difficult to organize. She says she also hopes to interview peacekeepers, to provide a more balanced look at the situation.

“There is a lack of understanding of how the economic situation for women and girls in Haiti leads them to engage in transactional sex, and I believe the perception by peacekeepers is that the women and girls  are willing participants,” she says. “There is a lack of recognition around how the living situation and lack of choice compromises one’s ability to give consent.”

One of the great joys of being a researcher is to be able to ask a question and follow it through to the answers. Even more powerful is when those answers translate to changes in policy that will positively impact vulnerable or marginalized populations. As a Dean, I am proud of Dr. Bartels’ accomplishments so far, and look forward to following her progress and the impact her work in Haiti and around the world. Please share your thoughts on Dr. Bartels’ inspiring work by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

2020: Year of the Nurse and the Midwife
2020-01-28 2020: Year of the Nurse and the Midwife

The World Health Organization has declared 2020 the year of the Nurse and the Midwife. Our new Director, School of Nursing, Dr. Erna Snelgrove-Clarke reflects on the importance of this declaration and what it means for the profession of nursing, and the populations that nurses serve.

 

Despite varying reports, by 2030, the global nursing shortage will reach the staggering number of nine million. 2020 is the year of the Nurse and the Midwife. Designated by the World Health Organization, this year we honor the 200th birth anniversary of Florence Nightingale and in turn, the many nurses who play a critical role in health promotion, disease prevention, and the delivery of care.

Nurses and midwives represent more than 50% of the global health workforce. The ongoing and increasing shortage of nurses and midwives will have a devastating impact on our health worldwide. In this, the year of the Nurse and the Midwife, it is time to reflect and to take charge. Achieving health for all depends on the education provided and the numbers of nurses we educate. It is our responsibility to ensure we are ready to meet health demands and to have nurses prepared to support this demand.

What does Nursing look like in Canada? Over the past five years, the annual growth rate has declined. Interestingly, this growth rate increases 1% per year and is similar to the Canadian population growth trend. Effective planning and management for healthcare requires careful consideration.

What do we know about health outcomes and university prepared nurses? In 2014, researchers reported that BSN prepared nurses’ both lower patient mortality and better patient outcomes when the proportion of BSN prepared staff nurses increased by 10%. That is, increasing education initiatives enables nurses to care more knowledgably for the patients for whom they provide care and ultimately improve outcomes.

Decision-making, critical thinking, and evidence-informed care are core competencies of a Queen’s nursing graduate. Growing demands for health-related knowledge and advanced competencies, in a world of ever-changing knowledge, require us to educate and graduate nurses who are prepared to meet the challenges of today’s healthcare system.

What can we expect to see in the provision of care? An aging population and increase health complexities; support required for mental health related issues and a nursing leadership ready to navigate the changing healthcare landscape.

What do we need to do? We need to be ready and we need to get ready! Our approaches to education need to be creative and innovative. Technological advances require us to reach out and explore all possibilities. Collaborative and interdisciplinary research will ensure we capture the depth and scope of initiatives required to transfer knowledge into practice and improve health outcomes.

In this, the year of the Nurse and the Midwife, the Queen’s School of Nursing is making these preparations. We are collaborating with healthcare providers to close that gap between research and practice, we are applying at increasing rates and increasing our successes with tri council funding, and we are growing out health quality endeavours. Supporting nurses to work to their full potential, it is not simply about the quantity of nurses but also the quality. Working collaboratively with educators, administrators, and government we will realize the full scope of nursing. Let’s celebrate our nurses: those providing and those receiving education, those researching to advance our health and well-being, and those providing care in the hospital, the community, and the home. When we value all persons in the context of care, healthful outcomes will be realized.

 

Dr. Erna Snelgrove-Clarke
Vice-Dean, Faculty of Health Sciences and Director School of Nursing

5,000 people leave the Canadian military each year; A PhD student looks at how they should be supported
2020-01-21 5,000 people leave the Canadian military each year; A PhD student looks at how they should be supported

When Ashley Williams’ brother left the military in 2015 after nine years of service, she witnessed the challenges he encountered with the transition to civilian life. Her brother, Shane, had been in the military since graduating high school. He left voluntarily to return home to Newfoundland. At the time, Ashley was working in Ontario as an occupational therapist with a family health team.

Although Shane had no health issues, Ashley found herself wondering how Veterans adjust to having to rely on provincial health care.

What many of us don’t realize is that members of the military have continuous access to the Canadian Forces Health Services. “This access requires next to no navigation on their part,” Ashley explains. It occurred to Ashley that making the transition to the provincial healthcare system – where the patient has to take charge of their care – could pose a significant challenge to Veteran populations.

Ashley Williams

GRAD CHAT with Ashley Williams, PhD student in Rehabilitation Science supervised by Drs Catherine Donnelly and Heidi Cramm .

Topic: Access to primary health care during the military to civilian transition.

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There are about 5,000 members of the Canadian military who leave for civilian life every year. In addition to considering how well they navigate the public system, Ashley wondered how well healthcare professionals understand the unique needs of Veterans. “We don’t know whether a persons’ status as a Veteran is something that is on the radar of primary care providers,” she says. “This may have implications for the care provided to Veterans.”

Ashley, whose MSc in Occupational Therapy is from the School of Rehabilitation Therapy at Queen’s, is now in the third year of her PhD in Rehabilitation Science.

In order to explore these questions about the care of Veterans – and to look at how the healthcare system could be improved to help people like her brother – she needed funding.

This past October, Ashley was thrilled to find out that she was the 2019 recipient of a $40,000 doctoral scholarship from Wounded Warriors Canada. Wounded Warriors is an independent veterans’ charity focusing on mental health and was founded in 2006. Applications for the award are submitted to the Queen’s-based Canadian Institute for Military and Veteran Health Research (CIMVHR). The winner is determined by an independent academic review committee.

The prestigious award provides Ashley her with two years of support to pursue her research into how military to civilian transition works when it comes to the public health care system. Ashley is the seventh award winner and the third from Queen’s. Queen’s student Celina Shirazipour received the award in 2014, and Linna Tam-Seto, who received the award in 2016, is now a post-doctoral research fellow at Queen’s.

 “When you look back at the other six recipients, you get a chance to see how their research has had a real impact on people. It is amazing to be in such company. It reinvigorates your drive to do the work and helps you realize you have the capacity and that it’s possible to make a difference. That’s kinda cool” says Ashley.

Ashley has already begun to recruit participants for the first phase of her research, which will be in-depth interviews with a variety of recently released military Veterans – those with a range of release types, service elements, and ranks – about their transition from Canadian Forces Health Services. The goal is to gain a solid understanding of their experiences accessing the public health system. The second phase will focus on how team-based primary care is provided to Veterans.

Throughout her academic career, Ashley has continued to work part-time as an occupational therapist with two different Ontario family health teams. “It’s nice to have a clinical role to be helpful at a more direct level,” she remarks. “But research and creating new knowledge will help at a different level. It has a broader capacity for impact.”

I always enjoy sharing stories of students in the Faculty of Health Sciences who are putting our vision into action by Asking Questions, Seeking Answers, Advancing Care and Inspiring Change. Please join me in wishing Ashley continued success as she seeks answers to her important questions by commenting on the blog, or better yet, drop by the School of Rehabilitation Therapy to congratulate her yourself!

This Queen’s oncologist is moving mountains to improve cancer care
2020-01-13 This Queen’s oncologist is moving mountains to improve cancer care

Mountains in NepalThe Himalayan country of Nepal has a population of 33 million. And yet there are  less than 20 medical oncologists in the country to treat the rising rates of cancer among the Nepalese people. If you compare that to Canada, there is quite a difference. We have about 620 oncologists available to treat our population of 37.5 million.

For a Nepalese cancer patient, this disparity means that access to care is not as simple as going to the local hospital each week for chemotherapy. There are only two public cancer centres in Nepal that offer treatment: one in Kathmandu and the other in Bharatpur. And in a country characterized by mountains and variable road conditions, those centres can be difficult to get to. Living expenses in Kathmandu are prohibitive, leaving some patients to travel more than 500km to get 45 minutes of chemotherapy on a weekly basis.

Dr. Bishal Gyawali, an Assistant Professor in the Department of Public Health Sciences, is acutely aware of the strain the lack of oncologists places on individuals and on the Nepalese healthcare system. After completing his speciality training in oncology in Japan, Dr. Gyawali - who was born in Nepal - returned home and spent six months working in a public hospital in Kathmandu.

There, he witnessed the challenges facing cancer patients. “One of my young male patients was from the far western part of Nepal and he needed chemotherapy every two weeks. It would take him more than 36 hours to come to Kathmandu for chemotherapy. This disrupted his job, on top of the cancer diagnosis and hassle of travel.”

With the burden of childcare often falling to Nepalese women, they face particular challenges. “A woman from rural Nepal stayed in Kathmandu with her relatives for more than three months to complete her chemo. She had two little kids back home who needed her care, but she had to complete the chemo first,” he says. “A weekly commute was impossible.”

But Dr. Gyawali sees a way forward.

He has a plan to import an initiative that has been successful here in Canada – to Nepal. It’s a training program for primary care doctors, which builds their capacity to deliver basic cancer treatment in rural settings. Here in Canada, this has dramatically increased the number of patients who can receive care close to home. Upon completion of the training, the Canadian physicians gain the designation of General Practice (GP) Oncology, and go on to provide rural cancer treatment.

When Dr. Gyawali came up with the vision for this project, he lacked the resources to make it happen. “I had thought about doing this for a long time but had no money or ability to implement it,” he says.

That changed last month when Dr. Gyawali received a prestigious award from the American Society of Clinical Oncology (ASCO) which will allow him to lay the groundwork for a training program modelled on the Canadian one.

The $50,000 award will be used to perform a needs assessment and to collaborate with Nepalese doctors to develop a training curriculum in basic oncology care. The training will be delivered to primary care doctors who practise outside the two main cancer centres in Nepal, thus increasing the capacity of GPs throughout the country. Ultimately this will make cancer care more accessible to patients, regardless of geography.

Dr. Bishesh Poudyal and Dr. Bishal Gyawali
Left: Dr. Bishesh Poudyal, right: Dr. Bishal Gyawali

In some cancers, chemotherapy needs to be administered once a week for 12 weeks. With that frequency, Dr. Bishesh Poudyal, Associate Professor and Chief, Civil Service Hospital in Kathmandu, agrees that a training program is much-needed. “If we can train GP oncologists, then patients can be treated locally and they don’t have to travel just to show bloodwork reports,” he says. “This will save lives and make treatment more affordable and efficient.”

Dr. Bishal Gyawali joined Queen’s in March 2019. In addition to his appointment to the Department of Public Health Sciences, he is a clinical fellow in the Department of Oncology at Queen’s.

What attracted him to the university was the global focus within the Department of Oncology under the leadership of department head, Dr. Scott Berry. He is thrilled to have Dr. Christopher Booth as a colleague, an oncologist who has worked extensively in India.  “The Queen’s Global Oncology team is made up of similar minded people,” he says. “I am fortunate to have this career path.”

As with our other Global Health initiatives in the Faculty of Health Sciences, Dr. Gyawali’s work is premised on building local capacity to address a specific need within a community. I am pleased that his work will be added to the slate of partnerships and projects that we have across the globe and I look forward to hearing about the impact that it has.

Please join me in celebrating Dr. Gyawali’s work by commenting on the blog, or better yet, drop by his office in the Cancer Research Institute…I’m sure he will be happy to chat with you about his project.

Signing off for the holidays
2019-12-17 Signing off for the holidays

By far, the thing I am looking forward to most over the holidays is that Cheryl and I get to babysit Saul.

Here is the plan – and we think it’s a pretty fair trade. Joanna and Jordan are coming to Kingston to use our house as a bed and breakfast so that they can get a break from their demanding jobs as a civil litigator and immunologist. With our bed and breakfast comes a dinner at Chez Piggy and a hair appointment with the best hair stylist in the world, Fletcher Nelson at Chic.

While Joanna and Jordan enjoy a few days away from work and a break from running after a 17 month old, Cheryl and I will be doing the opposite, looking after Saul.

Saul playing with toysFor those of you who are grandparents, I’m sure it will resonate with you that not only are Cheryl and I excited about the opportunity of looking after Saul, but find great joy in everything he does – every new milestone and every new discovery. Saul is a going concern having gone from crawling to running over the last two months, and transitioning from a baby to a toddler.

And for those of you who are parents, I’m sure this will resonate with you. It’s our distinct plan to break all of the parental rules that have been so carefully executed over the last 17 months: feed him things I’m confident we shouldn’t be feeding him and likely completely ruining his bedtime routine.

In addition to looking after Saul, we’re looking forward to our traditional family holiday rituals, which will include a lot of family gathering.

We celebrate with a fondue dinner on Christmas Eve, and not just any fondue, we go the whole 9 yards with chicken, beef, shrimp, potatoes cooked in two pots of oil and a third fondue pot with a create cheese and beer recipe with lots of bread and of course lots of wine.

Christmas day will be a relatively small crowd, for what will be a traditional Christmas dinner. This year Hanukkah starts a few days before Christmas and so we’ll have a chance to light the candles and give out gifts for 8 nights. I’m guessing somehow Cheryl has already bought 8 gifts for our grandson. On the 29th, Cheryl’s entire family will be coming in from Kitchener, Cambridge and Chatham for a family celebration. Unfortunately, Cheryl’s dad passed away this year so this will be the first Christmas celebration in her family where Cheryl and her sisters are now the senior generation. A significant transition that every family goes through.

The Roycroft Inn in East AuroraOn the 30th, Cheryl and I are going to one of our favourite places in the world for a few days’ holiday. We stumbled on the Roycroft Inn in East Aurora, NY 35 years ago, and have been going pretty much every year since. East Aurora is a magical little town that’s somewhat of a throwback to the 1950s and the Roycroft is a beautiful Frank Lloyd Wright-style Inn with a great ambience and great food. Three days in East Aurora of rest and relaxation will prepare me well to gear up for what will be the final six months of my deanship. 

I would like to wish all of my readers a fabulous holiday and I hope the season brings you a time of rest, a time of celebration with your families, and a season of joy.

Dean's Report : Faculty of Health Sciences 2018-2019
2019-12-09 Dean's Report : Faculty of Health Sciences 2018-2019

One of the things I really look forward to at this time of year is releasing the annual Dean’s Report. This report has come to be a tradition for the Faculty of Health Sciences, and it serves as reminder to pause and recognize all of the fantastic things we’ve achieved in the past year.

This report holds particular significance as it will be the last that I publish before the end of my deanship in July 2020. And so I am pleased to share my last issue of the Dean’s Report, for 2018-2019 with you.

The pages of this year’s Dean’s Report are filled with stories of the outstanding work coming out of our Schools of Medicine, Nursing, and Rehabilitation Therapy. All of the schools within the Faculty of Health Sciences share one vision: to ask questions, seek answers, advance care and inspire change. You’ll see in the enclosed pages that our faculty members, staff and students are doing just that, whether it is in research, education, or in the delivery of clinical care.

As you read through this year’s report, you’ll meet some of the changemakers who are working to make our faculty a more inclusive place to work and study. You’ll meet our talented researchers who are making discoveries that are improving the lives of patients. You’ll hear about the ground-breaking new programs that we’ve launched. You’ll also meet some of our exceptional students who are already making their marks as leaders in their communities.

Of course, behind the stories, statistics, and the many other successes that we share in this report are our tremendously dedicated faculty members, staff, students, partners, alumni, benefactors and friends. When you get to the last page of the report, you’ll read about the many things we have accomplished together over the past ten years, and I feel incredibly fortunate to have been a part of such a dedicated, hard-working team.

I hope that you enjoy this year’s Dean’s Report, and I look forward to hearing your thoughts. Please join me in congratulating everyone who contributed to our success in the past year by commenting on the blog, or better yet, drop by the Macklem House….my door is always open.

Diabetes on the rise in First Nations populations
2019-12-04 Diabetes on the rise in First Nations populations

New report shows the disease has reached an all-time high within Canada’s First Nations communities, impact on children is concerning.

A first-of-its-kind, First Nations-specific report, co-authored by Queen’s University professor Michael Green, shows the number of First Nations people in Ontario living with diabetes is at an all-time high at 14.1 per cent.

According to the report, developed jointly by the Chiefs of Ontario (COO) and ICES, the increase is particularly concerning as there is a rising, disproportionate number of First Nations children affected by diabetes.

“Lower monitoring, lower levels of diabetes control and less access to primary care mean First Nations people are more likely to experience complications of their diabetes at an earlier age and sooner after their diagnosis which is why focusing on prevention is key to making to changes to how diabetes affects First Nations people,” says Dr. Green, professor in the Departments Family Medicine and Public Health, and a senior scientist at ICES.

First Nations and Diabetes in Ontario takes a detailed look at diabetes and its consequences on First Nations people in Ontario from 1990 to 2014. The data presented in the report highlights specific inequalities and supports the development of effective health policies and programs to prevent diabetes in First Nations people.

The researchers highlight that the three dominant individual risk factors for type 2 diabetes among First Nations people living in First Nations communities are physical inactivity, weight/obesity and smoking. However, efforts to address these risk factors must consider the cumulative effects of ongoing racism, dispossession from land, childhood and intergenerational trauma, changes in diet and an increase in sedentary lifestyles associated with colonization.

The report found that in 2014/15, 39.3 per cent of First Nations people living in First Nations communities had good control of their blood sugar, compared to 56.5 per cent of other people in Ontario.

“This report is a step in the right direction to fill information gaps which have led to health policy gaps. This report builds on relationships and formal agreements to understand Indigenous health today, and in order to do that we have to know Indigenous history, government relations with Indigenous people, and the collective that the people have experienced,” says report co-author, Jennifer Walker (Laurentian University), the Canada Research Chair in Indigenous Health and the Indigenous Health Lead at ICES.

A series of studies, including this one, are being published in the journals CMAJ and CMAJ Open. These studies are the start of a series of papers on diabetes and First Nations health. They are part of a partnership between researchers and COO which engages First Nations patients, families, elders and community members in the project.

The research was funded by the Ontario SPOR SUPPORT Unit.

 

This story was originally published in the Queen’s Gazette.

Testing new models of care to address the challenge of low back pain
2019-11-25 Testing new models of care to address the challenge of low back pain

Low back pain is a common experience. An estimated 75-85% of people will experience some form of back pain during their lifetime. For the majority, it will improve quickly, but about half will experience recurrences within a year. For many, low back pain can lead to suffering and disability that interferes with participation in usual life roles and activities. In fact, Global burden of disease studies provide evidence that low back pain is the leading contributor to years lived with disability worldwide.

When people seek care for low back pain, the most common first point-of-contact with the healthcare system are family physicians. However, a growing population that is increasing in age and experiencing more chronic health concerns is making it difficult for family doctors to meet the diverse needs of patients. One way to support family physicians is to build a team of healthcare providers to help address the needs of patients. For people with low back pain, integrating physiotherapists (PTs) at the first-point of contact within primary care teams may provide a more focused low back pain consultation, improve patient outcomes, and reduce the workload for family doctors. Dr. Jordan Miller is a leading a multidisciplinary and international team of researchers and knowledge users who are conducting research to determine the effectiveness and cost-effectiveness of integrating PTs at the first point of contact within primary care teams for patients with low back pain. Team members include co-investigators Dr. Catherine Donnelly and Dr. Kathleen Norman from the School of Rehabilitation Therapy, and Dr. Michael Green and Dr. David Barber from the Department of Family Medicine at Queen’s.

Dr. Miller and his team have completed a pilot cluster randomized trial with four sites to determine the feasibility of conducting a fully powered cluster randomized trial. This pilot study was supported by a Catalyst grant ($100,000) from the Canadian Institutes of Health Research (CIHR). The pilot demonstrated feasibility through high rates of recruitment, retention, and  outcome measurement completion, as well as ability to implement the new model of care with high fidelity. These results suggest it is feasible to proceed with a fully powered trial.

Embedded within this pilot trial was a qualitative study to explore the perspectives and experiences of primary care providers and patients involved in the new PT-led primary care model for low back pain. Both primary care providers and patients described a positive experience with the new model of care. They suggested that they highly valued the thorough assessment, support for active management, improved access to rehabilitation, enhanced communication, and better continuity of care resulting from the integration of a PT in the primary care team. Primary care providers also suggested they felt the added musculoskeletal health expertise increased what they were able to offer to patients and provided opportunities for interprofessional learning amongst the team members. Patients expressed an appreciation for the additional time the PT was able to provide to listen to their experiences and concerns, and to demonstrate their understanding of the challenges patients were experiencing. They also expressed that the PT helped them to feel more involved in their own care, and to feel motivated, confident, and empowered to manage their back pain.

The next steps for Dr. Miller and his team are to carry out the fully powered cluster randomized trial, funded by a CIHR project grant (~$1.4 million). This fully powered trial will provide high quality evidence on the effectiveness and cost-effectiveness of the PT-led primary care model for low back pain. The results will provide important evidence to inform clinical practice and health system planning with the ultimate goal of improving health outcomes for people with low back pain.

 

This story was originally published by the School of Rehabilitation Therapy

The #NursesAre campaign: from class assignment to passion project
2019-11-19 The #NursesAre campaign: from class assignment to passion project

When Melissa Spadafora and Shannon Greer were given an assignment to develop a method to recruit young people to nursing in their final year of the Undergraduate Nursing Accelerated Standing Track (AST) program, they didn’t expect the assignment to turn into a passion project.

In order to complete the assignment – which was for their NURS 405 Practicum in Community Health Promotion course - the two students, who graduated this fall, developed the #NursesAre campaign to target school-age children and bust some of the misconceptions surrounding nurses. In choosing to create a video series, they were able to feature a diverse group of nurses who work in a wide variety of nursing professions.

With a projected nursing and midwifery shortfall of over 9 million worldwide by the year 2030, recruiting new nurses – and nurses from different backgrounds – is growing increasingly crucial to ensuring quality patient care in the future.

Using research and literature on the misconceptions, as well as talking with professionals within the nursing community about what their jobs actually look like, Shannon and Melissa were able to narrow down the list of words they wanted to use in the videos. As they listened to these stories, the unique experiences of each person helped to guide the final word choices.

Creative, team players, knowledgeable, unique, teachers, resilient, advocates, and strong. These are the qualities that would become the focus of the #NursesAre videos.

“Initially, it was just a school project but the more we worked on it, it began to become a passion project,” says Melissa. “As students in the AST program, we didn’t choose to go into nursing straight out of high school. We’d seen these misconceptions before we chose this path. Maybe if there had been a project like this when we were younger, we would have chosen nursing sooner.”

Neither Melissa nor Shannon had any videography or video editing experience, and while they wanted to control the direction of the campaign, they knew that they were going to need support to get it right. Sherri Schmidt -Stutzman, who is a faculty advisor for the program, helped the students to focus their project while giving them the freedom to run with it. Their project supervisors, Cheryl Pulling and Barbara Bolton, also proved to be valuable. They put the students in touch with Michael Ferguson, a member of the Faculty of Health Sciences’ Marketing and Communications team, for guidance.

“They spent time with us to see what our vision and our thought process was,” says Melissa about working with Michael and videographer Lucas Wang. “They sat down with us to show us how the filming equipment and editing software works, and helped us find the proper locations and lighting to make the project that we wanted to create.”

Michael saw the importance of the project, and his enthusiasm to assist helped to foster the passion that Melissa and Shannon began to have for their campaign. He allowed them to lead while being available to support their needs when they ran into difficulties. Throughout the project, the students found that they had a level of independence that they had been building towards over the course of the nursing program. They were able to apply the skills they had been developing as they rounded out their education.

“The project came at the perfect time. You have help from the faculty, you meet with your advisors, but there is also a lot of autonomy in deciding what you’re going to do and what’s feasible in the time frame. You learn autonomy throughout this program as you progress, kind of like taking the training wheels off as you move along, and this kind of hands-on experience is so valuable.”

Melissa and Shannon produced eight videos, each featuring a different nursing professional and a unique quality. The videos can be found on the FHS Youtube channel and you can get a sneak preview by watching the video below.

Please join me in congratulating our newest Nursing graduates by commenting on the blog

Training our OT students to solve problems through an innovative classroom space
2019-11-11 Training our OT students to solve problems through an innovative classroom space

For many of us, it’s easy to take for granted the daily activities that can be performed without difficulty. Most of us never think twice about our ability to cook dinner, wash the dishes, have a shower, or write an email.

But for those who experience difficulties performing daily tasks, the impact can be significant.

The Canadian Association of Occupational Therapists defines occupational therapy as “a type of health care that helps to solve the problems that interfere with a person’s ability to do the things that are important to them.”

In the School of Rehabilitation Therapy we are educating our Occupational Therapy students to be problem solvers who can help their clients get back to their daily responsibilities and livelihoods faster and with less interruption. They do this by developing individuals’ abilities and skills, recommending assistive devices, or making changes to the environment to make these tasks achievable. 

But when your goal is to prepare health professionals to serve people in performing ‘everyday’ tasks, a regular classroom won’t do.

This year, the School of Rehabilitation Therapy opened a new space, located in Botterell Hall. This innovative classroom is an integrated educational space which allows for collaborative theoretical work and hands-on learning.

Since OTs often provide care in a person’s home, assisting them in navigating their daily occupations, the hands-on space has a mock bedroom, a kitchen and a bathroom with fixtures in a few different configurations. There is a large collection of assistive devices like walkers and wheelchairs, which the students use to practice important skills for their future careers. Students can also learn how to apply a variety of strategies to overcome cognitive, emotional and sensory challenges that might be barriers to successful navigation of the home or workplace.

“This space enables students to take their theoretical knowledge and situate this in a context they can understand as future occupational therapists,” says Dr. Catherine Donnelly, Associate professor in the Occupational Therapy Program.

The faculty are thrilled with the new space and the cohesiveness it brings to the program. “Our students finally have a ‘home’ rather than having to travel to various learning spaces on campus,” reports Dr. Rosemary Lysaght, Associate Director of the Occupational Therapy program.

With reuse and cost-savings in mind, program leadership helped to repurpose the entire kitchen and some assistive fixtures from the now closed St. Mary’s of the Lake, which has conveyed some historical significance into this new space.

Now instead of just telling you about this fantastic new space, I thought I would show you around. Watch the video below to see our new training space for the OT program and how we’re using it to equip our students with the skills they need to become excellent Occupational Therapists.

Please share your thoughts by commenting on the blog, or better yet, drop by the new OT space in Botterell Hall and see it for yourself!

How a med student changed the course of his education to focus on Indigenous health
2019-11-05 How a med student changed the course of his education to focus on Indigenous health

This spring, Thomas Dymond, a medical student here at Queen’s, requested a change to the way that students do their upper year clerkships. He asked to complete his 4-month longitudinal integrated clerkship in the Indigenous community of Akwesasne, under the guidance of Dr. Ojistoh Horn, a Mohawk family physician.

Thomas, who is Mi’kmaq from the Bear River First Nation in Nova Scotia, hasn’t always found his path through medical school to be easy. Last year, he took time away from school because of stress, and began to feel uncertain about whether he would complete his MD degree.

During this time of uncertainty, Thomas, was in touch with Ann Deer. Ann works with Queen’s as an Indigenous Recruitment and Support Coordinator, and is from Akwesasne. She had met an Indigenous physician at a conference, who was also from Akwesasne. Ann encouraged Thomas to reach out to her.

The physician was Dr. Horn. Thomas connected with her and soon had arranged to do a 4-week elective, a precursor to clerkship, at Akwesasne. Dr. Horn is the sole full-time physician for Akwesasne, a community of more than 14,000 people which straddles the borders of Ontario, Quebec and New York state.  She and other visiting physicians care for patients at a variety of clinics, on home visits and at a long-term care facility in the community Thomas spent a month working alongside her, and for the first time, felt like he had found his place in medicine. “The elective revitalized me mentally, physically, emotionally and spiritually,” he says. “I felt lifted up, like I was contributing, learning and engaging. I wasn’t just giving back, I was also getting something out of it.”

What distinguished Dr. Horn’s practice from Thomas’ previous exposure to medicine was her focus on the environmental impact of health. “She thinks outside the box,” says Thomas, “she knows what her patients have been exposed to, and makes connections between the environment, diet, lifestyle and health.” Thomas’ time at Awkesasne allowed him to get to know the customs and ways of life of a Mohawk community. He was embraced with open arms, and quickly formed relationships with others living on the reserve.

When his elective came to an end, Thomas knew he wanted to return.

With Dr. Horn’s support, Thomas drafted a letter to the Director of Clerkship and the Assistant Dean, Curriculum. His letter made a passionate case, detailing how he would meet all of the curricular requirements for his pediatrics, family medicine and psychiatry clerkship courses by spending his four-month integrated rotation in Akwesasne. He laid out a plan. “I wanted to go back to Akwesasne, but I also wanted to change clerkship, to change the system, to change medicine,” says Thomas.

After submitting the letter, Thomas was terrified. He knew that it was an atypical request, and was fully prepared for the school to say no.

Instead, his letter was acknowledged and passed along to Dr. Shayna Watson, Director of the Integrated and Family Medicine Clerkships. Dr. Watson was in immediate support of Thomas’ request. There were hurdles to be overcome in a short period of time – Thomas’ request was made only two months before his clerkship was to start – but she committed to making it happen. “That was the first time I was advocating where someone said ‘I will help you and take some of the weight off,’” says Thomas. Though he was relieved that Dr. Watson was taking on his cause, he remained apprehensive.

Dr. Watson kept in touch with Thomas over those two months, giving him updates on her progress. In the background, she was coordinating the logistics. “I had the support of the Eastern Regional Medical Education Program,” says Dr. Watson, “and Dr. Horn graciously hosted Dr. Robin Kennie and I to visit and learn about the community as we made the arrangements for the rotation.”

Just before his clerkship was set to start, Dr. Watson confirmed that Thomas’ request to go to Akwesasne and work with Dr. Horn had been approved. Thomas would be the first student in the School of Medicine to do his longitudinal integrated clerkship in an Indigenous community, under the supervision of an Indigenous physician, caring for Indigenous patients.

Thomas is now completing his clerkship rotation at Akwesasne, and he could not be happier. “I feel like I am fully supported for who I am,” says Thomas, “both an Indigenous person and a medical student.”

Thomas has worked hard to forge a path for other Indigenous students in the School of Medicine, and his clerkship has broken new ground. While he navigates the challenges of establishing a new clerkship, he is setting a path for others, and helping to build an important relationship between the School of Medicine and the community of Akwesasne.

“As we work to Indigenize the school of medicine’s curriculum, forming relationships with nearby Indigenous communities is a crucial step,” says Dr. Leslie Flynn, Vice Dean Education, Faculty of Health Sciences, “Thomas is an exceptional student, and I am thrilled that he took the initiative to make this happen. He has led the way to enhancing our community partnerships.”

While Thomas is immersed in his clerkship, he is also thinking ahead to residency. He is applying to orthopedics, with his sights set on maintaining a connection to Akwesasne.

“Perhaps one day,” he muses, “I could run a clinic there and provide orthopedic care to a population that doesn’t always have easy access to that type of care.”

Given the passion, drive and dedication that Thomas has demonstrated so far, I have no doubt that he will.

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House, my door is always open. 

Two-Spirit physician visits Queen's to discuss decolonizing medicine
2019-10-29 Two-Spirit physician visits Queen's to discuss decolonizing medicine

Here at the Faculty of Health Sciences, we are working with indigenous partners to answer the Calls to Action from the Truth and Reconciliation. You can read about how we’re doing in our progress report. This work is ongoing and multi-faceted, and it includes championing talks by leaders in Indigenous Medicine, such as Dr. Makokis.

Dr. Makokis was chosen by our own medical students as someone from whom they wanted to hear, as part of their medical school journey on their way to becoming doctors. I would like to thank Dr. Tatham and her partner Donna Henderson for their generous support. It is truly a win for diversity and inclusivity at FHS, as we work to create a culturally safe environment for Indigenous students, staff, faculty, and patients.

The following story was originally published in the Queen’s Gazette

A new lecture series promoting equity, diversity, and inclusivity in medical education debuted with a talk by Dr. James Makokis, a family physician from Saddle Lake First Nation in Alberta who leads one of North America’s most progressive and successful transgender-focused medical practices.

“Indigenous youth have one of the highest rates of suicide in the country, and that rate increases even further when we look at transgender members of that group,” said Dr. Makokis to an audience that packed the Britton Smith Lecture Theatre and a second, overflow space at the Queen’s University School of Medicine. “Every family medicine physician has within their scope of practice a general medical license that gives them the ability to provide transgender care. Medical students and residents take time to learn to do this in your practice. It will be one of the most fulfilling areas of your career and you will help save lives.”

His lecture, entitled Decolonizing Medicine: Creating an Inclusive Space for Transgender and Two-Spirit People, is the first in the newly-created Dr. M. Nancy Tatham & Donna Henderson Lectureship – a series of talks featuring scholars and experts from diverse backgrounds discussing inclusivity in health, with a particular focus on LGBTQ2+ and Indigenous issues.

Dr. Makokis, who is both Cree and Two-Spirit, discussed language used around gender in medicine, the history of gender and First Nations people, and access to transgender care and hormone therapy. He explained that ideas of transphobia and homophobia are colonial social constructs and argued that decolonizing medicine can be achieved through simple acts, like acknowledging and accepting LGBTQ2+ patients and providing care that meets their needs.

“Take off your white lab coats,” he said. “It holds so much institutional symbolism, but it can also serve as a barrier. Take it off and seek to relate to your patients in a human way. I guarantee this will help you have a long, healthy, and happy medical practice and career.”

Supported by a donation from Dr. Tatham and Ms. Henderson, who are both long-time activists, the lectureship is organized by the School of Medicine’s undergraduate Diversity Panel. Students on the panel expressed a deep enthusiasm in putting Dr. Makokis forth as the first speaker in the series.

“Understanding the impacts of the historical and ongoing oppression faced by our patients is so essential in being able to provide excellent care,” says Ayla Raabis, Queen’s medical student and Diversity Panel member. “We must constantly strive to undo our own biases to be able to truly connect and ensure we are seeing our patients as the complex people we are tasked with caring for. Dr. Makokis’ talk was such a valuable opportunity to learn from his unique personal and professional experience, and to inspire us to push for making medicine a safe space for all patients.”

Notably, Dr. Makokis and his partner Anthony Johnson won the most recent season of well-known television competition The Amazing Race Canada. They were praised for using the platform to raise awareness of Two-Spirit people.

The October 23 talk from Dr. Makokis was the first in the new annual lecture series. Information on future Dr. M. Nancy Tatham & Donna Henderson Lectureship talks will be shared on the School of Medicine website.

“We're excited to carry the momentum of this talk forward by hosting additional events centred around improving access to healthcare and delivering culturally-informed care to LGBTQ2S+ and Indigenous populations,” says Danny Jomaa, Queen’s medical student and member of the Diversity Panel. “As trainees in medicine, it's important for us to build approaches to care that are formed on the principles of equity and respect for marginalized groups.”

I’d love to know your thoughts on Dr. Makokis’ talk in the comments below, or better yet, please stop by the Macklem House, my door is always open.

Dean Reznick with Qmed Students at Medical House
2019-10-22 Celebrating Queen’s Homecoming 2019

It was a great weekend. Cheryl and I always enjoy homecoming, but perhaps because this was my “last homecoming” as the dean, it was extra special. This past weekend we welcomed back Queen’s alumni from the Schools of Medicine, Nursing, and Rehabilitation Therapy.

The Faculty of Health Sciences had a great turnout of returning classes. We had the honour of hosting members of the Tricolour Guard including Meds ’54, Meds’59, Meds ’64 and newly inducted Meds ’69. Also returning were classes from 1974 through 2019: Meds’74, Meds’79, Meds’84, Meds’89, Meds’94, Meds’99, Meds’19, Nurs’64, Nurs’74, Nurs’79, Nurs’84, Nurs’89, Nurs’94, Nurs’04, Nurs’09, Nurs’14, PT’74, OT’79, PT’84, OT’89, PT’89, PT’94,  PT’04,  OT’14, OT’19, PT’19​

As always, Homecoming weekend was an opportunity to celebrate the spirit of Queen’s, and for friends – old and new – to meet and reconnect during class dinners, receptions, tours, open houses, and award ceremonies.

To kick off the weekend, it was my pleasure to host a reception for the Faculty of Health Sciences alumni. Held in the David M. C. Walker atrium of the School of Medicine Building, over 150 alumni attended the reception where they heard remarks from Dr. Andrew Pipe, (Meds’74), the Chair of our Dean’s Advancement Cabinet, Marcia Finlayson, Director of the School of Rehabilitation Therapy and Erna Snelgrove-Clark, Director of the School of Nursing. After I gave everyone an update on the Faculty, the reception provided an opportunity for alumni to reconnect and celebrate Homecoming weekend together.

On Saturday morning, we heard from students, past and present, during the presentations at the Continuing Professional Development (CPD) Symposium for Alumni. The sessions were themed around “Advancing Care…Inspiring Change” and included presentations by Danny Jomaa, Meds’22 & Aesculapian Society President, Dr. Robert Reid (Meds’74), Dr. James A. Stone, (Meds’84), Dr. Robert McCormack, (Meds’79), Dr. Janice Smith Kwon, (Meds’94) and Dr. Brenda Gallie, (Meds’69).

The School of Nursing also celebrated Homecoming weekend with an open house and brunch hosted by Dr. Erna Snelgrove-Clarke, who experienced her first-ever Queen’s Homecoming. Returning alumni ranging from Nursing ’59 to Nursing ‘14 were given tours of the Simulation Lab and shared memories and stories while enjoying brunch in the School of Nursing Building.

The School of Rehabilitation Therapy hosted its 7th Annual Homecoming Brunch and Distinguished Alumni Awards presentations. Under the leadership of Dr. Marcia Finlayson, this brunch has become an important and meaningful event for alumni to attend. The Distinguished Alumni Awards, established in 2013 by Diana Hopkins-Rosseel (MSc 1993 RHBS) and John Rosseel (Artsci’81), recognize one graduate annually from each of the Occupational Therapy, Physical Therapy, and Rehabilitation Science programs who have exhibited exceptional contributions to their chosen professions, fields, and communities.

This year’s recipients included Dr. Margo Paterson, (BSc, OT’74), Dr. Judi Laprade, (BSc, PT’93), Dr. Skye Barbic, (MSc, RHBS’07), all exemplify the School’s focus on advancing knowledge, inspiring practice, and transforming lives.

I also had the opportunity to visit with many of the returning classes which is always enjoyable, seeing the smiling faces of alumni, hearing them reminiscing, sharing stories, and seeing the impact that Queen’s Faculty of Health Sciences has had on so many students. One of my favourite events is our visit to Medical House where I have a chance to meet with our current students as they welcomed back alumni of Medical house for a fun-filled visit.

Class reunions could not be possible without the leadership and hard work of so many class volunteers including class presidents, reunion coordinators, and class giving volunteers. I would like to extend my heartfelt thanks to everyone who helped organize events for another successful Homecoming weekend.

I would also like to thank our great advancement team, Bill Leacy, David Young, Emily Rees and Nancy Hoogenraad, who worked tirelessly to make homecoming such a success. 

Even our dog Sophie, was keen to get into the action! Please take a look at our Homecoming 2019 Facebook Album for more pictures from the weekend. 

Share your thoughts on Homecoming weekend by commenting on the blog, or better yet, drop by the Macklem House, my door is always open.

Sophie the dog wearing a Queen's Hat at Homecoming
Sophie in her Queen's toque
Student studying at Four Directions Indigenous Student Centre
2019-10-16 Progress Report: Our faculty’s response to the Truth and Reconciliation Report Calls to Action

The word progress is key in the context of our response to the Calls to Action contained within the Truth and Reconciliation Report (TRC). The Faculty of Health Sciences has made great strides in responding to the calls to action of the Truth and Reconciliation Report, and we are proud of the work that we have done so far. But we are by no means finished. Creating a welcoming and safe place for Indigenous students, staff, faculty, and patients will remain a faculty-wide priority. The Indigenous Health Education Working Group, co-lead by Dr. Leslie Flynn and Dr. Michael Green will also continue work towards our main objective: directly responding to the Calls to Action in the TRC.

This year has seen growth in partnerships made with important stakeholders. Our Indigenous Access and Recruitment Coordinator, and Coordinator of Indigenous Curricular Innovation have developed meaningful working relationships with Four Directions Indigenous Student Centre (FDISC) staff, and Associate Vice-Principal of Indigenous Initiatives and Reconciliation at Queen’s, Kanonhsyonne (Janice Hill), and with Indigenous staff in other Queen’s faculties. These connections have stretched outside the Queen’s community as well. Partnerships have been made with the National Indigenous Health Sciences Circle (NIHSC), a group made up of indigenous representatives from health care programs around Canada and whose annual conference was hosted here at Queen’s in 2018, the Kingston Branch of the Métis Nation of Ontario, and importantly, prospective Indigenous students.

Our approach to recruitment and assistance, led by Cortney Clark, Indigenous Access and Recruitment Coordinator, is known as “wraparound service”. Students have her direct support from when they apply to when they graduate from their program. Cortney’s recruitment efforts have taken her across the province, where she engages with Indigenous students at all ages, including speaking with families at the Little Native Hockey League (LNHL) in Mississauga. This year, an unprecedented 17 Indigenous students were asked to interview at the School of Medicine. During this period, Cortney welcomed the students with invitations to meet current Indigenous medical students, interview preparation support, a tour of the facilities, and a communal meal.

When our incoming Indigenous students have arrived at Queen’s, Cortney collaborates with FDISC to offer cultural services such as sweat lodge ceremonies, smudging ceremonies, full moon celebrations, and monthly feasts. Cortney’s energy and dedication are infectious; “I understand the need for this work,” Cortney says, “and I want to use my lived experiences and abilities to help propel reconciliation through accessible and culturally safe higher education.” In fall 2019, we were thrilled to welcome 24 new Indigenous students to our faculty.  

As health educators, we continue to focus on decolonizing our curriculum in order to train health care providers who can offer culturally safe care. But this change must be led by those who are training our students. As such, this year we focused on initiating a culture shift among our faculty members, with the help of Indigenous scholars and community leaders:

  • In May 2019, Dr. Barry Lavallee, member of Manitoba First Nation and Métis Communities, and a family physician trained at the University of Manitoba, delivered three days of training on working with Indigenous communities. The public lecture, Racism as an Indigenous Social Determinant of Health, described systemic racism faced by Indigenous patients. Dr. Lavallee also facilitated a faculty development workshop on promoting cultural safety for Indigenous patients through teaching methods. His final session was a medical round on Indigenizing educational research and workforces in healthcare.
  • Since 2015, the Department of Family Medicine requires that all residents complete an Indigenous Cultural Safety course offered through our Department of Family Medicine’s Global Health day. As of October 2019, roughly 280 family medicine residents have completed the course.
  • Faculty members in leadership roles have been supported to attend workshops designed to improve their personal understanding of the Indigenous experience.

These types of learning opportunities have helped our faculty members to begin to incorporate Indigenous knowledge into their curricula and will be offered on an ongoing basis.

Full curricular reviews from an Indigenous perspective are already taking place, specifically with the following courses and faculty members:  Dr. Trisha Parsons in Physical Therapy (Health Conditions) and Dr. Joneja (Global Population Health and the accompanying online module). These reviews, paired with continuing education, will continue to be a priority as we move forward.

We are proud of the progress which we have made in a relatively short amount of time; none of which would have been possible without the support and dedication of the Indigenous staff, faculty, and students at Queen’s, and our Indigenous partners. We are energized for the future, and eager to continue this important work.

Share your thoughts by commenting on the blog, or better yet, drop by the Macklem House, my door is always open. 

Related: Oct. 23rd: Dr. James Makokis, Two-Spirit, Indigenous Physician Lectures at Queen's School of Medicine

As part of the Oasis Senior Supporting Living program Pearl Larson tries her hand at Wii-bowling, while Norm Fournier and Evelyn Farrar look on.
2019-10-07 A seniors’ oasis

With an aging population, it is critical that seniors living in the community receive the support they need. It is important that new effective and cost-efficient strategies are developed to help seniors live where they want to live and prosper in their chosen communities.

The Oasis Senior Supporting Living program, is a unique model of active aging-in-place originally developed with a group of seniors living in an apartment building in Kingston. While Oasis has been cherished for many years by members and the many people who work with them, its value and potential has recently been recognized outside the city.

Professors Catherine Donnelly and Vince DePaul from the School of Rehabilitation Therapy at Queen’s University are leading a research project to expand and evaluate the Oasis Model into seven new communities in four cities in Ontario. In this project, they have partnered with the seniors at the original Oasis program at Bowling Green II apartment in Kingston, the Oasis Board of Directors, and researchers at Western University in London, and McMaster University in Hamilton.  

 “The Oasis model is a unique model that’s seniors driven,” says Dr. Donnelly. “Isolation can be a major issue for seniors who are living alone and who may have challenges getting out and about. With Oasis, there is a support system naturally built in to where they are living. Members can connect with others in their familiar space.”

Each Oasis building features an Oasis members committee, a community board of directors and onsite program coordinator. Oasis members drive the program and direct the programming, including communal meals, social activities, and exercise and activity programs. The onsite program coordinator supports all aspects of the program delivery, working with the members. The community board offers oversight and governance support and has been instrumental in supporting Oasis.

All programming occurs in the apartment building where seniors are living ensuring that Oasis brings the services they need to them. Programming includes everything from a Wii bowling league, exercise classes, creative writing workshops, and daily coffee times. Three days a week, catered meals are served to Oasis members in a communal dining space.

“This was a very grassroots, seniors-driven, community-supported idea. The original Oasis building opened about 10 years ago in the Bowling Green II apartment owned and operated by Homestead Landholdings,” says Dr. DePaul. “Homestead has been very supportive from the beginning, including providing space for the program to operate. They continue to be very supportive as we move forward to expand the program to other buildings. We have also received support from another Kingston landlord, CJM, to open an Oasis program in one of their buildings here in the city. It’s these partnerships that are critical.”

The project has been funded through three separate grants from the Ontario Ministry of Health and Long-term Care, the Baycrest Centre for Aging and Brain Health Innovations, and the Ontario Ministry of Seniors and Accessibility. The funds from each grant are being used to support the expansion and evaluation of Oasis into different buildings. The project team includes colleagues from Western University, McMaster University and Queen’s. Work began on this project this past summer and will continue for the next 18 months. Kingston is now preparing to open its second facility.

This new funding will allow this multidisciplinary and multi-community project with new programs being put in place, and the model evaluation with an eye on refining the process and, potentially, bringing new aging in place communities on board.

For more information, visit the website.

This story was originally published in the Queen’s Gazette.

Dr. Marla Shapiro, NAMS past president, presented Dr. Soares with his award
2019-10-01 It’s time to change the way we think about depression and menopause

For middle aged women experiencing menopause, the struggle to have their symptoms and side effects acknowledged is real. These symptoms can include hot flashes, chills, irregular periods and anything from anxiety and fluctuating moods to clinical depression.  In 2015, The Guardian argued that the healthcare system is failing women who are peri- or post-menopausal: “menopausal symptoms are primarily a result of oestrogen deficiency; in the peri-menopause, which can commence several years earlier, fluctuating hormone levels are largely to blame. One in four women will experience debilitating symptoms that can last up to 15 years.”

And it turns out that a subset of women may be particularly vulnerable to depression around the time of menopause as a direct result of these hormonal changes.

Dr. Claudio Soares, head of the department of psychiatry in the Faculty of Health Sciences started doing research in this area almost 20 years ago. And last week, he earned a major award for what he discovered. Dr. Soares’ foundational studies for the treatment of perimenopausal depression research earned him the 2019 Outstanding Clinical and Basic Research Award from the North American Menopause Society.

But Dr. Soares’ findings haven’t always been widely accepted.

According to Dr. Soares, the role that hormones play in perimenopausal women’s health, and in particular their mental health, is not well enough known among doctors who graduated in the past 10 to 15 years. That’s because of the highly publicized results of the US Women’s Health Initiative (WHI) trial, published in 2002, which suggested that women taking hormone therapy could face more health risks - especially for breast cancer - than health benefits.

The initial interpretation of the WHI results led to a state of panic among patients and some doctors, and to a significant drop in women taking hormone therapy. “A full generation of physicians have been trained to be less aware of effects of hormones on brain, heart, and bone health–and depression–and to be very cautious or even sceptical of the benefits of hormone therapy,” says Dr. Soares, “and instead be only focused on the negative effects.”

Dr. Soares’ research identified a role for individually tailored hormone therapy. In other words, for some women, the benefits do outweigh the risks.  

The group that Dr. Soares focused on was women in their late 40s or 50s who experienced chaotic fluctuations in hormone levels and were prone to depression. The most vulnerable were women with a previous major depressive disorder, and those who suffered from premenstrual mood symptoms or post-partum depression.

When he began his research almost two decades ago, there was little attention paid to the ‘brain aspects’ of menopause. Dr. Soares says he and others were sometimes accused of pathologizing menopause, or perhaps more accurately re-pathologizing it.

Menopause is a normal condition that all women experience as they age. And before the WHI trial results, hormone therapy was quite widely prescribed for menopausal women to address hot flashes and vaginal dryness. But it was also heavily promoted - perhaps overly so - for its purported “anti-aging” capabilities.

Now more than a decade later, more doctors are becoming aware that there is no “one size fits all” hormone therapy for women experiencing menopause, and that there can be a role for different types, dosages, and durations of therapy depending on the issue.

But he says that still today when middle aged women come to their doctors complaining of a significant increase in irritability, mood swings and anxiety, “you’d be surprised how infrequently physicians ask whether there is any association with their hormonal changes or menstrual cycle changes.”

Physicians may ask if depression is getting worse, but they may not connect the dots about how hormonal changes could be making these women more vulnerable. Instead, doctors often focus on the possible role of iron deficiency, thyroid conditions, changes in life circumstances, and stress at work.

Dr. Soares is gratified that the Canadian Network for Mood and Anxiety Treatments has recognized the role of hormone therapy as a treatment for peri-menopausal depression, driven primarily by the results of his research. In the CANMAT’s 2016 guidelines for women with peri-menopausal depression, estrogen delivered through a skin patch has been recognized as a treatment, along with other conventional treatments such as antidepressants and psychotherapies.  With that, it will be more likely for women who do need hormone therapy to be able to access it.

Depression in humans can take more than two dozen forms. Naturally, clinicians and researchers are keen to better identify types of depression in order to better predict and diagnose particular vulnerabilities and thereby improve treatment.

Dr. Soares’ work has brought women who suffer from depression related to menopause one step closer to the treatment they need, and is paving the way for a change in how physicians interact with their female patients.

This past week, Dr. Soares was in Chicago to accept his award. I couldn’t think of a more fitting tribute to a researcher who persevered in the face of criticism to create a better outcome for patients.

Please share your thoughts by commenting on the blog.

How patients and researchers worked together to better understand hemophilia
2019-09-24 How patients and researchers worked together to better understand hemophilia

Danielle McCully is helping to open new avenues of research into inherited blood disorders. She has a unique understanding of this family of diseases. Her father had severe hemophilia A and died at 35 from tainted blood. She carries the gene for this disease, and both of her children have hemophilia. And more recently, she was diagnosed with another bleeding disorder, von Willebrand disease.

But it was her own diagnosis of mild hemophilia in her early 20s that set her on the path to finding better ways to diagnose and treat this disease. She works closely with Dr. Paula James, a clinician-scientist at Kingston Health Sciences Centre and one of Canada’s foremost experts on inherited bleeding disorders, particularly bleeding disorders in women.  Danielle is a frequent participant in Dr. James’s research and she does outreach and education on living with bleeding disorders. Here’s her story:

“For a long time we’ve understood only that hemophilia is a male disorder. After I was diagnosed, it explained so much to me – not just having heavy periods, but remembering that as a child, I was always covered in bruises. The bleeding affected my joints – I had ankle injuries.  I also had iron deficiency, which meant I was extremely tired, suffered from lack of motivation. It affected my moods and created anxiety as well. So the diagnosis was reassuring, and a positive thing. It opened up my eyes. I remember thinking, this a big thing, but I’ve lived this long with it and done OK. Many women live for 12-14 years with bleeding disorders before being diagnosed.

I’ve been taking part in Dr. James’s research for about 10 years, including studies on hemophilia symptoms in female carriers, and on self-reporting and physical mobility.  I do it because I want to impact quality of life for women with bleeding disorders.

After we were married my husband were referred to genetic counselling because we wanted to find out more about living with hemophilia and we had all the information before we decided to have kids.

Part of my decision to take part in research goes back to my father. In his day, there were a lot of unknowns. It made me realize that information is power, and people can only get that information if you provide it. I want to help researchers and physicians enable someone with a blood disorder to get that information. I want to make a difference for the future.

My husband and I also sit on a research study committee because of our son. We’re patient advocates for developing practical standards for people having a child with a severe blood disorder. There’s a lot of inconsistency across the country, especially in rural areas. It’s exciting and it’s been a great experience.

My main motivation is my kids. It’s the hardest thing having a genetic disorder, and the decision to have kids is profound. My hope is that there will be a cure in the future, and the only way for that is through research. In the meantime, there are important treatments that are available.

The future is looking promising. Treatment has come a long way. It’s made a huge difference in my son’s life. He’s active, he plays hockey, and he hasn’t had a bleed in many years. What more can you ask for?”

For more information about bleeding disorders, Dr. James recently launched a website, Let’s Talk Period, and an on-line Self-Administered Bleeding Assessment Tool. They can be found at letstalkperiod.ca

This article was originally published by Research Canada

Disturbing the peace – Meet Luissa Vahedi
2019-09-17 Disturbing the peace – Meet Luissa Vahedi

When you think of peacekeeping missions you might imagine blue helmeted troops handing out candy to children, and field hospitals helping the sick while distributing food and water.

But there are unseen challenges in introducing a large group of predominantly male soldiers into this type of environment for months or years at a time.

Luissa Vahedi has been studying the UN peacekeeping mission in Haiti as part of her masters in epidemiology – a field which focuses on the determinants of public health.

“As the mission wound down in 2017, there were anecdotal reports of sexual interactions between peacekeepers and local women,” she says. “My research aims to understand how these relationships occur and what could be done to support the women that have given birth to children or have been exposed to sexual abuse and exploitation. Examining the legacy of this peace operation in Haiti is very timely and will help us understand how to prevent human rights violations within future peacekeeping operations.”

When she was first considering masters studies two years ago, Luissa connected with Dr. Susan Bartels at Queen’s who had a funding opportunity to study peacekeeping. The research strongly related to Luissa’s interests, as Luissa previously volunteered at a sexual assault centre and wanted to research more about the intersection of health and gender. Dr. Bartels eventually became Luissa’s supervisor, alongside Dr. Heather Stuart.

The project involved analyzing data gathered from Haitians who voluntarily completed surveys through tablets provided by the research teams. The surveys provided broad prompts, asking the participants to tell the researchers a story about what it was like to live near UN bases. After this, the participants self-interpret their experiences which provided rich qualitative and quantitative data to Luissa and the team.

“You get to go back to the story and contextualize those numbers with the actual lived experiences of these women and girls,” she says. “Health is comprised of physical, emotional, social, and political factors, and projects like this provide greater understanding as to how those factors affect daily behaviors, population patterns, and who we are as people. Through this degree I have learned practical skills in data analysis that are very transferable to both public health and in policy making.”

Using the data, Luissa has built a regression model to try and predict where these interactions were geographically more likely to take place during the peacekeeping mission, and to understand how people's perceptions of these sexual interactions affects the legitimacy of the UN within Haiti.

Preparing for this project involved reading broadly about political science, the history of Haiti, and other related works. While this wasn’t something Luissa expected as she started her research, she feels the opportunity has helped her to better round out her education and keep her open to new learning opportunities – and, besides, reading is one of her passions!

As she nears the end of her program, Luissa is preparing for a year off from school to give her time and space to prepare a PhD application. She hopes to continue her studies in epidemiology or public health, while advocating for the use of epidemiological methods to help improve health outcomes for people in fragile states such as Haiti. In the meantime, she will also dedicate some time to hobbies such as yoga, Netflix, and more reading.

“Graduate studies can be stressful, so it has made all the difference for me that I have found a department that is supportive and had the opportunity to work with supervisors who want to see me grow and develop,” she says. “I knew it was a place for me because the campus is beautiful, it is housed in a really great city, and the public health sciences department at Queen’s has been so amazing. Working on a project that I feel very passionate about has been especially gratifying, and I am very privileged and grateful to have this opportunity.”

 

Hear more from Luissa on a recent edition of the Grad Chat podcast on 101.9 CFRC.

Learn more about the Epidemiology program on the School of Graduate Studies website.

 

This article was originally published by the School of Graduate Studies

Meet the latest cohort of Faculty of Health Sciences students
2019-09-10 Meet the latest cohort of Faculty of Health Sciences students

If the colours, cheering and clusters of students moving through campus and taking over city park last week didn’t give it away, a new cohort of students have started their studies at Queen’s.

This fall is a special time for the Faculty of Health Sciences – the majority of our 64 programs across the School of Rehabilitation Therapy, School of Nursing and School of Medicine welcome students to campus, or online, for their first term. Where nursing was the only undergraduate class that we welcomed to campus in the past, this year we have a brand new undergraduate class: the bachelor of health sciences (BHSc).

The BHSc program was conceived of five years ago. We imagined building a program that would give high school graduates a pathway to the healthcare professions: medicine, dentistry, pharmacy, rehabilitation therapy, and a direct pathway to careers in the healthcare sector, in government and in research.

But we didn’t want to just do a regular old health sciences degree. We enlisted our brightest faculty members to design courses that are competency-based, meaning that our students develop tangible skills through each module, and they are assessed based on those abilities; not just what they memorized in a textbook. And three years ago, we put all of those courses online, offering Canada’s first fully-online BHSc degree.

Fast forward to today, and we are thrilled to be translating our cutting edge curriculum to an on-campus degree. Dr. Michael Adams, the program’s director, and his team are extremely proud of the curriculum and constantly working on it to make it relevant both in terms of content and in our pedagogical approach. In their time at Queen’s, our BHSc students will spend time using flipped classrooms, learning in laboratories, doing hands-on research and most importantly, taking advantage of the interprofessional expertise right inside our faculty.

As the dean, I usually get the opportunity to address our incoming classes. And what I tell them all is this: the one thing I know for sure after leading this faculty for the last nine years – no other programs, whether it’s nursing, medicine or rehabilitation therapy, are as tight-knit as ours. And walking through campus last week, hearing the singing and cheering, I have no doubt that the BHSc class of 2023 will be the same. What starts as a room full of strangers, over four years, becomes a room full of close friends and a support network built through challenges, successes and the moments in between. 

Our communications team was hard at work last week capturing some of the magic of orientation week – and those new friendships being formed – and I am thrilled to be able to introduce you to some of our new Nursing and BHSc students. Watch the videos to get a sense of what brought these bright young students to Queen’s.

And now it’s our turn to welcome them to our Faculty. Please share your words of wisdom for our newest students by commenting on the blog, or better yet, tag @QueensUHealth on twitter with your best advice for our new students. I know they will be happy to hear it.

Gone Fishin'
2019-07-25 Gone Fishin’

I know that’s generally used as a generic expression, but it’s actually true. I’m going fishing.

Since I last took my dad, when he wasn’t perfectly well with a diagnosis of Alzheimer’s disease, on a trip together up to the Northwest Territories, I have been dreaming about going back with my sons for a fishing trip.

Gone Fishin'
fishing with my sons Joshua and Gabriel circa 1999

And so I’m starting my vacation in a couple of days on the adventure of a lifetime with my sons Joshua and Gabriel, and my son-in-law Jordan, up to Great Slave Lake to fish for Lake Trout, Pike and Arctic Grayling. One of the reasons I’m so incredibly excited is that for a solid week, my most important decisions, and to be sure, they will be important, is what kind of lure to use, what colour the lure should be, and how deep I should be trolling.

How good is that? When for seven days, those are the kinds of decisions I will be focusing on.

The scenery up there is magnificent. And somehow the barrenness and solitude put a new meaning on reflective thinking. I’m confident that when God created the earth, he started with the north and then did everything else.

Gone Fishin'
my grandson, Saul

Following fishing I’m looking forward to spending a bit of time with family and friends, but most especially Saul. Saul just turned one a few weeks ago and I’m confident I’m not in any way biased in saying he’s the most special little guy in the world.

Before you know it, I’ll be back at my desk, batteries recharged and in full gear for what will turn out to be the final ten months of my deanship.

I’ll look forward to getting back to the blog in early September when I brag about the big catch I had up in Great Slave Lake.

I want to wish all of our readers a fabulous summer and hopefully like me, you’ll have some great time to spend with your friends and families.

If you have any great fishing stories, and they can be perfectly accurate or grossly inflated, please comment on the blog, or better yet in a few weeks, please drop my the Macklem House. My closed door will then be open, ready to hear your story. 

 

Shades of grey: Ultrasound imaging of neck arteries helps identify risk of heart attack or stroke, research shows
2019-07-16 Shades of grey: Ultrasound imaging of neck arteries helps identify risk of heart attack or stroke, research shows

New research by Dr. Amer Johri, a clinician-scientist at Kingston Health Sciences Centre, shows that non-invasive ultrasound imaging of the major arteries in the neck may hold the key to better treatment of patients with coronary artery disease.

In a recently completed study, Dr. Johri,and his team used 2D ultrasound to look at the carotid arteries of 522 patients at Kingston Health Sciences Centre who also underwent angiograms for symptoms of coronary artery disease.

The researchers wanted to see whether ultrasound images of plaques, or deposits of fat and calcium, in the carotid arteries could help doctors identify patients who are at higher risk of heart attack or stroke.  

One of the big challenges in treating patients with coronary artery disease is understanding how serious the disease is, and it’s hard for doctors to tell the difference without performing an angiogram.

Angiograms are an invasive procedure in which dye is inserted via narrow tube, or catheter, into a patient’s blood vessel or artery, followed by X-rays. Angiography enables doctors to see blood flow and to identify problems in the arteries leading to the heart. 

“We were able to bring our ultrasound equipment right into the catheterization lab at the Kingston General Hospital site, and image the patients at the same time,” says Dr. Johri, who is also an associate professor of Medicine, Queen’s University. Unlike the arteries of the heart, the carotid arteries are easy to access by ultrasound.

In 2D ultrasound imaging, plaques show up in different shades of grey, depending on their composition. “Knowing the plaque type is important,” Johri explains. “Soft plaque is dangerous because it is more prone to break. Hard plaque, with lots of calcium, can also predict significant coronary disease.”

Analysis of these varying shades of grey showed that both the amount and the type of plaque in the carotid artery could help predict whether a patient had significant coronary artery disease.

“We found that in particular, the amount of calcium in the carotid plaques, combined with the height of the plaque, were good indicators of higher risk events,” Dr. Johri says. 

This five-year study builds on earlier ultrasound research, in which Dr. Johri and his team were the first to use 3D ultrasound to show that the amount of plaque found in the neck arteries could help predict whether a patient had coronary artery disease.

While more outcomes data is needed, using ultrasound on patients could ultimately help doctors better understand patients’ level of risk more quickly, Dr. Johri says. “It’s safe, quick and portable and could help us identify those who need early treatment, or aggressive treatment or no treatment. It could also be used with other tools, such as angiogram.”

 Longer term, he sees it being used in cardiac clinics or doctors’ offices for patients when their level of risk of future coronary artery disease isn’t clear.

The study was recently published in the Journal of the American Society of Echocardiography. Dr. Johri thanks Julia Herr and Marie-France Hétu for their assistance with this study. 

 

This article was originally published by KGHRI.

 Rehabilitating Education - Meet Christiana Asantewaa Okyere
2019-07-09 How Christiana Asantewaa Okyere is making education more inclusive

Believe it or not, Dr. Christiana Okyere says her favourite season is winter.

“Back home in Ghana, there are only two seasons – the rainy season and the dry season,” she says. “During the Canadian winter, I love to wear a jacket and I love to cover myself with a duvet and get nice and comfortable…I just love it.”

Dr. Okyere came to Canada in 2015 after completing a bachelor’s degree and masters at the University of Ghana. She recently completed her doctorate in rehabilitation therapy at Queen’s, marking a transition from pure social science to health science.

Dr. Okyere’s research focuses on inclusive education for children with intellectual and developmental disabilities, a concept which has three components: access, equity, and support. Access means that environmental barriers to educational opportunities are addressed to enable all children access quality education. Equity means making sure that there is fairness in available opportunities for all children. Support entails ensuring that adequate resources are available and also adjusted to satisfy the needs of all children – particularly those with disabilities – feel safe in the classroom environment.

She first became passionate about inclusive education when working with a non-governmental organization in Ghana called The Databank Foundation, which focuses on mental health leadership development and education for children with disabilities, and when she later volunteered at a psychiatric hospital in the capital of Accra.

“In the ward, you would find children with intellectual and developmental disabilities and a lot of them had been abandoned by their parents because of poverty and lack of education,” she says. “Working with them and being on the ground I developed a passion for the topic of inclusive education, and so I decided I would like to research how these children can get a quality education. For my masters I looked specifically at children with developmental disabilities in special schools – my PhD builds on that research by looking at schools which include a mix of students.”

Building on that effort through her doctoral research, she returned to her home country to understand how Ghanaian students with disabilities are supported during their learning.

Over the course of three months, she worked with 16 children in four inclusive schools, as well as 18 teachers including both general education and special education teachers. The children ranged in age from 9 to 15. Dr. Okyere would be present in class observing the students and teachers, but she would also work directly with the students who had disabilities to understand their perspective. Through a technique known as “draw and write”, Dr. Okyere would ask the students to draw a picture representing how they felt and then ask the student questions about the picture to help understand their thoughts.

One of the most surprising findings for Dr. Okyere during her research was how the children with disabilities were often punished for perceived ‘misbehaviour’ which tended to relate back to their disability. Through interviews with the teachers, she found many of the teachers were ill-equipped to help these students – especially in a class with as many as 80 children.

“Sometimes they genuinely forget that these students even exist,” she says. “The curriculum is not tailored to much deeper needs and it's a struggle for them. A lot of the teachers were really willing to support these students, but they did not know what to do.”

As she prepares for a post-doctoral position, Dr. Okyere is looking to the future – ideally a job that combined teaching and working in industry – and eventually plans to work with countries like Ghana in building more inclusive education systems.

She is also reminiscing about her time at Queen’s and Kingston, where she was able to explore some of her other passions – including volunteering with several local charities focused on inclusion, faith, and poverty alleviation.

“A lot of people have given to me to make me what I am now,” she says. “I am always thinking about giving back, even in my research. I'm thinking about research that would really make an impact.”

For new students starting or thinking about graduate studies, her advice is to take it one day at a time.

“Queen’s is a really nice environment. Your peers are supportive. The faculty are supportive. Take advantage of the support that is there, whether it is through the School of Graduate Studies, the athletic facilities, the Centre for Teaching and Learning, or wherever you find it.”

 

This article was originally published by the School of Graduate Studies

This month we are saying goodbye to another magnificent leader in the Faculty of Health Sciences. Dr. Roger Deeley will be stepping down from his role as Vice-Dean, Research in the Faculty of Health Sciences and Vice-President, Research at KGHRI.  When I came to Queen’s 9 years ago, I never would have expected that the person who I would work with most closely and most intensely would have been Roger Deeley. You wouldn’t normally find a colorectal surgeon who has a focus on competency-based medical educatio
2019-07-02 How Dr. Roger Deeley built a legacy of research strength at Queen's and KHSC

This month we are saying goodbye to another magnificent leader in the Faculty of Health Sciences. Dr. Roger Deeley will be stepping down from his role as Vice-Dean, Research in the Faculty of Health Sciences and Vice-President, Research at KGHRI.

When I came to Queen’s 9 years ago, I never would have expected that the person who I would work with most closely and most intensely would have been Roger Deeley. You wouldn’t normally find a colorectal surgeon who has a focus on competency-based medical education spending a great deal of time with a world-famous cancer biologist.

In most of our interactions, I’m the student and he’s the teacher. To be sure, I have learned a tremendous amount from Roger.

Roger has an incredible ability to tackle complicated issues. He does this by bringing calm and clarity to the issue at hand. He is incredibly thoughtful; every time he says something, he’s thinking at a strategic level. If 747s fly at 30,000 feet, Roger is a Concord, flying at 50,000 feet.

One thing we will all miss is Roger’s vast knowledge. He is probably more well-informed about research in Canada than any other person I know. And this has been to the huge benefit of our researchers here at Queen’s. He takes the time to know our researchers and to make connections. His grasp of the specifics of every one of our scientists and what they do, their strengths and needs, is Watson-like.

And make no mistake, he’s an unbelievably hard worker. In our quest for excellence in health care research, Roger has been an integral driving force.

The amount that he’s done for this faculty is incalculable. He served brilliantly as our Vice-Dean Research in the Faculty, but he’s also helped build the research institute at Kingston Health Sciences Centre and strengthened the commitment and approach to research at the hospital. He founded the Queen’s Cancer Research Institute, helped build it and was its Director for a decade. He has overseen our strategic research plan and led our Industry Engagement Strategy. Since research touches everything we do: from SEAMO to the hospitals to our academic mission at the University, Roger has been a glue that’s helped bind us all together.

As most of us have seen Roger in his administrative capacities, as a Vice-Dean and a Vice-President, what many people don’t know about Roger is that he truly is a world-renowned cancer biologist. If you don’t believe me, let me tell you about a few of the awards and accolades Roger has received over the years. In 2005 he won the Robert L. Noble Prize of the Canadian Cancer Society & National Cancer Institute for outstanding achievements in cancer research. He was awarded the National Cancer Institute of Canada Diamond Jubilee Award for outstanding impact and contribution to the field of cancer research in 2007. In 2013 he was named a fellow of the Canadian Academy of Health Sciences, and in 2014, he became a fellow of the Royal Society of Canada. These major accomplishments only brush the surface of what Roger has achieved in his career.

But of all of Roger’s great qualities and accomplishments, the one that I admire most is his passion for his family. Roger and his wife Shelagh McDonald live on Howe Island with their dog Vinnie, but they often have company, whether it’s their children and their partners, or their grandchildren who are an enriching presence in his life….perhaps with the exception of when his kids leave all the grandkids with he and Sheila for 3 weeks in the summer.

Please join me in congratulating Roger on his well-deserved academic leave and retirement by commenting on the blog.

Dr. Jennifer Medves will be stepping down from her role after serving two terms here at Queen’s.
2019-06-25 The lessons in leadership we've learned from Dr. Jennifer Medves

This month, Dr. Jennifer Medves, Vice-Dean (Health Sciences) and Director, School of Nursing, will be stepping down from her role after serving two terms here at Queen’s.

While Jenny will be deeply missed, her departure has caused me to pause and reflect on the tremendous work that she has done over the past ten years. To say that she has taught us a lot during her time in the Faculty of Health Sciences is an understatement. One of the biggest things that she has taught us, through her actions, is what the qualities of a great leader look like. Jenny is a visionary. About six years ago, she read the temperature of the Canadian healthcare system and she had a great idea. So she defined a need for a brand new program.

And make no mistake, Jenny executes. She took hold of this idea and this need for a new program, and she took charge. She moved what is now the Healthcare Quality program through the Queen’s process in record time. Where getting a program off the ground would normally take two years, Jenny got the program approved and through the hoops at Queen’s in less than half of that time. With foresight and planning and a little bit of elbow, the MSc in Healthcare Quality was born.

But she didn’t do it alone. As a leader, Jenny is a collaborator. She knows that it takes a village. So she co-opted cooperation from the department of anesthesiology and perioperative medicine and built a truly interdisciplinary program.

Part of being a great leader is just not being satisfied. Launching just one successful program wasn’t good enough for Jenny. Her drive to exceed expectations and bring things to the next level has put us in the situation where we are today. During Jenny’s tenure, the school has grown and improved by every measure. We now have more students, more faculty, and are in a more stable budgetary position. Our students perform better on the nursing licensing exams than students from just about any other school. And I think that it’s safe to say that she’s helped make our three schools, nursing, medicine and rehabilitation therapy, more integrated and collaborative than ever before. All of these successes are due to Jenny’s absolutely tireless work ethic and desire to do better.

Jenny hasn’t just been a leader in the Faculty of Health Sciences. She has served the University, as Vice Chair of the Senate and she has been a strategic leader for nursing in the province, as chair of COUPN.

Of all of Jenny’s many leadership qualities, I think the one that stands out most for me, is her undeniable passion. When she spoke at convocation last month, her theme was the purpose and joy of work. I truly can’t imagine a more fitting topic for Jenny’s final convocation address. Because I think that her goal as Vice-Dean has always been to ensure that her students and faculty alike, share in her strong belief that nursing is more than just a course of study, more than just a healthcare profession, but that it truly is a calling.

That’s the kind of leader Jenny is. She is a visionary, she executes, and she has a lovely blend of sharp elbows and never taking no for an answer. And then she looks at the success of the mountain she’s climbed and doesn’t stop to look down at the cheering crowds, but looks for the next mountain to climb.

All the while, she is motivated by her infectious passion for the profession of nursing. That is what has driven her to build a great school of nursing. And it is at the heart of the legacy she leaves.

Please join me in celebrating Jenny by sharing your stories and best wishes by commenting on the blog.

Working Toward Inclusion: Listening to LGBTQI2S+ Student Voices in Medicine
2019-06-17 Working Toward Inclusion: Listening to LGBTQI2S+ Student Voices in Medicine

The following is a guest blog by Dr. David Messenger, an emergency and intensive care physician and head of the Department of Emergency Medicine at Queen’s University.

Recently, I took part in a panel discussion organized by Queen’s medical students. A small group of faculty and resident physicians came together to speak about our individual experiences as LGBTQI2S+ persons in medical school, residency training and early practice. As the oldest panelist, I looked forward to learning how different becoming an LGBTQI2S+ doctor must be now compared to my own experience. 

When I started medical school at Queen’s in 1998, the landscape looked much different than it does today. Sexual orientation had only just been added to the Canadian Human Rights Act; same-sex marriage rights were still 7 years away. At 21, I had yet to come out to my family and many friends, and I had just started my first gay relationship (with my now-husband). I was keenly aware of a need to tread very carefully as I took my first tentative steps out of a meticulously-constructed closet.

As a gay medical student, I felt relatively isolated. Rather than seek community with the tiny group of visible LGBTQI2S+ med students, I avoided associations that might result in my being “outed”. I felt certain that coming out would be a liability to any number of my ambitions in medicine, particularly matching to a competitive specialty residency program. I worried about how I’d be viewed and treated by preceptors, colleagues, and by patients if I presented as anything other than the norm that was modeled for me in medicine. Gay clinical faculty exemplars or mentors? None were visible to me through my decade of training at Queen’s. Normalization of LGBTQI2S+ patients in the curriculum? Other than being taught to ask “do you have sex with men, women, or both?” when taking a sexual history, and discussions about gay patients in the context of HIV, I don’t recall much explicit reassurance that medicine welcomed the inclusion of the LGBTQI2S+ experience in its ranks.

Despite a sense of isolation, my actual lived experience at Queen’s has been mostly positive.
My coming out has been a gradual and continuing experience that started during residency. I feel immensely grateful for the acceptance and support that I’ve received from many peers and mentors here who have proved to be committed allies as I’ve become more open with my identity. But my experience has always felt more like good luck than it has deliberate institutional culture.

Two decades later, it’s clear that much has changed. Listening to the contemporary stories and experiences of my co-panelists and others revealed that LGBTQI2S+ students are more comfortable living that identity openly among their peers today. A more visible and supportive LGBTQI2S+ medical student community exists for those who seek it out. This community is finding a voice that is helping to promote the inclusion of more diversity in the curriculum.

But, even now, LGBTQI2S+ students describe considerable apprehension about if and how to be themselves when applying for residency training. They search for subtle signals during electives and interviews that prospective programs are safe to join. They consider redacting their CVs to exclude activities that brand them as “too political” (code for “too gay”). They speak of ruling out entire disciplines from their career choices because of worry that as LGBTQI2S+, they won’t fit with the culture of the specialty. Despite unique individual experiences, many learners describe being victim to assumptions, misunderstandings, and a hidden curriculum that can make them feel like outsiders within their disciplines. And finally, they expose an ongoing scarcity of accessible and visible LGBTQI2S+ mentors and role models within Queen’s Medicine.

June is Pride month – among other things, a celebration of diversity. At Queen’s, we often discuss a need to foster diversity and inclusion in medicine, but the stories of our LGBTQI2S+ students and trainees bring to light how much work remains for diversity and inclusion to become lived values.

An inclusive medical school welcomes and normalizes as many different populations of students as possible. An inclusive medical school does not explicitly or implicitly marginalize people or label them as “other”, including the patients our graduates will go on to care for. As one of a small number of gay faculty members in a position of leadership, my visibility and accessibility to students is an important contribution I can make to help us be a more inclusive community. I have a tendency to shelter behind my ability to visibly “blend into the crowd” and to obscure my identity – some habits die hard – and that tendency might be sending the wrong message to my students and colleagues.

Change begins with recognition. We all need to pay attention to the stories of LGBTQI2S+ students, stories as diverse as the individuals who tell them. We can and must do better as allies, and this starts by listening to, learning from, and advocating for our students and colleagues’ experiences in medicine at Queen’s.

Rethinking the way that we create positive spaces for our LGBTQI2S+ patients
2019-06-11 Rethinking the way that we create positive spaces for our LGBTQI2S+ patients

We live in an era where it is increasingly important for health care practitioners to create safe spaces for their lesbian, gay, bisexual, transgender, queer and questioning, intersex and two-spirit (LGBTQI2S+) patients.

Discrimination and marginalization are huge barriers to healthcare for people of diverse sexual or gender identities. Not feeling welcome or understood hinders the therapeutic relationship and affects how people access care, or whether they access care at all. And we know that working towards positive spaces is a way to foster safer health care environments for patients from LGBTQI2S+ communities; studies confirm this again and again.

So how do we create those positive spaces for both practitioners and patients? The traditional approach is through cultural competency training. The tools in such training focus on the provider developing a set of attitudes, knowledge, and skills that will support them in caring for and showing respect for clients of different cultures.

And yet even for the most well-meaning, creating those safe spaces and experiences isn’t as simple as relying on knowledge gained from prior trainings, such as an introduction to LGBTQI2S+ terminology.  

Kathryn Allwright, who recently graduated from Queen’s Master of Nursing Science (MNSc), explored this simple yet striking nuance: humility can be more effective than competency in making positive health care spaces for people from LGBTQI2S+ community.

According to Kathryn and her research, humility requires a different approach than competency.

Rather than aiming to have health care practitioners ‘know’ the issues and concerns faced by their colleagues and patients from LGBTQI2S+ communities, humility aims to have practitioners understand that knowing is a process, rather than a destination. Each person has a unique lived experience; if we can resist assumptions and instead seek to understand each individual and their unique situation, we can shift to a state of constant learning -- and act accordingly.

Exactly how humility might be embedded into nursing practice was the focus of Kathryn’s thesis. In her initial research, Kathryn found literature demonstrating that public health nurses could make public health unit spaces safer for sexually and/or gender diverse people through a cultural humility approach. However, she found something was missing. There was no way to measure this. Public health nurses needed to be able to assess whether they were in fact using a cultural humility approach and creating positive spaces.

So, she set out to validate the effectiveness of existing self and workplace assessment tools made available by the Ontario Public Health Association. “Despite these tools being used in practice, I was unable to find any psychometric testing to support that these were valid and reliable measures for positive spaces,” Kathryn explained.

In the end, Kathryn set her sights on testing modified version of the tools that reflected cultural humility rather than competence “A cultural humility approach encompasses critical self-reflection, a commitment to lifelong learning, and a recognition of power imbalances. It was important to ensure that these components were reflected in the positive space tools” Kathryn shared. Her work yielded a 40-item self-assessment tool with 15 underlying dimensions and a 38-item workplace tool with 10 underlying dimensions.

“This Exploratory Factor Analysis is a step in the direction toward having validated and reliable tools,” Kathryn said. The next step is testing the tools with different samples to assess generalizability of the results.”

Although Kathryn has now graduated, this won’t be the end of her work on LGBTQI2S+ healthcare topics. Kathryn, alongside project partners, have launched a podcast series on trans health care topics called TransForming Rounds. You can find all episodes of TransForming Rounds at: Rethinking the way that we create positive spaces for our LGBTQI2S+ patientshttps://player.fm/series/transforming-rounds.

Seeing the important work that Kathryn is doing to support diversity and inclusion is not just inspiring but brave and thought-provoking. I hope that it inspires those of you reading – whether you are a nurse, doctor, rehabilitation therapist, trainee, staff member or working outside the healthcare field altogether.

How are you incorporating humility and the idea of building safe spaces into the work that you do? I would love to hear your thoughts in the comments. Or better yet, please stop by the Macklem House: my door is always open.

 

Queen’s University offers positive space training through its Positive Space Program. Find out more here: https://www.queensu.ca/positivespace/home

A medical student has her voice heard on Parliament Hill
2019-06-05 A medical student has her voice heard on Parliament Hill

As an undergraduate student, Caberry Yu did not think of politics as something that she’d ever be interested in. But now, as a second-year student in Queen’s School of Medicine, she finds herself growing into a role as an advocate for seniors care in Canada. With the organization Daughters of the Vote, she was selected to represent Kingston and the Islands in Ottawa, during which she delivered a speech to the Senate about the shortcomings in care for seniors in Canada.

Even though advocacy wasn’t at the front of her mind at the time, Caberry now sees that the seeds of her political interests were being planted when she was still an undergraduate. To gain first-hand experience with patients, she volunteered for a seniors rehabilitation program at St. Peter’s Hospital in Hamilton. Through this experience, Caberry held in-depth conversations with many elderly patients and their caregivers. Caberry had many meaningful discussions at the hospital, but one patient said something that resonated particularly strongly with her: “most young people just don’t care about seniors.”

Looking back, Caberry sees this moment as a kind of call to action: it was one of the formative experiences that made her believe that younger people, especially in the health profession, need to become advocates for the care of senior citizens in Canada.

“Around that time,” she says, “I realized that the patient was right – most of us, including myself, didn’t know much about seniors care. We didn’t understand how ill-equipped our health system was to help seniors age with dignity.”

This past academic year, while she was in her second year of our undergraduate medical education program, Caberry became newly inspired to find her voice in seniors advocacy when she took part in the Day of Action organized by the Canadian Federation of Medical Students (CFMS).

Each year, CFMS puts together a delegation to Ottawa that enables medical students from across Canada to speak to Members of Parliament and advocate for reform to the health system. This year’s Day of Action took up the cause of ageing and seniors care, and it gave Caberry the opportunity to meet with MPs Celina Caesar-Chavannes and Kellie Leitch to discuss a national seniors strategy and pharmacare.

Caberry had such a positive experience on this trip in February, that she eagerly signed up to take a second organized trip to Ottawa in April, this time with Daughters of the Vote.

Daughters of the Vote selects young women between the ages of 18 and 23 from each federal riding in Canada to travel to Ottawa for the opportunity to engage with parliamentarians, learn about the workings of the federal government, and network.

Of the over 300 women who go on this trip, a few are given the opportunity to make a speech in the House of Commons or Senate about a topic that they are passionate about. Caberry was chosen for this honour, and she spoke in the Senate about the issue of Canadian seniors living in poverty.

Caberry’s goal was to make people understand that while the process of aging impacts us all, some of its complications are unevenly distributed. A disproportionate amount of seniors living in poverty are women. All too frequently, seniors in poverty cannot afford basic needs like food, housing, medications, and are more likely to age in nursing homes. She advocated for a National Seniors Strategy to coordinate best practices in seniors care and examine aging from multiple perspectives.

After giving her speech and making connections in Ottawa, Caberry feels like she has only just begun her work. She has already secured funding to put together an intergenerational exchange event in Kingston that will help seniors and university students connect with each other. Her goal is to help youth and seniors in the area understand each other better, and also to help humanize the issue of seniors care for young people.

“It’s really been a transformative year for me,” Caberry says. “When I think of successful politicians, I don’t see many individuals representative of my racial and gender identities. Having the opportunity to meet amazing women working in policy has inspired me to make advocacy a part of my career.”

Whenever I can, I take the opportunity to encourage students in the Faculty of Health Sciences to get involved in advocacy work. It is my sincere hope that Queen’s graduates will not only be outstanding practitioners but also leaders in our society, especially on issues related to the health system. I believe that our health professionals should aim to have their voices heard in Queen’s Park and on Parliament Hill.

I am so proud of Caberry for establishing herself as an advocate at such an early stage in her career, and I have no doubt that she has a bright future ahead of her. I look forward to learning more about her leadership work in the coming years. 

If you have any thoughts on the importance of advocacy work for health sciences students, please leave them in the comments below. Or better yet, please stop by the Macklem House: my door is always open.

 

--Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.

Dr. Maria Bartholomew, Daniel Bartholomew, and Rosalind Bartholomew holding Ethelbert Bartholomew's posthumous degree
2019-05-29 A long-overdue degree and hope for our future

Last Thursday was convocation for the School of Nursing and the School of Medicine, and those of us on the faculty had the joy of seeing our tremendous graduates receive their new degrees. Convocation is always a meaningful occasion, but this year’s stands out because we had the opportunity to grant a posthumous degree to Ethelbert Bartholomew.

Ethelbert should have been granted this degree 100 years ago, but the 1918 policy that banned Black medical students from Queen’s took away his opportunity to receive the degree he deserved.

You may remember that last month Principal Woolf and I signed a public letter of apology for this ban. Ethelbert’s son, Daniel Bartholomew, traveled to Kingston from Whitby to attend this apology ceremony, and I was grateful that he was able to be there.

Edward Thomas, Daniel Bartholomew, Dr. Maria Bartholomew, and Rosalyn Bartholomew
Edward Thomas, Daniel Bartholomew, Dr. Maria Bartholomew, and Rosalind Bartholomew

Afterwards, at a dinner marking the occasion, Daniel looked at me and said: “There’s one more thing I’m wondering if you could do. Could you give my dad his degree?”

Now, this sounded like a great idea to me, but I was somewhat taken aback by this simple yet profound request. So, being a polite dean, I told him I would see what I could do. Granting a degree is a complicated process, and it isn’t something I could just do on my own. Even if it were possible, I was afraid that it might take a long time. Universities, you might know, don’t exactly move at lightning speed.

So that evening, I spoke to Ann Tierney, our Vice-Provost and Dean of Student Affairs, and she said, “we can do this!”

The next day I spoke to our Director of Diversity, Mala Joneja, and she said, “we can do this!”

To my great thrill, everyone at Queen’s jumped into action with great commitment to granting this degree. Processes that would normally take us a year got finished within a month. Daniel asked for this degree in April, and we were able to confer it in May.

Conferring this degree was made all the more meaningful by the fact that Daniel and other members of Ethelbert’s family members came to Kingston to attend convocation. Two of Ethelbert’s descendants even agreed to accept the degree on his behalf: Dr. Maria Bartholomew, his great niece, and Rosalind Bartholomew, his granddaughter.

I am so grateful to all the members of the Bartholomew family who joined us for convocation. Handing Ethelbert’s long-overdue degree to Maria and Rosalind will stay with me as one of the most meaningful moments in my time as dean.  I am also grateful to PhD candidate, Edward Thomas, for his incredible and diligent work in unearthing many of the details of this story through his research.

Chancellor Leech and I with members of the Bartholomew family
Chancellor Leech and I with members of the Bartholomew family

The ban of 1918 is certainly a sad moment from our past, but, as I stood in front of our new graduates, I felt immense hope for our future. When it comes to embracing diversity, the class of 2019 is light years ahead of where we were, as a society, in 1918. Undoubtedly, they are even light years ahead of my generation.

It’s thrilling to see the ways in which they have all embraced inclusivity in the classroom, around campus, and in the hospital. For this generation, the drive to promote equity and diversity is part of who they are as people. And I know that they will all continue to work to make Canada a more equitable society as they embark on the next stage of their careers.

If you have any words of encouragement for our new graduates, please share them in the comments below. Or better yet, please stop by the Macklem House: my door is always open.

 

--Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.

 

Dr. Barry Lavallee
2019-05-22 A call to disrupt racism in health sciences education

Last week at Queen’s, we hosted Dr. Barry Lavallee, who is a member of Manitoba First Nation and Métis communities and a specialist in Indigenous health and northern practice. Dr. Lavallee stayed with us for three days and provided a series of events aimed at raising our awareness of the ways in which Indigenous people in Canada experience the health care system. I cannot thank Dr. Lavallee enough for agreeing to travel from Manitoba to speak with us, and for offering us such an important perspective that we all need to hear.

During the public lecture he delivered on Wednesday, he gave the audience an overview of the ways in which racism affects Indigenous health. Among other disturbing factors, Dr. Lavallee says that Indigenous people do not receive the care they need because the severity of their problems is ignored by practitioners. Dr. Lavallee illustrated this for us by drawing on the story of Brian Sinclair, a 45-year-old Indigenous man in Winnipeg who died in the waiting room of the emergency department while waiting 34 hours to be seen.

Dr. Barry Lavallee delivering a public lecture at Queen's
Dr. Lavallee lecturing at Queen's

Dr. Lavallee explained that sometimes Indigenous people do not even bother seeking out Western professional care because their experiences with the health system have been so negative. In a particularly chilling anecdote, Dr. Lavallee described how one of his Indigenous patients was once violently attacked but chose to try to treat herself at home rather than go to the emergency room and potentially experience racism.

One of the biggest takeaways from Dr. Lavallee’s talk for me is the fact that our medical education system in Canada still needs to do a better job of training future physicians not to make decisions about patients based on stereotypes.

As Dr. Lavallee explains, our students, starting in their clerkship years, frequently encounter unconscious biases towards Indigenous patients that can result in inequities of care. This does not mean that clinical professors set out to teach their students to think of Indigenous patients in a negative light. But rather that students learn to adopt these attitudes from the behaviours of their teachers. Often, these behaviours are subtle or unconscious, such as signs of irritation or off-hand remarks, but Dr. Lavallee stresses that the smallest acts can have large impacts on our learners.

With this context in mind, I was particularly grateful to Dr. Lavallee for holding a Faculty Development Workshop last Thursday on the subject of “Teaching Methods for Addressing Cultural Safety: Promoting Indigenous Health.” In this workshop, he taught participants how to disrupt the negative “coaching” of medical students by practising how to identify racism and question it in a productive way. 

Dr. Leslie Flynn, our Vice-Dean, Education in the Faculty of Health Sciences, has been a leading figure in our work to respond to the calls to action of the Truth and Reconciliation Commission, and she was instrumental in bringing Dr. Lavallee to campus. I reached out to her to reflect on his visit.

“Dr. Lavallee gave a very challenging lecture that I think was necessary to hear,” Dr. Flynn says. “As we continue with our work of answering the calls to action of the Truth and Reconciliation Commission, I think we should all keep in mind the ways in which he provoked us to examine our own position within the legacy of colonialism. I am very grateful to Dr. Lavallee for everything he taught us, and I feel that he has energized the faculty to pursue truth and reconciliation with a renewed sense of purpose.”

I wholeheartedly agree with Dr. Flynn. As we make progress on truth and reconciliation in medical education, we need the expertise of people like Dr. Lavallee. His visit pointed out the many challenges we still need to face, but he also gave us inspiration to tackle them head on.

If you have any thoughts on Dr. Lavallee’s visit, please leave them in the comments below. Or better yet, please stop by the Macklem House: my door is always open.

 

--Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.

 

Jung Lin
2019-05-14 Integrating Western and Indigenous care in northern Quebec
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Working as an occupational therapist in a Cree community in northern Quebec, Jung Lin was very far away from Queen’s when she heard about the DSc in Rehabilitation and Health Leadership (RHL) program - but the timing could not have been better.

Jung learned about the program through an informational email from the School of Rehabilitation Therapy, where she’d earned a Master’s degree ten years before. Just a few days before she received this email, she had been having a conversation with her manager about whether or not she’d be interested in taking a larger research and leadership role within their organization.

When the message about the RHL program reached her, then, it seemed almost like a sign.

The DSc RHL program is one of our newest offerings in the Faculty of Health Sciences, and it is designed for people, like Jung, who already have careers in health care but want to develop their skills in order to take on bigger challenges and larger responsibilities.

Jung’s goal in earning her doctorate is to put herself in the position to help rehabilitation professionals work more closely with Indigenous care providers. For her dissertation, she is conducting a mixed-method study to develop training modules that can help practitioners learn how to integrate Western and Indigenous methods of care. Her goal is to use her findings to develop better training systems for Indigenous paraprofessionals and to enhance service delivery.

“While I greatly enjoy providing care to my patients, I’m also looking to make bigger changes,” Jung says. “The Rehabilitation and Health Leadership program is teaching me how to make the larger impact I’m aiming for.”

Originally from Taiwan, Jung has been making connections across cultural divides her entire adult life. After earning her degree in Occupational Therapy in her home country, she worked there for several years at a mental health facility before moving to Canada with her family.

When she and her parents came to Canada, they settled in Montreal, which they chose because Jung’s older sister was working toward her PhD at McGill. After a few months, though, Jung decided on a change of scenery and to get started on earning her master’s degree.

She found her way to the Master’s in Rehabilitation Science program at McMaster University, where she developed a greater understanding of Canadian healthcare.

After finishing this one-year program, however, she felt like she had more to learn and explore in order to enter the workforce with a greater sense of confidence and mastery. Ultimately this desire led her to enrol in the thesis-based Master’s program in Rehabilitation Science at the Queen’s School of Rehabilitation Therapy.

At Queen’s, Canada truly started to feel like home for Jung. She gives a lot of credit to her supervisor, Dr. Rosemary Lysaght, for supporting her with her transition to Kingston and for helping her develop a professional network.

From Kingston, Jung returned to Montreal to be closer to her family, and she worked as an occupational therapist in the city. When she saw the job advertisement for her current position with the Cree Board of Health and Social Services of James Bay, she was immediately intrigued. She viewed it as an opportunity to provide useful services to a part of Canada that she wouldn’t get to know otherwise.

Jung says there are some challenges to working in the north. Her family still lives in Montreal, so every two months she drives 9 hours (each way) to spend time with them. The community she lives in is over an hour and a half away from the nearest grocery store, which means she has to plan her shopping trips much more carefully than she was used to before working there. And, of course, the weather can get extremely cold (as you can see in the picture below).

Jung in the north with frozen eyelashes
Jung in the north with frozen eyelashes

But Jung finds the experience highly rewarding despite any challenges.

The DSc RHL program is fitting in to her work and life commitments just as she’d hoped it would. The online nature of most of the coursework allows her to integrate studying into her busy schedule without much trouble.

Even more important, she strongly believes that the program is helping her to meet her goals. “I think I’ve gone through a transformation since starting the program,” she says. “I am more capable of making long-term plans for my work, and I have grown more confident as a leader. The classes ‘Leadership Development Seminar’ and ‘Applying Theory to Enable Change’ have had an especially strong impact on me.”

Jung felt confident in her decision to enroll in a second degree program at the Queen’s School of Rehabilitation Therapy because, as she worked toward her master’s, she thought it was an environment where the faculty truly care about students and their needs. “After ten years,” she says, “I think Queen’s is just as student-centred as I remember it.”

I wish Jung all the best as she moves through the DSc RHL program and does her important occupational therapy work in northern Quebec. If you have any thoughts about Jung’s project or how we can better educate tomorrow’s health leaders, please leave them in the comments below. Or better yet, stop by the Macklem House: my door is always open.

 

Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.

 

Dr. Jackie Duffin
2019-05-07 Jackie Duffin inducted into Canadian Medical Hall of Fame

Last Thursday, I had the thrill of attending the induction ceremony for the Canadian Medical Hall of Fame. This is one of my favourite annual events, and this year’s ceremony was especially meaningful because I was able to see a true legend of the Queen’s School of Medicine get inducted: Dr. Jackie Duffin.

From 1988 to 2017, Dr. Duffin was the Jason A. Hannah Chair in the History of Medicine at Queen’s, and in this role she taught all of our medical students to place our profession in a broader historical context and also to think critically about the ways in which medical knowledge is produced.

Dr. Duffin at the Canadian Medical Hall of Fame induction
Dr. Duffin at the induction ceremony

A number of the lessons she created for our curriculum became rites of passage for our students. I think almost everyone who studied here while Dr. Duffin taught for us has vivid memories of reading the original Hippocratic Oath with her during orientation and thinking hard about the concepts of “heroes” and “villains” in medical history during their first semester. Many students also traveled around Canada and the United States with her, as she arranged yearly field trips to medical museums in both countries.

Dr. Duffin’s students were so devoted to her that some of them created a conference in her honour the year after she retired. The Jacalyn Duffin Health and Humanities Conference has now run for two years, and it has been an outstanding success both times.

In its citation for Dr. Duffin’s induction, the Canadian Medical Hall of Fame says, “A haematologist and historian, her enduring contributions to medical research and education deepen our understanding of how the humanities inform balanced, effective medical training.”  

It is so terrific to see Dr. Duffin honoured for the way in which she has so effectively brought the humanities into medical education because, at Queen’s, we’ve been seeing for decades the positive effects that this kind of teaching can have on students.

Because I know how beloved she always was by our students, I reached out to a few to ask for their thoughts on Dr. Duffin and what she has meant to them. Here’s what they had to say.

“Dr. Duffin’s History of Medicine curriculum has provided an essential building block to the medical education of thousands of medical students,” Kate Rath-Wilson says. “She provided us with the critical reasoning tools to be skeptical when necessary and righteous in our advocacy. Learning about the history of our profession, its triumphs and tragedies, through Dr. Duffin’s critical lens was at once humbling and empowering. Her teaching discouraged us from becoming complacent in our responsibilities as health care advocates in our future careers.”

"There are few generalizations that are true in life but I can say without any reservation that Dr. Jacalyn Duffin is loved and cherished by ALL her students,” says Hissan Butt. “That's why Meds 2015 established the Jacalyn Duffin Student Award and students from Meds 2020 and 2021 started an eponymous health humanities conference. It's been an absolute privilege to learn from her and ask important questions about medicine and society."

I’d also like to point out that Hissan was also in Montreal for the induction ceremony, as he was receiving a Canadian Medical Hall of Fame Award. These awards recognize terrific work being done by a student at each medical school in Canada, and all of us in the School of Medicine are very proud of Hissan for being this year’s recipient from Queen’s.

I always cherish moments in the lecture hall with Dr. Duffin,” Yannay Khaikin says. “She teaches with a kind of energy and honesty that reverberates for decades in the minds of medical students, residents, and faculty who have been fortunate to hear her speak. Her commitment to preserving the study of philosophy and history in medicine is relentless, unapologetic, and utterly unique.

"Dr. Duffin has been the most influential and impactful teacher in both my medical and non-medical education," Chantal Valiquette says. “She is a resilient, passionate, and brilliant historian/physician who is a constant source of inspiration to her students. Her dedication to her students is unparalleled, and her support for history of medicine has inspired generations of students to realize the impact our history has on our present day understandings of medicine and medical education. There is no one more deserving of an induction to the Canadian Medical Hall of Fame."

“Equipped with a colourful scarf, her signature round glasses, a pair of neon sneakers and an exuberance that knows no bounds, Dr. Jackie Duffin is unlike any other professor I have ever had,” Harry Chandrakumaran says. “It is obvious to even the least attentive student that she is unapologetically in love with her job. I cannot imagine a more deserving candidate for induction into the Canadian Medical Hall of Fame. Many doctors have testified in court. Rarely have they had their testimony result in the canonization of a saint. Even more impressive than meeting the Pope, Dr. Duffin manages to engage a hundred medical students while discussing the intricacies of 16th century anatomical illustrators. Perhaps that is why she is so fondly remembered by a generation of physicians.“

 The Hannah Chair is funded by a program that was established by Associated Medical Services (AMS) to promote the history of medicine in curricula at medical schools across Canada. AMS funds eight Hannah Chairs at Canadian universities: six in Ontario, one in Alberta, and one in Quebec.

The Hannah Chair program is a fantastic contribution to Canadian medical education, and, at Queen’s, we have always been proud to host a Chair. While Dr. Duffin no longer teaches our students, they are still learning just as much about the history of medicine through our new Hannah Chair: Dr. Jenna Healey.

As I said, the Canadian Medical Hall of Fame induction ceremony is a tremendous event every year. I have fond memories of hosting the event in Kingston in 2014, and this year had the pleasure of sitting with Dr. Duncan Sinclair, a former dean at Queen’s and a 2015 inductee into the Hall of Fame. Thanks to everyone at the Canadian Medical Hall of Fame for hosting a wonderful evening in Montreal and for all of the work you do to recognize medical achievements in Canada.

Dr. Duffin with all of this year's inductees
Dr. Duffin (seated, front row, last on right) with this year's inductees and student award winners

If you're curious to read Dr. Duffin's thoughts on being inducted, please check out her most recent blog entry.

Do you have any memories of Dr. Duffin you’d like to share? Or any words of congratulations on her induction into the Hall of Fame? If so, please leave them in the comments below. Or better yet, please stop by the Macklem House: my door is always open.

 

Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.

 

Allison Nerbas
2019-04-30 On-campus and online: this student's unique journey in the Bachelor of Health Sciences program

Allison Nerbas grew up in Aurora, Ontario and moved to Kingston to attend Queen’s after high school, but she never sets foot in a classroom.

This isn't because she is a poor student, but because she ended up deciding that the course that was truly right for her at Queen’s was the online Bachelor of Health Sciences (BHSc) program.

When Allison was originally trying to decide which universities to apply to, she hadn’t given much thought to health sciences, so she did not think to apply to the BHSc at Queen’s. As she started her first semester, though, she took elective courses in pharmacology and anatomy and realized that she wanted to pursue that line of study. After doing some investigating, Allison figured out that the BHSc program would give her the best opportunity to take the courses she really loved.

Allison talked over the decision with her parents, and they encouraged her to make the choice that felt best for her. With her family’s support behind her, she started the process of transferring to the BHSc program. She would change from being an on-campus student to an online student.

After she’d made that transition, Allison had the option of moving away from Kingston. Since she now had all the flexibility that comes with being an online student, she didn’t need to worry about living in proximity to her classes.

But Allison ultimately decided that she wanted to stay in town. Over the course of her first year, she’d come to truly love both the campus and culture of Queen’s. She had found social groups that she felt connected to in both her residence hall and her clubs. Even if the courses she wanted to take most were online, she wasn’t willing to give up every aspect of the campus experience.

So Allison is now in the unique situation of being an online student with a foot in campus life. She lives in an apartment in Kingston with other Queen’s students, and she does a lot of her studying in the Stauffer library.

Allison Nerbas working in the ARC
Allison working in the ARC

Just having finished her second year of the BHSc program, Allison still feels confident in her decision, mainly because she continues to enjoy her coursework. While she hasn’t taken any classes in the program that she didn’t like, a couple have stood out as favourites. For instance, she says she has particularly enjoyed the ways in which the course “Social and Physical Determinants of Health and Disease” opened her eyes to the wide range of factors beyond biology that influence a person’s wellbeing. And she also found “Interprofessional Approaches in Health Care” fascinating for the insights it provided into the communication and team work that goes into patient-centred care.

These classes also point to what she appreciates most about the BHSc: the way it mixes basic science courses with classes that are oriented more toward the social sciences. Allison believes that this diverse range of classes is giving her a truly holistic understanding of the health sciences.

Allison is also so enthusiastic about the BHSc program because she feels like her professors really make an effort to help her and her online classmates as much as possible. Even though she doesn’t interact with her instructors in person, she says they always respond efficiently to her emails and leave helpful comments on her posts to the course discussion boards.

This fall, the Faculty of Health Sciences will be launching an on-campus version of the BHSc program, and Allison is planning on being a resource for this incoming group of students. She has already volunteered to be an orientation leader, which means she will soon be hard at work figuring out what the first-ever on-campus BHSc orientation will look like. At Queen’s, there are so many orientation rituals in many of our different programs, and our students seem to love the ways in which these connect them to the history of the university. Allison is drawn to that aspect of Queen’s, but also says “it’s cool to be a part of making the traditions.”

Looking to the future, Allison isn’t positive yet what specific career path she plans to go down after she earns her BHSc. But, rightly, she doesn’t let this stress her out too much. “I know I love what I’m learning,” she says, “and right now that’s the main thing.”

It’s so great that we have keen students like Allison in our online BHSc program, and I know she’ll make a great mentor to our first on-campus students in the fall. Do you have any thoughts about online education or undergraduate health sciences programs? If so, please share them in the comments below. Or better yet, please stop by the Macklem House: my door is always open.

 

Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.  

 

The participants in the EPA course
2019-04-24 A world leader in medical education teaches a course at Queen's

Dr. Olle ten Cate is a true world leader in medical education, and earlier this month Queen’s University was fortunate enough to host him as he taught his course “Ins and Outs of Entrustable Professional Activities.”

It would be hard to overstate how exciting it was to have this event at Queen’s. The Entrustable Professional Activity (EPA) is a relatively new concept in medical education, but it is changing the way we think about training doctors. An EPA is a key task of a medical discipline that trainees can be trusted to perform when they have demonstrated sufficient competence. For instance, EPAs can range from essential skills in all disciplines, such as taking a patient’s history, to highly specialized skills like the ability to perform a specific operation.

EPAs are so significant because they are a fundamental aspect of competency-based medical education (CBME).  In CBME, educators use EPAs to gauge a learner’s progress through the curriculum. The more EPAs a trainee is trusted to perform, the further along they are in their progress through their education.

While there is a constantly evolving discussion of EPAs among educational scholars, Dr. ten Cate is the originator of the EPA framework. No one, then, could be a more ideal choice to facilitate a course about how to think about EPAs and incorporate them into medical curricula.

Dr. David Taylor, Associate Professor in the Department of Medicine at Queen’s, served as the course coordinator and site director, and as such played an instrumental role in bringing this course to Queen’s. He also deserves a great deal of credit for making the course such a huge success.

In addition to Dr. ten Cate and Dr. Taylor, three other experts in EPAs helped teach the course: Dr. Jacqueline de Graaf from Radbound University in the Netherlands; Dr. Robert Englander from the University of Minnesota; and Dr. Claire Touchie from the University of Ottawa.

The tremendous appeal that this course holds for medical educators is obvious just from looking at the list of participants. People came from all over North America to learn from Dr. ten Cate and discuss EPAs with other educators who are working on incorporating this framework into their teaching. Two participants came from Mexico, six came from the United States, and one even traveled from the United Kingdom. The other twenty-one participants came from Canada; while some were Queen’s faculty members there were also medical educators from schools across Ontario as well as Nova Scotia, Saskatchewan, Quebec, and Manitoba. There were thirty available seats in the course, and Dr. Taylor and his team had no trouble filling them all.

“We had an absolutely fabulous group of participants come to the EPA course at Queen’s,” Dr. Taylor said. “An engaged group always makes teaching easy. And with our faculty team of Olle, Bob, Claire and Jacquie, it really was a world class course. I believe we were able to send out a group of leaders with a rich understanding of EPAs, prepared to advance CBME in their own settings.”

My schedule didn’t allow me to sit in on the whole course, but I did make a point to stop by one afternoon. Unsurprisingly, I was impressed by the intelligence and insight of Dr. ten Cate as he led the group. But I was also excited to see how collegial and energetic the group of participants was.

It was a real pleasure to see them share their experiences with and ideas about EPAs with each other. Enthusiastically, they discussed their understanding of concepts such as Nested EPAs and entrustment decisions and even what constitutes trust in medical education in the first place.

These kinds of conversations are essential for those of us in academic medicine working to embed the EPA framework into our training programs. Open dialogue is how we all learn from each other, create knowledge, and develop a set of best practices for teaching. And, during “Ins and Outs of Entrustable Professional Activities,” the participants were all having this necessary open dialogue and filled it with sharp insights and intellectual generosity.

I also think it was particularly fitting that all this terrific discussion of EPAs went on at Queen’s, where we’ve been leaders in working the EPA framework into our medical education programs. As we launched competency-based medical education (CBME) across all of our postgraduate programs, we put a lot of thought and effort into figuring out how best to incorporate EPAs into our curricula, as they are part of the backbone of CBME.

When I asked Dr. Taylor why he thought that Queen’s would make a good host for this course, it became clear that we had some similar thoughts. “Over the past few years,” he said, “Queen’s has not only shown that it punches far above its weight in medical education, we have established ourselves as the national leaders in CBME. It only made sense to bring the first North American edition the course to Queen’s. Olle ten Cate was more than happy to support this.”

Do you have any thoughts about how you’ve been incorporating EPAs or any other new educational framework into your teaching? If so, let me know in the comments below. Or better yet, please stop by the Macklem House: my door is always open.

 

--Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.

 

Principal Daniel Woolf and Dean Richard Reznick signing letter of apology
2019-04-15 The 1918 ban of Black medical students: Addressing our past discrimination to promote diversity in the future

Last fall, my understanding of the history of the Queen’s School of Medicine changed when I learned that, in 1918, we had put in place a policy to formally ban Black students. This policy was approved in a motion by the Queen’s Senate, and it was enforced until 1965.

I learned about this ban when Edward Thomas, a PhD candidate at Queen’s, presented his research on the topic to the Queen’s Senate and informed us that the motion that had set the ban in place had never been officially repealed. He asked us to formally rescind the motion, which we did during the October meeting of the Senate. 

According to Mr. Thomas, this ban was put in place in order to be in line with the discriminatory policies favoured at the time by the American Medical Association (AMA), the organization that ranked medical schools in North America.  While the AMA had no control over the policies of Canadian medical schools, the Carnegie Foundation and the Rockefeller Foundation consulted its rankings when they made decisions about whether or not to provide funding to medical schools. It seems, then, that the leaders of the Queen’s School of Medicine decided to ban Black students in order to receive a higher ranking from the AMA and thus receive more funding.

As a result of this ban, at least two Black students at Queen’s had their medical careers ended. Eight Black students resisted the policy and remained at the university, but they were subjected to racism and mockery from their peers.

After putting the ban in place, Queen’s repeatedly refused to consider the applications of Black students until 1965.

From the beginning, university leadership was not forthright about their reasons for putting the ban in place. In 1918, university leaders said that the school needed to ban Black students because veterans of the First World War who had returned to Kingston refused to be seen by them. The Black students themselves, however, claimed that they were not aware of any instances of such refusal.

It seems, then, that the university administration gave this explanation in order to disguise the more likely reason that the ban was being instated as part of their efforts to receive funding from the Carnegie and Rockefeller Foundations. Moreover, at the time, the School of Medicine claimed that Queen’s would make arrangements that would enable current Black students to transfer easily to other schools of medicine, such as Dalhousie. But there is no evidence that such arrangements were ever made.

This lack of transparency continued in later years, as university leadership misrepresented the ban or failed to hold Queen’s accountable for its actions. In 1978, for instance, the family of Ethelbert Bartholomew – an upper-year student whose medical career was suddenly ended by the policy in 1918 – asked the university why Ethelbert had been expelled from Queen’s in his fourth year, when he was in good standing. In response, university leadership simply reiterated the suggestion that Ethelbert’s expulsion would have been due to the prejudices of Kingston veterans, and they did not take the opportunity to apologize for the harm that the ban had done to Ethelbert.

University leaders also misrepresented the history of the ban on at least three other occasions in 1964, 1986, and 1988. In these instances, Queen’s leaders would make false claims that the ban had ended earlier than it had or that all students originally affected by it had successfully transferred elsewhere.

It would be hard to put into words how taken aback I was to learn about this history. This policy was so undeniably unjust, and I knew that formally rescinding the motion had to be only the beginning of the process of making amends for this wrong.

Knowing that we needed to do more, I formed a commission of faculty, students, and staff from Queen’s in order to discuss what concrete steps we can take to address this historical injustice.

Formal Letter of Apology to Black Medical Students - PDF
Formal letter of apology

As a first step, Principal Daniel Woolf and I will be publicly apologizing for the policy tomorrow – Tuesday, April 16th –  at this month’s meeting of the Queen’s Senate.

I am also pleased to say that Daniel Bartholomew, the son of Ethelbert Bartholomew, will be travelling to Kingston to be present at this public apology.

Going forward, the commission has also agreed to take a range of actions to address our past discrimination and promote diversity at our institution. We will send personal letters of apology to family members of the individuals who were affected by the ban. We will provide greater focus on inclusivity and diversity in our curriculum. We have initiated an admission award for Black medical students that will be implemented for the incoming class. We will create an exhibit addressing the ban that will be displayed in the atrium of the new medical building. In 2020, we will host a symposium that will focus on the history of the ban and the future of diversity in the medical profession. And we will implement a mentorship program for Black students in the School of Medicine.

As an institution, we can never undo the harm that we caused to generations of Black students, and we have to accept that our actions contributed to the inequities in the medical profession that still exist today. I hope, though, that the steps we are taking now will move the School of Medicine in the direction of greater inclusivity, diversity and equity.

This is a moment of reckoning for Queen’s, but it is also an opportunity to affirm our dedication to the principles of equality in the School of Medicine.

If you have any thoughts on how we can best take action to address this wrong from our past or help strengthen our commitment to equity in the present, please share them in the comments below. Or better yet, please stop by the Macklem House: my door is always open.

 

--Richard  

 

Update

Principal Woolf and I signed the letter on April 16, with Daniel Bartholomew in attendance. We both gave remarks, as did Stephanie Simpson, the Associate Vice Principal of Human Rights, Equity and Inclusion at Queen's. A recording of the apology is now available. You can watch the embedded video above or click on the link. 

Above, you can find a copy of the signed letter.

I'm sharing some pictures of the event below.

 

Principal Woolf and Dean Reznick signing letter of apology
Principal Woolf and I signing letter of apology.
Dean Reznick presenting on the work of the Commission on Black Medical Students
Reading from the letter of apology.

 

Edward Thomas and Daniel Bartholomew
Edward Thomas (third from left) and Daniel Bartholomew (seated)

 

Dr. Marian Luctkar-Flude teaching nursing students
2019-04-09 How this nursing professor is improving simulation-based education in Canada

When Dr. Marian Luctkar-Flude was in nursing school, she, like most other students in her generation, would practice giving injections on oranges and learned how to find veins by using the arms of her classmates.

Dr. Marian Luctkar-Flude
Dr. Marian Luctkar-Flude

In the past fifteen or so years, though, teaching methods have changed drastically thanks to the rise in simulation-based education. Now, nursing students at Queen’s and many other universities in the country work with a series of training devices, ranging from partial-task trainers to full-bodied computerized mannequins, to learn foundational skills for the profession, such as taking blood, performing cardiac resuscitation, and communicating as a member of a team. And Dr. Luctkar-Flude has played a significant role in the increasing sophistication of simulation pedagogy in nursing curricula, first at Queen’s and, more recently, across Canada.

Recently, she has worked with a group to develop the Canadian Certified Simulation Nurse Educator (CCSNE) exam and course, which is the first simulation certification program for nurse educators in Canada. CCSNE is run through the Canadian Association of Schools of Nursing (CASN), and it aims to provide educators with an understanding of how they can most effectively employ simulation training in their courses. The certificate that learners receive upon passing the exam is also the first credential of its kind in the Canadian nursing community.

As the first cohort to complete the online preparatory course just wrote the exam in March, CCSNE is starting to make a real impact on nurse education in Canada. And that impact is truly widespread: the course had participants everywhere from B.C. to  southern Ontario to Nunavut.

Looking back on her own experiences with simulation training, Dr. Luctkar-Flude sees that she and the field have both come a long way. As far as the story of simulation at the Queen’s School of Nursing goes, Dr. Luctkar-Flude was there from the very beginning.  

In 2005, the government of Ontario gave nursing schools in the province funds for simulation equipment, and Dr. Luctkar-Flude remembers opening the box of the first simulator  that Queen’s procured. While she was excited to start using the new teaching materials, she realized that she could use some specific training to understand how best to use these new tools.

Dr. Cynthia Baker, the director of the School of Nursing at the time, supported Dr. Luctkar-Flude’s goals and provided her with funds to undergo training in simulation pedagogy. Since that time, she has been very involved in implementing and expanding simulation in the Nursing program at Queen’s.

We now have 3 labs in the Patient Simulation Lab located in the Cataraqui building, which are almost always busy, and students in all years of the undergraduate nursing program use simulation. And students from different schools work together on interprofessional training exercises in scenarios related to fields such as obstetrics and pediatrics. Nursing students gain many valuable competencies through simulation, from basic clinical skills to knowing how to respond to different codes at the hospital. Dr. Luctkar-Flude remembers that when she was starting her career as a nurse she had to learn to respond to such codes in the moment, with no prior training other than basic CPR certification.

The more work she does on developing simulation curricula, the more that Dr. Luctkar-Flude believes in its benefits. That is why – in addition to helping to develop the CCSNE – she has co-created The Canadian Alliance of Nurse Educators using Simulation (CAN-Sim) along with Dr. Jane Tyerman, who received her PhD in Nursing from Queen’s and currently holds a faculty position at Trent.

 

Dr. Marian Luctkar-Flude and Dr. Jane Tyerman
Dr. Luctkar-Flude presenting a poster with Dr. Jane Tyerman

 

CAN-Sim is a network of nurse educators who promote excellence in simulation education and research. Through easily accessible resources like webinars, videos, and sample virtual simulation games, CAN-Sim aims to help educators generate ideas for how to incorporate simulation into the classroom and give them an understanding of current best practices. CAN-Sim connects educators and researchers in order to promote collaboration and exchange of ideas.

On the CAN-Sim website, nurse educators can find video-based virtual simulation games for a variety of clinical scenarios and educational purposes. Some of the games on the site help to better prepare students for a live simulation session in the lab, for instance, while others can be used in lieu of a lab session. And they teach learners how to handle conditions such as urosepsis and respiratory distress. Dr. Luctkar-Flude has played an active role in creating these games, doing everything from developing the scenario to filming the video with a Go Pro camera.

 

Dr. Luctkar-Flude with the team making a virtual simulation game
Dr. Luctkar-Flude (first on left) working on filming a virtual simulation game. 

It’s so great to see the way in which Dr. Luctkar-Flude has become a true leader in the community of Canadian nurse educators practicing simulation. The rise in simulation pedagogy has been one of the most important recent developments in health sciences, and I’m proud that Queen’s has been able to be at the forefront of the field thanks to dedicated faculty like Dr. Luctkar-Flude.

Do you have any thoughts about simulation and how it has changed health sciences education? Or any thoughts on where simulation might be going from here? If so, please leave them in the comments below. Or better yet – stop by the Macklem House. My door is always open.

 

--Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog. 

 

Class room in the School of Medicine
2019-04-02 Fighting bias against family medicine in the hidden curriculum

For some time now, those of us who work in medical education have been speaking about the “hidden curriculum.” The hidden curriculum refers to the many different things – ideas, behaviours, norms, values, and so on – that students learn informally while they are in medical school. These are the lessons that faculty members do not set out to explicitly teach students but that we pass on nonetheless.

 

Unfortunately, the hidden curriculum often weighs in with stereotypes of certain specialties. And I’m guessing that it is probably true that the hidden curriculum frequently portrays family medicine in a negative light more often than it does areas in specialty medicine.

 

Lately, we are seeing this bias having an especially strong impact on the decisions medical students are making as they enter the CaRMS process. This year, in the first iteration of the CaRMS match, there were 209 unfilled positions across Canada, and 138 of these positions were in family medicine. Also, notably, Queen’s medical school graduates choose family medicine as a career less frequently than graduates of other medical schools in Canada.

 

Many factors, of course, contribute to this problem. But I don’t think there is any denying that the hidden curriculum plays a part and that, inadvertently, medical education is steering students toward specialty medicine rather than family medicine.

 

I am writing this blog to say that I want to start taking action to correct this undesired effect of the hidden curriculum at Queen’s.

 

As a first step, Drs. Anthony Sanfilippo (Associate Dean, Undergraduate Medical Education), Ross Walker (Associate Dean, Postgraduate Medical Education) and Michael Green (Head, Department of Family Medicine) will be forming a working group to consider how best we can address this problem.

 

While this working group goes about its important undertaking, I would also like to ask all of you in the medical faculty to think about how you teach or mentor our undergraduate medical students. I think we all need to reflect on anything we do – or don’t do – that might indirectly make a student think less of family medicine. I know that none of our faculty who have backgrounds in specialty medicine would ever intentionally steer a student away from family medicine. However, we would all do well to keep a heightened awareness of the unintended consequences our words and actions can have. 

 

It has never made sense that the hidden curriculum would be biased against a field as important as family medicine, but it makes even less sense now than ever. Currently, there are concerted efforts by the Ontario government to create “Ontario Health Teams” and there is no question that primary care will be a backbone to an integrated system of care. Now, then, is a moment in which we as medical educators need to make sure we’re finding ways to make our students passionate about family medicine, as it will only be growing in its centrality to the health system in the coming years.

 

If you have any thoughts about how we as a medical school can address this issue, please share them in the comments below. Or better yet, please stop by the Macklem House – my door is always open.

 

--Richard

Cortney Clark representing Queen's at a recruitment event
2019-03-26 Making the Faculty of Health Sciences more inclusive for Indigenous students

Last year, the Faculty of Health Sciences welcomed Cortney Clark to our staff as our new Indigenous Access and Recruitment Coordinator. In this role, Cortney is doing the very important work of helping Indigenous students find their way into health sciences programs, navigate the university once they’ve arrived and ultimately thrive in their time here at Queen’s.  

 

“This work feels personal for me,” Cortney says. A Mohawk woman and member of the Bear Clan of the Wahta Mohawk Territory in northern Ontario, Cortney knows very well that Indigenous people in Canada face obstacles to resources, like higher education, that many settler Canadians never experience. “I understand the need for this work,” Cortney says, “and I want to use my lived experiences and abilities to help propel reconciliation through accessible and culturally safe higher education.”

Cortney with three generations of her family
Cortney (second from the left) with three generations of her family, all wearing traditional ribbon shirts.

 

She first started working to build connections with Indigenous communities as a Recruitment Coordinator for the Aboriginal Post-Secondary Information Program (APSIP). Through APSIP, Cortney travelled widely to more than 55 different Indigenous communities, many of them in remote and rural locations in northern Ontario. In these different communities, Cortney advised learners on Indigenous access policies to higher education, and specifically advised on the application and admissions processes for Canadian universities and colleges.

 

While she found it rewarding to help so many different people in so many different areas, Cortney has been particularly excited to be able to provide “wraparound service” to the community of health sciences students at Queen’s in her new role. Wraparound service means that Cortney works with Indigenous students from the beginning of their application process through to their graduation.

 

Cortney advises prospective students on their applications to the Faculty of Health Sciences; she works to create a culturally safe community for students when they arrive; and she helps connect them with career development resources tailored to their needs. She is also available to help students with anything else that arises during their time at Queen’s. All the students that she works with have her cell phone number, and they know that she will answer if they call.

 

On top of her recruitment, advising, and student support programming portfolio, Cortney is also an active member in a number of different committees in the Faculty of Health Sciences that are advancing our TRC initiatives. For instance, Cortney is a part of the faculty’s Indigenous Health Education Working Group (IHEWG), which is comprised of faculty members and students from each of our three schools.

 

IHEWG works to build connections with Indigenous communities to find out how Queen’s can help them achieve better health outcomes. The working group is also developing a range of initiatives to ensure that Queen’s trains health practitioners to deliver culturally safe care for Indigenous patients, who frequently encounter racism and insensitivity in the Canadian health care system.

 

To work towards this goal, the IHEWG, along with the Office of Professional Development and Educational Scholarship, has organized an important series of events with Dr. Barry Lavallee, a professor at the University of Manitoba, a practicing family physician, and an expert on Indigenous health. Dr. Lavallee will be visiting May 15-17, 2019. He will provide training on working with Indigenous communities and also give a public lecture on how racism affects Indigenous health. 

 

Dr. Barry Lavallee event poster

 

If you are interested in Dr. Lavallee's Faculty Development Workshop, please register here: https://healthsci.queensu.ca/faculty-staff/cpd/programs/teachingmethodsforaddressingculturalsafetypromotingindige

If you are interested in his Health Science Education Round, you can register here: https://healthsci.queensu.ca/faculty-staff/cpd/programs/lavaleeroundmay17

 

The IHEWG has also recently led the hiring of Tim Yearington, the new Indigenous Curricular Innovation Coordinator in FHS. Tim will take a key role in decolonizing our health sciences curriculum and ensuring that Indigenous knowledge as well as the perspectives of our Indigenous students, health professionals and patients are reflected in our programs.

 

Cortney is also working to help integrate services for Indigenous students across Queen’s by serving as an active member of the Community of Practice Working Group. This group is chaired by Kandice Baptiste, Director of the Four Directions Indigenous Student Centre, and it aims to connect all the Indigenous staff and leadership who work closely with Indigenous policy and Indigenous students at Queen’s.

 

As you can see, Cortney has already been very busy since starting her new role at the faculty in August. And she is planning a lot of projects for the coming months. Just over March break, she did recruitment work at the Little Native Hockey League in Mississauga, where she spoke to over 227 Native hockey teams of Indigenous students, and their parents, about post-secondary programs at Queen’s.  

Cortney with a student at the Little NHL
Cortney with a student at the Little NHL

And she is also hosting, in partnership with Four Directions, an academic recruitment fair for prospective Indigenous graduate students that will be occurring May 4th, at Queen’s. Universities from across Canada, including Trent University, McGill, Concordia, University of Toronto and Lakehead University, just to mention a few, will be participating in what promises to be an important event for helping Indigenous students realize the different research opportunities and programs in graduate-level education.

 

I am very grateful for all the work that Cortney has been doing to help the faculty work towards its goals for responding to the TRC report, and I know that the rest of my colleagues on the decanal team are as well. If you would like to express your own appreciation for Cortney, please do so in the comments below. Or better yet, please stop by the Macklem House: my door is always open.  

 

 --Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog. 

Hands raised at the first annual employee engagement event.
2019-03-18 92% job satisfaction in FHS: how we're building community at work

The following is a guest blog by Laura McDiarmid, leader of the FHS Employee Engagement initiative, with an introduction by Dean Reznick. 

 

Dean Reznick on the remarkable work of the employee engagement committee 

For a little over a year now, a small group of staff members in the FHS community have been working off the sides of their desks on a very important project: employee engagement. And I am very pleased to share a guest blog by Laura McDiarmid, the leader of the committee that has been organizing this work.'

I wanted Laura to write a piece for this blog because there have been two compelling recent developments on employee engagement. First, the report on the first year of the initiative is now available, and Laura is sharing and discussing it with us here. And second, the date has been set for the second annual employee engagement conference: Wednesday June 26th.

It would be hard for me to overstate just how impressive the results of this initiative have been so far. Part of this first-year report details a survey that roughly 25% of our over 700 staff members filled out. I want to highlight a few of the numbers from this survey before turning things over to Laura:

Highlights from the employee engagement survey

No, that is not a misprint: 92% of respondents are satisfied with their job! Numbers like this are essentially unheard of for employee satisfaction surveys. Many people deserve a great deal of credit for helping to make the Faculty of Health Sciences a positive workplace. Everyone in a leadership role for listening to and caring about your staff members. The entire Employee Engagement Committee – Kayla Desloges, Lindsay Lee, Nicole Rogerson, Jackie Moore, Laura McDiarmid, and Denis Bourguignon – for finding so many new ways to make the faculty an active, appreciative, and supportive place for staff.

But the most credit goes to our amazing staff members themselves. The reason why so many people find their jobs here satisfying, I suspect, is because the faculty gives them a chance to work with other energetic, passionate, and purposeful people. With such a fantastic group of people making up our staff, FHS becomes something more than a workplace: it becomes a community.

 

Laura McDiarmid reflects on the Employee Engagement Strategy

Employee Engagement Report 2018
      View Report

I am happy to share the first-year report on our employee engagement initiative with you. Thanks to a dedicated committee as well as support and participation from leadership, staff and faculty we have had a tremendous year filled with building connections across units, getting active, laughing, appreciating each other, learning new skills and enjoying some delicious treats!

Some of the highlights of our first year include several Fitbit challenges, a gathering to share pizza in City Park, a very successful holiday donation drive, the redevelopment of our employee newsletter, voicing our appreciation for each other in February’s “Gratitude Grams,” and, of course, our first annual Employee Engagement Event, which took place at the Isabel in May, 2018.

The goal of our engagement strategy is to promote a culture of engaged employees in the Faculty of Health Sciences through a deliberate and faculty-wide effort. We want to create an environment in which employees feel empowered, supported, connected to their colleagues and appreciated. As the numbers from our survey show, we are already well on our way to meeting these goals. But we need to maintain our momentum and build on our successes going forward.

Our initiative focuses on five key areas of employee engagement:

  1. Building community
    1. Creating employee connections across the faculty
    2. Creating employee connections to leadership
    3. Focusing on inclusivity and diversity
  2. Enhancing employee communications
  3. Recognition
  4. Empowering employees
  5. Encouraging and facilitating professional and personal growth of employees

Building connections across the Faculty leads to collaboration and innovation that is not possible if units work as stand-alone entities. Enhancing employee communication leads to understanding of the Faculty and supports building community. Recognition and appreciation is easy, and increases morale and dedication for both the person giving and receiving the praise. Empowering employees and encouraging personal and professional growth encourages mastery and excellence. By consciously working on these aspects of employee engagement across our faculty, then, we can continue to improve upon our culture and offer our staff members increasingly high levels of satisfaction in their work.

Across FHS, I see staff, faculty, and students constantly striving for excellence in every aspect of their life. Our employee engagement strategy is helping to build the culture and community to support them and help us all achieve our shared vision to ask questions, seek answers and inspire change.

And remember to save the date for the 2nd annual Employee Engagement Conference – June 26th . This year, we’ll be in the new medical building and we’ll have another great line up of speakers and events. Stay tuned for more information!

The Employee Engagement Committee at the Pizza in the Park event
The Employee Engagement Committee: Laura McDiarmid, Jackie Moore, Lindsay Lee, Kayla Desloges, Nicole Rogerson
Sarah Anne Cormier with her snowboard
2019-03-05 A Nursing student works toward her dream of snowboarding in the 2022 Paralympics

In 2017, Sarah Anne Cormier, a fourth-year undergraduate student in the School of Nursing, attended the Paralympian Search in Toronto in order to try out for running teams and development programs in Canada. While she was undergoing numerous tests of her running ability, she was also asked to fill out a form that asked her what other sports she participated in. Sarah had been snowboarding for years, but she didn’t think she should put it down. She had never really snowboarded competitively, and she didn’t want to be misleading.

 

When she asked a staff member working the Paralympic Search about the form, the staff member told her that she should definitely write down snowboarding. The Paralympic Committee was looking for snowboarders.

 

Sarah took the advice, and filling out that form ended up changing her life. Because now she’s training intensely to make it onto Team Canada, with the goal of competing in the 2022 Paralympics in Beijing.

 

After the Paralympian Search in Toronto, Sarah was invited to a snowboarding development camp in Blue Mountain, where she made an impression on the Canadian coach for Paralympic snowboarding. The coach told Sarah that he thought she had real potential, and that he wanted to train her. Sarah agreed, and shortly thereafter started an intense training regimen for the sport.

 

 

In the summer, when there is no snow for Sarah to train on, she works on strength and conditioning in the gym five days a week. In the winter, when she can actually snowboard, she still trains four days in the gym on top of getting on the snow every chance she gets. Sarah estimates that this winter she has spent 50 days training on the slopes.

 

One of Sarah’s strongest motivations to undertake all this training – on top of her rigorous academic schedule in the School of Nursing – is to help inspire other disabled people to know that they can achieve more than they probably realize.

 

Sarah was born with complications from amniotic band syndrome, a condition that occurs when a fetus becomes entangled in the amniotic bands of the womb. As a result of this condition, Sarah was born missing her left leg below the knee as well as having various finger amputations on both of her hands. She has had to undergo seven surgeries throughout her life to address the complications caused by the syndrome.

 

When she was five, her parents signed her up for Track 3, a non-profit organization that teaches children with disabilities how to ski. Sarah loved skiing, but when she became an adolescent the sport made her feel self-conscious. When Sarah skied, she did not wear her prosthetic leg, but instead used outriggers as support for balance.

 

This system worked great, but when Sarah was 12 she started to get uncomfortable with the feeling that people were giving her unwanted looks when she skied on one leg. She didn’t want the attention that came with skiing, but she also didn’t want to give up winter sports.

 

Sarah found an answer to her dilemma: snowboarding.

 

If she took up snowboarding, she realized, she’d be able to wear her prosthetic leg. She asked her parents if she could take up the sport, and they agreed.

 

Even though she has been snowboarding now for sixteen years, Sarah feels like she still has a lot to learn. “Right now I’m trying to break sixteen years’ worth of bad habits,” she says. But with the help of her coach and teammates, she also feels like she’s making significant progress.

 

And it’s clear that her hard work is paying off. In January, Sarah competed at her first provincial race in Bromont, Quebec. Even though she felt nervous to be competing, she didn’t let her nerves get the best of her: she won silver the first day of the event and gold the second day.

 

Sarah still has a lot of steps to take before she can reach her dream of making it onto Team Canada and competing in the 2022 Paralympics. Before she can make it onto Team Canada, she’ll need to make it onto the Next Gen team. And before she can do that, she needs to compete in two different World Para Snowboard Cups and finish with competitive times.

 

But Sarah is well on her way to making her dream come true, and all of us in the Faculty of Health Sciences are proud of her and are rooting for her.

 

At the same time, Sarah says she could never have achieved what she has so far without the support of the School of Nursing.

 

Sarah is currently halfway through her placement in the ICU at Kingston General Hospital, and she loves how much she learns there every day. Even though her schedule can be hectic as she tries to balance late nights in the hospital with long training sessions in the gym and on the slopes, Sarah says the Nursing faculty and her fellow students always do what they can to help her. When she has to be away from home for long stretches, her friends from the school will even come walk her two dogs, Odin and Atticus.

Sarah in the snow with her dog Odin (taken from her Instagram)
Sarah in the snow with her dog Odin. (Taken from her Instagram)

 

Sarah will graduate this May, and I’m very happy to share her story with you. Mostly because it is so inspiring, but also because it shows how well rounded our students at Queen’s can be. Even though we have the most dedicated students in Canada, they’re also often people who are pursuing additional passions outside their studies. And this is something that we embrace and encourage in the Queen’s Faculty of Health Sciences.

 

Before I go, I also want to share the video below with you. Sarah was gracious enough to be interviewed last year for a video series about being an Indigenous nursing student at Queen's, and it's well worth watching. 

 

If you want to keep up with Sarah’s progress toward her snowboarding goals, you can follow her on Instagram @sacorms12.

 

What passions do you pursue outside of your studies or work? I’d love to hear about them in the comments below. Or better yet, please stop by the Macklem House: my door is always open.

 

--Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.

 

Life Sciences students working with new microscopes in the Anatomy Learning Centre
2019-02-26 Who says technology drives us apart?

When students started using the new microscopes that were procured for the School of Medicine last November, Rick Hunt, the recently retired Coordinator of the Anatomy Learning Centre, noticed a difference right away.

 

Actually, he noticed several differences.

 

Most obviously, he saw an unmistakable upgrade in the quality of the images that the students were able to see. These 10 new microscopes are state-of-the-art equipment that can capture images at 8 mega pixels and adjust in real time. “You couldn’t even adjust the microscope fast enough to create a lag if you wanted to,” Rick says. They are also extremely easy to use. Within 30 seconds of hooking them up, the students are able to see crystal-clear microscopic images on the TV.

 

More importantly, though, he noticed a difference in how the students interacted with each other. They were all so excited by the images they were seeing through the microscopes that they naturally flocked together to collaborate. Gathered around a microscope and screen in groups of 3 or more, students looked at the slides in front of them, eagerly suggesting which aspect of the slide to zoom in on and quizzing each other about the structures they were looking at.

 

Rick retired from Queen’s at the end of last year, but, before then, he had worked at the university for over 35 years. In all that time, he cannot remember students being as excited about working with technology – or with each other – as they have been with the new microscopes.

Rick Hunt discussing the microscopes with Life Sciences students
Rick Hunt discussing the new microscopes with Life Sciences students

Before these new microscopes arrived, Rick mainly noticed students working individually. They were also prone to looking at copies of the slides online rather than using the microscopes themselves.

 

Since the microscopes were set up in November, though, Rick says the lab is full of conversation, even laughter. He also noticed graduate students from a variety of programs coming to the lab together now, when before they had usually come alone.

 

This technology and the space it is in is unlocking a previously untapped potential for students to work together to learn through microscopy. 

Life Sciences students project image from a new microscope onto the screen.
Life Sciences students project image from a new microscope onto the screen.

Procuring new microscopes might at first sound like a simple technological upgrade, but it is clear that it has large ramifications for how our students will experience this aspect of their education.

 

The primary users of these microscopes will be medical students and graduate students in Faculty of Health Sciences programs. But undergraduate students in the Life Sciences program will also be able to work with them, as you can see from the pictures I’m sharing here. Our on-campus Bachelor of Health Sciences students – who will be coming to Queen’s in the fall – will also most likely have opportunities to use these new microscopes during their education.

 

On a final note, I’d like to thank Rick Hunt both for talking with me about how students are using these new microscopes and, more importantly, for his decades of outstanding service to Queen’s. I’d also like to welcome the new Laboratory and Educational Coordinator, Logan Bale, who is already doing great work in the Anatomy Learning Centre.

 

How have microscopes or other technologies impacted your education? Let me know in the comments below, or better yet, please stop by the Macklem House. My door is always open.

 

--Richard

 

Thank you to Andrew Willson for his assistance in preparing this blog.

Dr. Susan Phillips
2019-02-19 How age, gender, and caregiving affect your health

Dr. Susan Phillips, a Professor in Family Medicine and Public Health Sciences, has noticed throughout her career that there can sometimes be a major discrepancy between how patients say they feel and how she would assume they’d feel based on their physical health.

 

“I have had patients who have several serious or even life-threatening illnesses come see me,” she says, “and when I ask how they’re doing they say ‘I’m doing really well.’” Dr. Phillips says she has always been interested in counterintuitive findings like this, where the wellbeing of patients seems to run counter to what one would predict. These patients – the ones who seem to feel fine despite their conditions – raise a number of questions that she has wanted to explore about the range of factors that determine a patient’s wellness. “People are not just their conditions,” Dr. Phillips says, “diabetics, for instance, are not defined by diabetes alone, if they are defined by it at all.” But she believes that medicine and research do not currently have sophisticated ways of addressing this phenomenon, which she refers to as "how the outside world gets under the skin".

 

Now, Dr. Phillips is the Canadian PI on a study that aims to provide a more robust understanding of how health is connected to a range of social factors, especially age, gender, and caregiving. The project is called FUTUREGEN, and it is a collaboration between Dr. Phillips and researchers in Sweden and Austria. Starting on March 1, FUTUREGEN will receive $1.3 million in funding from GENDER-NET Plus, an international consortium of sixteen research funders in thirteen countries. The funding for FUTUREGEN will come from the Canadian Institutes of Health Research (CIHR) as well as funding agencies in the European Union.

 

This project will bring together researchers with a range of academic expertise to explore these complex questions about health; Dr. Phillips is the only physician among the three principal investigators, as the other two are a social worker and an economist respectively. Dr. Janet Jull, an Assistant Professor in the Queen’s School of Rehabilitation Therapy, will also serve as a co-Investigator on the project. Dr. Phillips believes that this diversity of perspectives will enrich both the conceptualization and the interpretation of the research.

 

Work on FUTUREGEN will begin in March, and the researchers will start by examining datasets from all three countries to figure out what circumstances are having the most impact on people’s health, especially as they age. Dr. Phillips says that these datasets are so large that her research team will be able to make and compare highly refined categories. The dataset from the Canadian Longitudinal Study on Aging, for instance, has medical and demographic data from over 58,000 people over the age of 50. With such a substantial database, Dr. Phillips and her colleagues will be able to examine how factors, such as gender, location or income, affect the health of people in different age ranges. By looking at an array of different variables, Dr. Phillips aims to be able to explain what predicts different health outcomes for different people.

 

Currently, Dr. Phillips is preparing for this work by considering the methodology that she will use to study these large datasets. She wants to make sure that she employs a sophisticated approach to examining the intersections of and interactions among the social circumstances that influence health. By being reflective about her methods, Dr. Phillips hopes that she can create useful categories for understanding health outcomes that avoid the pitfalls of both assuming similarities within groups and of overgeneralization.

 

Dr. Phillips’s ultimate goal for FUTUREGEN is to use findings to better inform health and social policies at the provincial and national levels.  While working on the project, then, the research team will meet regularly with a specific group of policy experts who will reflect upon and challenge their findings and determine how their work could be useful to policy makers. Given the scope of FUTUREGEN, there is a real potential for this work to help the Canadian health care system use new methods to promote healthy aging for people across our society, and Dr. Phillips is eager to realize that potential.

 

Dr. Phillips sees this new project as building on the work that she previously did on the CIHR-funded International Mobility in Aging Study. In that study the evidence that people are often less concerned about the specifics of a medical diagnosis than they are about the practical effects those conditions will have on their daily lives and function first emerged. Many of the questions that Dr. Phillips hopes to answer with FUTUREGEN were inspired by these initial findings about self-defined successful aging.

 

Seeing the way that, for Dr. Phillips, one large research project opens up complex questions to explore in a subsequent project, it is clear to me that she has the keen and unfailing sense of curiosity that all the best researchers possess. That makes it especially interesting to me that she says she never intended to have a career in research when she was studying to become a physician. “I never set out to be a researcher,” she told me. “I set out to be a good family doctor.” Yet, as she kept finding herself asking questions that had no readily available answer, research gradually became more important to her.

 

Now, Dr. Phillips has a number of significant publications and grants, and she has been awarded with a Lifetime Achievement in Family Medicine Research Award from the College of Family Physicians of Canada.

 

Even with all this research success, though, Dr. Phillips says she is still primarily motivated by her patients. She decided to join FUTUREGEN because she wants to find ways to better understand what influences their health and how to help them age well.

 

“Everything for me,” she says, “starts with and comes back to being a family physician.”

 

How do you think your health has been affected by social circumstances? Please share your thoughts in the comments below, or, better yet, please stop by the Macklem House: my door is always open.

 

--Richard

 

I would like to thank Andrew Willson for his assistance in preparing this blog.

A robot
2019-02-11 Are robots going to replace doctors?

Artificial intelligence seems to be everywhere today. There are always new stories about ground-breaking innovations, new developments, or massive investments in AI technology. At Queen’s, as we seek to find the scholars of the future, many departments across the university are attempting to find researchers who have skills in areas such as AI, machine learning, or data analytics.

Health care is no exception to the spread of AI. Many aspects of work in the field will be evolving as, increasingly, new technologies are integrated into care. Increasingly, these evolutions are happening in ways that many would not have anticipated.

A few weeks ago, for example, researchers at Western University published a study that suggests that brain imaging and artificial intelligence can be used to accurately diagnose subtypes of post-traumatic stress disorder. This finding is potentially highly significant because it could lead to a greater incorporation of AI and digital technology into Psychiatry.

If physicians are able to rely on AI to reliably interpret fMRI brain scans and make diagnoses of PTSD based on them, this innovation could make the medical system more efficient by helping patients access the care they need more quickly.

And this is not the first study that could impact Psychiatry in this way. In August of last year, researchers found that an algorithm could examine scans and differentiate patients affected by major depressive disorder from those affected by bipolar disorder with 92.4% accuracy. This algorithm could also predict how patients would respond to different medications.

These stories are just a tiny window into the massive technological developments that will reshape health care in the coming years. Artificial intelligence and digital technologies are going to gradually leave an impact on many different aspects of the ways in which patients receive treatment and health care professionals conduct their work.

To respond to this ongoing shift, the Royal College of Physicians and Surgeons of Canada has established a Task Force on Emerging Digital Technologies, and I am very honoured to be serving as its chair. Broadly speaking, this task force will formulate and provide recommendations to inform the Royal College’s strategy regarding the impact of emerging digital technologies on specialty medical education, training, and delivery of care. As digital technologies spread further and further into health care, the Royal College wants to be sure that specialty medical education is keeping pace with all the different changes, so that our future specialist physicians are fully prepared for the medical landscape they’ll be working in.

In my work on the task force so far, I’ve had many thought-provoking conversations about AI and have learned a great deal about current technological developments in health care.

From a strictly educational point of view, there are four central questions that those of us working in health care and medical education need to address in order to deal with some of the most pressing challenges that we will encounter in implementing AI on a large scale. Those questions are:

 

  1. Are healthcare practitioners going to be replaced by AI?
  2. What kinds of students should we now be accepting into our health care education programs?
  3. Will the increased use of AI in health care have implications for curricula in medical school and residency?
  4. What are the implementation challenges of adopting new technologies for practitioners?

 

So: are healthcare practitioners going to be replaced by AI? The short answer to this question is “no.” But that no comes with a major asterisk. AI may not replace healthcare providers, but it will absolutely force us to evolve.

Every specialty is going to look different. As a colorectal surgeon, I spent twenty-five years removing colon cancer from patients’ bodies. But it’s hard to imagine that in fifty years it will still be a human surgeon holding the knife as opposed to a robot guided by exquisite patient-specific images that have been generated by the next generation of scanning technology. And I also wouldn’t be surprised if that fifty years were actually twenty years.

While it is true that the AI will be better than human physicians at a wide range of things, this doesn’t mean that surgeons or any other specialists are going to disappear.

For all of the power and potential of AI, there are some things that it will just not be able to do. AI may be able to remove cancer from a colon, but it cannot show compassion or understand social cues or emotions. It will certainly not be able to do so better than human caregivers.

This is significant because – as all healthcare practitioners know – giving a diagnosis is never as simple as repeating some lines from a medical textbook. When you tell a husband and father that he has cancer, you’re not just telling him some information about treatment plans and life expectancy. You’re also watching the tear on his wife’s cheek and the concerned look on his daughter’s face. You’re figuring out how to give the diagnosis without crushing all of their spirits. You’re looking for the right words to say – the ones that will reassure everyone, that will let them know that you care and that you will be doing all that you can for them.

AI has come a long, long way, but it’s still nowhere capable of understanding emotions and showing compassion at that level. AI cannot squeeze a patient’s hand, or give them a hug. Only human caregivers can do that.

One of the major obstacles to integrating AI into healthcare, then, is also a major opportunity for traditional practitioners. AI cannot show meaningful compassion to patients, but it can give human caregivers something that the medical futurist Eric Topol calls “the gift of time.” In the past several decades, patients and practitioners alike have been complaining that doctors do not have enough time with their patients. As AI makes healthcare systems more efficient, doctors and nurses will possibly be able to devote more time and energy to tailoring our treatments to suit the needs of individual patients. And we will have more time to care for them holistically, rather than just treating their illnesses.

The second major question we’ll need to ask in medical education is: What kinds of students should we be accepting into our programs?

It is becoming increasingly clear that the doctors of the future will need to have strong digital literacy skills. And by digital literacy, I don’t just mean that they will need to know how to use their iPhones really well. The medical students of the future will have to have working knowledge of AI, robotics, and many other technological advances.

They will also need to be exceptionally adaptable and innovative individuals. In other words, they should be people with an entrepreneurial spirit. At the moment, we are still primarily assessing applicants on grades and standardized aptitude tests. We do try to look for inferential evidence that applicants are creative and innovative people with leadership skills, but it is not the essential construct by which we choose medical students. My colleagues and I in education leadership, then, are going to have to figure out soon how we’re going to assess applicants to our programs to make sure that they have the skills that the future physicians of the AI generation will need.

The next question is closely related to the previous one: Will the increased use of AI in healthcare have implications for curricula in medical school and residency? The answer to this, from my perspective, is decidedly yes. Curricula for medical students at both the undergraduate and postgraduate level will have to adapt. We will need to incorporate serious instruction on AI algorithms and data science into our curricula.

This is certainly a great opportunity for medical schools to evolve with the times, but it is also a challenge. Changing curricula can be a slow process, and schools need to find the right faculty to teach new skills and areas. And hiring new faculty members can also be a difficult and protracted process in its own right.

To be sure, medical school curricula will change to meet the new demands of the profession. But it will take leadership and persistence to make those changes, and they will not happen overnight.

The final question that I think those of us in healthcare education need to consider when thinking about AI is: What are the implementation challenges of adopting new technologies for practitioners?

If we’re going to bring more and more AI into healthcare, we’re obviously going to need to make sure that our practitioners know how to use it. This will create a number of interconnected challenges. How will we deal with the cost? How will we ensure that everyone feels comfortable in their new role? How will we make sure that everyone has access to retraining? How will we make sure that everyone wants to be retrained?

In his preliminary report on technology in healthcare for the NHS in Britain, Eric Topol touches on several of these concerns. He recommends that time for retraining should be incorporated into normal working hours for practitioners. He also makes it clear that the case will have to be made that these new technologies are actually going to be improvements over the current methods that they are replacing.

To help provide widely accessible and cost-effective training for practitioners, Topol believes that our idea of the classroom will need to be changed. We can no longer think of medical education as students in an auditorium watching a power point. We are rapidly evolving to the flipped classroom where digital delivery of information is the default. And increasingly what is being delivered is not a one-hour lecture but a series of 3-minute YouTube videos or podcasts. These developments can be used to train learners at all levels – from the undergraduate medical student to the longtime specialist who needs to be retrained.

The solutions that Topol recommends in Britain could be potential solutions in the Canadian system, or we might find others that work better for us. But it’s undeniable that the re-training of our healthcare workforce to be able to work with AI will be a central challenge to the implementation of new technology.

In summary, I believe that AI will be able to play a central role in improving healthcare. But it will need to be implemented with the guidance of physicians. And those of us in healthcare will need to address the four central questions about challenges to implementation that I have laid out here.

Do you have thoughts on the spread of AI into health care? Has it already started affecting your practice or your treatment in any way? I’d love to know your thoughts on the topic in the comments below, or better yet, please stop by the Macklem House, my door is always open.

 

Richard

 

Photo of robot by Franck V. on Unsplash

Dr. Heather Stuart with students at a Bell Let's Talk event at Queen's
2019-01-28 Being proactive about student mental health

At Queen’s, we’re very proud to have Dr. Heather Stuart on faculty as the Bell Chair in Mental Health and Anti-Stigma Research. So, all of us in the Faculty of Health Sciences were especially thrilled when we received the news of the major honours that she has received this past year. In September, she was inducted into the Royal Society of Canada, and in December it was announced that she had been appointed to the Order of Canada. These are both amazing accomplishments, and I am thrilled for Dr. Stuart, as she is incredibly deserving of these honours.

I knew I wanted to draw attention to Dr. Stuart’s recent successes on the blog, and there’s no better time to do so than January 30th: Bell Let’s Talk Day. It’s become a tradition for me to cover Dr. Stuart’s work and the broader work being done by the Bell Let’s Talk campaign every year on Bell Let’s Talk Day, and now more than ever it seems appropriate.

I want to start by talking about the video that I’ve posted above. When Dr. Stuart was inducted into the Royal Society of Canada, our Faculty of Health Sciences communications team made a video of her that was played during the gathering of the Society in Halifax in October. I hope that you will watch it because in it Dr. Stuart tells us a bit about her background and what inspired her to pursue anti-stigma research.

As Dr. Stuart explains, her mother was an administrator at a mental health institution, and her family actually lived on the grounds of the hospital. As a result, the residents of the institution were Dr. Stuart’s neighbours when she was growing up. It was only when she got older that she realized that there was a stigma against the mental health patients who made up her community.  

I hope that you find Dr. Stuart’s story and message as inspiring as I do. The work that she does on mental health and stigma reduction is so important, and I think that she and the Bell Let's Talk campaign are creating real changes in how Canadians think about and discuss mental health.

Bell Let's Talk event at Queen's University

Over the past year, Bell Let’s Talk has been putting a greater emphasis on the prevention of mental illness, especially among post-secondary students. Along with the Rossy Family Foundation, RBC Foundation, Bell Let’s Talk has been funding the Post-Secondary Students Standard project that is being developed by the Mental Health Commission of Canada (MHCC) and the Canadian Standards Association.

Dr. Stuart is playing an important role in this project, as she serves on both the executive committee and the evaluation committee. She also led the research team that developed the literature review on the mental health of post-secondary students. A summary of that report is available on the MHCC website.

The goal of this project is to come up with a voluntary guideline that can help academic institutions in Canada promote and support and the mental health and safety of post-secondary students. We’re becoming increasingly aware of the fact that post-secondary students are at risk of developing mental health problems, and these guidelines will be an important step in keeping students healthy and safe throughout their education.

Along similar lines, at Queen’s we’re proactively trying to improve the wellness of our students by being mindful of our campus environment. Environment plays a huge role in wellness, and Queen’s has agreed to join the Okanagan Charter. The charter calls on post-secondary institutions to make wellness a key aspect of campus culture. Upon joining the Okanagan Charter, Queen’s has committed to developing a system-wide framework to support wellness on campus, and also to advance research and teaching on health promotion.

To encourage students to take a leadership role in how we approach campus wellness, we organized an event that put their ideas and experiences at the forefront. In the past, Queen’s has often organized a large public lecture to draw attention to Bell Let’s Talk Day, but this year we went in a different direction. On Tuesday January 22nd, Queen’s hosted an event that enabled students to come together to have a dialogue about mental health. Dr. Stuart led a group of panelists who shared their thoughts on, and experiences with mental health in a campus setting. The atmosphere of the event was so welcoming and supportive that a number of students in the audience felt comfortable sharing their own personal experiences of dealing with mental health issues while at Queen’s.

 

Events like this are so encouraging, because it shows that the efforts of the Bell Let’s Talk Campaign are working. People across Canada are becoming increasingly aware of mental health issues and are working against stigma more proactively. It’s hard to imagine previous generations of students being as comfortable discussing their mental health experiences in a public forum as the students at last Tuesday’s event were.

So please join me in celebrating Dr. Stuart’s anti-stigma work today, Bell Let’s Talk Day. Please, have open and honest conversations about mental health with the people you care about and help make a difference by reducing the stigma against mental health issues. As a helpful starter, keep Bell’s 5 ways to help in mind: choose your words carefully, educate yourself, be kind, listen and ask, and talk about mental illness. 

As a final note, I want to draw your attention to an upcoming initiative in the Queen’s School of Medicine. In the next few months, we will be conducting a survey of the medical school community on the topic of wellness. In our current strategic plan, we set the goal of creating a culture of wellness in the School of Medicine, and in order to achieve that goal we first have to assess our needs. The survey that will go around is going to be an important tool in conducting that needs assessment, so I hope that all medical faculty, residents, and students participate. With everyone’s help, I am confident that we’ll create an outstanding culture of wellness at Queen’s.

 

Thank you to Andrew Willson for his assistance in preparing this blog. 

 

Dawn Armstrong with her family
2019-01-22 A mother's road to medical school

When she was working as a welder in northern Alberta after graduating from high school, Dawn Armstrong had no idea that she would one day go to medical school. She wouldn’t even really start to think about pursuing a career in medicine until several years later, when she was in her late 20s with three children working towards a bachelor’s degree at Acadia, double majoring in Neuroscience and Biology and completing an honours thesis. Now, at the age of 31, Dawn is a mother of four, a strong aboriginal woman, and a first-year medical student at the Queen’s School of Medicine.

 

Each year, my wife Cheryl and I have all the first-year medical students over to our house for dinner in a series of small groups. When Dawn was over, she told me the story of her journey to medical school, and I instantly knew that I wanted to share it here.

 

Dawn’s path is clearly not the one that we typically associate with medical students. But she doesn’t want us to think of her as an exception; she wants us to look at her story and realize that anyone from any background at any stage of life can pursue a medical education. 

Dawn Armstrong wearing her white coat
Dawn wearing her Queen's white coat. (Post from her Instagram account)

While Dawn was growing up in a rural area of Nova Scotia, her family did not make her feel as if education was something especially important. Her father was a golf pro and her mother was an artist; neither of them had gone to university and neither of them ever made Dawn think that she should make a point to earn a degree.

 

After high school, then, she did not bother applying to any universities, and instead moved out to Edmonton. She did not know anyone out there, but she thought of Alberta as a place that had a lot of opportunities compared to her hometown.

 

At first, Dawn worked as a bartender at a golf course, but her career took a sharp turn after getting to know a regular customer. This man worked as a welder and, while talking about his job one day at the course’s restaurant, he bet Dawn that she couldn’t hack it in welding. Always up for a challenge, she took his bet and accepted a job at Strike Energy in Edson, Alberta.

 

Dawn did not take up welding, though, just to try to win a bet. She considers herself a very hands-on person who likes work that blends problem-solving with manual labour. In many ways, then, welding seemed like it might make for a perfect profession for her.

 

She started this job when she was 18 and enjoyed working with her hands and traveling around Alberta and British Columbia on various assignments. The man who had bet her that she wouldn’t be able to handle the profession was impressed by her and became a mentor to her.

 

But he was also the person who eventually encouraged Dawn to leave welding. He had been warning Dawn for some time that the work is very hard on one’s body over the long run, and that it makes aging much more painful than it has to be. When she became a single mother at twenty one, Dawn ultimately left welding after having her first child and switched her career track by earning a certificate from a community college. From there, she went on to work as an educational assistant, in which role she helped learners with special needs.

Dawn's daughter reading a med school textbook
Dawn's daughter reading one of her textbooks. (Post from her Instagram account)

Outside of work, Dawn’s life also continued to change, as she got married and started to move around the country with her husband, who is in the Air Force. Her husband’s assignments took them to Manitoba and British Columbia before Dawn needed to go back to Nova Scotia to care for her mother after she had suffered a severe stroke.

 

When Dawn thinks back to this period in her life, she sees the seeds of her interest in medicine being planted. Caring for her mother made her realize how fulfilling that kind of work can be, but she also had two other meaningful experiences at that time that made her consider pursuing medicine.

 

First, Dawn had agreed to become a surrogate mother for a couple wanting to have a child. One of the men in the couple was a family physician, and she found it extremely reassuring to be able to talk to him throughout the experience.

 

This experience taught Dawn just how meaningful doctors can be in people’s lives. She learned that healthcare providers do so much more than make diagnoses and prescriptions: they give peace of mind to the people in their care. Dawn wanted to be able to be a source of support for others in the way that this family physician was for her.

 

Secondly, she had started an undergraduate degree program at Acadia University – which is close to her mother’s home in Nova Scotia – and found herself particularly invested in her biology coursework. For the first time, this made her think that she had a strong interest in science. While pursuing her three-year degree, she had two children, one being the surrogate baby. By the time she graduated, then, she and her husband had three children.  

 

All of these different experiences – caring for her mother, raising children, surrogacy, and her coursework – made her decide to apply for medical school.

 

By the time she reached the interview stage of the admissions process, Dawn was close to the due date for her fourth child (not counting the surrogate pregnancy). When Queen’s offered her the opportunity to interview, she had to ask if they could accommodate her schedule, since the original date they proposed was very close to her due date.

 

Asking for this kind of accommodation, though, was scary. What if it hurt her chances at being accepted? What if they just said no and she couldn’t even interview at all? Even if they agreed to help her, would they be annoyed? Dawn had no idea how the school would treat her as an expecting mother.

 

To her pleasant surprise, though, Queen’s was more than accommodating. We enabled her to schedule her interview for after she gave birth, and assured her that we would make every possible arrangement to guarantee her comfort.  Two weeks after having her fourth child, then, Dawn traveled to Kingston from Nova Scotia to interview at Queen’s. While she says that being away from her newborn and three young kids was hard, Queen’s made her feel at ease.  When we offered her a seat in the class of 2022 a few weeks later, she had no trouble choosing to accept.

Dawn Armstrong preparing for her admissions interview
Dawn preparing for her medical school interviews while 38-weeks pregnant. (Post from her Instagram account)

Dawn is well on her way to meeting many of her goals. She has now completed her first semester of medical school, and she is currently completing a few research projects. She aims to be a dermatologist and knows Queen’s will prepare her well for this specialty.

 

Dawn also feels at home at Queen’s. She says that neither her fellow students nor the faculty have done anything to make her feel separate or unwelcome. At gatherings, her children are welcome and made to feel included.

 

Knowing firsthand how much work it is to raise children, I am extremely impressed by Dawn’s ability to be a mother and a medical student at the same time. When I asked her how she finds the energy for school, she told me that she has the energy because she loves it. In some ways, she sees her classes as a nice reprieve from parenting. “School is my break,” she told me with a smile.

 

Dawn also feels like her life experiences have prepared her well for medical school. She knows how to do the most with the time that she has. She knows not to cause herself undue stress over relatively small assignments, as she can see the bigger picture, like being grateful for having a healthy family.

 

What I love about Dawn’s story is the way that it overturns so many stereotypes about who can and cannot go to medical school. We usually don’t think of people who didn’t go straight to university after high school as going on to medical school. Or people who were young mothers, or people who start their careers in manual labour, or people in their 30s, or people who have four children.  But all of these things apply to Dawn, and she is thriving at the Queen’s School of Medicine.

 

If you’re reading this and you’ve dreamed of pursuing a career in health care but feel like you’re too old or have too many children or have the wrong kind of background, please reconsider. Please put aside any preconceptions you might have about what kinds of people go to medical school and what kinds of people don’t.

 

As Dawn’s story shows, all are welcome at the Queen’s School of Medicine.

 

If you want to keep up with Dawn’s adventures as a mother and medical student, you can follow her on Instagram at @dr.mumm. As you can see, I've borrowed some pictures from her page, and there's many more great posts to look through there. 

 

Thank you to Andrew Willson for his assistance in preparing this blog.

 

 

Photo of wrinkled hands by Rawpixel/Unsplash
2019-01-15 Is an exercise-related hormone the new frontier in Alzheimer's treatment?

Last week, our winter term got off to a fabulous start with some great news out of the Faculty of Health Sciences. Dr. Fernanda De Felice, an Associate Professor in the Centre for Neuroscience Studies,  co-authored a paper with collaborators at the Federal University of Rio de Janeiro that appeared in Nature Medicine, a prestigious journal of medical research.  

Dr. De Felice’s publication shows that irisin, a hormone that is released by exercise, could help protect the brain against Alzheimer’s disease. Speaking with the Queen’s Gazette, she says:

 

"In the past few years, researchers from many places around the world have shown that exercise is an effective tool to prevent different forms of dementia such as Alzheimer’s. This has led to an intense search for specific molecules that are responsible for the protective actions of exercise in the brain. Because irisin seems to be powerful in rescuing disrupted synapses that allow communication between brain cells and memory formation, it may become a medication to fight memory loss in Alzheimer’s disease."

 

Realizing the potentially huge impact that Dr. De Felice’s findings could have, media outlets have widely circulated the study. In the UK alone, for example, everyone from The Daily Mail to the NHS to the BBC (at the 2:49 mark in the segment) is talking about this potentially ground-breaking study. In the U.S., The New York Times has covered the study. In Kingston, Global News has produced a story on the research.

 

Dr. Fernanda De Felice
Dr. Fernanda De Felice

 

As with all studies, it will still take some time to realize the full ramifications of the findings. The study has generated so much interest already, though, because it has the potential to improve the conditions of millions of people affected by Alzheimer’s.  

If future studies support the case that irisin can protect against or slow the progression of Alzheimer’s disease, these findings could lead to novel and impactful treatments. Researchers may even be able to develop medications that could increase irisin levels in the brain without exercise. As the majority of people suffering from Alzheimer’s are elderly and therefore more at risk of having conditions (such as arthritis and heart disease) that make exercising difficult, a drug that increases irisin could be crucial to treating patients with the disease.

I’m sure that I’m not alone in eagerly anticipating more findings from Dr. De Felice and her team. In the meantime, though, I want to congratulate everyone involved in this study and thank them for their hard work and dedication to research.

This also seems like a good opportunity to point out the excellent work that is coming out of the Centre for Neuroscience Studies more broadly. Last month on this blog, I had the chance to share some information about the highly impactful research program of Dr. Stephen Scott, another member of the centre. Without a doubt, Dr. Scott and Dr. De Felice are representative of the terrific team of researchers at Queen’s who are reshaping what we know about many aspects of the brain.

As we move forward in the winter term, I look forward to sharing more success stories from across the faculty with you.

--Richard

 

Thank you to Andrew Willson and the Queen's Gazette for their assistance in preparing this blog. 

 

Cover photo by Rawpixel/Unsplash

 

 

Hilary Machan, Dr. Andrew Bruce, and Dr. Jennifer Medves
2018-12-18 The importance of compassionate care

Dean Reznick on the Margaret Leith Bruce Faculty Award in Compassionate Care

Compassion is such an important part of health care. By showing compassion to their patients, practitioners develop a meaningful bond with them and even improve the quality of their care. That is why all of us in the Faculty of Health Sciences are so grateful to Dr. Andrew Bruce for recently establishing the Margaret Leith Bruce Faculty Award in Compassionate Care. Dr. Bruce was Professor and Head of the Department of Urology at Queen’s for many years, and he is currently a member of the Dean’s Advancement Cabinet.

The award that Dr. Bruce has established honours his wife Margaret, and it will recognize one faculty member in the School of Nursing each year who serves as a model for the teaching and practice of compassionate care. The inaugural winner of this award was recently announced as Hilary Machan, Lecturer in the Queen’s School of Nursing. In the picture above, you can see Hilary (left) with Dr. Bruce and Dr. Jennifer Medves, Director of the School of Nursing and Vice-Dean (Health Sciences). 

To commemorate the establishment of this award, I’ve invited Hilary to write a guest post for the blog to reflect on what compassionate care means to her and how she incorporates it into her work. Hilary was gracious enough to agree, and you can read her contribution below.  

 

Hilary Machan on Compassionate Care

I am honoured to be selected by my peers as the recipient of the Margaret Leith Bruce Faculty Award in Compassionate Care. I thank Dr. Bruce for his investment in our students and the future of nursing.

Nursing was not a profession I had considered until my mother – a wise woman who also happened to be a nurse – encouraged me to apply to a Nursing Program.  Queen’s University was the only school that I wanted to attend, and so I applied to their School of Nursing, along with other universities, just in case.  When I received my acceptance letter, it seemed right; from the first day, I knew I had made the right decision.  My time at the Queen’s School of Nursing exposed me to different hospitals, such as Kingston General Hospital, Hotel Dieu, Smiths Falls District Hospital, and the Perth Great War Memorial Hospital. I even got exposed to different countries, as I did one placement in Barbados.  Since I have graduated, I have had the opportunity to nurse not only in Ontario but also Edmonton and the Northwest Territories.  Every experience has taught me new things, most importantly how to care.  Eleven years ago, I had the opportunity to come back to the Queen’s School of Nursing to teach, and I have enjoyed every minute since. 

The Queen’s School of Nursing places a focus on “Caring to Learn: Learning to Care.”  It is essential that we have faculty who can support our students in the required knowledge to provide excellence in evidence informed care, and it is equally important that our students have compassion and incorporate this into their care. 

It is a focus of mine to work with my colleagues to develop innovative ways that we can continue to integrate caring into the curriculum.  I believe that every encounter that we have with our students is an opportunity to do this, and I also believe that we can be most impactful when teaching compassion at the bedside, in the clinical environment.  We need to lead by example and identify moments that can result in a better understanding for our students of what it means to provide collaborative care that is compassionate.

Given the reality of the health care climate, time, cost and workload are barriers to providing compassionate care.  We need to discuss with our students how we can continue to involve and educate the patients and their families, to make them partners in their own care.  It is often what is considered “the little things” that are the most important, and end up not being little at all.  Actively listening, looking for verbal and non-verbal cues, responding to concerns and taking that extra moment with your patient and their family are  the moments that will often be the most meaningful to the people that we care for.

As much as I love teaching, I have not given up bedside nursing.  I have worked in Long Term Care, on Medical and Surgical floors and, for the last 20 years, in the Intensive Care Unit in my hometown. My commitment to teaching and to bedside nursing have complemented each other well and have strengthened my knowledge and understanding. This has ultimately improved my abilities as an educator and as a nurse. I have always believed that my role as an educator has made me a better nurse, and my continued bedside nursing has made me a better educator.

I believe that we need to provide our students with a solid foundation and assist them to build on this knowledge as they move from year one to graduation. I view learning as a continuum, and I see my greatest asset as my ability to assist students to integrate theory and compassion into the clinical setting.  This deeper understanding promotes critical thinking, better patient outcomes and patient focused care.  Our students come with various backgrounds, experiences and beliefs, this adds to the rich learning environment that we are able to offer our students and broadens their exposure and understanding. 

Throughout the year, the School of Nursing has identified opportunities to meet with faculty to further discuss how we will ensure that our students continue to be meaningfully exposed to the concepts of care and compassion.  I have recently attended the AMS Phoenix Conference, the aim of the AMS Phoenix Project is to bring compassion to healthcare.  I intend to continue to look for further opportunities to discuss with other Health Care Professionals how they achieve caring in the clinical setting and bring this learning back to the Queen’s School of Nursing to share with my colleagues. As identified by Dr. Bruce we need to “ensure learners of today remain committed to compassionate care while still being competent practitioners in an increasingly complex and automated health care system particularly in ICU”.

 

Hilary Machan RN, MN

Margaret Leith Bruce Faculty Award in Compassionate Care 2018-2019

Lecturer, Queen’s University, School of Nursing

Cover of the Dean's Report
2018-12-12 How the power of teamwork drives the Faculty of Health Sciences

It is hard to believe that another year is almost over already. Since things are going to be relatively quiet around Queen’s starting next week, this is going be my last blog post of the year. I want to take the chance now, then, to offer my best wishes to all of you for the holiday season and the new year, and also to unveil this year’s issue of the Dean’s Report, which you can find here: https://healthsci.queensu.ca/administration/reports/deans-report

As we leave 2018 behind, I hope that all of you will have a chance to catch your breaths, because I know that everyone in the Faculty of Health Sciences has been working exceptionally hard this year. And we have a lot to show for it. 2018 saw a lot of milestones in the faculty, and a sample of them have been captured in this year’s issue of the Dean’s Report.

Each year, I give a theme to the stories collected in the Dean’s Report, and this year’s theme is the power of teamwork. Looking over our accomplishments from the 2017-2018 academic year, it’s clear to me that collaboration is at the heart of everything we do in the faculty, and that we would accomplish very little without it.

I hope that you will take a chance to read this year’s report because it speaks to the breadth of work we’re doing in the faculty and the wide array of people who are behind that work. The stories span our accomplishments in research, education, and clinical practice, and they profile faculty, students, and staff from the Schools of Medicine, Nursing, and Rehabilitation Therapy.

I don’t have the space here to tell you everything that is in this year’s issue of the Dean’s Report, but I’ll share a few of the stories to whet your appetite. In the pages of the report, you’ll have a chance to learn about how competency-based medical education is impacting Dr. Julia Tai, a second-year resident in Internal Medicine. You’ll also be able to read about why two nursing students made these videos to let Indigenous students know that they are welcome and supported at Queen’s. And you’ll be able to learn about the faculty members who joined the School of Rehabilitation Therapy last year: Drs. Beata Batorowicz, Dorothy Kessler, David Pedlar, and Mohammad Auais.

As satisfying as it is to look backward, I’m excited for the new year and all of the opportunities it will bring to create new milestones and continue striving toward our goals.  You can tell that we’ll be having a busy year in the FHS just by looking at the faculty and administrative searches that we have planned.

Next year, we will be finding a new Vice-Dean (Health Sciences) and Director of the School of Nursing to replace Dr. Jennifer Medves, who will be concluding a fabulous ten years in those roles. Similarly, we will be looking for a replacement for Dr. Roger Deeley, who will be finishing a tremendous tenure as our Vice-Dean Research. We will also be finding new heads in a number of departments, including Public Health Sciences, Biomedical and Molecular Sciences, Anesthesiology and Perioperative Medicine, and Surgery. On top of these searches, we will also be recruiting four new Canada Research Chairs in the fields of bioinformatics, metabolomics, and microbiome research.

These are just a few of the developments in the works that I’m looking forward to telling you all more about in the coming months. In the meantime, though, I hope you have a wonderful and restful holiday.

 

 

Dr. Stephen H. Scott with the KINARM robot
2018-12-04 Stephen Scott's robot is changing what we know about the brain

When Dr. Stephen Scott, Professor in the Department of Biomedical and Molecular Sciences, explains his research, he frequently uses a picture that shows a running back on a football team who is about to run on a diagonal line to his right through a gap in the opposing team’s defense. In the picture, the running back hasn’t yet started to run through the gap, but he is angled towards it.  For Dr. Scott, this situation presents an endlessly complicated question: what would happen if the runner suddenly decided to run left instead of right?

He is not interested in this question because of football strategy but rather because of the complex neurological functions that lie behind all voluntary movement. By what process would the runner’s brain make a decision to completely adjust their course? What neural circuits would be involved? And how long, exactly - as in down to the millisecond - would it take?

Dr. Scott’s research focuses on such questions around voluntary movement, and he works in both basic and clinical science. Recently, he has been highly successful in securing funding for both aspects of his work, as he has won four prestigious grants in the past year. For his basic science research, he has obtained two grants from the Canadian Institutes for Health Research (CIHR) as well as a grant from the Natural Sciences and Engineering Research Council of Canada (NSERC). He has also recently obtained a grant from the Ontario Research Fund – Research Excellence competition to support his work in developing clinical assessment tools. Taken all together, these four grants total around $6 million in funding over the next five years.

The two sides of his research (basic and clinical), though, are always influencing each other.  They are also both partially underpinned by the KINARM robotic platform that he developed. With KINARM, Dr. Scott uses various behavioural tasks to observe how subjects move their arms and interact in a virtual environment to measure neurological functioning. In one task, for example, subjects see a number of objects in the workspace appearing to move toward them. As they see these objects, they must move the arms of the KINARM platform to “hit” the objects.

To an outside observer, it would look as if the subject were playing a video game like Pong. Through these tasks, though, Dr. Scott is able to collect large amounts of information about the sensory, motor and cognitive functioning of those individuals being tested. Moreover, even if the tasks appear simple, they are strategically designed to assess specific aspects of brain function. Over many years, Dr. Scott developed rigorous standards for determining which tasks can provide him and other researchers with valuable information. He now has rules in place that guide him when he seeks to make a new task. For example, tasks have to be short and there has to be a simple way for healthy subjects to respond to them.

In Dr. Scott’s basic science research, the information he gathers from the KINARM tasks helps him understand feedback processes in the brain and which neural circuits control which motor functions. In his clinical science work, the KINARM enables him and other researchers to determine the ways in which various diseases affect the brain.

Dr. Scott and his collaborators have done a good deal of work to measure the impact on the brain of conditions such as strokes, transient ischemic attack, Parkinson’s Disease, ALS, and epilepsy. But he has also collaborated on projects that seek to determine the neurological effects of conditions, like kidney disease, that have not been commonly associated with the nervous system. Through projects like this one, Dr. Scott aims to use KINARM to develop a much fuller picture of the connections between the brain and a variety of illnesses.

Dr. Scott’s academic work has also spawned a commercial venture. To make his KINARM technology available to a wide array of researchers, he manufactures and distributes it through a venture called BKIN Technologies. This commercial side of his work has enabled Dr. Scott to get his innovations into the hands of neuroscientists and clinician-scientists far from Kingston. Currently, there are roughly 100 KINARM robots in 14 countries around the world. By distributing his technology so widely, Dr. Scott is helping researchers conduct objective and quantitative studies of the brain that they would be unable to do otherwise.

 

Thank you to Andrew Willson for his assistance in preparing this blog.

Four doctors from the Chengdu Second People's Hospital standing in front of the Old Medical Building
2018-11-27 Why Four Doctors in China Traveled 10,000 Kilometres to Visit Queen's

When I met with a group of four doctors from the Chengdu Second People’s Hospital on November 7, they had taken a 20-hour flight from China to Toronto, then, the next day, rented a car and drove down the 401 to Kingston. Needless to say, this is not a journey that anyone would take lightly.

But it was important for all four of our visitors – Drs. Ya Liu, Xiaoju Ma, Wen Xue, and Pan Li – to travel 10,000 kilometers to come to Queen’s because our university and their hospital share something very important: history. Specifically, our histories converge in the life and work of one man, Dr. Omar Leslie Kilborn.

Dr. Kilborn graduated with both his bachelor’s and his MD from Queen’s, and, in 1891, he left Canada for western China as a medical missionary. His goal was to open a series of clinics in the region in order to make healthcare more widely available to the people there.

Dr. Omar Leslie Kilborn
Dr. Omar Leslie Kilborn

His first clinic opened its doors on November 3, 1892, but Dr. Kilborn was far from finished with his work. He went on to open a number of other clinics and hospitals, including a hospital for women and a stomatology clinic. Perhaps most importantly, though, Dr. Kilborn helped establish the Medical College of West China University.  

Our visitors from Chengdu trace the history of their hospital back to one of the hospitals that Dr. Kilborn founded during his time in Sichuan. Today, the Chengdu Second People’s Hospital now has well over 500 beds, takes referrals from all over the area, and has a wide range of specialists. It seems safe to say, then, that Dr. Kilborn’s goal of spreading access to healthcare in China has been realized in ways that he could not have even imagined.

I must confess that I was unaware of this history before the members of the hospital reached out to me over the summer. In their initial email to me, they told me a little about Dr. Kilborn and his work, and they said that they wanted to come to Queen’s as part of a visit to their roots.

To pay their respects to Dr. Kilborn and his legacy, they wanted to visit the university that trained him and connect with people who continue to carry out the mission of the school. Moreover, they wanted to tell the story of their history, to let those of us at Queen’s know how large of an impact that Dr. Kilborn had on healthcare and education in their region.

It is not every day that I receive such a request, so my interest was piqued immediately. My staff and I worked to find a date that would work for both our visitors and us, and we all decided on November 7th. That morning, I had a long meeting with them in which they told me about both the history of Dr. Kilborn’s medical work in Chengdu and the current work of the Chengdu Second People’s Hospital.

Frankly, I was moved by the passion and admiration with which our visitors spoke of Dr. Kilborn. Being on the campus of the university that he attended was clearly a highly meaningful experience for them. And their enthusiasm rubbed off on me. After our meeting, I had a renewed appreciation for working at Queen’s, a university that has touched the lives of so many people around the world.

Official seal for Chengdu Second People's Hospital
Note the maple leaf on their seal

After their meeting with me, Dr. Michael Fitzpatrick, Chief of Staff at Kingston Health Sciences Centre, graciously took our visitors on a tour of Kingston General Hospital, where they learned about our relationship with the hospital and the work that is being done there. This meeting also provided all parties with a chance to have productive conversations about similarities and differences between healthcare in Canada and China.

Since I knew that our visitors from Chengdu were going to share their history with us, I asked Dr. Jenna Healey, our Jason A. Hannah Chair in the History of Medicine, to meet with them in the afternoon in order to share our history with them. Dr. Healey took our guests on a historical tour of the campus, pointing out some of the buildings and objects that remind us of our roots.

The highlight of this tour was the Old Medical Building, where Dr. Kilborn received a large part of his medical education. Our visitors lingered there a little longer than they did anywhere else, trying to soak up as much of the history of the location as they could. They even took a short video of Dr. Healey standing outside the building, explaining some facts about its past.

This visit reminded me of how important it is to remember our history and to keep in mind those we share it with. Until our visitors reached out to me, I had no idea that a large hospital in Chengdu traced its roots back to a clinic started by a nineteenth-century Queen’s graduate. Now, I see the Chengdu Second People’s Hospital as a part of our broader network, as a place with a rich historical connection to Queen’s.

During our meeting, both the representatives of the hospital and I agreed that we would like to keep in touch and develop meaningful ways to commemorate our shared history.

The Chengdu Second People’s Hospital is currently developing a new expansion, and they are planning on building a small museum to honour their past. As a gesture of goodwill, I am trying to think of an object that we might share with the hospital to display in their museum – something that captures the history of Queen’s at the time when Dr. Kilborn studied here.

If you have any ideas for a meaningful object that we might share with the hospital, please let me know in the comments below.

Dr. Setareh Ghahari
2018-11-20 Accessing the Canadian healthcare system isn't always as simple as you think

As a newcomer to Canada, Dr. Setareh Ghahari experienced first-hand some of the challenges faced by newcomers in attempting to access health services.  Despite being a registered occupational therapist with extensive knowledge, experience, and access to resources, she experienced difficulty accessing health-related services. These experiences provided motivation to develop and launch an innovative new program aimed at supporting newcomers to Canada (including groups such as immigrants, refugees, and international students) as they navigate a complex and unfamiliar health system. 

After completing some research, it became clear to Dr. Ghahari that her experience and the barriers she faced in accessing health services were fairly representative.  These difficulties are often compounded for immigrants or refugees with significant language barriers, or who are experiencing traumatic personal circumstances. Dr. Ghahari concluded that there was a gap in resources. In other words, there needed to be something in place that could enable newcomers to access the Canadian healthcare system. They need to be educated about what services are available and how they can best be accessed, but newcomers also need help with building networks of support to enable this access to services. Dr. Ghahari decided that she would develop a program to do this work.

Since coming to Queen’s as an Assistant Professor in 2014, following the completion of a postdoctoral fellowship at the University of British Columbia, Dr. Ghahari launched Accessing Canadian Health Care for Immigrants – Empowerment, Voice and Enablement (ACHIEVE). ACHIEVE is a seven-week program that brings immigrants and refugees together to learn how they can get the care that they need in their new country. The program features one two-hour session each week, covering different topics, such as screenings and preventions, finding a family doctor, mental health, and prevention.

Some of the aspects of the program that Dr. Ghahari has found most useful for participants are those that teach newcomers how to use English to communicate about illness. This addresses a serious issue, because immigrants and refugees will wait too long to seek out healthcare because they don’t feel comfortable talking about their conditions in English, even if they are otherwise capable speakers. While many of the newcomers in ACHIEVE have very strong English skills, that does not always mean that they know the specific words to convey pain or sickness. Reinforcing language skills around health is especially important, Dr. Ghahari explains, because people need them most in highly stressful situations – exactly when people often have trouble speaking precisely in their first language, let alone their second.

As a critical part of this work, Dr. Ghahari built partnerships with several community organizations in the Kingston area, including the KEYS Job Centre, Loyola School of Adult and Continuing Education, and Immigrant Services Kingston and Area (ISKA). Immigrants and refugees frequently seek out services at these different centres, so they make for a convenient place to hold the classes. No less important, they are also spaces in which newcomers feel welcome and comfortable.

When ACHIEVE first started, Dr. Ghahari taught every session herself, but now the program has grown and she has trained students in the Queen’s occupational therapy program to deliver the sessions. To help ACHIEVE expand beyond Kingston, she is training ESL teachers and healthcare practitioners, and she is developing online modules that can both deliver the program and train new facilitators. Even when the program is online, Dr. Ghahari will encourage individuals to participate as part of a group, as this is a fundamental aspect of ACHIEVE – to build a community of support for new Canadians. This all feeds into Dr. Ghahari’s ultimate goals for ACHIEVE: to build and empower communities of newcomers, thereby enabling their access to Canadian healthcare systems while also reducing feelings of vulnerability or social isolation.

I am so pleased to see an initiative like this one come to fruition here in the Faculty of Health Sciences; it speaks directly to our vision to ask questions, seek answers, advance care and inspire change. Please share your thoughts on ACHIEVE and the great work that Dr. Ghahari has done by commenting below.

 

Poster for the Queen's Health and Human Rights Conference
2018-11-14 This Conference is Changing Locations to Walk the Talk

The following is a guest blog by Sharon Yeung, Co-Chair of the annual Queen's Health and Human Rights Conference 

 

In my elementary school days, before the rise of vintage fads and oversized fashion, I wore an exclusive wardrobe of my brother’s hand-me-downs, patched and re-patched meticulously in ways only my immigrant mother could do. I was, unsurprisingly, very vocally opposed – not only because being a stylistically questionable grade three girl is simply undesirable – but because I felt like those clothes, riddled with the scars and bruises of lives past, weren’t my own, regardless of how much I wore them. Simultaneously, however (though I would never admit it to my mother) wearing those clothes also imbued me with a pride that came from knowing the victories and milestones they had lived through: the ripped knees from the first home run, or the celebratory ice-cream stains from placing first in the spelling bee. In many ways, I also wore those clothes with a sense of inadequacy and uncertainty if I could truly give them a new life of adventures.

Last year, I inherited the leadership of the eighteenth annual Queen’s Health and Human Rights Conference, and the emotional wave I associated with my brother’s tie-dye t-shirts and GAP hoodies flooded me inexplicably. The handover was brief and matter-of-fact: some documents, some contact information, and a few emails. And that was that: leaving me alone and clutching the leftover legacy of more than a hundred students’ ideas, passions, and hard work over the last seventeen years. I struggled with what it would mean to now drive this conference – to make it into something genuinely grounded in the contemporary frameworks and politics of our time, all the while paying homage to the original goals and values that so many before me have worked for it to espouse.

I turned to the best source I knew for guidance (Google) and uncovered pieces of the conference’s past that inspired and impressed me: its appearance in the Kingston Whig Standard, its receipt of the Queen’s University Human Rights Initiative Award – multiple times, and its hosting of headline speakers time and time again. The history of conference themes also pays respect to the health equity issues that have gripped the international stage over the years: the genocide in Darfur, the HIV/AIDS epidemic in sub-Saharan Africa, and the refugee and migrant crisis worldwide. In a haphazard and overly dramatic way, I reached out to Dr. Monika Dutt, a role model I have followed (and re-tweeted) too enthusiastically over the years, and – as I discovered – the conference’s original founder and Chair. I asked her for the story of the conference, to which she chuckled softly and admitted that she and her classmates had simply hoped to create an adjunct learning experience on subjects they felt were overlooked in curriculum. Simple hopes that – as we now know – have carried forward eighteen years.

This year, the Queen’s Health and Human Rights Conference Planning Team is honoured to present our 2018 event: “Modern Rx: Pharmaceuticals, Recreationals, and Other Drugs”. Like its predecessors, the conference seeks to unpack critical and current issues – this time, in relation to the multitude of drug use, regulation, and access issues that bombard our national landscape.  Inspired by the conference’s history, and determined to build the values of social justice throughout the entire planning process of our event, we have thoughtfully challenged the nature of traditional of academic spaces and who they are home to. In that vein, we have relocated the main conference venue to the Rideau Heights Community Centre, and our conference agenda has emphasized creating more space and priority for learning from lived experiences. We have hoped for change in the details, too: we have been adamant in reducing the entry fee to the event to $10.00, and using half of the proceeds to fund the Kingston Community Health Centre, whose staff have been ever gracious in offering their time and mentorship throughout the process of conference planning.  We have aimed for sustainability and environmental responsibility in our catering choices, our purchase of gifts and accessories, and our use of a shuttle bus to bring attendees to the conference.  We have aimed for diversity in our roster of speakers and in our invited attendees, and have tried to include as many voices in the space we have created as we can. We acknowledge, however, that even in our attempts to remain as true as we could to these values, there were limitations, and we hope that our audience will also be critical to this and learn from the event in light of its strengths, but also of its weaknesses.

I hope that you will consider joining us at the annual Queen’s Health and Human Rights Conference on November 16th – 18th, 2018. This event has evolved in many ways over the last seventeen years, and I hope this year will not only do justice to its past, but will continue challenging the future of the conference to continue in its journey to becoming more critical and more responsible to the values it represents. Your presence, in this journey, would be invaluable to us.

 

What: Queen’s Health and Human Rights Conference
When: November 16th – 18th, 2018
Where: Queen’s University School of Medicine and Rideau Heights Community Centre
More information: www.queens-hhrc.com

Vanessa Silva e Silva
2018-10-31 How one PhD Student is Helping Hospitals Secure Life-Saving Organ Donations

Vanessa Silva e Silva, a fourth-year PhD student in the School of Nursing, had applied for a fellowship from the Kidney Foundation of Canada and the Kidney Research Scientist Core Education and National Training Program (KRESCENT) and was expecting to hear the committee’s decision by the end of May. In the first week of June, she still had heard nothing and figured it meant bad news: rejections always come out later than acceptances.

She was so sure she hadn’t gotten the grant that she broke the bad news to Dr. Joan Almost, one of her mentors on the Nursing faculty, in one of their regular meetings. Dr. Almost said that in some cases there is a delay in results being announced, and she offered sympathy and encouragement. Even if the fellowship didn’t come through, there would be other grants to apply for.

But then, as Vanessa walked down the stairs of the building after her meeting with Dr. Almost, she got an email notification on her phone. She had heard back about the KRESCENT fellowship – and she’d received funding.

Vanessa quickly turned around and went back up the stairs to tell Dr. Almost, who had also received the email. The sympathies of a moment before became congratulations.

Vanessa’s fellowship from KRESCENT will fund her dissertation research on organ and tissue donation, and the fellowship will enable her to work on her research full time. While she is excited about this aspect of the funding, she is just as thrilled that the fellowship comes with an opportunity to participate in KRESCENT’s training program. As a trainee, she will be able to participate in workshops on topics like grant writing and transdisciplinary research, and she will be able to take part in a journal club that is designed to enhance critical reading skills of academic studies.

As for her dissertation, Vanessa will be using her KRESCENT funds to conduct a social network analysis of the organ and tissue donation programs in several hospitals in Ontario. Through her research, she aims to find out which collaboration and communication patterns lead to the most successful donation programs. Moreover, she wants to understand how a variety of relationships affect organ donation rates.

Vanessa’s research will have four methods of data collection that she will use at each hospital she investigates. First, she will review the policies that the hospital has in place for organ donation. After this step, she will have the donation coordinator answer a questionnaire about their work. Then, she will observe the hospital’s donation process in action. And finally, she will interview all of the healthcare professionals involved in the donation process at that hospital. Her goal is to understand what practices are most successful in helping hospitals – and, ultimately, patients – secure the donations that can save lives.

Organ donation is Vanessa’s central academic and professional interest, but she found her passion almost by accident. As an undergraduate at the Federal University of Sao Paulo in Brazil, where Vanessa is from originally, she went to the meeting of a journal club one evening because her older sister asked her to go with her. The topic of the meeting was organ donation, and, through it, Vanessa volunteered to help conduct a study that gauged the opinions of local high-school students on the issue.

After graduating from university, she worked as a primary care nurse before deciding that she wanted to devote her energy to donations. From there, she pursued a series of opportunities that deepened her understanding of donations and the processes that make them possible. She earned a certificate in donation from a postgraduate program; she worked in an organ donation centre in Sao Paulo and then a large hospital; and she earned a master’s degree in nursing.

For her master’s thesis, she evaluated the organ donation program she was working for, which involved a nurse-led process that significantly improved the number of organ donors. Significantly, her thesis also made a case for the importance of organ donation programs, and her research ultimately helped the government to create and approve legislation for public funding of Organ and Tissue Donation Coordinators (registered nurses) in public trauma centres.

After all of these experiences, Vanessa knew she wanted to pursue a doctorate in nursing, and she decided that she wanted to complete her studies abroad, either in North America or Europe. She ultimately chose to study in Canada, and she picked Queen’s over other programs because of its reputation – both in Canada and around the world. She knew it would be an institution that could help her achieve her academic and professional goals. On top of that, she was impressed by how warm and inviting all of the faculty members whom she talked to were. She remembers how promptly and enthusiastically everyone responded to her emails at Queen’s when she was making her decision.

Now, in her fourth year in the program, she is ready to embark on the research project that she came to Queen’s to conduct, and she has the funding to make that research possible.

I am thrilled to see Vanessa embark on her work, and I am keen to follow her progress. Of course I would be remiss if I didn’t end with a reminder that in Ontario, you need to register to be an organ donor – click this link to find out more.


Do you have any thoughts on or experiences with organ donation that you feel comfortable sharing with Vanessa as she conducts her study? If so, please let us know in the comments below.

Thank you to Andrew Willson for his assistance in preparing this blog. 

Ontario Lyme Disease Map 2018: Estimated Risk Areas
2018-10-23 Fighting One of the Fastest Growing Diseases in Southeastern Ontario

The following story originally appeared in the Queen's Gazette and is being republished with the permission of its author, Dave Rideout, Senior Communications Officer at Queen’s University. The story is followed by a postscript from Dean Reznick.

 

$4 Million in CIHR Funding for Lyme Disease Research Network

 

The Canadian Institutes of Health Research (CIHR) and the Government of Canada announced a $4 million investment in a new multidisciplinary research network that will bring together scientists, clinicians, and patients to address gaps in the approach to prevention, control, diagnosis, and treatment of Lyme disease, on Monday, Oct. 15.

Led by Queen’s University Professor of Emergency and Family Medicine Kieran Moore, the Pan-Canadian Research Network on Lyme Disease’s multi-pronged mandate seeks to make a national impact on health outcomes, practice, programs and policy related to Lyme disease. Lyme disease is becoming more prevalent each year, due in part to climate change.

Dr. Kieran Moore
Dr. Kieran Moore

“We would like to thank the Government of Canada and CIHR for the opportunity to advance the science of Lyme disease prevention, diagnosis, and treatment,” says Dr. Moore, who is also the Medical Officer of Health with Kingston, Frontenac, Lennox & Addington Public Health. “Our network, based at Queen’s University, will collaborate with patients and our many academic and government partners to protect the health of Canadians from coast to coast. We will provide the national capacity to have a coordinated, integrated, and multidisciplinary response to the emerging infectious disease threat of Lyme disease.”

Lyme disease is an infectious disease caused by a bacteria transmitted to people through the bite of infected blacklegged ticks. Symptoms of Lyme disease can vary from person to person, but most people experience an expanding red rash at the sight of the tick bite, fever, chills and flu-like symptoms while others may have more serious symptoms, such as heart, joint and neurological disorders.

“With the incidence of Lyme disease on the rise in Canada, Dr. Moore and his team will be uniquely positioned to respond to the research gaps related to Lyme disease in Canada,” says Kimberly Woodhouse, Interim Vice-Principal (Research) at Queen’s.

This federal government’s investment, through CIHR, in partnership with the Public Health Agency of Canada, is part of a concerted commitment to support the Pan-Canadian Framework on Clean Growth and Climate Change. The Pan-Canadian Research Network on Lyme Disease also builds on Canada’s ongoing efforts to tackle the illness through surveillance, research, sharing of best practices, laboratory diagnostics and testing, prevention education, and public education and awareness.

“The Government of Canada is proud to support a research network that focuses on collaboration between Lyme disease stakeholders from across the country to improve patient outcomes and access to care,” says Ginette Petitpas Taylor, Minister of Health for the Government of Canada. “We understand that Lyme disease is emerging in many parts of the country, due in part to climate change, and we are committed to minimizing the public health risk associated with this disease.”

Learn more about Canada’s federal framework for Lyme disease and the CIHR.

 

Postscript: Congratulations and Next Steps

 

The article above originally appeared in the Queen’s Gazette on October 15, and I would like to thank Dave Rideout for sharing the story with us.

                     

I’d also like to congratulate all of the many people in the Queen’s Faculty of Health Sciences who worked tirelessly to develop the Lyme Disease Research Network and secure CIHR funding for it. This was truly a team effort involving many people across FHS and our partners. Special congratulations, however, are reserved for Dr. Kieran Moore, who has been the tireless leader of the network.

 

Lyme disease is a very pressing issue in Canada today, and Southeastern Ontario – where Queen’s makes its home – is no exception.  At the top of this blog, I’ve shared a map from Public Health Ontario that shows which areas in the Province are at risk for tick bites and Lyme disease. It is truly alarming how many areas in Southeastern Ontario are at risk in 2018. It is impossible to look this map and not think that something needs to be done immediately to address the spread of the disease. The work that Dr. Moore and his team of researchers are doing is poised to make significant strides in addressing the problem. Through their combined efforts, I’m confident we’ll be taking steps in the right direction to keep people in the region safe.  

 

Please Share Your Thoughts

 

Do you have any thoughts on or experiences with Lyme Disease that you wish our researchers knew? Or would you like to congratulate Dr. Moore and his team? If so, please share your ideas or words of encouragement in the comments below.

 

--Richard  

Why We Need to End Hallway Medicine
2018-10-16 Why We Need to End Hallway Medicine

On October 3rd, the Ontario government announced the formation of the Premier’s Council on Improving Healthcare and Ending Hallway Medicine, and I was asked to join this council. Dr. Ruben Devlin, who serves as a special advisor to the premier on healthcare, has been named the chair of the council, and he will be leading a group of ten individuals who bring various expertise from across the health professional sectors. Together, we will advise the government on ways in which patient care could be improved, and we will develop and recommend strategic priorities that could guide the government’s efforts to make the system more efficient.

Hallway medicine has been a systemic problem in our healthcare system for a while now. When hospitals do not have the capacity to provide appropriate beds to all of their patients, nurses and physicians end up treating patients in hallways and other spaces that are far less than ideal. In these circumstances, patients lack the privacy and resources that they deserve, and it is difficult for healthcare providers to do their best work. More important, it’s a barometer and reflection of some fundamental stresses (and flaws) in our system. This problem has deep roots and hallway medicine will not easily be solved. Some of these roots can be traced to issues outside of hospitals, including our systems of complex continuing care, home care and long-term care. But even more profound, it is likely that many of these issues trace to the ways in which we deal with more fundamental issues – determinants of health, like poverty, homelessness and many other social inequities.  Despite the challenges, forming this council marks a promising step in the right direction.

I am excited to be working with my colleagues on this council because I believe that there is much work that could be done to improve healthcare for people in Ontario. Hallway medicine is certainly one of the larger problems we face, but it is by no means the only one. There are complex challenges in our healthcare system that will require broad vision, creative thinking, and dogged determination to solve. As Dean of the Faculty of Health Sciences, I see on a daily basis both the strengths and weaknesses of our system, and I am optimistic that this council will develop ideas that can intensify the former and mitigate the latter.

My colleagues on this council come to it with a wealth of experience that I am confident will be used to help us generate meaningful insights into the problems facing our healthcare system. No less important, I believe that we are all coming to the council with an open mind and a willingness to listen and collaborate. And I believe that the government is willing to do the same as well.  

 

The full list of members of the council is as follows:

  • Rueben Devlin, Special Advisor and Chair
  • Adalsteinn Brown, Professor and Dean, Dalla Lana School of Public Health at the University of Toronto
  • Connie Clerici, CEO, Closing the Gap Healthcare
  • Barb Collins, President and CEO, Humber River Hospital
  • Michael Decter, President and CEO, LDIC Inc.
  • Peter Harris, Barrister and Solicitor
  • Gillian Kernaghan, President and CEO, St. Joseph’s Health Care London
  • Jack Kitts, President and CEO, The Ottawa Hospital
  • Kimberly Moran, CEO, Children's Mental Health Ontario
  • David Murray, Executive Director, Northwest Health Alliance
  • Richard Reznick, Dean, Faculty of Health Sciences at Queens University
  • Shirlee Sharkey, President and CEO, Saint Elizabeth Health
     

I am eager to work with all of them, and I look forward to updating the readers of this blog on our efforts as they develop.

In the meantime, have you been affected by hallway medicine in some way? What factors do you think should be taken into account by the council? Please share your thoughts or experiences in the comments below or, better yet, please stop by the Macklem House – my door is always open.

 

 

Damon Dagnone Publishes Powerful Memoir
2018-10-05 Damon Dagnone Publishes Powerful Memoir

I’m pleased to let you know that Dr. Damon Dagnone – Associate Professor in the Department of Emergency Medicine and our CBME Lead – has recently published a memoir called Finding Our Way Home: A Family’s Story of Life, Love, and Loss. Damon was kind enough to share the manuscript with me before it even came out, and I don’t know if I’ve ever finished a book faster. Damon’s story is almost impossible to put down once you start, and it is even more moving than it is gripping. I had always known that Damon was an excellent physician and educator. But, I have to admit, I didn’t realize before reading his book that he is such a powerful writer as well.

I wish, though, that Damon had been able to write a much more boring book. Because no one should have a story as heartbreaking as that of Damon and his family. In 2006, Damon lost his 3-year-old son Callum to cancer. His book takes us through the agony of that whole experience, from the terror caused by the initial diagnosis to the crushing grief caused by Callum’s death. As devastating as these parts of Damon’s story are, though, there’s also hope and inspiration in the book. He shows us his family’s pain, but he also shows us their growth and recovery.

At the beginning of the book, Damon tells us about a vacation that his family took to Disney World. The trip was just as fun as they were hoping, except for a strange health problem. During the vacation, Damon and his wife Trisha noticed Callum vomiting three times without any obvious explanation. While this vomiting was suspicious on its own, it was even more alarming given that Callum also hadn’t gained much weight in the previous six months.

When they took him to the doctor to try to figure out what might have been causing the problem, they learned that Callum had a brain tumor. When he and Trisha heard the diagnosis, Damon says that “Our hearts stopped and life changed forever.” They then started on an agonizing journey of surgery, procedures, chemotherapy, and long, long stays in the hospital. Tragically, Callum died on November 11, 2006.

The section of the book dealing with Callum’s illness is very powerful, to say the least. Damon describes in aching detail having to watch his son struggle – always with amazing bravery – through the cancer and the chemotherapy. With this story, Damon gives us an important look into the lives of families who find themselves practically living in hospitals, their lives completely shattered by the illness of a child. For those of us in the healthcare community, Damon’s experiences are a striking reminder of just how vulnerable our patients and their loved ones can be when they come to us. Damon’s story also emphasizes just how comforting a compassionate doctor can be, and just how lost and confused a seemingly distant one can make you feel – even when, like Damon, you’re a physician yourself.

But there’s another side of this book too: the story of Damon and his family slowly recovering from their loss. Damon shares many of the milestones they pass on their way to recovery, such as painful anniversaries, making new routines, holidays without Callum, moving to a new house (to get away from oppressive memories), finding meaningful ways to commemorate their lost son, and adopting their daughter.

 As a fellow healthcare professional, I was perhaps most affected by the story of Damon returning to medical practice, especially because it wasn’t always clear to him that he would. Here, we see Damon wrestling with this decision shortly after Callum dies:

Moving forward meant going back to work. It was a big step. The thought of the many responsibilities waiting for me was daunting, and working again necessitated being away from Trisha and Thai for long periods of time. A major issue was that I had no idea if I was still capable of practising Emergency Medicine. Being an ER physician is a demanding job, and I was worried I might have lost the expertise and emotional reserve to care for patients and families the way they deserved. Would I be able to see patients in the same rooms where Callum had been, and interact with the nurses and physicians who had looked after him? I’d have to care for and counsel patients and parents facing life-threatening illnesses, and I didn’t know if I had it in me.

Luckily, Damon realized that he still had it in him, but his path back to medicine wasn’t easy. As he tells in the book, he needed to ease his way back into the emergency room and, sometimes, having to deal with patients in critical situations could be nearly overwhelming. In one highly moving scene from the memoir, Damon describes treating a critically ill child – a girl who was the same age as Callum had been when he died – for the first time since his son’s death.

As he worked to resuscitate her, Damon says, “I forced my mind to stop sending me visions of Callum so I could focus on her.” When the girl was finally in stable condition, Damon needed to excuse himself to the on-call room, where he “cried for five minutes straight” because, he says, “all the pain I’d felt at losing Callum had come back with an intensity I hadn’t experienced in months.”

It’s moments like these that make Damon’s book not only powerful but timely. His story shines a light on something that I think we forget too often in healthcare: that doctors are people first and foremost and that, as people, they can suffer. With his book, Damon reminds us that physicians sometimes need to be given space and time to be vulnerable, to grieve, and to recover. In our profession, we’re finally having meaningful conversations about physician wellness, and Damon’s book is an essential contribution to this discussion.

Damon’s book isn’t light reading, but it’s necessary reading, especially for those of us in the healthcare community. Really, though, his story will speak to anyone whose life has been affected by illness or grief.

Thank you, Damon, for sharing your personal journey with all of us. Writing this book was truly an act of bravery, and we’re all better off for your courage.

If you’re interested in reading Damon’s book, you can find it here: https://www.amazon.ca/Finding-Our-Way-Home-familys/dp/172387616X/ref=sr_1_fkmr0_2?s=books&ie=UTF8&qid=1538586897&sr=1-2-fkmr0&keywords=dogbone+finding+our+way+home

Thank you to Andrew Willson for his assistance in preparing this blog. 

Dr. Robert Connelly with Dr. Jagdeep Walia
2018-09-21 Celebrating Career Milestones in the Faculty

On September 5th, we had one of my favourite annual events in the Faculty of Health Sciences: the Faculty Promotion Reception.  During this event, many of the Department Heads and I publically recognize our colleagues who have been promoted to the rank of Associate Professor or (Full) Professor. Celebrating these career milestones is important because it gives us, as a faculty, a chance to recognize the years of hard work and dedication that went into making these achievements possible. Getting promoted is no easy thing to do in the academy. You have to prove beyond a doubt that you have made significant and impactful scholarly contributions and that you are an effective teacher. Each of these roles is difficult enough on their own, and, together, they add up to the signature of a highly impactful academic.

Dr. Annette Hay with Dr. Stephen Archer
Dr. Annette Hay with Dr. Stephen Archer

For how demanding it is, such important work goes unsung too often, and that is why promotion is such a significant affirmation of all the contributions that faculty members have made to the university. When you’re promoted, that means that your colleagues and students value your accomplishments. When you’re promoted, you can be confident that you have become the academic that you aspire to be.

As special as it is, though, promotion itself might feel anticlimactic if it isn’t marked in some way by your colleagues. That’s why I make sure that we make a big deal out of it every year by gathering members of the faculty together in the David M.C. Walker atrium of the new medical building at Queen’s for refreshments and public remarks.

 

Dr. Tara Baetz with Dr. Nazik Hammad
Dr. Tara Baetz with Dr. Nazik Hammad

I was very pleased to see so many of our department heads speak with great admiration about the people being promoted within their departments. Public attestations of pride in each other’s work is so meaningful, especially, I think, for colleagues receiving their first promotion.

I wish I had the space to say things about each of our promotees individually, but I think I’ll have to settle for listing them below.

 

 

Dr. Robert Siemens with Dr. Michael Leveridge
Dr. Robert Siemens with Dr. Michael Leveridge

Promotions to Associate Professor

Dr. Randy Wax, Critical Care Medicine

Dr. Andrew Hall, Emergency Medicine

Dr. J. Gordon Boyd, Medicine

Dr. Jocelyn Garland, Medicine

Dr. Benedict Glover, Medicine

Dr. Annette Hay, Medicine

Dr. Khaled Shamseddin, Medicine

Dr. Benjamin Thomson, Medicine

Dr. Nazik Hammad, Oncology

Dr. Susan Brogly with Dr. John Rudan
Dr. Susan Brogly with Dr. John Rudan

Dr. Khaled Zaza, Oncology

Dr. Amy Acker, Paediatrics

Dr. Dawa Samdup, Paediatrics

Dr. Jagdeep Walia, Paediatrics

Dr. Susan Brogly, Surgery

Dr. Douglas Cook, Surgery

Dr. Mark Harrison, Surgery

Dr. Michael Leveridge, Urology

 

Promotions to Professor

Dr. Karen Smith with Dr. Stephen Bagg
Dr. Karen Smith with Dr. Stephen Bagg

Dr. Karen Smith, Physical Medicine and Rehabilitation

Dr. Lindsay Davidson, Surgery

 

Congratulations to all of our recently promoted faculty members. I wish them all the best of luck as they begin a new phase of their careers, and I hope that you’ll join me in congratulating them yourselves, either in the comments here or the next time you see them around campus.

Adam Devon and Darsan Sadacharam
2018-09-13 Using Innovation to Address Health Inequities

Guest blog by Adam Devon and Darsan Sadacharam, Queen's medical students in the class of 2020. 

 

As medical students, early clinical encounters are invaluable.

These clinical encounters provide exposure to patients and their stories. In addition to learning medical information, students are flooded with patient narratives that begin to shape their view of medicine. Most importantly, students begin to gain insight into the challenges that exist within our healthcare system.

We learned about the power of medical narratives firsthand through a clinical experience, during which a patient came in with severe mechanical back pain. For this problem, the physician recommended pain medications and physiotherapy. Unfortunately, the patient did not have physiotherapy coverage and was unable to personally bear the cost. Without any alternatives, the patient was left to rehab on their own. This health inequity deeply resonated with us. It is this common narrative that motivated us to try to help patients in this position.

This past summer, we had the privilege of participating in the Queen’s Innovation Centre Summer Initiative through the Dunin-Deshpande Queen’s Innovation Centre. This program allowed us to jump into the space of healthcare innovation. The supportive and collaborative environment at Queen’s allowed us to explore ways to improve care for back pain patients. Working alongside a fellow Queen’s student, Dylan Brookes (Computing ‘20), we have been developing a web-application for primary care providers to help prescribe home-based exercise and mindfulness therapy to their patients with low back pain, who are unable to access or afford physiotherapy. We plan to evaluate the impact of this platform in the fall, and hope it can provide a solution for patients unable to access physiotherapy.

We have been fortunate to gain some valuable insights from the Queen’s Community. A common sentiment shared by many medical professionals is that medicine is far too clinic centric. There is a need for initiatives that educate and empower patients to take on a larger role in managing their health. In recent years, health equity interventions have been leveraging advances in research and technology to ensure patients do not continue to fall through the cracks. We hope that our project will provide patients with the knowledge and resources to take an active role in their rehabilitation process.

Healthcare providers continue to consistently demonstrate the desire to improve the status quo. With burgeoning technological advancements, a unique opportunity now presents itself to the healthcare field. We now house the capacity to challenge the status quo and develop solutions that alleviate existing barriers to equitable care. As long as we continue to be inspired and guided by the stories and experiences of patients, impactful advancements are sure to come.

Successes in the Office of Professional Development and Educational Scholarship
2018-09-06 Successes in the Office of Professional Development and Educational Scholarship

The Office of Professional Development and Educational Scholarship has always been a true strength of the Faculty of Health Sciences, and it has recently added two tremendous honours to its impressive list of achievements. First, they received a glowing accreditation report from the Committee on Accreditation of Continuing Medical Education (CACME), and then they earned a Royal College Accredited CPD Provider Innovation Award – their second in three years!

Dr. Karen Smith
Dr. Karen Smith

The Office is able to accomplish so much because of the many truly wonderful people who work there. I’d be remiss, though, if I didn’t point out the strong leadership that has been guiding it. Dr. Karen Smith took over as Associate Dean in 2013 and has just stepped down this year. During her tenure, the Office accomplished truly incredible things. Even though it’s sad to see her leave this role, I know that Dr. Richard van Wylick, who is the new Associate Dean, is going to be a terrific leader as well. He’s already provided capable leadership in the Office as the Director of Faculty Development. Thank you, then, to both Karen and Richard, who have been instrumental in guiding the team to their successes.

The Office of Professional Development and Educational Scholarship received what I think must be one of the most positive accreditation reports I’ve ever read. CACME evaluates the institutions it reports on by ranking them on a scale of compliance – from non-compliance to exemplary compliance – with the various evaluation standards. Usually, schools are found to be in compliance and partial compliance on many items, and, often, they are deemed non-compliant on a few items as well. If they’re lucky, they might have an exemplary compliance or two on their report.

Dr. Richard van Wylick
Dr. Richard van Wylick

Our Office not only received four exemplary compliance marks on its accreditation but was also deemed in compliance on all fifteen of the other standards. That’s right: that means they didn’t receive a single “non-compliance” or “partial compliance” on the whole report. In my experience, that’s practically unheard of. As far as accreditations go, this is truly acing the test.

It would take me too long to talk about all of the different strengths that led the Office to receive such a positive review, but I will try to touch on a few of them. For example, the Office has been remarkably effective in developing and adhering to strategic goals. In many cases, these goals are driven by societal needs, such as the opioid epidemic. To meet the need for continuing education on this issue, our Continuing Professional Development (CPD) team has put together extensive programming on how best to prescribe opiates in the current environment.

The Office of Professional Development and Educational Scholarship is also highly sophisticated in its use of educational methodologies. They always work hard to ensure that they are setting clear learning objectives for every learning event that they offer. Once these objectives are set, the Office holds committee meetings to determine the most appropriate methods for meeting the goals of every session.  This strategic approach to education highly impressed the CACME committee, and rightly so. It shows a true commitment to methodological rigour.

The Office winning another Royal College Innovation Award, though, is no less impressive than their accreditation results. This latest award recognizes the significant role that our Faculty Development team played in making Queen’s the first school in Canada to launch competency-based medical education (CBME) in all specialty training programs.

I’m particularly excited that this award draws attention to the fact that the implementation of CBME at Queen’s was an enormous team effort. CBME was able to launch here because so many people across the university came together to achieve a shared vision. Through their extensive CBME training programs, the Faculty Development team played an integral role in ensuring that people both understood that vision and could see themselves in it. They understood that empowering our teachers and getting them to buy into our new system was the key to the transformative change we were pursuing.

In October, the Faculty Development team will have the chance to present their innovation to the 10th National CPD Accreditation Conference in Mississauga. This will be a great opportunity for schools across the country to learn about their work. As dean of the Faculty of Health Sciences, I can see just how much impact our Faculty Development initiatives have had throughout the school. I sincerely hope that our colleagues across Canada will be inspired by our methods as they prepare for their own transitions to CBME.

 

 

Cultural safety training
2018-08-28 Queen's Family Medicine to Introduce Cultural Safety Training into Curriculum

Guest blog by Dr. Hugh Langley,  Assistant Professor in the Queen's Department of Oncology and Primary Care and Aboriginal Lead, Cancer Centre of Southeastern Ontario 

First Nations, Inuit and Métis (FNIM) peoples bear a disproportionately high cancer burden and face a number of health disparities, barriers and gaps to health services. One barrier FNIM people face is fear and at times mistrust of the health care system that can lead to lower use of cancer prevention and screening services. Also, when symptoms arise, many may delay seeking help or completing treatments.

However, when FNIM people experience culturally safe health care they are more likely to access care earlier, feel more at ease and empowered throughout the process of receiving care; share details about their health concerns and care preferences, return for follow up visits and follow treatment plans recommended by health care providers. In short, cultural safety is a critical component for improving patient experiences/outcomes.

One of the most impactful ways that FNIM people can feel culturally safe is through their interactions with health care providers. Recognizing this, Cancer Care Ontario has developed online Aboriginal Relationship and Cultural Competency (ARCC) courses, which help healthcare professionals to learn about FNIM peoples and how to provide care in a culturally safe manner.

The Queen’s Family Medicine Residency Program will be implementing the ARCC courses as part of their mandatory curriculum for residents.  Dr. Eva Purkey is the Director of Global Health and Health Equity and states: “These courses and other activities will allow our residents learn how they can provide a positive and culturally safe environment for their Indigenous patients and families”.

I encourage all programs and institutions that have a responsibility on training and teaching the health care professionals of tomorrow to also incorporate these courses into their curriculum.  The courses are interactive and address a key recommendation from the recent Truth and Reconciliation Commission of Canada report, to provide skills-based training in cultural competency, conflict resolution, human rights, and anti-racism.

Currently, the ARCC courses have over 10,000 course enrollments and a course completion rate of 81 per cent. The courses are free of charge and can be taken at anytime, anywhere by anyone. We are thrilled to be able to acknowledge and thank Queen’s Family Medicine for this landmark move in helping to build an inclusive health care system and look forward to seeing the participation and interest in building culturally safe spaces spread across Canada.

To take the ARCC courses, please visit https://www.cancercareontario.ca/en/resources-first-nations-inuit-metis/first-nations-inuit-metis-courses

For more information on how your faculty or institution can begin this work, please contact our Aboriginal Navigator at Dionne.Nolan@kingstonhsc.ca

 

 

Richard with Baby Saul
2018-08-08 Baby Saul

Not long after I returned from my administrative leave (sabbatical), I was taken away from campus again for what must be the best possible reason: to meet my first grandchild, Saul Arthur Schwartz.

Saul was born on July 11 in Toronto, and Cheryl and I had the tremendous joy of being in the hospital when he arrived. As she was with our daughter in the delivery room, Cheryl even got to meet Saul the second he came into the world. I wasn’t too far behind, though, as I got to see him just five minutes after that.

Cheryl with Baby Saul
Cheryl with Baby Saul

I suppose I might be biased, but I think that our little Saul has the greatest parents he could ask for. Cheryl and I are extremely proud of my daughter Joanna and her husband, Jordan. Joanna is a lawyer working in civil litigation at a law firm in Toronto, and Jordan has recently earned his PhD in Immunology from the University of Toronto. Clearly, Saul will have no shortage of professional role models in the house growing up! More importantly, though, Joanna and Jordan are compassionate people who will give him all the love he needs and then some.

I’m particularly touched by the fact that they chose to name Saul after my own father. In the Ashkenazi Jewish tradition, naming a child after a deceased relative is a highly meaningful display of love and respect. I cannot tell you how much it means to me that my daughter chose to honour her grandfather in this way. As I watched Joanna grow up, it gave me endless pleasure to see her develop a special bond with my father. Now that I am a grandfather myself, I hope that I can have as rich of a relationship with Saul as my father did with Joanna. As you can see from the picture above, I’m already working on it.

So far, being a grandfather has been a truly ineffable experience. It would be impossible to put all of the thoughts and feelings I have when I’m with Saul into words. But, if I had to try, I’d focus on the word legacy. From the second I met Saul, I became even surer of something I’d already known: that my family is my true legacy.

As I think about my father, my daughter, and my grandson, I can’t help thinking about a different kind of legacy as well. My father was a Queen’s student, Joanna received her Master of Public Administration at Queen’s, and I have the privilege of working at their alma mater. Sometimes, when I walk around our beautiful campus, I think about how my father must have taken the same route past Summerhill or how Joanna must have seen the same view of Lake Ontario on her way to class. Now, I occasionally catch myself wondering if Saul will grow up to carry on my family’s Queen’s legacy and walk the same paths as a student.

Obviously, I’m getting a little ahead of myself. I should probably let Saul learn to crawl before I imagine him walking around Queen’s. But whether or not he ever ends up studying here, he’s on campus all the time right now in the form of hundreds of pictures on my phone. Next time you see me, stop me and ask to see one. I always have time to talk about my grandson.

 

-Richard

Unmatched Canadian Medical Graduates
2018-07-30 Unmatched Canadian Medical Graduates

Guest blog by Andrew Dawson, a 4th-year medical student at Queen’s and the current Chair of the Ontario Medical Students Association

Medical students are selfish.

This shouldn’t shock or offend you. The reason I make this sweeping generalization is not because I believe that it is a revelatory statement, but rather that thinking in this way allows us to reframe an important and timely issue in the world of medical education - that is, the unmatched Canadian Medical Graduate (CMG). Selfishness happens to all of us at times, but it may increasingly be gaining momentum in medical students out of perceived necessity.

Starting clerkship, medical students are just starting to flex our diagnostic muscle. Sure, we’ve learned how to conduct a history and complete a physical on basic patients with common presentations. But when faced with a clinical picture that doesn’t fit into tidy algorithms, we are confronted by just how little we truly know. And that self-realization is a frightening and powerful thing. After all, once we recognize that we are mostly incompetent, what is there to prevent other people from noticing our woeful inadequacies too?

To combat this, medical students steer towards selfishness. We become so concerned with figuring out pathology and disease, so hell-bent on impressing preceptors with our finely tuned investigative toolkit, and so stressed about missing something that might impact an assessment we receive, that we disconnect from the individual we are treating. We rush past patient anecdotes and jokes and the staples of regular conversation. No longer is this a person with a life, a family, and a personal history; they are a riddle that needs prompt solving.

But let us qualify this vested self-interest and flesh out why this occurs. Med students are often taught to believe in meritocracy. If we successfully tick off all the necessary boxes - the grades, the extracurriculars, the award-winning research - most of us have been lead to believe we’ll find a career waiting at the finish line. In the past, this may have been accurate. However, that reality is becoming less and less common, as recent health and human resource planning decisions have left more and more medical students without residency positions. This year there were over one hundred and twenty Canadian medical graduates without a residency position after the second iteration of the CaRMS match. The future of their clinical careers in medicine now in question, they will scramble to arrange supplementary electives, enroll in Masters programs, and bulk up their applications to run through the CaRMS gauntlet next year. But going unmatched even once acts a scarlet letter and many of those individuals will never match. Sure, there are non-clinical careers available, but that remains a bitter pill for many students to swallow. Some will leave the profession entirely. And that leaves us with highly trained and motivated individuals with limited career options in a brutally stigmatizing and unforgiving medical community. Let’s not forget the staggering six-figure debt load that seems impossible to pay back without a physician’s salary. It is no wonder medical students are running scared. As the stakes grow higher and the perceived margin for error grows slimmer, becoming more self-focused and evaluation-oriented is necessary. It seems like the only way to keep our heads above water.

So the question needs to be asked: has the hyper-competitive and cut-throat environment (whether perceived or real) resulting from fewer residency spots changed how medical students interact with their patients? I recently completed a family medicine rotation in Brighton, Ontario. The physicians I worked with made it clear from the beginning that they wanted medical students to take time to talk to the patients; that focusing on efficiency doesn’t necessarily make for the most effective appointments. I was permitted to take extra time without fear of reprisal from my preceptors for working too slowly. And it has been completely rejuvenating to listen to people tell their stories. The richness and quality of these people’s histories – not just medical histories for once – helped me to re-center and refocus. It reminded me that I chose medicine because of the people I would be afforded the opportunity to care for. Chronic stress can chip away at even the most empathetic and optimistic of people, however, taking the time to talk to patients about their personal circumstances, and the contexts surrounding their illnesses helped me reclaim my professional values. Moving back into hospital medicine following the conclusion of my community rotation I worried about falling back into old habits and anxious thought-processes. I’m not alone among my peers in this line of thinking. I can’t help but wonder if the hyper-competitive environment medical trainees are entrenched in has caused an erosion of the ‘soft skills’ in medicine that often resonate the most with our patients.

Moving forward, how do we shift this cultural paradigm? When it comes to residency spots, we need to either decrease the inflows, or increase the outflows. It will require a multi-faceted approach from all relevant parties. It will require more appropriate matching strategies. It will require oversight from the Council of Ontario Faculties of Medicine (COFM) and the Association of Faculties of Medicine of Canada (AFMC), as well as input from the provincial ministries responsible for residency position allocation and funding. It will certainly require buy-in from med students themselves, and representative associations like the Ontario Medical Students Association (OMSA) and the Canadian Federation of Medical Students (CMFS) have been working hard to keep student interests heard. Earlier this year, the Provincial government took steps to alleviate some of unmatched backlog by allocating one-time funding for fifty-three new residency positions for unmatched graduates from Ontario. While I commend the government for this initiative, it is ultimately a one-time measure; a system-level overhaul needs to occur if we are to effectively address this expanding problem. But everything is in flux and shrouded in uncertainty, and none of the key players really seems to have a pulse on what the next steps should be. Though no one is to blame, downplaying and deferring the significance of unmatched CMGs does not serve anyone. This issue demands prompt attention.

Until something changes, fears of not matching will continue to alter how medical students interact with their patients. Until something changes, medical students will continue to be selfish.

 

 

Richard and Professor Derek Alderson, President of the Royal College of Surgeons of England
2018-07-05 Energized and Recharged

It’s great to be back at Queen’s after spending six months away. This was my first academic leave (sabbatical) in over thirty years of academic life. I found the experience energizing and intellectually enriching. The visits to the various centers to which I travelled were stimulating and informative. There is a lot of information that I will be bringing back to Queen’s, and I also hope and believe that I have imparted some of my experience to the institutions that welcomed me as a visitor.

Cooking together on sabbatical (administrative leave)
Cooking together on
sabbatical (administrative
leave)

On a personal level, there were many days where I had both breakfast and dinner with my wife, and, with great satisfaction, we both appreciated that we really do enjoy each other’s company.

Overall, I had an excellent experience on my administrative leave and felt that my time away from my role as dean was very productive. Before I tell you about everything that I did, though, I want to say how truly grateful I am to Dr. Chris Simpson for stepping into the role of Dean FHS and CEO of SEAMO for the past six months. During this time, I believe that Chris did a remarkable job. Importantly, we stayed in touch on a regular basis, and, through our discussions, I was able to still feel connected to the ongoing issues of the faculty. I also want to thank everyone else in the faculty for keeping things running so smoothly while I was away.

I ended up being much busier than I thought I’d be when I first decided to take a leave. I kept a log of my activities for the Provost’s office, and, by the end of the six months, I had made over 400 entries. Among other things, I travelled to medical education centers on three different continents, met with a wide range of leading educators, and gave ten lectures.

To make all of these activities manageable, I divided my sabbatical into two phases. For the first three months, I worked at the Wilson Centre at the University of Toronto, which was a kind of homecoming for me. I was the Founding Director of this Centre, and it is now widely recognized as one of the top institutions for medical education research in the world. The Centre is home to approximately twenty medical educators and thirty trainees. As a Scholar-in-Residence, I participated in the activities of the Centre, which included actively researching medical education and mentoring graduate students.

During these first three months, I had formal visits to four other organizations. Specifically, I had the opportunity to travel to the American College of Surgeons, the Royal College of Physicians and Surgeons of Canada, the Accreditation Council for Graduate Medical Education (U.S.), and Haramaya University in Harar, Ethiopia.

Picture of Chicago: taken on an architectural boat cruise
Picture of Chicago: taken on an
architectural boat cruise 

The American College of Surgeons is a leading organization in the world for continuing professional development for surgeons. I have been a long-standing member of this organization and was previously on the organization’s College of Governors. There I met with Ajit Sachdeva, the College’s Vice-President in charge of Surgical Education, and his entire executive team. Dr. Sachdeva and I are life-long colleagues, and my visit gave us the chance to discuss emerging concepts of professional development for surgeons that I hope to bring to Queen’s. I also imparted to the College Queen’s experiences with competency-based medical education (CBME) transformation.

My second visit was to the Royal College of Physicians and Surgeons of Canada, the organization that sets the professional standards for the education of medical specialists in Canada. I have a long-standing association with the College and am currently on Council, which is equivalent to a board of directors. I was invited as their inaugural Professor-in-Residence for a one-week stay. During that week, I had productive conversations with approximately thirty different people at the College and gave two lectures. The focus of my visit was conducting work with the College on its implementation of CBME across Canada. Our innovation at Queen’s in transforming all of our residency programs to CBME is part of a national initiative being led by the College. I was able to share our initial experience with large-scale transformation and, in so doing, assist the College in its discussions on a national roll-out of this new method of training.

My third visit was to the Accreditation Council for Graduate Medical Education (ACGME) in Chicago. ACGME is the organization that is in charge of setting the standards for residency education in the United States. Led by two colleagues, Dr. Eric Holmboe and Dr. Stan Hamstra, the ACGME has initiated a program, similar to CBME, but with some fundamental conceptual and structural differences to our Canadian model. While visiting the ACGME, I explored their model in depth, comparing and contrasting it to the Queen’s (Royal College) model. As a result, I will be bringing back new ideas for quality improvement to enrich our current efforts in CBME.

New hospital build in Harar, Ethiopia
New hospital build in Harar, Ethiopia

My fourth visit was to Haramaya University in Harar, Ethiopia. This visit has been the product of a year-long discussion with Haramaya about forming a partnership around the training of residents. For this initiative, I have developed an arrangement with   the Royal College of Physicians and Surgeons of Canada to join Queen’s School of Medicine in this partnership. Harar serves as the regional medical referral center for eastern Ethiopia, which has a population of approximately 5 million people. They are currently building a new hospital with 1,000 beds there, but they have only 25 specialists serving the entire hospital. During my visit, we discussed our mutual goals, and we made a decision to partner in the development of three new residency training programs in a number of core disciplines.

Saw lots of sheep in the English countryside
Saw lots of sheep in the
English countryside 

After all these visits and my time at the Wilson Centre, the second three-month block of my sabbatical was centered in London, England. My academic home for ten weeks was Imperial College, London. I have a long-standing association with Imperial and hold an Honourary Professorship at that institution. I was invited there by Professor Lord Ara Darzi, a global leader in surgical education. Professor Darzi and I have been colleagues for over twenty-five years, and we share an abiding interest in the use of simulation as a vehicle to accelerate technical training for surgeons.

The surgical skills laboratory at Imperial is one of the best in the world, so I had a great opportunity to explore the laboratory and learn philosophies and practices from it that I can bring back to Queen’s. While I was at Imperial, I also had the chance to have productive conversations with approximately twenty people. These discussions focused on a range of things, including issues of medical school administration, approaches to research infrastructure, and emerging digital technologies.

Dinner with Professor Derek Alderson, President of the Royal College of Surgeons of England, at Jules, London’s oldest restaurant
Dinner with Professor Derek Alderson, President of the
Royal College of Surgeons of England, at Jules,
London’s oldest restaurant

In addition to Imperial, I was also a visitor at the Royal College of Surgeons of England, which is also located in London. I have many close colleagues at the College and, over the last year, have been consulting to the College on a pilot program they are initiating, which is instituting a program of CBME for training in General Surgery in England. While at the College, I participated in the activities of the pilot project in General Surgery, and I lectured at a conference they had dedicated to CBME implementation.

While abroad, I also spent a week at the Royal College of Surgeons of Ireland (RCSI) in Dublin as a Visiting Professor. While there, I had an intense program of meetings, discussions, and lectures, focusing for the most part on postgraduate medical education and training.

After this whirlwind of activities, I find myself reenergized for the last two years of my term as dean. Now that I’m back in Kingston, I’m excited to hit the ground running and use my experiences to bring fresh ideas to my work at Queen’s. Now that you know what I’ve been up to for the past six months, I’m looking forward to hearing about how all of you in the FHS community have been while I was away. Leave me an update in the comments or better yet, please stop by the Macklem House, my door is always open.

Richard

First Annual Employee Engagement Event
2018-06-18 First Annual Employee Engagement Event

Guest blog by Andrew Willson, Senior Communications Officer, Queen's University Faculty of Health Sciences. 

As I walked into the performance hall of The Isabel Bader Centre for the Performing Arts the morning of the first annual Employee Engagement Event, the sound of drums hit my ears. While I still didn’t know what exactly the “surprise event” scheduled for 9 AM was, one thing was clear: this was not a typical day at the Faculty of Health Sciences.

When my co-workers and I got to our seats, there were drums waiting for us. Over the next hour, the group Drum Café led all of us – the over 200 staff members in attendance – in a large group drumming session. The whole thing culminated in a dozen or so staff members dancing wildly across the stage while shaking maracas (there’s video evidence if you don’t believe it).

While this session was a fun way to wake up and get energized, it also set the tone for the rest of the day. The leader of Drum Café encouraged all of us to hear our own contribution to the larger rhythm filling the hall. Only by each person playing their drum enthusiastically, he said, could we create this immense sound.

The theme of teamwork kept popping up throughout the day in various ways. Acting Dean Dr. Chris Simpson gave a presentation that showed all the goals that have been accomplished through collaboration in FHS over the past year. Ophelia Rigault, a guest speaker from Homewood Health, explained how to build strong working relationships.

One of the day’s speakers, Dr. Leeno Karumanchery, gave an especially eye-opening talk about diversity and innovation. While he pointed to studies saying that diverse workplaces give rise to innovation, he made it clear that inclusion is not enough on its own. All people in a workplace need to feel welcome, valued, and empowered in order to harness the innovative powers of diversity.

Even though his topic was serious, Dr. Karumanchery spoke with a great deal of humour and compassion, making his presentation just as enjoyable as it was educational. This talk gave us all a chance to reflect on what we can do – both as individuals and as members of larger teams – to make sure that Queen’s is as welcoming of a workplace as possible.

As funny as Dr. Karumanchery was at times, though, he may have been outdone in the humour department by the day’s keynote speaker, the comedian Deborah Kimmett. In an uproarious set, Kimmett managed to keep us all laughing constantly while also getting us to think about aging, adversity, and gratitude, among many other things. She had many pieces of wisdom for us, but what stood out for me was her emphasis on the ways in which having a sense of humour and an optimistic outlook can get you through most things in life.

The day, though, wasn’t all just about drumming and listening to inspiring speeches. There were also ample opportunities for staff members to break out of the silos of their departments, teams, and units to connect with people from across the faculty. During lunch and several nutrition breaks, we were all given coffee, food, and the chance to network.

These breaks gave me the chance to learn much more about many of the wonderful people who keep the faculty running.  It didn’t hurt at all either that I got to make these connections while spending time on The Isabel's sunny patio, which overlooks Lake Ontario.

Throughout the day, we were all encouraged to collaborate, innovate, pursue wellness, and embrace differences. Even with all the drums and comedy, then, in some ways it was a typical day in the Faculty of Health Sciences after all.

Value-Based Healthcare through Collaboration
2018-06-04 Value-Based Healthcare through Collaboration

Guest blog by Dr. Seth Chitayat, Director, Health Research Partnerships at Queen's University, Faculty of Health Sciences

On May 16th, the Faculty of Health Sciences at Queen’s and the Kingston Health Sciences Centre co-hosted a panel discussion entitled, Value-Based Healthcare through Collaboration: How do we make progress? The panel included industry leaders in healthcare from across the region who generously took the time to speak to our community. First and foremost, I would like to thank all of our panelists for their time, and I want to give a special thanks to Kevin Empey, the former Supervisor of Brockville General Hospital, for giving an insightful plenary address. The goal of this event was to better understand how we can extract more value in healthcare both from the procurement of major capital equipment and in the design of new technologies. The event was a great success, thanks primarily to our incredible panelists.  The discussion has also left me thinking about some important questions concerning value, procurement, and healthcare in Canada.

For instance, how should we define value in the first place? In my view, value can be defined as that which something or someone does to make a material difference between the present and the future. There are economic examples of this, such as pricing that targets customer preferences and their respective willingness to pay. Love is another example, albeit of social value. When in a partnership, individuals extract benefits from the relationship that they appreciate and cherish.  How greatly do we appreciate it when our partner makes us laugh, or when they make us feel better when we are feeling down? We appreciate these qualities in partners because they create value: they change our experience of life for the better.

It’s sometimes tempting for people to think that low prices and value are the same thing.  For instance, it’s very easy to think that something that’s cheaper represents better value for a consumer. We can sometimes see this line of thinking in debates about healthcare.

But I don’t think we should care about low costs above all in healthcare. When discussing healthcare, we should think of value as patient outcomes per dollar spent.  According to the Canadian Institutes for Health Information, hospital procurement accounts for 28.3% of all healthcare costs, which translates into approximately $13B worth of spends in Ontario alone.  It would be easy to see this figure and use it as a basis for a decision to make cuts to healthcare. Such a decision, however, would strip away the potential for hospitals to realize improved outcomes for patients. Reducing capacity to procure would also mean that hospitals will be unable to adopt new technologies, thereby forcing healthcare organizations to fund capital equipment themselves through philanthropy – a scenario that challenges our principles of fairness.

Going forward, hospitals must collaborate with academia, physicians, industry, and patients to demystify what value in healthcare means for patients and its potential to make healthcare more cost effective. We must continue to have discussions like the one we hosted in Kingston so as to ensure that governments and people understand that value in healthcare is good public policy for all.

Thank you again to all those who participated in “Value-Based Healthcare through Collaboration.” Through discussions like that, we can help work towards maximizing the value of care provided to all Canadians.

Convocation 2018
2018-05-23 Convocation 2018

One of the greatest joys of being a faculty member in the Queen’s Faculty of Health Sciences is the great privilege of guiding, mentoring, and developing the next generation of health professionals.

Spring has sprung, which means that it is time once again to celebrate the successes of another remarkable crop of newly minted colleagues.

Graduates, you have earned a remarkable degree. It is a degree that gives you great authority. But it is also one that demands that you hold yourselves to the highest possible professional standards. Having to live up to the standards of healthcare professionalism may sound like a daunting task. But you shouldn’t be afraid of those high standards. You should embrace them. 

First of all, you should embrace the responsibility that you have to your patients. As their healthcare provider, you will need to offer them counsel and care in their darkest moments. Your patients will put their trust in your judgment and their lives in your hands. The relationship you will have with your patients is a privilege. And it is one in which you should take great pride, as you have earned that privilege through years of hard work. This fiduciary relationship is fundamental to our professionalism and must always be at the centre of everything we do.

But we also have a social contract with Canadians. Society bestows upon us great respect, authority, and the privilege of self-regulation. In return, we owe Canadians and Canada (and indeed all of humanity) a duty to the greater good that can be conceptualized as civic professionalism. We must relentlessly advocate for a better system, for health equity, and on behalf of the most vulnerable. This is our duty, and it is an essential component of a career in service of others.

Part of this civic professionalism will be assisting in the transition – already underway – to a democratized information environment. Technological change has brought all the knowledge in the world to nearly everyone’s fingertips. No longer do health care professionals exclusively hold much of the body of knowledge of health care. No longer do we decide with whom we share the knowledge or how. No longer do we decide when and what physiologic data will be acquired – patients increasingly are taking charge of their own data.

As technology democratizes medicine, it has the potential to do enormous amounts of good for society – putting unprecedented power in patients’ hands. This is a good thing. But it does not mean that we no longer need experts. Experts critically evaluate information; and they use experience and judgment to contextualize and filter. In this era of “fake news”, people need trusted experts more than ever before to help them evaluate and wisely apply the information to which they have such ready access.     

To meet all of the challenges of the future, doctors and nurses and pharmacists and occupational and physical therapists – and all health professionals – will need to work together in transdisciplinary models of care. It is significant that doctors and nurses graduate together in the same ceremony, because from now on you will be a part of the same team. By committing to collaboration and mutual respect, you will live up to the high standards of our calling. Our careers are careers of service – and our patients must always come first; they must be at the centre of everything we do.

Our faculty’s vision is that “we ask questions, seek answers, advance care and inspire change.” It is a vision you can take with you as you begin your careers. Maintain that spirit of inquiry. Constantly strive for new solutions. Be restless and relentless as change agents. Embrace the nobility of civic professionalism. 

I am very proud to call you the Queen’s Class of 2018. I have tremendous confidence that all of you, individually and collectively, will change the world.

Congratulations, Colleagues.

Spring Convocation 2018 info: http://www.queensu.ca/registrar/students/convocation-graduation/ceremon…

Leadership Lessons From KHSC’s Operating Rooms
2018-04-03 Leadership Lessons From KHSC’s Operating Rooms

Guest blog by Dr. Darren Beiko, Associate Professor, Department of Urology, and Dr. Julian Barling, Borden Chair of Leadership, Smith School of Business

Leadership defined.

The late Warren Bennis, leadership guru and USC business school professor, once said “To an extent, leadership is like beauty; it’s hard to define but you know it when you see it.” And this applies equally to both positive and negative leadership behaviours. Many people struggle to craft a categorical and precise definition of leadership (ourselves included), yet those of us working in operating room (OR) environments have all been exposed to the very best, and sometime worst, of leadership. But have we truly considered the potential consequences of leadership in the OR?

Leadership affects team performance in the OR.

There is mounting evidence that leadership behaviours affect performance of the OR team. In our recent American Journal of Surgery article, we studied both positive (transformational) as well as three negative (over-controlling, laissez-faire and abusive supervision) forms of leadership. Our analyses showed that negative leadership behaviours tended to override the effects of positive leadership on the performance of the OR team, including psychological safety.

Leadership impacts patient outcomes.

Patient outcomes – really? Yes. Our most recent analyses suggest that surgeon involvement with surgical team members, together with surgeon elevation of team members, contributed to higher surgical team psychological safety, which in turn predicted better patient outcomes, particularly for complex operations. Perhaps even more importantly, a recent quantitative systematic review showed that leadership training positively impacts patient safety and patient outcomes in acute hospital settings. And we expect further evidence to emerge in the literature.

Shared leadership: it’s not just about the surgeon.

Although our initial publication in the American Journal of Surgery focused on the effect of leadership behaviours of surgeons on team performance, we also studied the same leadership behaviours enacted by nurses, anesthesiologists and surgeons in the OR. Anyone who works in the OR knows only too well that nurses, anesthesiologists and surgeons function as leaders in the OR, hence the need to study all these OR healthcare professionals in a shared (or distributed) model of leadership. However, our findings showed that surgeons enacted both positive and negative leadership behaviours more frequently than anesthesiologists and nurses. Thus, leadership is not yet equally shared in the OR, pointing to the importance of the cultural changes that will be necessary before a shared leadership model can become a reality.

“Leadership skills” vs. “scalpel skills”?

Taking everything into consideration in the OR, how important is leadership? Earlier this year, The Globe and Mail printed an article entitled “For surgeons, their leadership style can be as important as their scalpel skills”. Catchy title? Sure. True? Not so sure. The Globe’s story was based our American Journal of Surgery article which reported initial findings from our research in the ORs at Kingston General Hospital (KGH). Our research team studied the leadership interactions and communication among OR nurses, anesthesiologists and surgeons, including interpersonal and team behaviours, during 150 live operations. Despite The Globe’s eye-catching title, not for a moment are we suggesting that positive leadership could ever compensate for the technical scalpel skills necessary to safely and proficiently perform complex surgical operations. At the same time, high quality leadership during complex surgeries could enhance team performance and patient safety.

No evidence for a leadership “style”

A widespread belief is that leaders can be characterized by their “style” of leadership. Based on our study’s findings and our personal experiences, we find little support for this. Thus, classifying a surgeon as a good or bad leader is simplistic and often wrong, and strategies that follow from this myth, such as ensuring that we select leaders who manifest a specific style, are likely to lead nowhere. Instead, it would best to develop the leadership skills we need to enhance surgical team performance and patient outcomes.

Leadership can be taught!

Yes, it’s true. And as repeatedly shown in the leadership literature, great leadership is not just the result of winning the genetic sweepstakes! We can learn how to become better leaders, and organizations have a role to play here. Increasingly, research from the leadership and medical literatures demonstrate the impact of leadership and leadership training in the OR and other healthcare environments on patient outcomes. Because of this, we cannot no longer afford to ignore the importance of leadership training.

Leadership training: where do we stand?

All healthcare professionals will be thrust into formal and/or informal leadership roles during their career. And these are invariably significant leadership roles, with people’s well-being in the balance. Are we missing an opportunity for our future nurses, physicians and other healthcare professionals by not institutionalizing leadership training in their respective curricula? More importantly, are we failing our patients by not offering leadership training? Probably (and sadly), yes, because we know that leadership can be taught. In the words of Christina Lacerenza and colleagues who recently conducted a meta-analysis of 335 independent groups that received leadership training, “leadership training is substantially more effective than previously thought”. We are encouraged by our School of Medicine’s UGME leadership curriculum, and think it is now time for Canadian nursing schools, medical schools and/or residency programs to offer leadership training in their curricula if we are to graduate well-rounded professionals who are highly skilled at leadership, who can navigate complicated relationships with patients and succeed in challenging, dynamic and technologically evolving healthcare working environments. What do you think?

Strengthening global health collaboration
2018-03-28 Strengthening global health collaboration

The Global Health Team within the Faculty of Health Science’s Office of Professional Development & Educational Scholarship recently became an institutional member of the Consortium of Universities for Global Health (CUGH), an international body tasked with fostering interdisciplinary collaborations and the sharing of knowledge to address global health challenges.

Global health entails study, research, and practice that prioritize improving health and achieving equity in health for all.

Through this membership in the CUGH, all Queen’s global health and equity educators, advocates, and researchers will be able to connect with a network of more than 19,000 individuals and over 145 academic institutions involved in global health worldwide. Membership also provides access to interest groups, educational, and program development materials, as well as conferences aimed at building partnerships and engaging in advocacy across research, education, and service. In joining the consortium, all Queen’s staff, faculty, and students may now enjoy the benefits of membership and have access to CUGH resources.

In light of the university’s commitment to internationalization and new membership in CUGH, the OGH is looking to strengthen Queen’s global health network by gaining a full understanding of the global health community at Queen’s. The OGH is conducting a survey to gather information on global health work being done at the university. The survey will also serve to collect information from the Queen’s community about program information to be shared with the CUGH network.

“There is so much important global health and health equity work being done across the faculties at Queen’s. It seemed like the perfect time to both join the ever-growing CUGH network, and identify potential collaborations here at Queen’s,” says Jenn Carpenter, Director of the Global Health Team. 

To complete the survey about work being done at Queen’s or to join the CUGH network, visit https://queensu.qualtrics.com/jfe/form/SV_8tXre9zWgcTkuEt.  Please note that the global health survey will collect information on academic global health programs to be shared on the CUGH Global Health Academic Programs Database. Only faculties and departments that would like to share their program on the CUGH academic programs database should complete that particular part of the survey. For further information about the survey, please contact the Office of Global Health.

You can also register online to subscribe to the OGH newsletter.

This post originally appeared as an article in the Queen's Gazette.

BHSc student at laptop
2018-03-19 Bachelor of Health Sciences agreements highlight college-university collaboration

Queen’s University has signed agreements with 10 Ontario colleges which will allow students enrolled in a one-year health-centred certificate program to gain advanced standing in a Queen’s online health degree.

New articulation agreements signed with colleges across Ontario, including Kingston’s St. Lawrence College, will allow graduates of the colleges’ Pre-Health Sciences advanced pathway who enroll in the Queen’s online Bachelor of Health Sciences program to receive credit for roughly one semester of courses.

Colleges who have signed onto this agreement:
• Algonquin College, Ottawa
• Cambrian College, Sudbury
• Fleming College, Peterborough
• Georgian College, Barrie
• Humber College, Toronto
• Loyalist College, Belleville
• Niagara College, Niagara-on-the-Lake
• Northern College, Timmins
• Sheridan College, Toronto
• St. Lawrence College, Kingston

“These agreements are an example of our commitment to collaboration and innovation within the higher education system,” says Principal Daniel Woolf. “We are simplifying the process for qualified students who are seeking a high-quality education in the health field, while also delivering that education in a way that is flexible and forward-looking. We look forward to welcoming these students and helping them begin rewarding careers in healthcare.”

The agreements are effective immediately and are designed to pair the students’ introductory training and experience in health and healthcare with the necessary theoretical knowledge to pursue a variety of health professions or further studies at the university level.

“We are so pleased to work with Queen’s University to be able to offer this new pathway to our students,” says Glenn Vollebregt, President and CEO of St. Lawrence College. “We know that many of our students are just beginning their post-secondary journey and opening up accessible ways for them to be able to achieve their educational goals is an important way we can help them on their career path.”

Post-secondary student mobility has been a priority of the Ontario government. In 2011, the government established the Ontario Council on Articulation and Transfer (ONCAT) to enhance student pathways and reduce barriers for students looking to transfer among Ontario’s 45 publicly assisted postsecondary institutions.

In response, Ontario universities and colleges have stepped up their efforts to develop transfer credit policies and practices, making it easier for students to choose their path through the postsecondary system. According to ONCAT, 55,000 students transfer institutions each year in Ontario.

Queen’s receives dozens of college graduates each year through academic pathways that have been established between individual faculties and colleges across Canada, including a collaborative degree in Music Theatre where students complete two years at St. Lawrence College and two years at Queen’s.

To learn more about the Queen’s online Bachelor of Health Sciences degree, visit bhsc.queensu.ca. Applications for the Spring 2018 term are now open.

This post originally appeared in the Queen's Gazette.

Students in OSCE exam
2018-03-05 Queen's Standardized Patient Program Set for Expansion

Simulated learning is an evolving and expanding aspect of health care education, and one that our faculty has invested heavily in over the last several years. Today, we are excited to announce that one element of the simulated learning programs at Queen's is ready to take things to another level, as the Standardized Patient (SP) & Objective Standardized Clinical Examination (OSCE) Program at Queen’s is preparing to expand to the wider university and Kingston communities. After years of success within the Faculty of Health Sciences, 2018 will mark the official expansion of the program. The mission of the program is to prepare future health professionals for the challenges of an increasingly diverse society.

Standardized Patients (SP) are actors who are trained to convincingly portray the physical, historical and emotional features of a real person for educational purposes. This is done through simulated interviews and examinations; SPs are also trained to provide feedback so students can gain insight into their strengths as well as areas requiring improvement. 

“The standardized patient program allows our medical students and residents the opportunity to practice their clinical skills in a safe and non‑threatening environment. This then translates into success at their OSCEs. The quality of our SPs makes the encounters seem like the real thing,” says Dr. Melanie Jaeger, Anesthesiologist & Medical Educator.

Any department or organization which involves human interaction can benefit from the use of standardized patients as part of their education and training.  Watching our students develop through simulated learning is truly rewarding.  As the request for SP encounters has increased, the program has evolved to meet this growing demand.” says Kate Slagle, the SP & OSCE Program Manager.

Some areas in which SPs can be utilized include: 

  • Interviewing skills and techniques
  • Conflict resolution training
  • Facilitating difficult conversations: Breaking bad news, end of life care, organ donation, etc.
  • Continuing education/training support
  • Role play
  • Mystery shopper experience
  • Lecture hall learning
  • Educational and/or promotional videos
  • Research participants
  • General physical exams and clinical techniques
  • Complex and/or invasive physical exams and clinical techniques

For the past six months, those behind the program have been working with the university to get everything in place to take on external clients. The team is now looking to offer its services to both the wider university community (for staff and student training/development) and Kingston-based organizations (e.g. police, paramedic, fire and correctional departments, and local hospitals and colleges).

The launch is set to begin this month with an open house at the Queen’s School of Medicine Clinical Teaching Centre on March 26, 2018 from 1:00-4:00pm.  At the open house you can learn more about what the program has to offer, take a tour of the facility, and hear testimonials from those who have benefited from the program.

For more information about the open house, program or to apply to be an SP, visit the website. Other Queen’s faculties and community groups interested in utilizing the program can contact Rebecca Snowdon queenssp@queensu.ca.

The Queen’s Standardized Patient & OSCE Program has been operating since 1992 and employs more than 100 standardized patients who assist in clinical skills and examinations for Queen’s Faculty of Health Sciences.

Katherine Soucie, a second-year post-graduate family medicine resident (PGY2), assesses patient Norma Edwards in clinic at the King Edward Memorial VII Hospital (KEMH) in Stanley, the Falkland Islands. (Supplied Photo)
2018-02-26 Queen’s family medicine residents participate in unique Falkland Islands rotation

One of the strengths of Queen’s Family Medicine residents is their ability to work almost anywhere. As a part of their two-year residency, these family doctors spend six months of training in a community setting, and at least two of those months are spent in a rural setting.

So, when a remote British overseas territory off the coast of South America found itself in need of medical professionals, a Queen’s alumnus knew exactly where the Falkland Islands’ government could find help.

“Thanks to a connection made by Andrew Pipe (Meds’74) of the Ottawa Heart Institute, Queen’s Family Medicine residents have been taking on placements in the Falkland Islands in recent years as part of a strategy to help the territory meet their need for well-trained family doctors,” says Geoffrey Hodgetts, Enhanced Skills Program Director, Rural Skills Program Coordinator and Kingston Residency Site Director in the School of Medicine.

While the Falklands previously relied on British and foreign-trained physicians, it has been more difficult to attract doctors with the necessary skills to work in a remote setting such as the small island nation, located to the east of South America’s Patagonia coast. Additionally, providing medical care to the population – which is divided up across several islands – requires medical experts who can work in the field with limited equipment.

Since forming the agreement, approximately six Queen’s family medicine residents per year have headed to the Falkland Islands with one or two residents making the trip at a time. During their rotations, residents work under the direction of the Falkland’s Chief Medical Officer, Rebecca Edwards, and her delegates. 

“We are privileged to work with these skilled, knowledgeable, and experienced young doctors,” says Dr. Edwards. “I am always extremely impressed with the ability of these residents to travel across the globe, to a new country and unknown hospital where medical practices might be unfamiliar, and be able to just get on with the job at hand. The residents seem unfazed by the changes, meeting each new challenge with focus and dedication and asking appropriate questions when needed.”

This rotation gives residents an opportunity to experience the Falkland Islands, and assess their interest in the territory’s available enhanced training scholarship. The scholarship offers a post-graduate third-year training position provided the resident stays for a one-year return of service. Most importantly, it helps the island nation potentially recruit physicians to help meet their needs longer term. 

Belle Song (Meds’15), a Queen’s family medicine graduate, is the first to take advantage of the Falkland Islands’ training scholarship. Dr. Song is currently completing her enhanced rural skills training. When she completes her training later this year, she will work at the King Edward VII Memorial Hospital in the Falkland Islands.

She is already familiar with this setting, as Dr. Song was one of the earliest Queen’s family medicine residents to complete a two-month rotation in the Falkland Islands in 2016.

"From the moment I arrived, I felt that I was a part of the Falklands community. Some of the nurses, pharmacists, radiation techs, and physiotherapists have become close personal friends, and even residents of the island were incredibly welcoming,” she says. “I am certain that this year in the Falklands will help me become a stronger and more confident rural generalist, developing skills that will be useful when I come back to Canada. I've always believed that you can't learn and grow without pushing yourself outside your comfort zone.”

While rural medical training is an expectation among Canadian family medicine post-graduate medical programs, Queen’s Department of Family Medicine has had a long tradition of preparing family physicians for practice in various rural and remote settings.

“I know that the residents enjoy their time with us as we have received great feedback, and this is definitely a two-way relationship,” Dr. Edwards adds. “The constant flow of keen, intelligent, up-to-date young doctors that we get to work with and mentor provide our team with fresh and valuable perspectives on clinical scenarios.”

To learn more about the Falkland Islands scholarship for Family Medicine residents, visit the Department of Family Medicine’s website.

This blog originally appeared in the Queen's Gazette as an article by Phil Gaudreau, Senior Communications Officer. 

The following is a guest blog by Bachelor of Health Sciences student Kyla Tozer.
2018-02-20 Chasing A Dream

The following is a guest blog by Bachelor of Health Sciences student Kyla Tozer. 

The question I kept asking myself - how do you repay someone for saving your life? -  slowly began to have an answer. To my surprise, the answer wasn’t what I thought it would be. I figured that somewhere along my journey I would hear a story, or a doctor would tell me “this is how you can repay us,” but that moment never came. It was such a hard question because the answer was not a tangible thing. I couldn’t put a price on repayment because there is no amount of money in the world that can add up to someone’s life. I finally realized that I needed to change my question - how can help the team that saved my life, continue to save other people? - and this has such an amazing answer.

In 2009, I was diagnosed with a meningioma brain tumour. At the time, the life that I was living was no life at all. I had severe headache pain, worsening vision, hand tremors – things no one should be subjected to. When I received the diagnosis, I thought I would be scared, but ironically, it was the moment when I felt the most at ease. I had such faith and confidence in the neurosurgery team that my worries didn’t seem to surface. I know I am one of the lucky ones; I went into surgery with little to no life ahead of me, and now, because of them, I am in a place where I can grow as a mother, daughter, sister, student, and best of all - individual. 


Video by Faculty of Health Sciences Student Media Team

On May 7th, 2017, the Neuro Race Weekend happened here in Kingston Ontario. This was my way of saying “thank you” for saving my life. When I think back to this day, my emotions overflow. We all arrived at the event at 5am (don’t worry future runners, this isn’t the start time) to begin the preparation. I looked around at the tired faces of those who got out of bed on a rainy Sunday morning to help me set up. We began to load up the trucks and set up the course, I remember laughing and thinking to myself, “I hope people are happy and have fun today”. As I got back to the Norman Rodgers Airport and saw the runners warming up; doctors, nurses, families, and kids were all smiling as they prepared to accomplish something they had been training for for weeks on end. It hit me, I did it - I answered my question. “How do you repay someone for saving your life?” You help them save other people.

Throughout the day, I watched all ages of runners cross the finish line; 500 runners ranging from grade 2/3 at Centennial Public to 90+-year olds just wanting to say thank you. There was a special vibe that day that I can’t explain, it was that moment when people could come together and it didn’t matter if you had a tumour, aneurism, concussion, stroke, spinal surgery, epilepsy, hemorrhage, depression/anxiety, or you just wanted to support someone. Today was the day that were all there to support each other. I have always explained the path to recovery as a bridge, and the neurosurgery team builds us a bridge to get over an ocean of problems. But, it takes the first person walking the bridge to help the next person cross without fear.

The day wrapped up flawlessly, with the military search and rescue helicopter landing to show their support everyone walked away feeling like they accomplished their goal. There is a special thing about Kingston - we are a close community and when we all come together, amazing things can happen. On June 1st, Chase a Dream - Neuro Race Weekend donated $26,533.12 to the neurosurgery department at KHSC. With 63 local sponsors, 500 runners, and a strong community, we made this happen.

There are times in your life when you get to a cross road and one path seems easy, and the other seems terrifying. More often than not, that terrifying path is the one that leads to the greatest discoveries. After the launch of the 2017 Neuro Race Weekend I decided to change my path. I never excelled in high school and the idea of attending Queen’s University was nothing more than a dream in my wildest imagination. But after the surgery and “recovery”, I discovered something that many of us brain injury survivors discover. I was the new me. This new life I have been granted had a brighter future, and being accepted into Queen’s University in Health Sciences has been an accomplishment I would not have been able to gain if it wasn’t for this new life.

May 6th, 2018, we will host the second annual Neuro Race Weekend. We need the support and strength of Queen’s University to come together and support not only the team that saved my life, but the lives of loved ones all around us.

When people think of the Neuro Race Weekend, I want people to think one thing. It’s never too late to say thank you. And most importantly, we are and always will be…

Stronger. Together.

 

To register for the event, go to:

https://raceroster.com/events/2018/14404/chase-a-dream

To donate to one of our runners, Joseph, go to:

https://www.gofundme.com/fund-joseph-to-the-finish-line

To learn more about us, visit our Facebook page: @neurohalf

CMA Candidates
2018-02-13 Civic professionalism – why leadership matters

By Chris Simpson, MD

We can all be forgiven for being a bit cynical about leadership these days. “Fake news”, “alternative facts” and endless political spin seem to have replaced critical discussions and debates of ideas. Identity politics have polarized debate on everything from social issues to economic policy. Social media, though positively transformative in so many ways, have (somewhat ironically) served to separate and silo us; reinforcing our biases and feeding a culture of cognitive dissonance. As opportunities for consensus and compromise seem to diminish, a fundamental question arises: Where have our leaders gone?

As health care professionals who have been entrusted with the privilege of self-regulation, we have a special responsibility. It is our job to serve our patients and clients and to discharge our fiduciary duties faithfully. There is a certain nobility inherent in these professional-patient partnerships; our commitment to put patients and families at the centre of everything we do builds trust. It is right and proper that we advocate for those we serve. It is the essence of our professionalism.

But is this enough? Is this the limit of what we have to offer society? Or is there a broader responsibility and leadership opportunity? What do we owe to the health care system, to our educational institutions and to equity-seeking groups? How should we be contributing to the development of economic and social policy both in Canada and internationally? It can be reasonably argued, I would submit, that if we accept the fact that the health and well-being of our patients and fellow citizens is critically impacted by things like poverty, inadequate housing and food insecurity, we should be keenly interested in the development of solutions. In an era of fiscal restraint in health care that has directly impacted our ability to provide care, we should be heavily invested in helping to secure a strong and growing economy that can underwrite stable, predictable and planned incremental investments and innovations in the health and wellness sector.

Our roles as trusted professionals provide us all with a platform on which to build a new civic professionalism, in which we see ourselves as leaders in pursuit of a better, healthier society. When we explore our roles as stewards, innovators, advocates for system reform, policy contributors, and knowledge translators, we can start to envisage a professional persona that, while always grounded in our bedside role, also strongly embraces our broader responsibility to society as a whole. Canadians want and need us to lead.

It is in this spirit that I write enthusiastically today about the upcoming election for the next Canadian Medical Association president-elect nominee. There are four outstanding candidates vying for the position. The winner, if affirmed by CMA General Council, will serve as CMA president in 2019-2020.

Sandy Buchman (http://voteforsandy.ca/) is a family physician practicing predominantly in palliative care. He has served as a president of both the College of Family Physicians of Canada as well as the Ontario College of Family Physicians. Sandy is a well-respected leader with a long track record. He has put forward a three-pillar platform: A CMA for Physicians, A CMA for Trainees, and A CMA with Patients.

Mamta Gautam (http://votemamtacma.ca) is a psychiatrist at the Ottawa Hospital, the President and CEO of Peak MD Inc. and an expert in physician health and physician leadership development. An accomplished leader and the winner of numerous awards, her campaign has been based on three themes: taking care of the self, taking care of the system, and taking care of the future.

Atul Kapur (https://atulkapur.ca/) is an Ottawa-based Emergency physician who serves as President of Physicians for a Smoke-Free Canada and as a Director at the OMA. He has served on the CMA Board for several years. Thoughtful and articulate, Atul has laid out a three-point platform focused on physicians, patients, and the system.

Darren Larsen (http://larsen4cma.com) is an experienced physician executive with a masters certification in physician leadership. He is a family physician, the Chief Medical Information Officer at OntarioMD, and the Vice-Chair of the Cancer Quality Council at Cancer Care Ontario. He has presented three campaign themes: decisive action for Canada’s election in 2019; diversity, respect and our medical culture; and supporting physicians and innovating in our health system.

We are truly fortunate to have four experienced and committed leaders who all understand the importance of positive leadership. They are all grounded in the principles of our fundamental professionalism, but they all also demonstrate a sense of civic duty as well; seeking to lead a CMA that has become more than just the national association of Canada’s doctors.

Don’t forget to make your voice heard! Voting opens for all CMA members from Ontario on Feb 15, 2018 (https://app-7-live-cma.e1c.vote/interface/#/auth). You’ll need your CMA number and the PIN you will have received in the mail.

Good leadership has never been more important. Thank you, Sandy, Mamta, Atul and Darren for offering so graciously to lend your talents to the CMA. And thanks to all the health professionals out there – in both formal and informal leadership roles – for embracing your duty to serve.

 

 

 

 

 

 

Some research studies have found light to moderate drinking to be protective of heart health; others have found long term drinking to be damaging. (AP Photo/Richard Drew)
2018-02-05 Is drinking wine really good for your heart?

This article was originally published on The Conversation. Read the original article.

Adrian Baranchuk, Queen's University, Ontario; Bryce Alexander, Queen's University, Ontario, and Sohaib Haseeb, Queen's University, Ontario

As the weekend approaches, people are opening wine bottles in bars and restaurants and homes around the world, ready to kick back and relax.

This relationship with wine has a long history. The oldest known winery, dating back to 4100 B.C, was discovered in 2010 by archeologists in an Armenian cave. Wine was used in ceremonies by the Egyptians, traded by the Phoenicians, honoured by the Greek God Dionysus and the Roman God Bacchus. By 2014, humanity was consuming more than 24 billion litres of wine every year globally. Now there is some fear that extreme weather events in western Europe during 2017 have reduced production substantially and prices of this high-demand commodity are set to rise.

So why is wine so popular? Aside from its flavours, and capacity to help people relax, wine has gained something of a reputation as a “healthy” alcohol — with researchers in the past noting associations between red wine drinking in France, and lower incidence of heart disease.

However, wine drinking is also known to increase risks of serious health issues, including liver cirrhosis, sudden cardiac death, alcoholic cardiomyopathies and cardiac rhythm disorders. Excessive consumption and chronic misuse of alcohol are risk factors contributing to an increase in global disease.

How does the average drinker know what to believe? And how much wine is safe? As medical researchers, we recently published an in-depth analysis of the anatomy of wine. This included analysis of the risks and benefits of consumption, comparisons with other alcoholic beverages and a discussion around wine’s much publicised health benefits.

Wine and heart disease

Modern scientific intrigue surrounding wine has grown immensely since the 1970s, when large, international studies first reported a link between light-to-moderate consumption of alcohol and lower rates of ischemic heart disease (IHD) occurrence and associated deaths. IHDs are a group of diseases characterised by a reduced blood flow to the heart, and account for significant deaths worldwide.

Similar results have been reported individually for wine, specifically red wine. This phenomenon was eventually coined “the French paradox” after Renaud and de Lorgeril, two scientists who became known for this work, observed a relatively low risk of IHD-associated mortality in red wine drinkers despite a consumption of a diet rich in saturated fat.

Does this mean red wine is good for the heart? This is a complex question and as yet there is no consensus on the answer. More than one factor needs to be considered in order to explain this situation. Drinking patterns, lifestyle characteristics and dietary intake are all important for individuals to obtain a healthy cardiovascular profile.

The Mediterranean diet has been put forward as one explanation. This diet emphasizes consumption of plant-based foods in addition to the moderate consumption of red wine and has been labelled as beneficial by scientific advisory committees.

In the Mediterranean diet, the low-consumption of saturated fat, emphasis on a healthy lifestyle, and more independently, alpha-linoleic acid (an essential fatty acid) and red wine, may allow this diet to confer the much researched cardio-protective benefits.

Cholesterol, inflamation, blood pressure

Red wine contains over 500 different chemical substances. One class, called “polyphenols,” has been widely investigated for imparting the apparent antioxidant and anti-inflammatory effects of red wine.

Alcohol and polyphenols are thought to have several positive health impacts. One is a contribution to an increase in HDL-cholesterol or “good cholestrol” and a decrease in LDL-oxidation or “bad cholesterol.” They also contribute to a decrease in inflammation. They are thought to increase insulin sensitivity. And they are understood to improve blood pressure.

There is no consistent pattern when wine is compared to beer and spirits. Some report wine’s superiority in a reduction from IHD and mortality. Others report it for beer and spirits. Others suggest there is no difference. This suggests that alcohol and polyphenols both contribute to explaining the French paradox, in addition to lifestyle factors.

Despite the beneficial effects of wine and alcohol consumption, drinking is still a potential risk-factor for atrial fibrillation, the most-common “rhythm alteration” of the heart.

How much should you drink?

In much of the research, adverse effects were increasingly observed with excessive or binge-consumption of wine, while low-to-moderate intakes lowered IHD and mortality risks.

In response, various governing bodies have come forth with guidelines for alcohol consumption. These follow similar patterns, but vary remarkably by country and source. And the definition of “one standard drink” used in each guideline is highly variable, and discrepant between country borders. This causes great confusion. Readers should be wary of this when interpreting alcohol consumption guidelines.

Most guidelines suggest a moderate consumption of no more than one or two alcoholic drinks per day. But is yours a 4 oz. or an 8 oz. glass? (Shutterstock)

 

The World Health Organization recommends low-risk alcohol consumption of no more than two standard drinks per day with at least two non-drinking days during the week. Here one standard drink is defined as 10 g of pure ethanol.

The American Heart Association recommends alcohol in moderation — less than or equal to one to two drinks per day for men and one drink per day for women. Here one drink is defined as 12 oz. of beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits.

The Dietary Guidelines for Americans 2015 – 2020 developed by the United States Department of Agriculture recommends a moderate consumption of alcohol. This equates to up to two standard drinks per day for men and one for women. Here, one standard drink is defined as 14 g of pure ethanol.

The Canadian Centre for Addiction and Mental Health guidelines recommend low-risk alcohol consumption — up to three drinks per day for men and two for women. One drink is defined as 12 oz. of 5 per cent beer, 5 oz. of 12 per cent wine, and 1.5 oz. of 40 per cent spirits.

Future research opportunities

Observational data around alcohol consumption and heart health suggests that a light-to-moderate intake, in regular amounts, appears to be healthy. However, when mathematical models have been applied to determine causation (an approach known as Mendelian randomization) the results have been mixed.

Some studies have found light-to-moderate drinking beneficial, while others have reported long-term alcohol consumption to be harmful for the heart.

For doctors, it is quite clear what to recommend to patients when it comes to diet, exercise and smoking. Given the inconsistencies in the findings relating to alcohol, and wine specifically, recommendations for consumption are less obvious.

For wine drinkers too, definitive answers on wine and health remain elusive. There is, however, immense research potential in this area for the future.

And as all the guidelines say, one or two glasses of red wine tonight will be just fine.

 

Adrian Baranchuk, Professor of Medicine, Queen's University, Ontario; Bryce Alexander, Medical Student, Queen's University, Ontario, and Sohaib Haseeb, Student, Queen's University, Ontario

This article was originally published on The Conversation. Read the original article.

Office of Professional Development and Educational Scholarship
2018-01-29 An Integration of Health Sciences Education Offices

Guest blog by Dr. Leslie Flynn, Vice-Dean of Education, Faculty of Health Sciences

After careful planning and discussion of opportunities to improve delivery of educational programs, we are pleased to share news of an integrated office in Health Sciences – the Office of Professional Development and Educational Scholarship. One common administrative structure will leverage the strengths and expertise of four former offices within Health Sciences, including the Office of Health Sciences Education, the Office of Global Health, the Office of Faculty Development, and the Office of Continuing Professional Development.

The amalgamation is the result of a two-year strategic planning process undertaken to map the landscape for the new structure. Senior members of the office and faculty were engaged in this planning process, though they have since transitioned the process to the office team to continue the work of operationalizing the change.

“We are excited for the potential that this change will bring,” says Dr. Richard van Wylick, Interim Associate Dean of Continuing Professional Development and Director of Faculty Development. “We now can more easily align our teams of experts on projects, and expect to achieve more success with this group of dedicated and high-performing people.”

The Office of Professional Development and Educational Scholarship will work collaboratively through an inter-professional approach to meet the needs of learners, educators, scholars, and practitioners. The integrated office will continue to offer services in the core areas of Education Science, Global Health, Faculty Development, Continuing Professional Development.

As the office progresses with development of a new vision and mission, we will also embark on a formal process to engage stakeholders in the creation of a new official name and brand. Our team will operate under the temporary name of “Office of Professional Development and Educational Scholarship”, however we anticipate that a potential outcome of the stakeholder engagement process may be a new permanent name. Our office also looks forward to receiving guidance and direction from stakeholders with regard to external branding and marketing; the process will include a review and guidance for direction on the offices three active websites for Health Sciences Education, Global Health, and Continuing Professional Development.

This integration of four offices into one team is a positive change that will bring many benefits. These four offices have collaborated on projects and programs for a number of years, and their integration is simply a formalization of those existing relationships. With the integration, and with a new shared vision and mission, we expect the team to continue on their successful path with tremendous contributions to education for health care professions.

Person with walker in hospital
2018-01-23 The “Big Squeeze” on hospital budgets in Ontario: Get ready for the backlash

Since shortly after the 2008-2009 downturn, Ontario’s relatively modest economic growth has meant for public services a prolonged period of austerity. For the healthcare sector, where annual growth had previously been in the 6.5% range, the change from the base of 2010-11 to 2.6% per annum, representing a slight decline in real per capita terms, has been painful. This reduction in spending growth has been largely borne by the hospital sector, where after contracted salary increases, inflation, etc., are factored in, there has been essentially zero growth for nearly a decade. Continued restraint in health spending, which now exceeds 40% of the total, anchors the government’s 2017/18 balanced budget projection.

At the same time, the much discussed demographic shift has started. The Baby Boomers are starting to retire: the number of Canadians over the age of 65 will double in 20 years and those over 85 will quadruple. While this is surely a reason to celebrate, it also presents daunting challenges. How do we transform our acute, episodic illness focused, hospital dominated “system” into one that also accommodates to the new health care landscape filled by people with multiple, complex, chronic diseases who need, want, and should have care in their own homes and communities?

The solution, so the thinking has been, would be for us to invest more in chronic care and community-based solutions rather than in hospital care. The new care model would be more appropriate for the chronic disease paradigm, closer to home, more team-based, and cheaper. Meanwhile, hospitals would be freed up to do what they are supposed to be doing – looking after acutely ill people – rather than being overfilled with patients waiting for home and long term care. Squeezing hospital budgets will force efficiency, and we can invest proportionally more in the community resources that patients increasingly need.

So how is it turning out?

Hospitals have certainly been squeezed. Effectively flat budgets have forced some efficiencies, like some decreases in lengths of stay (despite increasing complexity of patients) and some limited improvement in wait times for targeted surgical procedures. But in broad strokes, what has happened (very simply) are hospital program cuts; real reform continues to be frustrated by the “system’s” siloism and the agonizing slowness in expanding the capacity of home and community care to relieve hospitals of ALC patients[1] and of primary care to provide care for patients 24/7. Meanwhile, the volume of patients presenting to hospital increases unabated. Emergency Departments and hospitals are more congested than ever, alternate-level-of-care (ALC) patient numbers are at an all-time high, and occupancy rates hovering around 100% (and often higher) have made “Code Gridlock” (a term used to describe the inability to move patients through the system because of congestion) a daily rather than an occasional reality. Hospital leadership teams are increasingly consumed with just getting through the day – managing patient flow – rather than having time to think strategically about reform. And so, hospitals find themselves in a position where they can’t control their inputs, can’t control their outputs, and cannot make investments outside their walls in order to influence either.

There has been some progress. The HealthLinks initiative, which aims to deliver better, more efficient care to the sickest 5% of our population, is a good example. Despite all the hype, the recent re-jigging of Community Care Access Centre (CCAC) services into a LHIN-controlled model promises no meaningful impact. No home and community care initiative is making enough of an impact to slow the relentless increase in demand for hospital services. Those in charge of and working in Ontario’s hospitals are well aware that the Ontario Government is determined to keep healthcare spending in line with economic growth and avoid a repeat of the mid-1990s when a period of austerity was followed by a catch-up spending boom . But hospitals are in crisis. They have deferred significant capital spending. They have squeezed all the efficiency they can out of their operations. Health professionals and hospital leaders are exhausted. And the demographic tsunami has only begun. Genuine reform of the healthcare “system” has to get in gear very soon because a backlash is imminent.

If patients keep coming in increasing numbers and nothing is done about their ALC patients, hospitals will need a significant cash infusion very soon. As the congestion continues to worsen, any efficiency gains that have been made will be threatened. It is crucial that new investments be targeted at “anti-gridlock” initiatives. The creation of a “pull” culture (where patients are actively moved along to the next point in their care trajectory) to replace the current “push” culture, together with a funding model whereby money follows the patient wherever they are in the system would help. Running hospitals at full capacity on the weekends, as we do during the week, would also make a big difference. Enhanced regionalization would help to knit the silos closer together. And getting community-based and hospital-based teams together to better manage the transition points in patient care is absolutely essential. It is at the transition points where mistakes are made, negative perceptions are born, and inefficiencies are generated.

There is no doubt that we need to “de-hospitalize” our system to a significant degree. But it is clear that crude budget cutting has not accomplished the reform we need. Hospitals have been squeezed, but the transition to a community-based health system remains in its very early days. These years of squeezing the sponge have bought us time, not change. And now we are out of time.

[1] https://www.google.ca/search?q=Walker+report%2COntario+ALC&oq=Walker+report%2COntario+ALC&aqs=chrome..69i57.14513j0j7&sourceid=chrome&ie=UTF-8

***

This post was originally co-authored by Dr. Chris Simpson, Dr. Ruth Wilson, Dr. David Walker, Don Drummond, and Dr. Duncan Sinclair for Queen's School of Policy Studies. 

Stethoscope
2018-01-15 Why is Transformation of Healthcare so Hard?

The need for change in healthcare has been obvious for years. Many studies have been conducted and recommendations made on what’s needed to meet optimally the needs of the population in the current and coming decades. But change itself has been very scarce.

One reason is that none of our 14 provincial/territorial/federal healthcare delivery ‘systems’ has a single governance; the place where the ‘buck stops’ with respect to what each does and does not accomplish and how well or poorly. It is only by default that Canadians hold their governments accountable for how well their hospitals, physicians, pharmacists, and other providers meet their changing needs for healthcare services. On the other hand that there are 14 ‘systems’ could be an advantage as it was when Saskatchewan’s pioneering introduction of Medicare was copied by other jurisdictions.

That there is no governance of healthcare’s delivery rests on David Naylor’s phrase “public payment for private practice”. Throughout Canada, healthcare services are provided in the main by private individuals, organizations and institutions that are answerable only to their owner/operators and/or their boards of directors. Our publicly funded healthcare systems are, in fact, healthcare insurance systems intended to remove, in part, the financial barrier between those in need of healthcare services and those who provide them.

Oxford defines system as a “complex whole, set of connected things or parts, organized body of material or immaterial things”. The key words are connected and organized, neither of which can be applied legitimately to the several elements that we refer to glibly as our healthcare ‘system’ – hospitals, physicians, nurses, physio-and occupational therapists, pharmacists, dentists, optometrists, home care, public health, etc. There are 23 separately regulated health professions in Ontario alone, over 200 hospitals, nearly 1,000 independent health facilities, and an indeterminate number of other community based organizations and agencies, all of which provide to the public some form of health or healthcare service. Making the transformative changes to knit this whole collection together, connecting and organizing all of them into a complex whole, thereby creating a genuine system, is a daunting prospect under any circumstances. It may well be mission impossible given that a substantial number of these many and varied providers, especially those currently operating what are considered to be independent businesses, do not accept the need for direction by a system’s governing body nor, indeed, for their particular healthcare business to connect with any other.

Another reason why change is so hard is that the hierarchies established over five decades of Medicare are well entrenched. Those at the top, hospitals, physicians, and nurses are understandably resistant to proposals for change that would diminish their standing or incomes. They fear the ‘zero sum game’ in our contemporary no- to slow-growth economy and resist change of the kind that, for example, would mean less funding for hospitals and physicians’ services and more for home and community services. No political party, whether in government or in opposition, relishes the challenge of countering the very public ‘death-in-the-streets’ rhetoric that they know would result from such proposals.

And then there are the bureaucrats on whom, under the status quo, governments depend for regulatory control. Bureaucracies, especially of governments, are notorious for their resistance to losing control, status, income, and employment, particularly if the changes recommended involve devolution of authority to regional or sub-regional agencies or to the providers of services themselves, as many reports have recommended.

Another reason for the absence of change is public complacency. For years evidence has been accumulating that healthcare services in Canada are both harder to access and of lower quality than those in comparable OECD countries yet cost the consumer/taxpayer more. But the myth persists that the Canadian ‘system’ ranks among the best in the world, relieving governments and political parties alike from ballot box pressure to lead transformative change. And at the ‘coal face’ where patients and families interact with providers, it relieves the latter from having to meet what should be much higher expectations for faster access, better communication, and higher quality services and outcomes all around.

Finally transformative change has not occurred because right up to the present day Canada and its provinces and territories have not faced a crisis sufficiently severe and prolonged as to overwhelm resistance to change or to shake the public’s passive acceptance of paying high costs for a narrow range of services of mediocre quality. Heretofore governments have had enough money to avoid the challenge of change. They have had enough to ‘buy peace in our time’ as it were, to wait for the economy to turn up again as it did in the mid 1990s. In this second decade of the 21st century everybody, governments and providers alike, could well be in for a very long wait.

***

This post was originally co-authored by Dr. Chris Simpson, Dr. Ruth Wilson, Dr. David Walker, Don Drummond, and Dr. Duncan Sinclair for Queen's School of Policy Studies. 

CCTG logo
2018-01-08 Major clinical cancer trial collaboration announced

The internationally-recognized, Canadian Cancer Trials Group (CCTG) at Queen’s University, together with the US-based Cancer Research Institute (CRI), announced a multi-year, multi-trial collaboration today, designed to accelerate the clinical development of new immunotherapy treatments for cancer.

There are currently 940 immunotherapy agents in clinical development, all of which have the potential to improve the standard of care for patients fighting myriad types of cancer.  This new partnership will combine CRI’s expertise in immunology research and therapy with CCTG’s expertise in the design and execution of clinical trials to improve the practice of treating cancer and to enhance the quality of life for cancer survivors.  The collaboration is a multi-trial agreement over a five-year period.

“International collaborations and partnerships are essential to the success of clinical trials and are critical in moving the cancer research agenda forward. We will leverage the strengths of both CCTG and CRI in this strategic collaboration, to bring important improvements in cancer therapies to the patients who need them,” says Janet Dancey, CCTG Director.

Broadly, immunotherapies work by stimulating a patient’s own immune system to attack the disease, either by generally strengthening its function or by leveraging it to target cancer cells.

“Combating cancer demands the expertise and cooperation of the world’s top minds,” says John Fisher, Interim Vice-Principal (Research). “Queen’s University has long been the home of CCTG’s groundbreaking research group, which includes many of our esteemed faculty members. We are very proud to see their efforts continue to evolve into exciting international collaborations like this newly-minted partnership with the renowned Cancer Research Institute.”

CRI is a non-profit organization that has supported the discovery and development of immunotherapeutic cancer treatments for 65 years. Its unique clinical program, the Anna-Maria Kellen Clinical Accelerator, supports non-profit, academia, and industry partnerships designed to develop and organize the clinical study of combination cancer immunotherapies. 

“This collaboration is what great partnerships look like – uniting CRI’s cancer immunology expertise with the clinical research expertise and global footprint at CCTG, which I’ve observed is the fastest and most effective cooperative group worldwide,” says Aiman Shalabi, Chief Medical Officer, Clinical Accelerator, CRI. “Together, and with our combined global expert network, we will accelerate innovation for patients.”

CCTG is a non-profit cancer research cooperative and is recognized as being one of the most impactful and influential research groups, with a proven record of accomplishment in the rapid and efficient conduct of studies across an extensive network in Canada and around the world. Currently, CCTG is running phase I-III trials of cancer treatment and supportive therapies at over 80 institutions across Canada and internationally.

This article was originally written for the Queen's Gazette by communications coordinator Dave Rideout.

Pike cottage in England
2017-12-19 A forecast of my next six months

I’m not sure exactly what I’m going to do with myself. Though not entirely true, I am about to start six months, technically known as administrative leave and commonly known as sabbatical. So, you won’t see me blogging until I get back in July, but I assure you that I will be back reenergized, recharged, and firing on eight cylinders for my final two years in my term as dean. I’m very much excited for the next six months, but as I have never taken any prolonged time in the last forty years, I’m not altogether certain how I will cope with anything less than the hour-by-hour structure I’ve become accustomed to. But I am looking forward to trying. One thing I am certain of, is that my wife Cheryl, although she may be excited to be spending a bit more time with me, will not want me around the house 24-7!

So here is my plan.

Twenty-two years ago, I had the good fortune to be the founding director of what is now known as the Wilson Centre. This is a centre dedicated to the focus of my academic scholarship, namely research in health professions education. The good folks at the Wilson Centre have been kind enough to provide me with an office for the first three months of my administrative leave. From that perch, I will plan on carrying on with some research in and around the transformation of our residency programs to CBME. I will also be involved in graduate student education. And I very much hope to do some writing, which has long been pushed to the side of my desk. During this time, I have a lot of travel planned. At the beginning of February, I will be travelling to Ethiopia to visit Haramaya University, where together with the Royal College of Physicians and Surgeons of Canada (RCPSC), I will be exploring, on behalf of Queen’s, a potential partnership in residency education. Later that month, I will be the inaugural Professor-in-Residence at the RCPSC for a two-week period. In March, I am planning to travel to Chicago, where I will be formally exchanging ideas about residency education with both the Accreditation Council for Graduate Medical Education (ACGME) and the American College of Surgeons.

For my second three months, I will be travelling to England. We have already rented an English country cottage in a small town, Stow-on-the-Wold. So I will be living in the Cotswolds and training into London where I’ll be working. While in the UK, I will be a Visitor at Imperial College of London to which I was appointed as an honorary Professor in 2007. Imperial College is regarded as one of the leading institutions in surgical education in the world, and I’m confident I will learn much there to bring back to Queen’s. I will also be spending time at the Royal College of Surgeons of England, with whom I have recently been involved with, consulting on CBME. I also have plans to travel to Dublin to the Royal College of Surgeons of Ireland, an organization that has pioneered the use of digital media for surgical training.

During my administrative leave, I also plan on lecturing, and currently I’m scheduled to deliver keynote lectures at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) in Seattle, the Royal Society of Medicine (Coloproctology Section) in Guildford, England, and the Kergin Lecture for the Department of Surgery at the University of Toronto.

I am certainly excited for the next few months, and know that the Faculty of Health Sciences will be in excellent hands with Dr. Chris Simpson serving as Acting Dean. Most of our readers will know Chris, an outstanding cardiologist and former Division head at Queen’s, our former President of the Canadian Medical Association, and our current Vice Dean (Clinical) in the faculty. I am very grateful to Chris for agreeing to step in, and know that he will have the entire faculty’s support for the next six months.

Best wishes to all of my readers here for a very terrific holiday season and a happy new year. Before you know it, six months will pass quickly by, and I will be back blogging. See you soon.

Richard

Sandra, Pam, and Wendy
2017-12-11 A million thanks to our staff

In the Faculty of Health Sciences, we are blessed with a very large staff of nearly 750 individuals who, day in day out, work extremely hard to enable our academic mission to thrive. One thing we don’t do often enough is say thanks. This blog is dedicated to all of our staff.

For many, the reason they work in the Faculty of Health Sciences is that the work we do, researching important areas for the health and well-being of our populations, and teaching and training the next generation of scientists and clinicians, resonates so strongly. To be sure, we could not do any of this without the support and dedication this amazingly talented and strong group of staff.

Last Thursday, Principal Woolf held his annual Staff Appreciation event at the ARC, where he handed out nine Special Recognition for Staff Awards. This year, those of us in the Faculty of Health Sciences were proud to learn that three of our outstanding staff members were being recognized by the principal this year: Sandra Turcotte, from the School of Rehabilitation Therapy, and Wendy Cumpson and Pamela Livingston, from the Department of Biomedical and Molecular Sciences (pictured together above).

There were many cheers in the crowd as our three colleagues stood to accept their award from Principal Woolf for their “outstanding contributions to the learning and working environment at Queen’s at a level significantly beyond what is usually expected.” Principal Woolf was kind enough to share his remarks from the event with me below, which are based off of the nomination letters written by their colleagues and the students they support.

Sandra Turcotte, School of Rehabilitation Therapy

Since 1999, Sandra Turcotte has been the backbone of the School of Rehabilitation Therapy.

Imbued with compassion and a quiet leadership style, she also possesses the confidence to make hard decisions when required. Sandra does not back away from challenges. Instead, she gathers information, consults others and develops the best course of action.

Sandra nurtures her staff, ensuring that they have the required skills in a changing workplace through in-house education and continuing development opportunities. She recognizes ability and promise in new employees and mentors them through to positions of greater responsibility.

Sandra is fiercely loyal and will go to bat for her work colleagues, family and friends. Her zest for life is infectious and contributes to a happy, positive work environment. Sandra brings the school together. Sandra is content to stay out of the limelight and is happy to see that light shine on others.

Today, the limelight belongs to Sandra.

Pamela Livingston, Biomedical and Molecular Sciences

Pamela Livingston’s attention to detail ensures that the entire biochemistry laboratory teaching program runs like a well-oiled machine.

As a senior technician, Pamela provides a nurturing teaching environment for about 150 undergraduate biochemistry and life science students and eight teaching assistants. She is accommodating and willing to adjust her role to make the lab experience as positive and efficient as possible. Her detailed notes and “cheat sheets” help to keep everyone on track. Her approachable nature encourages one and all to reach out without hesitation.

Pamela is a huge advocate for her students. If an experiment does not yield the best results possible, she will troubleshoot and adjust the protocol until it meets her high standards.

Pamela’s vivacious spirit is renowned. She has been known to wear a tiara on special occasions and hand out gold star stickers for exceptional work. Her exemplary organizational skills make it easy for new staff to join the team and adapt quickly. She literally wants the university to shine and will come in to clean up after hours to prepare the labs for tours and the new school term.

Wendy Cumpson, Biomedical and Molecular Sciences

With her exceptional organizational skills, discipline, and capacity for hard work, Wendy Cumpson is known as the “go-to” person in her office – always willing to take on new challenges.

Last spring, when the department was accepting a flood of new applications for its new graduate programs, Wendy took the lead in processing that flood – on top of her other responsibilities.

Wendy demonstrates the highest standards of ethics and responsibility, and takes great pride in her work. She knows the regulations and has every nuance memorized. Graduate students know they can trust the information she provides without question. Wendy knows every single graduate student by name. That makes each one of them – and there are a lot of them – feel important.

Wendy is always willing to help others by lending an ear and giving expert advice. As one graduate student remarked, “I go to the fifth-floor office to freak out at least once a week, and Wendy is always there to provide warm words of encouragement. She calmly assesses the situation and provides me with the resources I need.”

***

Congratulations to Wendy, Pamela, and Sandra on this well-deserved honour. They are a shining example of the Faculty of Health Sciences staff who work tirelessly every day to support our faculty members, students, academic programs, and research initiatives. Thank you to each and every one of you.

Richard

2016-17 Dean's Report Cover
2017-12-06 The 2016-17 Dean's Report

I am pleased to share with you the 2016-17 Dean's Report, which is now available online, with a print version on the way. The report serves as a retrospective on the year we’ve had and is full of successes across our three schools. In the interest of giving you a sneak peak, I've shared my opening remarks, with mention of some of the stories that you’ll see highlighted in this year’s report.

View Report

Queen’s University has, for many decades, been known for its phenomenal student experience. But in recent years, there has been a big collective push to realize our goal for a balanced academy by combining that excellent student experience with an intensified research environment. There is a general appreciation around campus that what’s needed most, notwithstanding increasing challenges in the funding environment, is a redoubled focus on fortifying our research endeavours.

Our Faculty of Health Sciences has long been committed to the notion that we are an essential contributor to the university’s research mission. Success in that mission is measured, in part, by research revenues.

For many years, our faculty has hovered between $75 and $90M in research revenues. This year, we are pleased to present, in this report, a new threshold for success – $118M. Although one shouldn’t be wed to the exact number, breaking the $100M barrier for our small faculty is a significant milestone.

All hands have been on deck. Under the guidance of our Vice-Dean (Research), Dr. Roger Deeley, the $118M has come from all sectors of the faculty, across all three schools, across all disciplines, and across all of the four Canadian Institutes of Health Research pillars: biomedical research; clinical research; health services research; and social, cultural, environmental, and population health research.

The breakdown of the revenues for this year (as highlighted on page 6) reveals that, while we have held our own with respect to major federal grant funding, we have intensified our growth on the industry and corporate side of research. It is my view that this traces to – first and foremost – spectacular successes in the Canadian Cancer Trials Group, and also the product of what is now a five‑year‑strong industry engagement strategy across the entire faculty.

We’ve proudly listed recent successes that have surpassed the $500K threshold on the next few pages, though we are very aware there is a long list of other grants and contracts that have collectively contributed to the final total.

There are, of course, many research‑related elements to celebrate, in addition to the strengthened revenues. This year we have seen significant progress, led by Dr. Deeley, on our vision to create Canada’s first Integrated Research Institute between a Faculty of Health Sciences and its academic hospital partners.

We are proud of the progress made through the International Centre for the Advancement of Community Based Research (ICACBR) under the leadership of Dr. Heather Aldersey. The ICACBR team recently secured a $20.4M partnership between Queen’s University, the University of Gondar in Ethiopia, and the MasterCard Foundation.

We stood alongside our hospital partners with pride as Kingston Health Sciences Centre unveiled the William J. Henderson Centre for Patient‑Oriented Research, which will serve our faculty dedicated to this specific type of inquiry.

We celebrated the launch of Queen’s Cardiopulmonary Unit (Q‑CPU), which recently opened its doors. The unit is a testimony to the vision and leadership of our Head of Medicine, Dr. Stephen Archer, and a strong team of scientists and clinicians dedicated to pulmonary, cardiac and vascular research.

Part of our agenda is to advance transdisciplinary research efforts and collaborations. A great example of this is a project led by Dr. Marian Luctkar‑Flude, which studies the after‑care breast cancer survivors receive from their primary care practitioners. Along with an expert panel that included an oncologist, family physicians, nurse practitioners, and breast cancer survivors, Dr. Luctkar‑Flude identified 21 key recommendations for post‑treatment breast cancer survivorship care as part of her research.

We have an enormous amount to be proud of in this year’s activity in the Faculty of Health Sciences beyond the realm of research. Our three schools remain incredibly popular for prospective students, and our student satisfaction metrics are off‑the‑scale high. We continue to advance our agenda of educational innovation through initiatives like the significant transformation of our 29 specialty medicine residency programs to competency‑based education, the elaboration of a Doctor of Science in Rehabilitation and Health Leadership, and the spectacular success of our Healthcare Quality program, with a recent approval of a new PhD stream.

Thank you to the faculty, staff, and students who have made this year an exceptional one. We have set these new milestones together.

Richard

 

Looking forward to accepting our first students in the DSc in Rehabilitation and Health Leadership
2017-11-27 Looking forward to accepting our first students in the DSc in Rehabilitation and Health Leadership

The following is a guest blog by Dr. Marcia Finlayson, Vice-Dean of the Faculty of Health Sciences and Director of the School of Rehabilitation Therapy.

Through the spring and fall of 2017, the School of Rehabilitation Therapy received all of the necessary approvals from Queen’s Senate, Ontario Universities Council on Quality Assurance, and the Ministry of Advanced Education and Skills Development to launch a new innovative doctoral-level program. The Doctor of Science in Rehabilitation and Health Leadership (DSc RHL) is the first of its kind at Queen’s University. Our first cohort of students will begin their studies on May 1st, 2018.

Over the past two years, the faculty of the School has been working hard to develop this 36 month executive-style program. The program’s development and curriculum were informed by extensive consultation with stakeholders, including national-level healthcare organizations. We designed the curriculum to equip currently practicing rehabilitation and health professionals with the knowledge and skills they need to confidently pursue career opportunities requiring advanced competencies in leadership, program development, applied research and evaluation, advocacy, change management, and knowledge translation. The program and its curriculum was developed to fill a recognized gap in the preparation of leaders in the rehabilitation and health sector that has evolved as demographic shifts, funding challenges and other factors are pushing transformations in service delivery. Current entry-level programs for rehabilitation professionals must focus on knowledge and skills necessary to enter the profession, rather than to advance through one’s career and into more demanding and challenging roles. Our goal is to prepare individuals who want to feel confident and flourish in these roles – or who want to move into these roles in the future.

Students admitted into the program will be able to continue working while completing the degree, through a blend of on-campus intensive sessions and online-learning. The program will offer a mix of core and elective courses so that students can tailor their programs to their career goals. In addition, we developed a unique applied thesis model specifically for this program through which students will identify a real-world problem in a rehabilitation or health setting, and design, implement and evaluate a process, program or system to address this problem. This approach will enable students to carry out applied research that can have a direct impact on rehabilitation and health programs and services in real-life contexts.

Because rehabilitation is by nature inter-disciplinary, the program is open to all professionals whose backgrounds or future career goals focus on advancing programs, services, and systems that will positively influence the everyday lives of people affected by or at risk of disability. Our applications are currently open – for more information, please visit the program website at http://rehab.queensu.ca/programs/dsc

All of the members of the School are very excited about this program, and look forward to accepting our first students!

Co-creation
2017-11-21 Engaging in the change: Co-creation

The following guest blog was written by a friend and colleague, Dr. James Wright, who is a recognized Canadian leader in orthopaedic surgery and health care outcomes research. He has also been very involved in leadership activities, both as a part of his professional work and as a student of the discipline of leadership. Jim recently started a new blog on clinical leadership, and I'm delighted to share one of his posts as a part of Dean on Campus. - Richard

You have an ambitious agenda for change. While the specific initiatives are clear, you want to have an overarching approach to increase the potential for successful implementation. What should that approach look like? How do you maximise buy-in from everyone affected by the changes?  

A recurring theme throughout all my posts is the need to engage everyone early and meaningfully in the process of change. People like to be involved in changes that will affect them. Their involvement improves the change and/or the plan to achieve change through feedback. Also, allowing people to contribute to the change process increases their engagement through involvement and the opportunity to participate. I have come to know this approach by the name ‘co-creation’. The concept comes originally from the private sector, where involvement of customers was hoped to improve the quality of a product and its attractiveness to the customer. While most clinical groups don’t function like the private sector, the term has also been adopted by those in Implementation Science, whose aim is to improve the use of best evidence in the care of patients.

There is no set way to co-create, but it surely requires involving the key people (often called stakeholders) in multiple ways and, as indicated above, at the earliest stages. One of the steps to major change initiatives is the requirement for a guiding coalition. The guiding coalition is responsible for managing the change process and to ensure the change actually occurs. Bringing key stakeholders into the guiding coalition seems a good place to start co-creation. Remember that members of task forces and committees need to understand their role is to support the change and not to exclusively advocate for their constituencies.

Understanding who to involve can be partly solved by what has been called ‘stakeholder analysis’. Stakeholders are everyone involved in the change or those potentially affected by it. A stakeholder analysis considers which individuals or groups are influential and interested in the change. Those that are influential and interested should be part of the guiding coalition and approached individually. Those that are interested, but are not that influential should have opportunities to participate and provide input. Those that are influential but aren’t interested should be kept informed. Those that aren’t influential and aren’t interested shouldn’t occupy much concern. In many circumstances, the public or patients also must be part of co-creation.

There are two elements to any change: the change itself and the method employed to achieve that change.  Co-creation can be used to influence both components. For example, the elements of the change itself will need to be modified to suit the particular context. Also, the way the change is achieved is critical to its success, but in my opinion, should be based on inspirational leadership and specifically what is best for patients.

Considering the change itself, the stakeholders need to be consulted on several issues. What is the outcome the change is trying to achieve? Why this change and why now? Does the change need to be modified overall, or according to individual context, to make it successful? Considering the strategy to achieve the change, is there someone or a group responsible for implementing the change? Have the stakeholders bought into the need for change and the strategy to achieve the change? Do the individuals who are expected to change have the necessary knowledge and skills? Have everything been put into place that is likely to make the change successful?

Effective involvement of individuals requires presentation of many opportunities via multiple routes. Advisory groups are an important way to involve stakeholders. However, such groups can only involve a few individuals and may not represent the broad range of views. Social media represents an interesting way to gain feedback from a broader and geographically disparate group. However, social media has its own quirks and runs the risk of advocacy and negativity that sometimes is not easily controlled. Time will tell if this is the best medium to gain the broadest input, but for now represents a prospect worth pursuing.

In conclusion, the concept of co-creation shifts the thinking from a leader or group of leaders who decide what and how to change, to instead a process whereby the change initiative is created together in a meaningful way by everyone affected by the change.

91% Canadians want a national pharmacare program
2017-11-13 Long overdue: Canada needs a national pharmacare strategy

Another study!

Just a few weeks ago our provincial health ministers secured federal support to study universal pharmacare in Canada. This “study” will involve a bilateral federal-provincial commitment to “jointly research how a pharmacare program might work, including potential costs, timelines to implement, and how far the program should go to expand access to drugs.”1

To be sure, this is not a new discourse; calls for national pharmacare date back to the 1960’s. Yet despite hundreds of reports, multiple studies, innumerable policy discussions, and our justifiable pride in our universal health care system, we in Canada still have this basic inequity: many Canadians cannot afford quality healthcare because they can’t afford the medications they need.

A recent Angus Reid Survey of Canadians showed that many Canadians struggle with their healthcare given their poor access to drugs.In their report Pharmacare 2020: The Future of Drug Coverage in Canada2, Morgan, Martin, Gagnon, Mintzes, Daw, and Lexchin, underscore four important principles of access, fairness, safety and value for money, that would translate to: a) the provision of universal coverage for selected medicines a little or most to patients; b) the selection and financing of medically necessary prescription drugs at a population level without needs-based charges — such as deductibles, coinsurance, or risk-rated premiums — on individuals or other plan sponsors (e.g., businesses); c) establishing a publicly accountable body to manage pharmacare; d) establishing pharmacare as a single payer system; and e) fully implementing pharmacare.2

In their report, they alluded to a declaration form the The World Health Organization, which has said that that “all nations are obligated to ensure equitable access to necessary medicines through pharmaceutical policies that work in conjunction with broader systems of universal health coverage. The authors add, “to that end, every developed country with a universal health care system provides universal coverage of prescription drugs—except Canada.”2

A recent Angus Reid Survey of Canadians showed that many Canadians struggle with their healthcare given their poor access to drugs.3 As seen in the table below, almost one quarter of Canadians responding to the survey indicated material issues due to our lack of prescription drug coverage.

Our Health Minister in Ontario, Dr. Eric Hoskins, a long time proponent of Pharmacare, wrote in an op-ed in Globe, “in treating my patients, I became acutely aware that some of them wouldn’t fully benefit from universal health coverage in our country. Why? Because with every reach into my sample drawer, I knew there was a struggling mom who wouldn’t fill her child’s prescription because she simply couldn’t afford it.”4 In an excellent analysis in the Globe and Mail, André Picard discusses a recent governmental report5 on the costs of a national pharmacare strategy.6 Picard suggests the plan would result in both good news and bad news. The good news is that such a strategy would save $4.2 billion. The bad news - and the likely reason as to why Picard entitled his article Price tag on national pharmacare will dissuade Ottawa - is that the net costs to the federal government would be $19.3 billion. Picard aptly concludes, “… parliamentarians have failed, once again, to advance the implementation of medicare, by ordering up an analysis that is a political non-starter.” Of course, there are opposing views. In an article published in the Financial Post, Brett Skinner, CEO of the Canadian Health Policy Institute, argues that a national pharmacare strategy would lead to higher costs and and inferior coverage. He asks, why would Canadians want pharmacare?7

All that said, my strong personal view aligns with Picard’s, the authors of the Parmacare2020 report, and literally hundreds of other Canadian policy makers who have called for national coverage. The current system is a mess. We often refer to our “universal” health care system as a national treasure. But I don’t believe that a system that has 24% of its citizens not filling or renewing a prescription because of its cost can be called universal or thought of as a national treasure. We have indeed had enough studies, enough debate, and enough rhetoric. Canadians deserve a national pharmacare strategy - period! If you have any thoughts on this issue, respond to the blog, or better yet, please drop by the Macklem House, my door is always open.

Richard

  1. http://edmontonjournal.com/news/local-news/provincial-health-ministers-secure-federal-support-to-study-universal-pharmacare
  2. http://pharmacare2020.ca/assets/pdf/The_Future_of_Drug_Coverage_in_Canada.pdf
  3. http://angusreid.org/prescription-drugs-canada/
  4.  https://www.theglobeandmail.com/opinion/why-canada-needs-a-national-pharmacare-program/article21086014/?arc404=true
  5. http://www.pbo-dpb.gc.ca/web/default/files/Documents/Reports/2017/Pharmacare/Pharmacare_EN.pdf
  6. https://beta.theglobeandmail.com/opinion/price-tag-on-national-pharmacare-will-dissuade-ottawa/article36470756/?ref=http://www.theglobeandmail.com&
  7. http://business.financialpost.com/opinion/higher-costs-and-inferior-coverage-why-would-canadians-even-want-pharmacare
  8. https://www.google.ca/search?q=why+canada+needs+a+national+pharmacare+s…:8 – balloon photo
Prime Minister Justin Trudeau and Dr. Mona Nemer, Canada’s new chief science adviser, check out a robot that launches balls, with science fair participants Van Bernat and Kate O'Melia of Governor Simcoe Secondary School in St. Catharines, Ont., on Parliament Hill in September. (THE CANADIAN PRESS/Sean Kilpatrick)
2017-11-06 Science in Canada needs funding, not photo-ops

Andrew Craig, Queen's University, Ontario

Fresh off an election win in 2015, the Trudeau government won the support of the Canadian research community with a declaration that science and evidence-based decision making was back.

Early action included the appointment of Canada’s first minister of science, and a modest increase in funding to the federal agencies that administer federal research funds in their first budget. While disappointed with the magnitude of investment, the research community rationalized that much more substantive changes to science funding would require more time, and hoped for an evidence-based process.

To this end, Science Minister Kirsty Duncan commissioned a review of federally funded research led by David Naylor and a panel of university administrators and distinguished researchers, including Nobel laureate Arthur McDonald.

The report was delivered in late 2016. But the official release was delayed until early April 2017, after the government presented its second federal budget with no new funds for Canada’s three federal research agencies, commonly referred to as the tricouncil: Canadian Institutes of Health Research (CIHR), Natural Sciences and Engineering Research Council of Canada (NSERC) and the Social Sciences and Humanities Research Council (SSHRC).

Picking winners instead of basic research

In fact, there was no mention of these funding agencies or the importance of fundamental research in the 2017 federal budget, despite a major focus on innovation, which inevitably builds on fundamental discoveries.

Instead, Ottawa continued the trend of previous governments to support directed funding for specialized themes, including $6 million for stem-cell research, $81 million for space exploration, $10 million for quantum computing and $35 million to support international collaborations. This approach amounts to picking winners, and ignores the value of broad support for the science ecosystem.

To this day, there has been limited endorsement of the Naylor report recommendations by the Canadian government. Some suggest the science minister and the Naylor report failed to make a compelling case that a major reinvestment of $485 million dollars annually — less than 0.1 per cent of GDP — is needed to restore funding for fundamental research to 2005 levels.

Duncan was slow to endorse the report and appeared to question whether funding recommendations should be left to elected officials — surprising since she herself commissioned the report, and it provides the basis for evidence-based decisions on how to bolster Canadian science funding and delivery.

Research funding dire

Instead, a grassroots effort among Canadian researchers led to the organization of town hall meetings across Canada where researchers weighed in on their concerns. These forums revealed how dire the funding situation is for researchers, especially for those in early and mid-career positions who are attempting to build or sustain their research program.

Research funding in Canada has remained relatively flat. (Handout), Author provided

The meetings also demonstrated that the research community strongly supports implementation of all recommendations in the Naylor report. “Support the Report” became a mantra taken up by many Canadian scientists on social media and in meetings with government officials. We collectively met with most federal MPs and ministers and often found ourselves educating them on the Naylor report — even those within the Liberal government.

Since then, there has been no evidence that the science minister or the prime minister will provide the budget support needed to enact the report’s recommendations.

Now at the midpoint of its mandate, the Trudeau government is attempting to traverse an ever-widening gap between the government’s messaging on science and its actions. Due to inaction, they have effectively reduced available funding for federal research in open competitions where the research topics are not constrained or dependent on industry partnerships.

Serious implications

Why should the public be concerned? The loss of investigator-initiated grants means that we are currently limiting the support for new fundamental discoveries that cannot be predicted by well-intentioned government or granting council executives.

Further, these discoveries are often not translated into new treatments or devices immediately. The late Tony Pawson, who made seminal discoveries during his biomedical research career in Canada, had an important message for all governments when accepting the prestigious Kyoto Prize in Japan in 2008: “Governments increasingly want to see immediate returns on the research that they support, but it is worth viewing basic science as a long-term investment that will yield completely unexpected dividends for humanity in the future.”

This was certainly a failing of the Harper government, and still largely applies to the science policy of the Trudeau government, despite the warm platitudes of how they value science.

Action needed now

It is time for the Canadian government to move past boutique programs and photo-ops. Without new investment in unfettered research funding to the tricouncil agencies, we will see generations of highly skilled scientists leave Canada or choose another career.

This will further the steady decline in Canada’s reputation for world-class research. It also has the unintended consequence of stemming the flow of new discoveries that feed into the innovation sector.

Recently, several positive steps on the science portfolio have included appointment of Canada’s chief science adviser to the government and a Canada Research Coordinating Committee. These are promising developments, but without a major increase in federal funding, the research ecosystem will remain on life support.

The ConversationIt is now 2017, a time for evidence-based decisions in science policy. It is time for the Canadian government to demonstrate they are moving ahead with all recommendations from the Naylor report to return balance and support Canadian science in all its wonderful diversity.

Andrew Craig, Associate Professor of Biomedical and Molecular Sciences, Queen's University, Ontario

This article was originally published on The Conversation. Read the original article.

Building Better Together event at Queen's University
2017-10-30 Building Better Together

The following is a guest blog by Dr. Catherine Donnelly, Associate Professor in the School of Rehabilitation Therapy's Occupational Therapy program.

The need for interprofessional education is well recognized in health care literature, but there are few examples of health care professionals learning with broader disciplines to solve complex real-world problems. One such problem is our aging population. Our ability to keep seniors safe and living independently in their own homes often requires the use of assistive technology. One potential solution is to look to engineers or occupational therapists, both of which have roles in designing, building, and providing access to technology for members of society. But what if these groups worked together to design a solution?

Up to 75% of older adults report using some form of assistive technology, however, up to half of the prescribed technology is not used, and the rate of non-use increases over time. One of the biggest issues contributing to use is the fit between the person, environment and their equipment and the importance of understanding the complex interplay between person-level factors and the technology. One solution is for engineers, who specialize in design, and therapists, who focus on disability, to work collaboratively with older adult end-users to address this issue.

For the past six weeks, 65 engineering students and 76 occupational therapy students have been working together with older adult end users to design a solution to a past, current, or potential everyday challenge. Last week was the culminating showcase where 24 innovative designs were unveiled. Building Better Together, is an educational initiative between mechanical engineering and occupational therapy created to enable students in each profession to gain a deeper understanding of their respective roles, design collaboratively with older adults and spark innovation.  

The Building Better Together initiative was created by Claire Davies and Elizabeth Delarosa from mechanical engineering and Susanne Murphy and Catherine Donnelly from occupational therapy. Mechanical engineering and occupational therapy students attend lectures within their designated home courses and come together in interprofessional teams each week for two hours. During this time, the 24 student teams work on a collaborative design project with older adult volunteers from the community. Volunteers share their experiences and work alongside the student teams to co-develop an assistive technology to address a specific challenge that they have identified. 

Building Better Together is a unique opportunity to bring together two professions who would otherwise rarely intersect in the university learning environment. It has been exciting to watch the teams develop over the course of the project and expand the reach of their own professions through their new skills and perspectives. As part of the program, students have had access to emerging technologies including 3D printers through the SparQ Studios Makerspace and Design Studies. We hope this year’s showcase is just the beginning of the design process.  Following the 2016 Building Better Together, three devices proceeded to additional prototype development, and two devices are now in use. 

Under Claire’s leadership, the project has received development support from the Centre for Teaching and Learning’s Leadership Initiative and Faculty of Engineering and research support through the SSHRC. And, we are already planning 2018 Building Better Together!

For more information, please contact Dr. Claire Davies (claire.davies@queensu.ca) or one of the other project leads.  We are always looking for community volunteers who have ideas about assistive technology that would help them to age in place. For further pictures of the showcase you can go to the Faculty of Health Sciences and Faculty of Engineering Facebook pages.

Dr. Roberta Bondar
2017-10-24 Dr. Roberta Bondar visits Queen's to share A Cautionary Tale

This guest blog was written by Kate Rath-Wilson, PhD, and MD Candidate (Class of 2019). 

Many share the feeling of a delightful combination of wonder and mystery when we peer into the sky on a clear night. In the summers here in Canada, the darkness arrives late and may be obscured by aurora or the V-shaped passage of a group of honking geese. In the winter, getting a good look at the sky means crunching through loud snow and rearranging toques and scarves to get an unobscured view. No matter how often we may get the chance to look, the promise of a short glimpse at a shooting star or the eventual clarity of a difficult to find constellation brings us back again and again. Not much has changed about the view of the night sky since Roberta Bondar looked up as a child in Sault Ste. Marie and was unsatisfied with simply viewing the stars.

Rumour has it that Dr. Bondar could fly an airplane before she could drive a car. She studied biology and zoology at Guelph, before completing her Master’s and PhD at Western and Toronto respectively. She continued her education with an MD from MacMaster, completing her Residency in Neurology. She then went progressed her studies in Neuro-opthalmology with internships in Toronto and Boston. In December 1983, she was chosen from thousands of applicants as one of Canada’s first six astronauts. She became the Payload Specialist for the space shuttle Discovery in January 1992. She was in charge of experiments for the first International Microgravity Lab Mission, which investigated the effects of weightlessness on the human body. Long beyond this mission, she would continue her studies in neurological illness, leading an international research team at NASA.

While her career in the sciences is astronomically impressive on its own, her second career as a photographer must be appreciated in its own rite. She has authored multiple best-selling books, and has exhibited her photographs internationally. She uses her photography to communicate, educate and encourage responsible environmental stewardship through her charitable organization, The Roberta Bondar Foundation. Her photographs inspire scientific discovery, preservation, and human rights around the world.

Dr. Bondar is extremely busy. As the first neurologist in space, the first female Canadian astronaut, and an accomplished scientist and photographer, her attendance is sought at many prestigious events and institutions. She was unable to make the original HG Kelly date because her presence was requested by the Queen (yes, THE Queen) at the inauguration of Julie Payette as Canada’s next Governor General. Despite the demands on her time, she has graciously agreed to speak at Queen’s on November 1st, with the hope of inspiring students to follow their dreams, overcome adversity, and be responsible leaders. She will discuss her time in space, update us on her research, and share some of the wisdom that has carried her this far in her career; and she has promised to explain how toilets work in space.

Please join us at 4:30pm on November 1st in the David M. C. Walker Atrium for refreshments before Dr. Bondar’s 5:00pm lecture entitled – Beyond Earth: A Cautionary Tale, which will take place in the Britton Smith Lecture Theatre (132A) in the School of Medicine Building.

Ms. Murphy sits, surrounded by Dr Edge, Dr Van Den Kerkhof, Dr Sears, Dr Rotter, Dr Duhn, Dr Turner and Dr Medves.
2017-10-16 Head, Hearts and Hands: An open letter to Ms. Margaret Murphy

Dear Ms. Murphy

Two weeks ago, we had the honour of having you at Queen’s University as an International Visiting Scholar, funded in part by the Principal’s Development Fund, School of Nursing, Department of Anesthesiology and Perioperative Medicine, Faculty Development, A. William, Austin, and the Amos Friend Memorial Visiting Professorship. It was a huge privilege to host your visit in the School of Nursing. You shared your story about the circumstances of your son Kevin’s death due to healthcare error and thanks to years of advocacy on your part, Kevin’s story is now viewed as the consciousness of healthcare. You have left us to ponder how we can make a difference and accelerate the quality and safety mechanisms to ensure healthcare becomes much, much safer.

You gave us many messages during the week – reach out to patients, don’t call health care providers 'second victims' as though there are degrees of victims, ensure patients are involved in research projects from the start – not as an afterthought, and remember that we all need to use our head, heart, and hands.

Approximately 800 people heard you speak over four days including: nursing undergraduate and graduate students; patients and patient advisors; physicians and residents at Kingston Health Science Centre; healthcare quality students, graduates and researchers; and members of the Canadian Forces. We have all been affected by your message. What we are challenged with now is not to become complacent. You charged us with reaching out to families and patients and remembering that when a mother says something is not right – then we must listen as mother’s do know when something is not right.

We have been charged in the province of Ontario to pledge to change for improvement. Within the School of Nursing, we pledge to improve the way we recruit members of the public to our committees, how we ask patients and families to become part of developing our research projects, and making sure we teach learners to really listen – they need to Care to Learn so that they can Learn to Care.

Sincerely, 

The School of Nursing and the Department of Anesthesiology and Perioperative Medicine at Queen's University

CIMVHR Forum 2017 welcomes Prince Harry
2017-10-10 The Canadian Institute for Military and Veterans Health (CIMVHR) Forum 2017 - an outstanding success

There was an indescribable energy in the air as more than 600 delegates came together from around the world for the Canadian Institute for Military and Veteran Health Research’s Forum 2017, forming the organization’s largest conference to date. As Chair of the Board of CIMVHR, I couldn’t have been more proud. Undoubtedly, CIMVHR’s connection as the official research partner to the Invictus Games helped fuel that energy, as the games simultaneously showcased the power of the human spirit and the ability of sport to aid in military and Veteran recovery and community re-engagement.

The Forum was proof of CIMVHR’s growing impact; it is an organization that now represents 43 Canadian universities and eight global affiliates. There was a strong presence of military and government personnel, Veterans, students, national and international researchers, industry partners and leaders, philanthropists, clinicians and practitioners.

Over the course of just a few days, 173 different experts delivered 198 research presentations on the health of military, Veterans, and their families. Their topics included: advances in primary and trauma care; gender differences in health; mental health and rehabilitation; novel health technologies; occupational health; physical health and rehabilitation; social health and wellbeing; and the transition from military to civilian life.

A number of research themes were also explored in the pre- and post-Forum working groups: Cannabis for medical use, exploring risks and possibilities; Towards a better understanding of how and when musculoskeletal injuries occur, Aiming for more effective preventative strategies; Culture and diversity in relation to the mental and physical health of military personnel; Transition and the family; and Contemporary research with public safety personnel. Leading up to Forum17 and funded through the Queen’s International Research Leader’s Fund, Dr. Heidi Cramm convened a successful international roundtable of researchers and government representatives to compare the policy of the United States, United Kingdom, Australia, and Canada as it relates to defining military and Veteran families.

In addition to the incredible breadth of world-leading research that was shared throughout the Forum, there were a number of highlights:

  • His Royal Highness Prince Harry, here in Canada for his flagship philanthropic event, the Invictus Games, came to speak at our conference.
  • Dr. Celina Shirazipour, a Governor General Gold Medal award winner, and Queen’s alumni (now a post-doc at Dalhousie University) gave an incredibly poised and articulate presentation of her research on the impact of adaptive sport on recovery for those wounded both physically and psychologically through military service. She had previously been funded through CIMVHR’s Wounded Warriors Canada Doctoral Award.
  • We were pleased to announce Dr. David Pedlar as the new Scientific Director of CIMVHR, as of December 1, 2017.
  • The Honourable Seamus O’Regan, Minister of Veterans Affairs, also joined us at the conference and spoke on the Tuesday morning.
  • Six new CIMVHR Fellows were named, celebrating the diversity of research in military, Veteran, and family health across Canada.
  • We witnessed fantastic engagement from students and post-doctoral fellows – Wounded Warriors Canada hosted an engagement event attended by 40 students/PDF from 20 universities and six countries.

I would like to extend a big thank you to the Interim Co-Scientific Directors of CIMVHR, Drs. Stéphanie Bélanger and Heidi Cramm and their team for putting on such a great event. Next year’s CIMVHR Forum will take place in Regina, and I know it will further build on the organization’s spectacular work in this important area of research.

Next time you are on campus, go up to Kingston Hall and visit the CIMVHR team, and on your way “down the hill” please top by the Macklem House, my door is always open.

 

How healthy is the Canadian health-care system?
2017-10-02 How healthy is the Canadian health-care system?

Chris Simpson, Queen's University, Ontario; David Michael Cumnor Walker, Queen's University, Ontario; Don Drummond, Queen's University, Ontario; Duncan Sinclair, Queen's University, Ontario, and Ruth Wilson, Queen's University, Ontario

This article is part of our global series about health systems, examining different health care systems all over the world. Read the other articles in the series here.

Canada’s health-care system is a point of Canadian pride. We hold it up as a defining national characteristic and an example of what makes us different from Americans. The system has been supported in its current form, more or less, by parties of all political stripes — for nearly 50 years.

Our team at the Queen’s University School of Policy Studies Health Policy Council is a team of seasoned and accomplished health-care leaders in health economics, clinical practice, education, research and health policy. We study, teach and comment on health policy and the health-care system from multiple perspectives.

While highly regarded, Canada’s health-care system is expensive and faces several challenges. These challenges will only be exacerbated by the changing health landscape in an aging society. Strong leadership is needed to propel the system forward into a sustainable health future.

A national health insurance model

The roots of Canada’s system lie in Saskatchewan, when then-premier Tommy Douglas’s left-leaning Co-operative Commonwealth Federation (CCF) government first established a provincial health insurance program. This covered universal hospital (in 1947) and then doctors’ costs (in 1962). The costs were shared 50/50 with the federal government for hospitals beginning in 1957 and for doctors in 1968.

This new model inspired fierce opposition from physicians and insurance groups but proved extremely popular with the people of Saskatchewan and elsewhere. Throughout the 1960s, successive provincial and territorial governments adopted the “Saskatchewan model” and in 1972 the Yukon Territory was the last sub-national jurisdiction to adopt it.


Read this article in French: Système de santé canadien : un bilan en demi-teinte


In 1968, the National Medical Care Insurance Act was implemented, in which the federal government agreed to contribute 50 per cent toward the cost of provincial insurance plans. In 1984 the Canada Health Act outlawed the direct billing of patients supplementary to insurance payments to physicians.

The five core principles of the Canadian system were now established: universality (all citizens are covered), comprehensiveness (all medically essential hospital and doctors’ services), portability (among all provinces and territories), public administration (of publicly funded insurance) and accessibility.

For the last 50 years, Canada’s health-care system has remained essentially unchanged despite numerous pressures.

Long wait times

The quality of the Canadian health-care system has been called into question, however, for several consecutive years now by the U.S.-based Commonwealth Fund. This is a highly respected, non-partisan organization that annually ranks the health-care systems of 11 nations. Canada has finished either ninth or 10th now for several years running.

One challenge for Canadian health care is access. Most Canadians have timely access to world-class care for urgent and emergent problems like heart attacks, strokes and cancer care. But for many less urgent problems they typically wait as long as many months or even years.

Patients who require hip or knee replacements, shoulder or ankle surgery, cataract surgery or a visit with a specialist for a consultation often wait far longer than is recommended. Many seniors who are not acutely ill also wait in hospitals for assignment to a long-term care facility, for months and, on occasion, years.

Canada ranks 9th out of 11 countries in The Commonwealth Fund ‘Mirror, Mirror 2017’ report.

And it’s not just accessibility that is the problem. Against measures of effectiveness, safety, coordination, equity, efficiency and patient-centredness, the Canadian system is ranked by the Commonwealth Fund as mediocre at best. We have an expensive system of health care that is clearly under-performing.

A landscape of chronic disease

How is it that Canada has gone from a world leader to a middle- (or maybe even a bottom-) of-the-pack performer?

Canada and Canadians have changed, but our health-care system has not adapted. In the 1960s, health-care needs were largely for the treatment of acute disease and injuries. The hospital and doctor model was well-suited to this reality.

Medical care offered in homes can be more efficient and comfortable than hospital visits. (Shutterstock)

Today, however, the health-care landscape is increasingly one of chronic disease. Diabetes, dementia, heart failure, chronic lung disease and other chronic conditions characterize the health-care profiles of many Canadian seniors.

Hospitals are still needed, to be sure. But increasingly, the population needs community-based solutions. We need to “de-hospitalize” the system to some degree so that we can offer care to Canadians in homes or community venues. Expensive hospitals are no place for seniors with chronic diseases.

Another major challenge for Canadian health care is the narrow scope of services covered by provincial insurance plans. “Comprehensiveness” of coverage, in fact, applies only to physician and hospital services. For many other important services, including dental care, out-of-hospital pharmaceuticals, long-term care, physiotherapy, some homecare services and many others, coverage is provided by a mixture of private and public insurance and out-of-pocket payments beyond the reach of many low-income Canadians.

And this is to say nothing of the social determinants of health, like nutrition security, housing and income. None of these have ever been considered a part of the health-care “system,” even though they are just as important to Canadians’ health as doctors and hospital services are.

Aging population, increasing costs

Canada’s health-care system is subject to numerous pressures.

First of all, successive federal governments have been effectively reducing their cash contributions since the late 1970s when tax points were transferred to the provinces and territories. Many worry that if the federal share continues to decline as projected, it will become increasingly difficult to achieve national standards. The federal government may also lose the moral authority to enforce the Canada Health Act.

A second challenge has been the increasing cost of universal hospital insurance. As economic growth has waxed and waned over time, governments have increased their health budgets at different rates. In 2016, total spending on health amounted to approximately 11.1 per cent of the GDP (gross domestic product); in 1975, it was about 7 per cent of GDP.

Overall, total spending on health care in Canada now amounts to over $6,000 (US$4,790) per citizen. Compared to comparably developed countries, Canada’s health-care system is definitely on the expensive side.

Canada’s aging population will apply additional pressure to the health-care system over the next few years as the Baby Boom generation enters their senior years. In 2014, for the first time in our history, there were more seniors than children in Canada.

The fact that more Canadians are living longer and healthier than ever before is surely a towering achievement for our society, but it presents some economic challenges. On average, it costs more to provide health care for older people.

In addition, some provinces (the Atlantic provinces, Quebec and British Columbia in particular) are aging faster than the others. This means that these provinces, some of which face the prospects of very modest economic growth, will be even more challenged to keep up with increasing health costs in the coming years.

Actions we can take now

The failure of our system to adapt to Canadians’ changing needs has left us with a very expensive health-care system that delivers mediocre results. Canadians should have a health-care system that is truly worthy of their confidence and trust. There are four clear steps that could be taken to achieve this:

1. Integration and innovation

Health-care stakeholders in Canada still function in silos. Hospitals, primary care, social care, home care and long-term care all function as entities unto themselves. There is poor information sharing and a general failure to serve common patients in a coordinated way. Ensuring that the patient is at the centre — regardless of where or by whom they are being served — will lead to better, safer, more effective and less expensive care. Investments in information systems will be key to the success of these efforts.

2. Enhanced accountability

Those who serve Canadians for their health-care needs need to transition to accountability models focused on outcomes rather than outputs. Quality and effectiveness should be rewarded rather than the amount of service provided. Alignment of professional, patient and system goals ensures that everyone is pulling their oars in the same direction.

3. Broaden the definition of comprehensiveness

We know many factors influence the health of Canadians in addition to doctors’ care and hospitals. So why does our “universal” health-care system limit its coverage to doctors’ and hospital services? A plan that seeks health equity would distribute its public investment across a broader range of services. A push for universal pharmacare, for example, is currently under way in Canada. Better integration of health and social services would also serve to address more effectively the social determinants of health.

4. Bold leadership

The ConversationBold leadership from both government and the health sector is essential to bridge the gaps and break down the barriers that have entrenched the status quo. Canadians need to accept that seeking improvements and change does not mean sacrificing the noble ideals on which our system was founded. On the contrary, we must change to honour and maintain those ideals. Our leaders should not be afraid to set aspirational goals.

Chris Simpson, Professor of Medicine and Vice-Dean (Clinical), School of Medicine, Queen's University, Ontario; David Michael Cumnor Walker, Professor of Emergency Medicine, Queen's University, Ontario; Don Drummond, Stauffer-Dunning Fellow in Global Public Policy and Adjunct Professor at the School of Policy Studies, Queen's University, Ontario; Duncan Sinclair, Professor of Health Services and Policy Research, Queen's University, Ontario, and Ruth Wilson, Professor of Family Medicine, Queen's University, Ontario

This article was originally published on The Conversation. Read the original article.

Pap Party Poster
2017-09-26 QMed Students Host Annual "Pap Party" Clinics in October

The following is a guest blog by Queen's Medicine students Melissa Lorenzo (Class of 2018), Katherine Rabicki and Lauren Wilson (Class of 2019).

Two years ago, in an interdisciplinary initiative promoting women’s health in Kingston, a number of Queen’s Medical Students hosted the inaugural Pap Party event. Set during Cervical Cancer Awareness Week in October, Pap Party is a free pap smear clinic run by medical students and physicians working with the Cancer Centre of Southeastern Ontario and Queen’s Department of Obstetrics & Gynaecology (Ob/Gyn). With every passing year, under the guidance of Drs. Julie Francis (Gynaecologic Oncology) and Dr. Hugh Langley (Family Medicine), Pap Party has grown to become a series of clinics serving not only Kingston, but also Deseronto, Napanee, and Tyendinaga.  Ultimately, the goal of Pap Party is to reach out to women, who may not otherwise have access to cervical cancer screening, to provide them with care and increase awareness of the Human Papilloma Virus (HPV).

Despite being a relatively young initiative, Pap Party has been successful over the past couple of years. Last year, 18% of the women screened during the free clinics were found to have an abnormal pap test requiring physician follow-up. In addition, the 2016 Pap Party was awarded the national title of “Project with the Most Interdisciplinary Collaboration” by the Society of Gynecologic Oncology of Canada (GOC) and Association of Academic Professionals in Obstetrics and Gynaecology (APOG). 

This year, in conjunction with the Federation of Medical Women of Canada’s (FMWC) annual Pap Campaign, Pap Party will be in:

  • Deseronto on October 16th, 5:30 pm-7:30 pm
  • Kingston (Kingston Health Sciences Centre - Kingston General Hospital site, Burr 2) on October 17th, 5:30 pm-7:30 pm
  • Napanee on October 18th, 5:30 pm-7:30 pm
  • Tyendinaga on October 19th, 5:30 pm-7:30 pm

The clinics will be overseen by Dr. Francis, and staffed by medical students and Ob/Gyn residents from Queen’s University. In an effort to reach marginalized populations and patients without a family physician, any woman between the ages of 21 - 70, with or without a health card, is eligible and encouraged to attend.

In an effort to expand Pap Party further and combat declining cervical cancer screening rates, we’ve reached out to all primary care clinics in the Kingston area encouraging them to host their own pap smear clinics during Cervical Cancer Awareness Week. Clinics that register with the FMWC receive a kit that includes a tip sheet, colour poster, news release template, and patient education brochures. By hosting their own Pap clinics, physicians will be able to not only screen women, but also offer the HPV vaccine.

Interested in hosting your own Pap Party and helping us make cervical cancer rates zero?  Hoping to find a clinic near you?  Just seeking more information in general?  Register your clinic and find more information here: https://fmwc.ca/events/pap-campaign/.

Otherwise, please help us spread the word and encourage women to come out to our clinics. Thanks for taking the time to read, please don’t hesitate to reach out if you have any questions about Pap Party. As a team, we’re excitedly continuing our work towards reducing cervical cancer rates to zero!

 

Queen’s welcomes new partnership with Lakeridge Health on Chair in Palliative Care Research
2017-09-18 Queen’s welcomes new partnership with Lakeridge Health on Chair in Palliative Care Research

Last Thursday, I hosted our annual reception to recognize members of our faculty who had recently been promoted. It is always a pleasure to see so many familiar faces and celebrate some important career milestones, but this reception was made even more special by the faculty’s good fortune in naming several new chairs over the last year. That night, it was a thrill for me to introduce Dr. José Pereira as the inaugural Dr. Gillian Gilchrist Chair in Palliative Care Research to our community for the first time.

Chairs are a very important part of our academic culture and send a strong message about the quality of our university’s scholarship and the investment that others have made in Queen’s future. But this chair is a unique one, in that it draws on a partnership with Lakeridge Health in Oshawa, and it is the first academic chair in palliative care based at a community hospital in Canada. In this position, Dr. Pereira will lead palliative care research in the Durham region sites and contribute to our palliative care program and our Department of Family Medicine here at Queen’s.

“As we look ahead and plan for the future, we know that we’ll need to grow and develop our services to help meet the demand for palliative care in our region,” says Matthew Anderson, Lakeridge President and CEO. “Dr. Pereira’s extensive expertise will help deepen our knowledge in this important area of healthcare so that we can improve the quality of life for more of our patients and their families in our community.”

First announced in February 2016, the chair was made possible by a very generous donation from Dr. Hak Ming Chiu and Mrs. Deborah Chiu, who named it in honour of Dr. Gillian Gilchrist, Medical Director of the Palliative Care Team at Oshawa General until her retirement in the mid 1990s. I am sure that our donors are delighted that we’ve found a chair recipient so passionate and devoted to this field as Dr. Gilchrist was.

Years ago, Dr. Pereira was working as a family doctor out west when a patient with cancer was in pain and came to see him and asked him for help, explaining that “the Demerol shots weren’t working.” He replied, “that’s all we can give you and I’m sorry I can’t help you any further,” but he was plagued by his patient’s reaction.

Soon after, he heard there was a course for family doctors in Hamilton to help equip them with basic palliative care skills, but when he called for a spot so he could learn how to help that particular patient, he was told that they were filled. Undaunted, he went anyhow and asked them to let him in. When they finally did, he was completely inspired and it changed his life.

In the subsequent years, Dr. Pereira went on to found the organization Pallium, which helps equip primary care providers with fundamental information on palliative care. It is one of many prestigious appointments that he holds within this expanding and challenging field of work.

In short, we are so grateful to have Dr. Pereira join Queen’s in this critical role. I have no doubt that both Queen’s and our partners at Lakeridge Health will benefit greatly from his knowledge, expertise, and dedication to his work.

Please join me in welcoming Dr. Pereira to his new role in the comments below.

Richard

Placing Patients at the Centre
2017-09-11 Placing Patients at the Centre

One of the great joys of these last eight years as dean has been working alongside one of Canada’s most well-known and talented scientists, Dr. Roger Deeley. Roger’s successes are many, but importantly, a very major one just opened its doors this morning – the W. J. Henderson Centre for Patient-Oriented Research.

As Vice-Dean of Research in our Faculty of Health Sciences, Vice-President of Health Research at Kingston Health Sciences Centre (KHSC), and the President of the KGH Research Institute, Roger was uniquely positioned to champion the partnership between the three organizations in creating a state-of-the-art centre with improved patient outcomes in mind.

The centre will bring together the facilities, equipment and research projects requiring direct patient involvement into a single venue, giving clinician-scientists, researchers, and research volunteers a safe and accessible environment where patients can be consulted, assessed and monitored as they take part in research studies.

“We have spent ten years envisioning this centre, and we think it’s a model for fostering collaboration and multidisciplinary discovery – whether it’s patients working with clinician-scientists, researchers sharing ideas, treatment teams supporting clinical trials with hospital services, or industry, university researchers and health care institutions joining forces to improve health care,” notes Roger. “It also increases KHSC’s research space in health sciences by 25 percent, and includes, for the first time, facilities and capability to conduct Phase 1 and 2 clinical trials, the vital first steps in developing new treatments or devices.”

I must say that I was blown away by the spacious and modern facilities as I first toured them during the opening ceremonies this morning. The centre includes shared laboratories and work spaces as well as a treatment room for minor surgeries and procedures. There is a clinical trials unit, including overnight stay facilities, and a comfortable waiting area complements the new patient examination rooms. There are state of the art meeting rooms and areas for monitoring visits. Amongst other research themes, the Centre will host both the eye-tracking labs and KINARM™ robotic assessment labs, as well as the gastrointestinal diseases research lab.

The Centre provides a home for many of our talented clinician scientists, some of whom provided the opening’s guests with demonstrations of their current research projects, including Dr. Anne Ellis, who conducts leading-edge allergy research, Dr. Amer Johri, an innovator in the use of 3D echocardiography imaging of the carotid artery, Drs. Gianluigi Bisleri, Damien Redfearn, and Ben Glover who are pioneering new approaches to cardiac ablation technologies, and Dr. Graeme Smith, who founded one of the world’s first clinics that focuses on disease prevention in pregnancy and the postpartum period.

The Centre will also include the work of two scientists whose success in Canadian Foundation for Innovation grants has helped fund the centre – Drs. Stephen Vanner (from the Gastrointestinal Diseases Research Unit) and Doug Munoz (from the Centre for Neuroscience Studies). In total, more than 150 donors made the centre a possibility, including the William J. Henderson Foundation with a $1M donation, and the University Hospitals Kingston Foundation with a $3M donation.

“This is big step towards a bold new vision for health research in our community: Queen’s, Kingston Health Sciences Centre, the KGH Research Institute, and Providence Care are all working together towards a new Academic Health Sciences Network Research Institute,” Roger noted at the opening today. “It will enable us to combine resources, increase efficiencies, attract and train world-leading researchers and clinician-scientists, and build dynamic networks in our areas of strength. Collectively, we’ll be one of the top health research institutes in Canada.”

I wish to congratulate Roger and the large and talented team of physicians, scientists, hospital and university staff, and generous donors who have made this a reality for our community. Today, I am especially proud of the healthcare we provide to the people of Kingston and beyond. If you would like to leave a message of congratulations and/or thanks to those who make the WJH Centre for Patient-Oriented Research a possibility, please do so in the comments below, or better yet, please stop by the Macklem House, my door is always open.

The Queen’s Medicine Class of 2021 participates in a cardboard-and-duct-tape boat race competition during Orientation Week.
2017-09-05 A return to campus life

It is hard to believe that this will be my eighth September as the Dean of the Faculty of Health Sciences. Wasn’t it just yesterday that I wrote my first blog! There are a number of traditions and annual events that fall during this month, but my favourite is welcoming of new students and faculty to our campus. There’s a palpable buzz at this time of year for all of us at the Queen’s campus, or for that matter, all around Kingston. I love it.

My first order of business last Monday morning when I returned from summer vacation was, perhaps symbolically, welcoming our 100 first-year medical students to Queen’s. This morning, I did the same for our newest group of students in the School of Rehabilitation Therapy, and our School of Nursing students join our campus today as well. We are, of course, thrilled to have so many bright and engaged students to teach and learn from over the next several years.

We are also delighted to have many new faculty join our community this month. Over the course of the summer, we have continued to announce many new appointments. Given that many of you were likely also enjoying some time off, it bears repeating the list of appointment highlights. Congratulations to our new and continuing heads of departments, to new chairs, a new associate dean, and to Vice-Dean Finlayson who was reappointed for a second term.

I would like to take this opportunity to welcome you all back for the 2017-18 academic year. The faculty leadership is very excited about the successes of our three schools. Collectively we are delivering some of the most advanced health care education in the country. We will soon announce a breakthrough in the research funding we have achieved. And, I predict in this year, our work on strong partnerships will yield new and innovation approaches to research and scholarship.

Even though I’ve said it a thousand times, I do mean it; please stop by the Macklem House, my door is always open.

Richard

Signing off for summer vacation
2017-07-30 Signing off for summer vacation

There is always an expectation throughout the Macklem House that the academic year will be somewhat hectic, and collectively at the university I think we all take a big breath when the summer finally comes. That said, this past month has felt busier than Julys of the past. With great anticipation, I look forward to signing off at the end of this week to spend some quality time with my family and take a break from the emails (and this blog).

My annual summer break is also a time for me to reflect on all that our faculty has accomplished over the year, and this has been an exciting one for each of our three schools. Our new programs are seeing an influx of talented students, our scientists are making great gains in their research, and we continue to push the envelope in how we educate future healthcare providers. I am very proud of this faculty, and feel confident in saying that my colleagues, Dr. Jennifer Medves and Dr. Marcia Finlayson, are as well.

Importantly, we have welcomed our new Provost, Dr. Benoit-Antoine Bacon, who is already making his mark at Queen’s. Our School of Rehabilitation therapy has initiated a bold new $20M partnership with the University of Gondar in Ethiopia. Our School of Nursing continues to expand its innovative programs, like the Master of Science in Healthcare Quality, which will take 60 students this September. Our School of Medicine has launched a major initiative to transform all of its 29-specialty medicine residency programs to a new paradigm of training – competency-based medical education. It’s been quite a year!

Finally, a break from the day-to-day allows me to think about what is in store for us as we embark on a new academic year. In conjunction with our teaching and research endeavours, we will focus on implementing the recommendations set out by our faculty’s Truth and Reconciliation Task Force and the university’s inclusion and diversity report, we will continue our efforts in finding a new home for our schools of nursing and rehabilitation therapy, and we will develop new ways of communicating our student, staff, and faculty accomplishments.

Thank you to each of you who have contributed your time, energy, and brain power to the Faculty of Health Sciences over the last year. I will be back in three weeks, and by the beginning of September and post my first new blog for my eighth year as dean (yes I also cannot believe I have been here for seven years). Please share any summer stories with our readers, as the blog has now attracted over a million page views (also hard to believe).

All my best to my colleagues, alumni, students and friends, for an enjoyable and relaxing rest of summer.

Richard

We regulate doctors to protect the public from harm – why not journalists?
2017-07-23 We regulate doctors to protect the public from harm – why not journalists?

Should journalists be licensed? The Conversation Canada commissioned two articles to argue for and against the idea. Read the counterpoint of this argument to get the full picture.

In the post-truth haze that has enveloped public discourse, a free press is more crucial than ever in educating the public and holding leaders to account. Reliable, accurate news is an essential public good, while false or misleading news can foment confusion and distrust.

In this regard, the practice of journalism has much in common with the practice of medicine. The best medical practice can enhance the public’s health, while careless treatment can lead to real harms. One of these professions is tightly regulated. The other is practised without any formal systems of oversight.

Doctors are granted a licence to practise medicine by a medical board, or a college of physicians. Licensure typically requires proof of completion of medical school, as well as passing a series of examinations, and payment of an annual fee. Many physicians are additionally registered with other professional bodies that require evidence of continuing medical education, to better ensure that practitioners stay current in their fields.

Medical colleges establish clear rules and guidelines about how, in general terms, a physician’s practice should be carried out. Clear policies govern the professional standards that must be met, as well as how investigations and disciplinary actions are to be brought forth in the event of a suspected violation.

Certain types of misconduct — be it a failure to maintain the standards of the profession, disgraceful behaviour, abuse of a position of authority, or other misdeeds — can land a physician before a disciplinary committee with the power to revoke their licence if they are indeed found guilty of malfeasance.

Board serves public and profession alike

Medical boards serve the public, providing mechanisms through which patients can lodge complaints about physicians. They also serve physicians, who use credentialing to demonstrate good standing.

Importantly, medical boards and colleges do not represent an additional layer of government bureaucracy. Rather, they are formed by groups of doctors, patients and members of the public.

The potential parallels with journalism are easy to spot. The media fulfils an essential role in public life. Anyone writing and publishing news stories is given a potentially powerful voice. While our hope is that journalists will use their voice to reliably inform the public, we must also recognize their potential to lead people astray.

Not long ago, accurate, fact-based and ground-breaking reporting was valued – think Knowlton Nash, Woodward and Bernstein or the Boston Globe’s Spotlight team. Highly respected journalists collected information first-hand, bringing stories to press or to air only after the most stringent of vetting and corroboration.

The upside of the hard work that goes into producing and filing a story included nothing more than a good reputation and a modest pay cheque. Though by no means perfect, reporting was for the most part done with the best of intentions, by those most qualified to do it.

Anyone can now report on a story

Our current media ecosystem presents a far different picture. The internet has given voice to anyone wishing to report on a story, enabling shoddy research based on secondary sources (or even pure fantasy). It has become possible to publish at the push of a button, at any time of day.

The upside now includes an influx of cash from clicks and page views; being provocative may be more profitable than being correct. As a consequence, the lines between news and entertainment are now blurred. Consumers of news are adrift in a sea of stories, left to disambiguate the fake news from the real thing.

This state of affairs constitutes a threat to the public good.

One needs look no further than recent votes in the United States and the United Kingdom to see that elections have serious and far-reaching consequences. While failing to vote may be a dereliction of one’s civic duty, voting while uninformed can be downright dangerous.

This state of affairs — in which a profession has a duty to protect the public but the means to do harm — underscores the need for a journalism licensing body.

Journalistic bona fides

A self-regulating college of journalists could determine what sort of education is needed in order to become licensed. Standards of journalistic practice and norms of professional conduct could be established based on a consensus of expert opinions. Formal processes to investigate malpractice and strip wrongdoers of their credentials could be put in place.

A licence in good standing would be a visible sign of a journalist’s bona fides, akin to the post-nominal “MD” that medical school graduates use.

A college of journalists would in no way infringe upon free speech or freedom of the press, much as a medical board does not preclude patients from seeking treatment from complementary and alternative sources.

In fact, seeking health treatments or news stories outside the mainstream may in many cases be a safe and reasonable thing to do. The difference is that the consumer becomes better informed about their choices, and practitioners can’t as easily claim to provide a service they aren’t qualified to deliver.

Physicians inhabit a unique place of trust in society, conferred at least in part by the recognition that their practice is regulated, and that those operating outside of accepted bounds face consequences.

The ConversationTrust in journalists is no less important, but increasingly scarce these days. While the licensing of journalists may do little to stem the tide of fake news, it might at least make it easier to call it out for what it is.

David Maslove, Queen’s University, Ontario

Dr. Kim Sears (centre) with her colleagues on the poster scientific committee at the International Council of Nurses in Geneva, Switzerland.
2017-07-16 Planes, trains, and automobiles – nursing professors travel during academic leave

The following is a guest blog by Dr. Jennifer Medves, Vice-Dean of the Faculty of Health Sciences and Director of the School of Nursing at Queen’s University.

One of the privileges of working in a university is the opportunity to take a year-long academic leave. Sometimes called a sabbatical from the Greek sabbatikos (of the sabbath), one modern definition from the Merriam-Webster dictionary is ‘a break or change from a normal routine (as of employment).’ It is an important definition particularly the ‘change.’ Academic leaves are not the nirvana that many people assume. The leave is an opportunity to refocus research, develop as a teacher, expand research networks, write, publish, and present, and travel to another academic setting as a visiting scholar. The privilege of a sabbatical is that it can occur every seven years during an academic career.

In the School of Nursing, we often have one or two professors on sabbatical at any given time. In my position, I review the plan for the year and then read the reports the following year. However, the most joy I feel is the reports I receive during the year by email, phone, or face-to-face. Having a call from Geneva to describe a ‘unique and wonderful opportunity’ and ‘can I say yes to be appointing to…’ makes my job one of the best in the world.

For many nurses, the first time that they have to design a year of leave can be hard to imagine and plan. Many who end up in academia have spent at least ten years in nursing education, have or are raising children, and/or have had a busy clinical career. For some it is scary, as they will travel alone for the first time or be taking their family on a journey of discovery with them. Organizing travel and home schooling for the children are all of a sudden really difficult and nutty problems. Some let their houses out or find a house swap with another academic in another place.

I have been faced with many questions over the last few years as a consequence of a complete renewal of faculty about the expectations of an academic leave. Eight years ago, the School of Nursing faculty started a cycle of recruitment and we now have the start of academic leaves, as five faculty have been granted tenure and promotion. Dr. Kim Sears returned on July 1st 2017, as her colleagues Dr. Kevin Woo and Dr. Rosemary Wilson started their leaves. Dr. Christina Godfrey is leaving on January 1st 2018 and Dr. Joan Almost on July 1st 2018.

They have taken or are about to take their leaves all over the world – Australia, South Africa, Rwanda, France, Switzerland, Italy, England, Scotland, Chile, Brazil, Hong Kong, and China. They are going to conferences – to present and to listen, to conduct primary research and implementation science, they are going to teach health care professionals, sit on national health care quality committees, participate in international committees to develop guidelines or policy statements. All in all, they will be really busy.

The travel will provide outstanding opportunities to share with the perspectives of nursing in Canada and academia with those who will, in turn, share their unique perspectives. These exchanges of ideas then enrich our nursing curricula and guide our lines of inquiry in the future. Academic leaves do not simply revitalize individuals, they expand our understanding, develop new and exciting international partnerships and influence our education program.

I can’t wait to hear about the travel and research. I am ready for new and radical ideas for refocusing our education and research programs. My Go-To-Meeting room is open for conversation and stories, and my door is also always open – particularly as my office is freezing cold with an over enthusiastic air-conditioner blasting cold air on my head at the moment. To those of us left in Kingston, have a wonderful and restful summer break, whenever it comes. It is only two weeks until we welcome our first cohort of new students so we are busy ramping up to welcome them to Queen’s and Kingston.

First Canadian hybrid cardiac ablation procedure performed in Kingston
2017-07-10 First Canadian hybrid cardiac ablation procedure performed in Kingston

The following story has been republished with the permission of Meaghan Quinn and Matthew Manor, Strategy Management and Communications staff members with the Kingston Health Sciences Centre. 

In a Canadian first, a hybrid cardiac ablation procedure has been successfully completed at Kingston Health Sciences Centre (KHSC). The procedure is a revolutionary treatment for patients who suffer from atrial fibrillation – the most common type of irregular heart rhythm.

The new procedure will help patients heal faster, stop or reduce their use of medication, as well as reduce the number of future hospital visits that they require.

“This new procedure represents a combination of the most advanced surgical techniques along with less invasive catheter techniques,” says Dr. Gianluigi Bisleri, a cardiac surgeon at KHSC and associate professor of surgery at Queen’s University. “Instead of the traditional approach to fix chronic irregular heart rhythms, we now offer an extremely innovative and effective hybrid approach.”

Atrial fibrillation affects approximately one in four Canadians. Historically patients have relied on medication along with traditional cardiac ablation procedures to help restore normal heart rhythms. During a traditional ablation procedure, physicians create scars inside the heart which prevent abnormal electrical signals from moving through the heart tissue. This traditional approach is typically performed either by inserting long, flexible tubes with wires – called catheters – into the heart through the patient’s groin or by using more invasive surgical approaches that often require opening the chest and stopping the heart.

With the new procedure, a cardiologist uses digital technology to map the inside of the heart while the surgeon performs ablation on the outside of the heart using another specialized device. This requires only three keyhole incisions to navigate to the heart, removing the need to open a patient’s chest.

Cardiologist, Dr. Ben Glover (R) speaks with cardiac surgeon, Dr. Gianluigi Bisleri (L) prior to their procedure at KHSC. Photo by Matthew Manor for KHSC

“We are treating patients in a way we haven’t before,” says Dr. Ben Glover, a cardiologist at KHSC and assistant professor of cardiology at Queen’s University. “By combining technology with the knowledge and expertise of our medical teams, we are able to treat complex cases with a high success rate in a minimally invasive manner.”

The cardiac mapping system technology used during this procedure is the first of its kind to be used in North America and is a result of a strategic capital investment made by KHSC earlier this year. Known as the Ensite Precision cardiac mapping system, this technology provides highly detailed models and maps of the heart that allow physicians to diagnose a wide range of irregular heart rhythms.

Cardiac surgeon, Dr. Gianluigi Bisleri (L) can see where he is working on the monitors inside the operating suite at KHSC. Photo by Matthew Manor for KHSC

In addition to treating patients in a new way, this procedure also offers new insights into atrial fibrillation that will help expand further medical research in the field.

“Through this novel procedure, we have been able to see the mechanisms of atrial fibrillation and the effects of this hybrid approach in an unprecedented way. This will allow us greater insights and understanding into this common heart condition,” says Dr. Bisleri. “We are extremely excited that KHSC is a pioneer in delivering this treatment which is due to the unique collaboration among the teams of cardiologists and cardiac surgeons.”

Creating a Live Renal Donor Program: Overcoming the 4 Hurdles to Achieve Excellence
2017-07-04 Creating a Live Renal Donor Program: Overcoming the 4 Hurdles to Achieve Excellence

The following is a guest blog by Dr. Stephen Archer, Head of the Department of Medicine at Queen’s University.

This is the story of how we are beginning to perform live donor renal transplant (LDT) at Kingston Health Sciences Center (KHSC). Like many of the stories in this News Discovery and Innovation blog much of the high tech is built on a strong team of doctors (surgeons and physicians) from several Departments, nurses, and technicians. This story emphasizes a common series of barriers that must be overcome to create programs of innovation such as this one.

Kidney failure is a big problem-for the patient and for society. In 2013, 41,931 Canadians were living with end stage kidney disease (ESKD) an increase of 35% since 2004. Of these, 58% were on dialysis at an annual cost well over $100,000 and less than half (42.7%) of the patients treated with dialysis survive 5 years!

To read this blog imagine that you have kidney failure. This is your life. Three times a week you drive to Kingston Health Sciences Center (KHSC). You look for parking. You walk to the Dialysis unit. You sit in an overstuffed chair. Nurses connect you to a hemodialysis machine. It processes your blood, substituting (more or less) for the kidneys that failed you. You look at the other 30 people receiving this same therapy. The time slowly passes, tick-tock. Perhaps you think about life’s fairness, tick-tock or perhaps you think, there must be some better way to do this, tick-tock. You might even ponder why, at a cost of >$100,000/year per patient, this isn’t a more enjoyable experience! Thoughts like this have been pushing us to do home dialysis and other alternatives to the central dialysis unit model.

However, there is a way to replace failed kidneys and this alternative to dialysis is better for the patient and cheaper for the health care system. What you say? If there is a better and cheaper alternative to dialysis why are we still dialysing patients in 2017? Before I start a revolt, let me come clean, the better cheaper solution is renal transplantation and the best version of renal transplantation is to receive a kidney from a living donor (LDT), as opposed to, receiving a kidney from someone who has died (still better than dialysis, just not as good as LDT). Neither form of transplantation is available to all patients, either because of the lack of a suitably matched donor-patient pair or because of patient factors that preclude surgery.

There are a multitude of reasons why transplantation may not be an option, including patient choice, medical and surgical contraindications and system reasons. Patients may choose not to undergo dialysis or transplantation. The reasons are diverse but are not dissimilar for the reasons patients declining chemotherapy and other treatments that offer potential gain at the price of some definite pain (or at least inconvenience). Physicians may decline to offer transplantation (or dialysis) for reasons including therapeutic futility (e.g. due to the presence of severe co-morbid conditions, such as advanced cancer or heart disease the treatment will not extend life or improve the quality of life). The system (locally or provincially) may fail to offer this option or provide inadequate access to meet the demands for renal transplantation.

However, if you are a candidate it is best to undergo kidney transplantation (instead of being dialyzed). The main two impediments to success are immunologic rejection of the transplanted kidney and damage to the transplanted kidney during the harvesting process (due to the absence of blood supply after harvesting the organ-this is called ischemia).

So where do we get kidneys for transplantation? From people who have died (deceased donor kidney transplantation), from people who have undergone cardiac death in a supervised hospital setting (donor after cardiac death), and from volunteers who agree to be living donors. This latter group is ideal because they are optimally matched immunologically, which reduces the risk of rejection (the main problem for renal transplantation) and the harvesting of the kidney is done in parallel with implantation in the recipient, ensuring the shortest time of interruption of blood flow (kidneys like all organs don’t like interruption of blood flow). For a living donor, the organ is harvested electively while the recipient is simultaneously readied in another operating room.

To minimize the risk of rejection and ischemia the best donor is therefore a) a perfect genetic match (i.e. an identical twin) and b) live (i.e. the kidney is harvested from the donor and immediately transferred into an adjacent operating room and implanted in the recipient). However, few people have identical twins and the next best scenario is to receive a kidney from a living donor who is related to the recipient and matched for HLA type and blood type, even though they are not identical. Once again by using a live donor the kidney can be removed and immediately transferred into the recipient (who is being cared for in a parallel operating suite by their own team of surgeons and nephrologists). Using living donors and a parallel operation on the recipient ensures the procedure is elective (and thus well supported by staff) and minimizes renal ischemic time. The next best option is to receive a kidney from a live but unrelated donor (i.e. a spouse). This offers excellent graft (kidney) survival. For example, Gjertson and Ceka (Kidney International, Vol. 58 (2000), pp. 491–499) showed that when the spouse donated a kidney it was still functioning ~80% of the time at 5 years.

So we now know that transplantation is desirable but not always feasible or indicated. However, there is one reason for not being transplanted that is not acceptable, namely lack of willingness on the part of the physicians or a University hospital to create the capacity to offer the service. Failure to offer complex care services at academic health sciences centres often reflects personnel and system level impediments to overcoming the 4 Barriers to Excellence, which I will discuss subsequently. Note that I am not talking about community hospitals, who may best obtain transplantation (which requires tremendous technical expertise) for their patients by referral to designated centres. However, for University hospitals, such as our centre in Queen’s, a number of hurdles had to be overcome to allow LDT to become a reality. It turns out these hurdles are similar for any new high tech program and by recognizing their existence one can envision a systems approach to ensuring a clean pass over the hurdles. I call these hurdles, Inertia, Chaos, Lack of expertise, and Fear of failure.

Overcoming the 4 barriers to implementation of living renal transplantation program (or any tertiary care medical program)

 Barrier 1: Inertia (The old ways- dialysis and cadaveric transplantation – will do)

Solution 1: Vision

Barrier 2: Chaos (Lack of a formal table at which to consider innovative programs and technologies)

Solution 2: Creation of an Innovation Committee to provide planning and administrative support

Barrier 3: Lack of expertise (We don’t have the right doctors/equipment/nurses/technologists-or some combination of these)

Solution 3: Coordination of a Strategic Priorities Committee that has hospital and university representation and a mandate to accelerate the hiring of the types of physicians, nurses, physician assistants and technologists required for innovative programs that been endorsed as priorities at the innovation table. This accelerates the assembly of a competent team

Barrier 4: Fear of failure (doing the first case frightens some physicians/hospitals)

Solution 4: Courage. Ultimately the properly planned and constituted group must have leaders and patients willing to take the leap forward together. Of course, beginning with carefully selected, straightforward cases, is key.

To launch the program a small group of passionate experts, usually those that will perform the procedure and their Department Heads must create the vision. In the absence of vision nothing happens; inertia dictates that the status quo persists. Our vision was that patients with renal failure in the SELHIN are better and more economically served by provision of a local live donor transplantation program (LDP) than by referring them to other University hospitals or by performing more of the cadaveric renal transplants that we have been doing. We overcame barrier 1 several years ago when we developed a vision shared by Urology/Nephrology/Medicine and Surgery. We then engaged the hospital and created an ad hoc table, which considered the vision and, having accepted it, provided the administrative support and legitimacy to cross the second hurdle. Getting over barrier 2 involved many meetings and included formal consultation with other renal transplantation centres in Ontario (who said, “Please start a program-we are swamped”!). Armed with hospital approval we then began to assemble the team required to propel us over barrier 3. This required recruitment of Dr. Tom McGregor, a talented and experienced renal transplantation surgeon, to co-lead this initiative with Dr. Shamseddin (a transplantation nephrologist). The team of course is much larger than this and the program requires each member be an expert in his or her craft (see image). Before clearing hurdle 3 we still need approval from Health Canada to begin this new program. With help from our administrative lead, Mr. Richard Jewitt, this was obtained, and several years after crossing hurdle 1 we did our first case (see story below).

 TEAMS

 

Dr. Lois Shepherd and the HLA and Microbiology Team

Kristina Jones, Leslie Todd, Kelly Clark, Dr. Lois Shepherd, Marie Guthrie, Laura Webber, Julie McClatchey and Tammy Edwards

Nephrology Transplant Team

Dr. David Holland, Sharon Mulkerns, Arlene Funnell, Jenine Kramer, Dr. Khaled Shamseddin

Surgery Team

Dr. T. McGregor, Ms. Laurie Thomas, Dr. S., Dr. R. Siemens

Recent advances include the ability to harvest the kidney for the donor (who is a healthy volunteer-so it’s a high stakes low risk surgery and a small scar is ideal). One of our key team leaders, Dr. Tom McGregor has been a champion of living donor transplantation and has shown that laparoscopic harvesting of the donated kidney is safer and better tolerated (if slightly more expensive and slower) than an open nephrectomy (think big incision and large, painful wound). Transplantation raises many considerations. For living renal transplant procedures all must go well when operating on a healthy volunteer. Surgeons are used to operating on a patient to cure a disease- a major procedure on a healthy person is a gut check for most surgeons.

Many Others to be Thanked

Although we have acknowledged many people on the current team, it’s important to remember that many championed this program and it was built on the foundation of their enthusiasm. Included in this group are former Regional Director of ORN, Julie Gordon-Woolf, and physicians Rob Siemens and David Holland.

Our case: Living Related Donor Transplant- With the consent of the donor and recipient we summarize the story of Case 1 at KHSC

On June 13th, 2017, Mr. RH was our first patient to receive his live donor kidney transplantation from his son (donor) at our Kingston Health Science Center – KGH Site.

Recipient story

Mr. RH is a 67 year-old gentleman with a history of kidney disease caused by high blood pressure (hypertensive nephrosclerosis). He had been on dialysis for several years (first hemodialysis and later peritoneal dialysis).

The morning of the first day post his live related kidney transplantation, Mr. RH said: “Doc, I really feel good, I’m great. I can’t even remember when was the last time I felt like this”. He added, “I’m not sure why I didn’t get this done many years ago. No more machines. I definitely will not miss my dialysis machine or the dialysis unit, even though I will miss people and nurses there. They were my family”.

Mr. RH’s serum creatinine improved significantly from 645 umol/L (immediately after transplant surgery) to 189 umol/L – 24 hours post-transplant. By the time he was discharged, seven days later, his creatinine was 136 umol/L.

A week later, he was seen in the Kidney Transplant Clinic. His creatinine remained stable (~ 140umol/L). His surgical wound healed well and he is doing well at home.

Donor story

Meanwhile, Mr. RH’s son, the donor, was discharged home two days post his laparoscopic nephrectomy (the surgery that yielded the kidney-below-which was given to his father) in stable condition.

He was able to resume his daily life activities without major limitations and within a week was back at work. His creatinine was only mildly higher than his baseline. He (the donor) will be followed up closely in our Post Live Kidney Donation Clinic at 1, 6, and 12 months post donation to monitor his kidney function as well as to optimize his blood pressure and monitor him for albumin/proteinuria.

Although his (the donors) live kidney donation surgery was not associated with any extra physical or health gain, he has always wanted to provide his father with a better quality of life and longer life survival so that his father can enjoy his grandchildren. Their picture below highlights the joy and satisfaction that the transplantation has brought to their lives. 

Surgery

We have now completed our first two living-donor kidney transplants. Both donors were performed laparoscopically and the surgeries went off without any hitches. Both donors were fully mobile the day after surgery and were discharged home within 24-36 hrs thanks to the minimally invasive nature of the surgery, which allows for an expedited recovery. Furthermore, the recipient surgeries went equally as well, with both transplanted kidneys making urine immediately and functioning very well in the days to follow. 

Which scar would you like? Open procedure or laparoscopic renal harvest?

Result: 

Our patient and donor did well. A laparoscopic approach was utilized.

Moving forward: So our program has launched and our first cases went well. However, challenges remain. These include a shortage of donors and some concerns about risks to the donor.

First and foremost, there are not enough kidney donors to meet demand. In Canada only 1/3 of potential kidney transplant recipients on the waiting list are transplanted each year.

To try and increase the availability of living donor kidneys a new program has begun. Some patients have a living related donor who wants to give them a kidney but is not a good immunological match. Instead of wasting that kidney the donor gives their kidney to some other person (that they have never met) and another donor (somewhere else in the country) who is a match for the first patient supplies the first patient with their kidney. Patients who have a willing living donor are entered in a national LDPE Registry that identifies these other potential transplant opportunities.

Not every donor is able to give their kidney to the intended recipient; however, they can be matched through a registry another recipient. A second donor then helps their original recipient.

Currently this program sends the donated kidney across the country (by plane train or automobile).

 For anyone who has traveled recently this imposes some logistical challenges and the kidney can be protected by shipping it in a specialized pod that perfuses the organ with oxygenated solution to keep it happy until transplantation. This is called a kidney perfusion and transportation pod.

So is it safe to give a kidney? The answer, yes – but their risk is not zero. In what at first appears paradoxical donors live longer than the average population. For example, in a study of 1332 Norwegian kidney donors followed up for an average of 32 years, there was a survival benefit for kidney donors, relative to the general population (0.7 for female and 0.5 for male donors). The apparent (and surprising) increased survival reflects not the benefit of giving a kidney but the fact donors are selected and screened to ensure they don’t have disease (Holdaas H, et al. Mortality of kidney donors during 32 years of observation. J Am Soc Nephrol1997; 8:685A). However when one corrects for the health state of donors some risk of donation emerges.

In UptoDate, the acute and long-term risks for donors are summarized. The acute surgical and perioperative risks include a 90-day perioperative mortality of 1/3000. In addition to death, important perioperative risks to the donor include haemorrhage, pneumothorax, pneumonia, urinary tract infection, wound complications, and deep vein thrombosis with or without pulmonary embolism. Longer term, there is a very small increase in risk to the donor of developing end stage kidney disease, although it is low. A US registry study compared 96,217 donors with healthy participants in NHANES III, estimated lifetime ESRD risk of 90 per 10,000 donors compared with 14 per 10,000 among healthy non-donors (Muzaale AD et al JAMA. 2014 Feb;311(6):579-86).

Are kidney donors remorseful later? 95% of the time no! In an interesting study of living donors only 1.4% of donors whose recipient was alive regretted making the donation (although this % was higher when the recipient was dead 4.3%).

https://academic.oup.com/ndt/article/18/5/871/1833143/The-risk-of-living-kidney-donation

Lessons to be learned? We have begun the journey to making live donor transplantation the norm for appropriate candidates requiring renal replacement therapy. We also need to learn from the arduous process that was required in this case to surmount the 4 barriers to excellence. KHSC still needs a formal innovation table at which to consider proposals for new programs of excellence. At this table proposals by physician leaders can be discussed and ultimately refined so there is an accepted and well-understood vision. The proposal can be accepted, rejected and prioritized. The table will require input from KHSC (where the work is done and infrastructure resides), Queen’s University (with which the faculty are aligned), SEAMO (the alternative funding plan which controls physician hiring), the Southeast local health integrated network, SELHIN (which controls resources for health care) and the physician leadership (Department Heads and others who offer the vision and/or are technical experts). This much-needed new table will ensure that early in the process there is the clarity of vision that is a prerequisite for clearing the hurdles and doing so with a speed and ease that an Olympic hurdler would appreciate.

So KHSC, SEAMO, Queen’s University, and the SELHIN-next hurdle neurostimulation for Parkinson’s disease and epilepsy surgery: On your mark, get set, GO!

Front-line faculty undergo simulation training in preparation for the new CBME curriculum
2017-06-20 Queen’s set to lead the country in transition to competency-based medical education

On this auspicious occasion of our CBME launch, I have invited Dr. Damon Dagnone to write a guest blog. I would like to thank Damon for his extraordinary efforts as Queen’s CBME Lead.

At the start of every summer, we welcome around 130 post-graduate medical students to Queen’s University to begin their residency programs. Orientation day, which kicks off this important chapter in their careers, is particularly exciting and a bit nerve-racking for the group. But this year, it might just be the PGME faculty and staff who are feeling that way. For them, July 1st represents a new beginning at Queen’s, and an opportunity to lead the rest of the country in transforming medical education.

As Canada celebrates its 150th anniversary, Queen’s will officially launch competency-based medical education (CBME) across all 29 of its specialty programs. To be fair, we are following the lead set by Family Medicine in successfully implementing their “Triple C” competency-based curriculum more than five years ago. But at Queen’s, we have embraced the Royal College of Physician & Surgeons of Canada’s (RCPSC) Competency by Design (CBD) Project wholeheartedly. While the rest of medical schools in Canada are implementing CBME over the next five years, we committed ourselves to an accelerated institutional path back in 2015, and are now in a remarkable position to be at the leading edge of the needed transformative changes in how we train doctors in Canada.

It might sound difficult to justify investing so much institutional time, energy, and resources to transforming all of our specialty programs into CBME curriculums given that we have trained excellent doctors for years. Yet a number of factors have shown us that a change was necessary: current systems of medical training cannot keep up with our rapidly changing world of technology; there is an ever-expanding body of medical knowledge; important and essential patient safety initiatives have been developed; there has been a reduction in duty hours and the renewed focus on trainee wellness; and our learners have a growing set of advanced needs.  The traditional blueprint for medical education, first introduced by the Flexner Report in 1910, needs urgent transformative change.

Leveraging the teaching and learning methods, tools, relationships, and passion we collectively share as learners and educators within our School of Medicine, we have spent the last two years designing a path for 29 programs at Queen’s. We have done this by supporting each other in this institutional change process, and in so doing, strengthened and expanded the community of education leaders that values principles such as a shared aspirational vision, co-production, responsive leadership, the diffusion of innovation, and a systems-based approach to transformative change.

From my point of view, as the CBME Faculty Lead for PGME, our readiness for launch on July 1st is thanks to many stakeholder groups. First and foremost, the vision, expertise, and strategic approach by the Faculty of Health Sciences decanal leadership cannot be understated. Next, the creation of a central CBME executive team, comprised of key leaders from within postgraduate medical education and the Faculty of Health Sciences, was essential to keeping us on track. The executive’s decision to take a systems approach for this institutional change has also been critical to our success in providing central support to all of our 29 programs.

At the program level, 29 program leadership teams have been created and they have done a fantastic job. Each team has had four fundamental tasks to complete over the last two years: perform a critical review and implement a reform of their curriculum; implement new concepts such as entrustable professional activities (EPAs), milestones, and competencies into their training programs; perform a critical review of their assessment methods that would result in the redesign of a comprehensive program of assessment; and identify education champions within their program to become academic advisors (“coaches”) to trainees and competence committee members, who will guide decisions for promotion.

There are many other stakeholder groups that have joined us on our journey, and we couldn’t have done this important work without their partnership. This includes our many CBME sub-committee members, our hospital partners in Kingston and at distributed sites, our frontline faculty, our current resident trainees, patient advisors and community members, and – last but certainly not least – the RCPSC executive leadership. Each group has been influential in the co-production and evolution of this transformative project. Moving forward, we will continue to nurture these ongoing partnerships to assist us in the implementation process. To them, and to all others that have assisted us thus far, I would like to say a very big “thank you”.

Looking ahead to July 1st, after over two years of preparation, we’re excited to be ready – but this is just the starting line. We are going to need a lot of ongoing communication and continued hard work to make sure our accelerated institutional path to CBME is a success.

As well, there are many questions to be answered as we start our CBME transformation. How will we know we’re implementing CBME as intended? How will we measure the benefits, risks, and unintended consequences of this innovation? And how will we adapt to unexpected challenges? It is imperative that we accumulate evidence of the impact of CBME and continue to approach implementation as an iterative process that’s committed to quality improvement, program evaluation, and improved outcomes for our trainees and the patients we provide care for.

Congratulations again to everyone for helping us get here. We’re ready to launch CBME across our 29 specialty programs at Queen’s and I’m excited for the next part of our journey together.

Signed (a proud Queen’s faculty member),

Damon Dagnone

CBME Faculty Lead, Special Assistant to the Associate Dean

Postgraduate Medical Education, Queen’s University

OMA Binding Arbitration Vote Imminent
2017-06-15 OMA Binding Arbitration Vote Imminent

This week, Ontario Medical Association (OMA) members will be asked to vote on the tentative OMA-Ministry of Health and Long-Term Care Binding Arbitration Framework (BAF). As with all democratic processes, I would encourage all OMA members to express their opinion.

After years of failed negotiations, discord, and significant leadership changes at the OMA, the parties have signalled their interest in trying to nail down what has been a controversial issue, and that is, the OMA’s long-standing position that binding arbitration is an important conceptual underpinning for the negotiations process. After years of this being a sticking point, it’s encouraging to see that the negotiating teams from both government and OMA have developed a tentative framework.

As health reporter Kelly Grant outlines in a recent Globe and Mail column, “the agreement says that, within 30 days of talks commencing, the two sides will try to agree on one person to act as both a mediator and arbitrator, unless the parties decide the roles should be separated. The arbitrator, who will have the final say on a new contract, will be the chair of a three-member arbitration board that will also include panelists appointed by the OMA and the government.”

Further stipulations include the notion that physician compensation needs to be “fair and reasonable” and that in making a final decision, the arbitrator can consider the economic situation in Ontario.

To me, there is a clear signal that both parties – the OMA and the government – are making an earnest attempt to get back to the table and strike a deal that would see an end to what has been an unsettling few years.

However, not all groups are happy. Concerned Ontario Doctors have argued against the tentative binding arbitration framework. They argue that the framework is flawed, doesn’t include a mechanism for the recovery of unilateral clawbacks, and has expanded the definition of a strike, amongst various other concerns.

My personal view is to strongly support a “yes” vote for the tentative BAF. As I indicated in a previous blog, the most important aspect in my mind is that the parties need to get back to the table. It now appears as if there is a strong will on both sides to do just that. Creating opposition to a BAF is, in my view, ill-conceived and counterproductive.

As such, I am extremely hopeful that the framework will be ratified, and the parties can begin to work together. And with goodwill on both sides, at long last, an agreement between the province and its doctors will emerge.

To my fellow OMA members, no matter what your position on this is, please vote by June 17th. And, if you would like to share your thoughts on the BAF, please do so in the comments below, or drop by the Macklem House; my door is always open.

 

Setting the course for our next five years
2017-05-29 Setting the course for our next five years

Five years ago, we developed a strategic framework that would unite the three schools in the Faculty of Health Sciences under one vision: to ask questions, seek answers, advance care, and inspire change. In that time, the faculty has established itself as a point of pride for the university and it has been thanks to the dedication and commitment of our students, faculty members, and staff that we have advanced the respective strategies of the schools of medicine, nursing, and rehabilitation therapy. In the past five years, we have fostered new approaches to collaboration and interprofessionalism, we have developed new programming, piloted new models of education, and we have fortified our research initiatives.

With the Faculty of Health Sciences and School of Medicine’s five year strategic plans coming to an end in 2016, we spent the last year evaluating our past, talking to our stakeholders, and envisioning our next five years. I would like to thank our two steering committees who were the driving force behind these plans; over 30 individuals put in countless hours of work to bring these plans to life.

I am now pleased to share our 2017-2021 Faculty of Health Sciences Strategic Framework and 2017-2021 School of Medicine Strategic Plan with you – both can be read online, or you can come by the Macklem House to pick up your own hard copy.

As you read through the strategic framework and strategic plan, you’ll see that both the Faculty and School of Medicine have committed to four unifying strategic directions:

  • Conducting targeted and collaborative research
  • Developing, leading, and implementing new models of education and training
  • Building strong and collaborative partnerships
  • Keeping patients and populations at the centre of our academic mission

We have also re-committed to our vision: to ask questions, seek answers, advance care and inspire change will remain at the heart of everything that we do.

Of course, behind our past successes and the bold initiatives that we have set for the future are a faculty of dedicated staff, students, faculty members, alumni, partners, benefactors and friends. We are fortunate to have such a hard-working team. Through collaboration and alignment with our partners, I am confident that we will continue to contribute leadership across education, health care and research, and enhance the regional, national and international impact of the important work that we do.

I encourage you to take the time to read through our new strategic plans, and once you have, please share your thoughts by commenting on the blog. Or better yet, drop by the Macklem House…my door is always open.

Richard

Will we soon be replaced by machines?
2017-05-23 Will we soon be replaced by machines?

The prospect that much of what humans do will be replaced by machines is nothing new. From the earliest days of the industrial revolution, there has been a massive amount of human labour that has been replaced by machine-based solutions. But many predict, we are on the cusp of another, digitally-based revolution that will see much of our professional work being replaced by artificial intelligence technologies.

In a recent Harvard Business Review Webinar, Oxford professors Richard Suskind and Daniel Suskind indicate that despite the common wisdom that doctors, lawyers and other professionals will remain relatively unscathed by AI tools, their research has led them to the opposite conclusion. They opine “that we expect that within decades the traditional professions will be dismantled, leaving most, but not all, professionals to be replaced by less-expert people, new types of experts, and high-performing systems.”1

In an interesting article by Jen Wiecszer, she discusses how revolutionary AI has already become profoundly useful. She refers to the current reality that “IBM Watson could read a patient’s electronic medical record, analyze imagery of the cancer, and even look at gene sequencing of the tumor to figure out the optimal treatment plan for a particular person.”3

The phenomenon of computer technologies rivaling a doctor’s capabilities extends to many fields. For example, in a recent article in Nature, it was reported that AI systems rivaled the accuracy of 21 board certified dermatologists in the recognition of serious dermatologic conditions.4

And it is not just doctors who are at risk of, if not being replaced, certainly seeing their work change drastically with the advent of AI. Bernard Marr, in an interesting article in Forbes Magazine, suggests that many professions are at risk, or on the cusp of a massive transformation.5 He discusses the “top ten” professions at risk and they include: 1. healthcare, 2. insurance, 3. architects, 4. journalist, 5. financial industry, 6. teachers, 7. human resources, 8. marketing and advertising, 9. lawyers and 10. law enforcement.

Einstein is quoted as saying, “Computers are incredibly fast, accurate, and stupid. Human beings are incredibly slow, inaccurate, and brilliant. Together they are powerful beyond imagination.”6

Well, artificial intelligence is bringing brand new meaning to this quote. Indeed, the professional world is rapidly and disruptively changing as the adjective “stupid” is quickly becoming inaccurate.

If you have any thoughts about artificial intelligence and the implications for the medical profession, comment on the blog, or better yet, please drop by the Macklem House; my door is always open.

Richard

  1. https://hbr.org/2016/10/robots-will-replace-doctors-lawyers-and-other-professionals
  2. http://int.search.myway.com/search/AJimage.jhtml?&searchfor=watson+as+d…
  3. http://fortune.com/2016/11/02/ibm-watson-ai-3d-printing-athenahealth-doctors/
  4. http://news.stanford.edu/press-releases/2017/01/25/artificial-inteltify-skin-cancer/
  5. https://www.forbes.com/sites/bernardmarr/2016/04/25/surprisingly-these-10-professional-jobs-are-under-threat-from-big-data/#63b1f31d7426
  6. http://www.quotes.net/quote/38086
Paving the road for mental health advocacy with Jack.org
2017-05-17 Paving the road for mental health advocacy with Jack.org

The following is a guest blog written by Queen’s MD/Phd candidate Lori Minassian with contributions by QMed 2019 student Elisabeth Merner.

One in five young people suffer from mental illness. This is a statistic that I was completely unaware of until I met the amazing Windeler family. Seven years ago, they lost Jack, then a first-year student here at Queen’s, to suicide due to depression. Unfortunately, they were unaware that Jack was suffering. In fact, three out of four young people who suffer from mental illness don’t reach out for help. Jack’s parents, Eric and Sandra, recognized this and created Jack.org, Canada’s only national network of young leaders changing the way we think about mental health. The initiative started off small, as a partnership with Kid’s Help Phone to develop services for young people to reach out for help. Due to the success of this project, Jack.org transitioned to Queen’s University to have the opportunity to work directly with young leaders. In 2013, Jack.org incorporated as a registered Canadian charity. They now have chapters in 40 universities, eight colleges, and 70 high schools all across Canada.

Jack was my boyfriend’s brother. And though I never had the chance to meet him, his parents have kept his memory alive in the most powerful way. To say that Eric and Sandra inspire me everyday would be an understatement. Like many people, they suffered a great loss. But instead of letting it tear them down, they’ve created a powerful movement to prevent others from losing loved ones to mental illness. I’ve spent the last three years learning as much as I can about their cause and joining in on conversations surrounding mental health. They always stress that while one in five people suffer from mental illness, five in five have mental health. It is our job to make sure we are taking care of our mental health, just as we do with our physical health. What I find so amazing about Jack.org is its focus on empowering young leaders. They encourage students to be the drivers of conversation and change, not only with each other, but also with decision makers. Throughout all four years of my undergraduate degree, I was a peer mentor to younger students. I saw them go through all of the stress that comes with the transition from high school to university. Looking back, I wish I had the tools and support that Jack.org provides. These are the reasons I am inspired to participate in the Jack Ride.

This year, the Queen’s medical community has committed to helping young leaders eliminate the stigma around mental health by sending a team to the Jack Ride. The Jack Ride is Jack.org’s biggest annual fundraiser and all of the funds raised go directly to the charity’s youth mental health programs. With 16 members, including medical students, doctors, friends, and family, we are hoping to raise at least $6,000 for this amazing cause! Most students in the “QMed Cycles” Team have opted to challenge themselves by doing the Jack 100 (100 km ride), exemplifying resilience, strength, and determination – qualities needed to pave the road for mental health advocacy.

Opportunities like this one provide physicians, medical students, and community members with an opportunity to create a culture of openness. By de-stigmatizing mental health issues, we are creating an atmosphere that empowers and encourages a younger generation to see vulnerability as a strength rather than a weakness. Medical professionals, and medical students are key to changing the discussion around stigmatized mental health issues. We are setting the standard and expectations for the future generation of colleagues and aspiring physicians. Although the culture has begun to shift, there is a long road ahead in medicine. While we must continue to inspire and encourage youth to be the key players in changing the conversation surrounding mental health, it is important to remember that health care providers are not immune to the same mental health issues. The QMed Cycle Team members, the Wellness and Mental Health Committee, and the Anti-Stigma Campaigns are all concrete examples of our medical students creating awareness and opening the discussion surrounding mental health issues.

If you are interested in making a donation to our team and helping end the stigma surrounding mental health in young people, you can follow the link below.

https://jack.akaraisin.com/pledge/Team/Home.aspx?seid=13658&mid=10&tid=122063&sgid=

If you are interested in joining our QMed Cycles team, you can register at: https://www.jack.org/ride

The new Providence Care Hospital opens its doors
2017-05-08 The new Providence Care Hospital opens its doors

In late April, the longstanding quest to create a facility that meets the aging, rehabilitation, and mental health needs of the people of southeastern Ontario came to fruition with the opening of the spectacular and brand new Providence Care Hospital.

That which once existed across two sites has now been seamlessly blended into a state-of-the-art building. Just one month before its official opening, Cathy Szabo, Providence Care Hospital CEO, was kind enough to give me and my wife Cheryl, along with former dean David Walker and his wife Emily, a private tour of the new building. I can honestly say it was a magical moment and all four of us were awestruck by the combination of how beautiful the new hospital was, how modern an approach they took to designing the facilities, and how – most importantly – every single aspect of the building spoke to a focus on the patient.

“Providence Care Hospital brings to life the concept of patient-centered care, where services are not siloed in separate facilities but instead are working in collaboration to meet the physical, emotional, social and spiritual needs of each person,” explains Ms. Szabo. “With 622,000 square feet of new construction, Providence Care Hospital incorporates the latest technology and best-practice design elements to enhance quality of life for our patients, clients, visitors, and staff. This is truly a one-of-a-kind hospital that is both innovative and person-centered.”

The hospital is equipped with 270 private in-patient rooms surrounded by several spaces for activities, including family lounges, kitchenettes, and dining rooms. The hospital is also home to a number of Providence Care’s outpatient services and clinics that are conveniently located in the centre of the building closest to the main entrance.  The security, communication, and computer systems are completely modernized, and new telemedicine and videoconferencing platforms will support collaboration and connection across the region. The hospital was also designed to be energy efficient, and was built with the lake, landscape, natural light and outdoor accessibility in mind. The Worship Centre overlooks Lake Ontario and was designed with input from faith leaders in our community. Finally, dedicated teaching and research space has been thoughtfully incorporated into the new hospital, as it will be the new home to Queen’s Department of Psychiatry, Department of Physical Medicine and Rehabilitation, and the Department of Medicine’s Geriatric Medicine Division.

There are so many people who have made this new hospital a reality for our community, and I must name a few who are front of mind. Dale Kenney, the former Providence Care CEO, deserves a lot of credit for moving the whole initiative forward, and he was helped by many, but significantly by John Gerretsen, who served as the Member of Provincial Parliament for Kingston and the Islands from 1995 to 2014. Of course, I must also congratulate the current leadership of the hospital for their instrumental work in seeing the transformation through, including: Cathy Szabo, CEO; Maurio Ruffolo, VP, Hospital Transition and Chief Nurse Executive; Krista Wells Pearce, VP, Planning and Support Services; and the rest of the senior team at Providence Care. We have greatly benefitted from your vision and dedication to this project.

As both dean and an enthusiastic hospital board member, I know this new centre will be a tremendous benefit from so many perspectives. It will, without doubt, assist us in attracting the best health care professionals to Kingston who will have much to gain from working in this fabulous space. It will be a wonderful environment for our students to learn in and for our faculty who are invested in mental health, rehabilitation science and complex care to perform their research. But the ultimate beneficiaries will undoubtedly be our patients and clients from Kingston and beyond.

If you didn’t have a chance to see the new hospital for yourself during one of Providence Care Hospital’s open houses, the community is encouraged to stop by – grab a cup of coffee at the VOCEC at the Lake Café or Starbucks and enjoy the lake view from the cafeteria patio.

Congratulations to all who contributed their time, advice, and expertise to help open the doors of the new Providence Care Hospital. If you would like to share your thoughts on the new hospital, please leave a comment below, or better yet, drop by the Macklem House; my door is always open.

Richard

eConsult pilot improving access to care
2017-05-01 eConsult pilot improving access to care

Guest blog by Danielle Claus, Executive Director, Southeast Ontario Academic Medical Organization (SEAMO)

It’s no secret that lengthy wait times for specialist appointments are one of the biggest barriers to accessing health care in Ontario. Here, in our corner of the province, however, we are diligently chipping away at that obstacle, one eConsult at a time.

eConsults allow primary care providers (PCPs) to send patient-specific questions to specialists using a secure web-based platform. Specialists can then respond with advice, suggestions for treatment, or a recommendation that patients be seen by a specialist.

SEAMO, in collaboration with the Ontario Telemedicine Network (OTN), South East Local Health Integration Network (SELHIN), OntarioMD, and the Champlain BASE Project Team embarked on a six-month eConsult pilot project on Feb. 1, 2017. The goal of the pilot is to reduce the number of unnecessary referrals to Kingston specialists and to assist PCPs in better preparing patients for specialist appointments.

We are now halfway through the pilot, we have already seen the impact a timely, online conversation between a PCP and a specialist can have on patient care.

“I wish I had this years ago,” said Dr. Arawn Therrien, a family physician at Stone’s Mill Family Health Centre in Gananoque. “Patients are excited because I’m getting answers back within 48 hours.”

Therrien, who is the most active PCP in the pilot, went on to say that easier access to specialists through an online communication portal is ideal when a PCP wants to seek direction on a particular case or make minor adjustments to medication dosages.

Anecdotally, specialists are also noticing a decrease in the number of referrals received. Dermatologist Dr. Mark Kirchhof, who has answered 18 eConsults to date, believes the pilot has helped prevent referrals to his busy outpatient clinic.

“The wait time to see a dermatologist continues to increase, so any method to limit the in-person clinical demands benefits patients and the healthcare system,” he said.

As of Apr. 25, 2017, the project received a total of 144 eConsult requests from 38 different PCPs. The top five requested specialties are dermatology (29), cardiology (14), gastroenterology (13), neurology (13) and endocrinology (11). The average specialist response time is between 48 and to 72 hours.

The project has 124 active registered users — 52 PCPs and 72 specialists in 24 specialties. Early adopters of the new technology are using it often, with 70% of PCPs sending an eConsult request since the project launched. To date, three PCPs have sent 10 or more requests, seven have sent between five and nine requests, and 26 have sent between one and four requests.

Word of the pilot’s popularity continues to spread, with SEAMO receiving 19 new requests in April to join the project to join the pilot. With three months to go, we want to build on the momentum of the first half of the project and continue to increase access to health care for patients in our region.

I would to thank our PCPs and specialists for embracing this new technology in an effort to improve care in our region. For more information on the SEAMO eConsult Pilot Project, visit the SEAMO website.

Indspire Award winner embraces personal journey
2017-04-24 Indspire Award winner embraces personal journey

University often offers young people more than just a degree. For Thomas Dymond, currently a first-year medical student at Queen’s, post-secondary education has been a journey of self-discovery.

“It wasn’t until I got to Memorial University for my undergraduate degree that I started getting to know about my culture. I jumped over that barrier of not being sure how I fit being an Aboriginal person in modern society,” says Mr. Dymond, who recently accepted an Indspire Award, the highest honour the Indigenous community bestows upon its achievers.

Mr. Dymond is Mi’kmaq from the Bear River First Nation in Nova Scotia. He lived off reserve growing up and didn’t learn a lot about his Aboriginal culture from his mother and relatives.

“Even though my grandfather didn’t attend a residential school, the system definitely impacted the way he felt he should share knowledge with his children and grandchildren,” Mr. Dymond says. “Given his own background and the racism he experienced, my grandfather never really forced our family to self-identify.”

Despite having minimal affiliation with the culture, Mr. Dymond says he always felt an Aboriginal presence inside of him growing up. When he moved to Newfoundland to attend Memorial University, he started to get more in touch with his Aboriginal identity.

However, as someone with mixed ancestry – his father is white – Mr. Dymond felt he faced another barrier to expressing his Aboriginal identity.

“I wanted to get involved, but I wasn’t sure how I was going to be received. I worried about walking in and being the whitest looking person in the room. I thought about how I was going to be received by other Indigenous students in the room,” he says. “Once I overcame all of that, it just sparked something in me. I wanted to learn more, I wanted to do more, and I wanted to get involved more.”

Mr. Dymond was elected the Aboriginal student representative on the Student’s Union at Memorial University, a position he held for three years. He advocated for Indigenous students on campus, and also got involved in national campaigns such as Sisters in Spirit, which raises awareness about violence against Aboriginal women and girls, and Education is a Right, which seeks to increase financial support for Indigenous post-secondary students.

Mr. Dymond also got involved with a number of initiatives across the university and in the local community. He co-founded the Wape’k Mui’n drum group and facilitated events such as sharing circles. He sat on the board of the St. John’s Native Friendship Centre for two years as the youth representative. As a member of the board, he voiced the needs and desires of Aboriginal youth in the community, which helped shape planning and policy within the friendship centre.

Reflecting on his volunteer and community work, Mr. Dymond can’t pinpoint one activity that he is most proud of.

“I do things because I have a passion and I am driven to do them. Everything along that path has led me to where I am today. All of those experiences have made me who I am,” he says. “I find it interesting that I have gone from a level of trying to be educated and to learn more about my culture to this point where people turn to me for knowledge.”

After years of contributing to the university and broader community in St. John’s, Mr. Dymond found himself navigating a new and unfamiliar environment last fall after arriving at Queen’s to pursue his medical degree. When he came to campus for his School of Medicine admission interview, he visited Four Directions Aboriginal Student Centre and walked through the building on Barrie Street. Mr. Dymond said he received a warm welcome from the staff at FDASC, which made him feel comfortable going there.

Mr. Dymond admits that there was an adjustment period coming to Queen’s. It took him a while to get comfortable with the other medical students and the Aboriginal community on campus. Furthermore, the demands of medical school meant that he couldn’t attend as many events or get as involved as he had been at Memorial University.

Over the past few months, though, Mr. Dymond feels he has come out of his shell, opening up about who he is and where he comes from.

“The more comfortable I’ve gotten with the people I am surrounded by now, the new community, the more I’ve been open and able to share my knowledge, understanding, and perspective on a lot of things,” he says. “And that’s really what it’s all about: I have a perspective as one person, and it’s nice that I am being heard.”

Having the opportunity to share that perspective with Aboriginal youth is what excites him the most about the Indspire Award. As part of the honour, Mr. Dymond will visit several different cities across Canada and deliver his message to other Indigenous youth: “stay in school and you can achieve anything you put your mind to.”

“If you had asked me five years ago, I never thought I would have been here. It’s amazing where I have come from and how I got here, and I am excited to share that with other Indigenous youth and let them know they can do what they want in life.”

Visit the Indspire website to learn more about Mr. Dymond and the awards.

***

This post originally appeared in the Queen’s Gazette on April 20. I’d like to thank Mark Kerr, Senior Communications Officer, for sharing the story with us. If you would like to share a congratulatory remark for Thomas, please respond to the blog below.

Richard

Health careers beyond academia: exploring connections with industry
2017-04-18 Health careers beyond academia: exploring connections with industry

Our number one goal for our students has always been to provide them with the knowledge, skills, and experiences that will allow them to sustain a fabulous career in their particular field of interest. Graduate studies is one area where our strategy for achieving this is changing rapidly and requires constant re-evaluation. For some of our graduate students, a career as a university scientist is the end goal. However, we have seen this landscape shift dramatically over the last decade, and as a faculty, there is a recognition of the importance of exposing all of our students to engaging careers in science beyond the borders of campus.

Recently, our faculty’s Industry Engagement Strategy has highlighted a number of opportunities for our graduate students that we want to capitalize on. The strategy focuses on building and intensifying public-private partnerships with Canada’s large multinational pharmaceutical and medical device companies, all of which are seeking out early-career scientists with specialized knowledge of how industry functions.

Over the last four years, we have initiated conversations with over 40 companies, 30 of which have sent delegations to Queen’s to explore collaborative research opportunities with our junior and senior investigators. These discussions have undoubtedly served to catalyze new areas of investigation and other forms of collaborative work. And, they have helped us to identify how we can prepare our students for fulfilling careers in the pharmaceutical industry.

The strategy is maturing and becoming quite foundational in our thinking, especially as funding agencies such as the Canadian Institutes of Health Research (CIHR) become more explicit about the need for partners who could support knowledge translation activities. There are other important trends to note such as an increased desire by provincial and federal governments to focus on life sciences as a key driver of economic growth through innovative procurement and their changing view of healthcare as a cost driver to an economic opportunity. Strengthening our national capacity in life sciences will ultimately provide greater opportunities for academic institutions to partner with the private sector. To capitalize on the promise of life sciences to deliver new wealth and improved healthcare for Canadians, we must ensure, as an academic institution, that our students and trainees have the necessary experience and skill set to contribute to building this sector over the long-term.

Over the last year, we have worked diligently to create a new program that addresses these realities. On May 11, we are hosting our first Career Pathways in the Healthcare Industry event, to kick off our new Certificate in Pharmaceutical and Healthcare Management Innovation and strengthen our connections with industry. This event will be oriented towards our student communities who may be interested in understanding more about health science related careers in industry.

We are thrilled to have some of Canada’s leading life science executive join us for this interactive symposium, including Vratislav Hadrava, Vice-President & Medical Director at Pfizer Canada, Dion Neame, Head of Scientific and Medical Affairs Canada at Sanofi Pasteur, and Michael Duong, Director of Medical Affairs (Evidence Generation) at Hoffmann-La Roche. Our guests will highlight unique career opportunities in the pharmaceutical industry and speak to how the different functional areas in research, medical, and scientific affairs intersect in contributing to Canada’s healthcare system. And of course we could not have brought this event together without the generous support of our sponsors: Sanofi Pasteur, Pfizer, and AstraZeneca.

I have no doubt that this will be an engaging and informative event for all attendees, whether or not a career in industry is on the radar. As such, I warmly encourage all students – from Queen’s and beyond – to attend this event either in person or via webcast to learn about emerging trends in the Canadian health sciences.

Tragically Hip honoured for contributions to brain cancer research
2017-04-10 Tragically Hip honoured for contributions to brain cancer research

On April 5th, the Canadian Cancer Trials Group (CCTG) honoured the Tragically Hip for their contributions to brain cancer research, and presented the band with a commemorative plaque.

In the research world we talk a lot about the importance of collaboration in driving research breakthroughs. Today, no researcher would question that pooling expertise, trading ideas and sharing resources is a better way to solve problems or answer difficult questions than working alone.

One of the finest examples of this collaborative approach is the Canadian Cancer Trials Group, right here at Queen’s. A truly global endeavor, CCTG’s collaborations encompass 80 member institutions across more than 40 countries. In Canada alone, more than 2,100 cancer specialists are taking part in its trials.

For 25 years, CCTG has been one of the most significant players in the cancer trials space in the world; and we saw an example of this just last year. The American Society of Clinical Oncology’s annual meeting, one of the most prestigious cancer meetings, has a special session where they present the four most important international papers to showcase. Last year, two were from CCTG. This was an unprecedented honour that recognized their trial research as being among the highest impact in the world.

But research collaborations aren’t always confined to research labs. Sometimes they arise unexpectedly, out of adversity and challenge, and today we celebrate the results of one such collaboration.

Thanks to the members of the Tragically Hip and their fans, the Canadian Cancer Society and the Canadian Clinical Trials Group are making new progress towards better treatments for brain cancer.

The band’s decision last year to share with its fans that its frontman, Gord Downie, had an aggressive form of cancer called glioblastoma, led to an overwhelming response by fans wanting to show their support, resulting in $400,000 in donations to the Canadian Cancer Society.

This funding will support research into this difficult-to-treat disease. The CCTG, for example, collaborates with colleagues in Europe to test a new combination therapy for glioblastoma. The results are positive, and today many patients, including Mr. Downie, are benefiting from the trials that test new therapies.

Together, the Hip, their fans, the Canadian Cancer Society, and CCTG have shown us how collaboration can have unexpected, powerful consequences that create positive change. They have raised awareness of this disease, supported cancer research through funding clinical trials and then translating that support into better treatments for patients.

So let us celebrate today this unique collaboration, and extend our heartfelt thanks – to Gord Downie, Rob Baker, Paul Langlois, Gord Sinclair and Johnny Faye, and the legions of Hip fans who supported the band’s last tour; to the Canadian Cancer Society and who channeled that support into research; and to the Canadian Cancer Trials Group, whose researchers continue that organization’s groundbreaking work in finding better treatments, and ultimately cures, for cancer.

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

The Integration of Kingston General and Hotel Dieu Hospitals
2017-04-03 The Integration of Kingston General and Hotel Dieu Hospitals

Saturday was an auspicious day for the patients of Kingston, for our health system and for Queen’s hospital partners. On Saturday April 1, 2017, Hotel Dieu Hospital and Kingston General Hospital officially integrated their functions, and a new corporation was born. The integrated hospital will adopt a new “legal name” the Kingston Health Sciences Centre, pending a full analysis over the coming months of a permanent “business name”, by which the hospital will operate.

As observers of healthcare in Kingston will understand, the integration of our two acute care hospitals, is a momentous occasion. In this new configuration, there will be a new board of directors, a new executive team, and a unified professional staff.

I am delighted that Dr. David Pichora will be the new Chief Executive Officer, and Dr. Michael Fitzpatrick, the new Chief of Staff. We wish them, and the rest of the new executive team, well as the move forward with the mission of an integrated hospital.

The notion of an integrated hospital started almost a year and a half ago. Through the incredible work of two board chairs, George Thomson and Michael Hickey, and with the help with many, many others, the process unfolded in a extraordinarily positive way.

As Kingstonians and would know, the notion of integrating a faith-based hospital and the secular hospital has not been an easy one. But as someone who has been very materially involved through he entire process, I can attest that once the decision was taken by both boards to integrate,  there has been nothing but a spirit of incredible cooperation and positivity.

I would like to single out Jim Flett and David Zelt, as per my blog from a few weeks ago, for special recognition. Jim and David worked indefatigably on integration and have helped make this marriage a very successful one.

I would also note, that the professional staff have been extraordinarily positive about the integration, and are extremely charged by the advantages that an integrated hospital will proffer.

Of all the files on my desk in my almost 7 years as dean, this has been the largest file. And, justifiably so. I cannot think of a single issue that’s more important in our current healthcare environment than moving forward as an integrated system.  Kingston, as a community will benefit greatly from “all boats rowing in the same direction” under single leadership.

Perhaps, a final comment about Dr. David Pichora. David has been a long-standing colleague and a good friend. I can honestly say that I can’t think of another individual who is more poised to take on this leadership challenge than David. He’s incredibly smart, extraordinarily hard working, and most importantly, absolutely committed and dedicated to the welfare of our patients in Kingston and those in our region.

I’m equally excited about the new Board of Directors at the Kingston Health Sciences Centre, a board that I will join. It will be led by David O’Toole the current President and Chief Executive Officer of the Canadian Institute for Health Information. David’s a terrific individual and we are very lucky to have has him as our inaugural board chair.

Please join me in congratulating all the many people who were involved in the creation of this new hospital, including the two board chairs who started the process, Dr. Scott Carson and Ms. Sherri McCullough.

If you have any comments forward to graduation so I can pass on, please respond to the blog… or better yet, please drop by the Macklem house, my doors always open.

 

Richard

Join the Neuro Half Marathon and 5K on May 7th
2017-03-27 Join the Neuro Half Marathon and 5K on May 7th

Guest blog by Ilan Mester, student communications ambassador for the Faculty of Health Sciences and OT ‘17

Running played a key role in Kyla Tozer’s recovery from a brain tumour. Now, things are coming full circle for the Kingston native; she’s giving back to the hospital that helped save her life by launching an ambitious charity run for Kingston General Hospital’s neurosurgery unit.

Before her own surgery, Tozer describes being reckless; she drank often and was a heavy smoker. But after the surgery that removed a softball-sized tumour from her brain, she continued to inhabit a dark place, despite letting go of most of her careless lifestyle. When a cousin suggested running, Tozer quickly realized its life-changing abilities.

“Every day, every week I would try to go just a little bit further,” she shares. “I started to feel like I’m completely in control of this; for once in my life, I control my mind. I can go out and run and I can go any direction as fast as I want, as slow as I want, however long I want – and nothing can stop me. There’s nobody telling me not to do it.”

Tozer ran on her own for months before she decided to join the Running Room. There, she met a Queen’s student doing her PhD in exercise physiology. “I was able to totally open up to her about everything and she would explain things to me. It was a big part of my rehabilitation.”

Tozer traces her symptoms back to when she was just 16. She experienced headaches on a daily basis and it got to the point where she could barely tolerate fluorescent lighting. “I remember saying, ‘If I could just take my eyeball out, I could poke it – I could tell you exactly where it is.’”

After years of chronic headaches and trembling hands, Tozer got fed up and ‘Googled’ her symptoms (which she doesn’t endorse), only to realize there was a single diagnosis: brain tumor. She instantly got a hold of her family physician, who booked her an MRI. Within 24 hours, she got a call from her doctor saying she had a brain tumor.

Tozer’s family physician referred her to KGH’s neurosurgery unit, where she met Dr. Pokrupa and his team. Tozer describes the care she received at the hospital as nothing short of phenomenal. The team had a ton of patience with her, answering every little question and supporting her in both the lead-up to the surgery and the lengthy recovery following.

“Where the tumour was located has a lot to do with intelligence, rational thinking and all of that,” she says. “I was never ever good in high school; my marks were horrible and I had a difficult time staying on task.” In hindsight, she knows part of the reason why.

Tozer managed to turn her life around; she now works, has a family of her own and is a student at Queen’s. She’s taking health sciences courses out of interest, with hopes of migrating to neuroscience.

The Kinston native is excited to give back to the hospital that helped her by launching the Neuro Half Marathon and 5 kilometer race. Kicking off May 7, the inaugural event has a number of sponsors, including Best Buy and Fly Kingston. Tozer says all of the proceeds will go directly to KGH and more specifically, the neurosurgery program.

“Neurology and neurosurgery is one of the most under-funded departments in the hospital, and it’s by far one of the most important,” she adds.

Tozer hopes Queen’s students will join the run, adding that many from the Faculty of Health Sciences are involved in the hospital already through clinical placements and residency.

“Someone who has a brain injury has a really hard time understanding long-term plans; they get stuck in a way and that’s the way it goes. It’s kind of the same with students; you get overwhelmed, bombarded with work and you’re just stuck. And not giving up on exercise and any sort of physical activity that’s going to make you feel balanced again – it’s just super important.”

Students who register for the run have a chance to win a year’s supply of pizza from Boston Pizza. Tozer also assures the race is nowhere near the water, “so there won’t be any May flies,” she adds with a laugh.

She’s hoping that her run will be around for years to come. “I think it’s going to be something Kingston really needs – something that will pull everybody together.”

You can find more information on the Neuro Half & 5K here: https://www.facebook.com/events/862210160583140/

2017-03-20 A big thank you to David Zelt and Jim Flett

It was almost a year ago that Kingston General Hospital (KGH) and Hotel Dieu Hospital (HDH) held a press conference to announce that a monumental change was underway: the two hospitals would be integrating. A lot has happened since Iblogged about it about it in July;

  • Administrative approvals have been granted by the LHIN and the province
  • The two boards have consulted widely with the community and other stakeholders
  • A new board of directors has been established
  • A new executive team is in place for April
  • And the new hospital has a legal name, but business name(s) are still to be determined

Along with these and many other changes still to come, I wanted to dedicate today’s blog to acknowledging two people who will be stepping down from their roles this month. David Zelt, Executive Vice President and Chief of Staff at KGH and Jim Flett, Interim President and CEO at KGH.

David Zelt earned his MD here at Queen’s, and stayed to do his postgraduate medical training in general surgery before continuing his training in vascular surgery at Harvard. And it wasn’t long before he was back at Queen’s, starting his career as a professor and surgeon at KGH. In his long career here with Queen’s and the hospital he has served in a variety of administrative roles in addition to membership on many provincial and regional committees; including Clinical Medical Leaders of the Canadian Academic Hospitals of Ontario and the South East LHIN CCAC and Hospital Executive Forum. In 2008, he stepped into his current role Chief of Staff and Executive VP, Medical Administration.

Though he has had many accomplishments over his career, what stands out about David his is complete dedication to his three roles as a clinical surgeon, an academic, and an administrator. David could walk out of the operating room at 1am, take time to teach a student or a resident and still be ready to go for his 7am meeting the next morning. I have spent most of my career around surgeons and hard-working physicians, and I can honestly say that David is one of the hardest-working people I know. We are all beneficiaries of David’s passion for what he does, and although he will step down from his role on April 1, he won’t be going too far: he will carrying on his work as an academic vascular surgeon at Queen’s, and without doubt, will continue to be engaged in improving the system he works in.

A Chartered Accountant, Jim has a Commerce degree from Queen’s and an MBA from the Ivey School of Business at Western. Jim stepped into his role as interim President and CEO just over a year ago with a huge amount of experience in hospital administration. Over a 31-year career, he has held several senior positions and has been a key player on many initiatives, committees and task forces. Most recently, Jim served as Executive Vice President and Chief Operating Officer at KGH. In this role, Jim can proudly take credit for leaving the hospital in excellent financial shape, and well poised for the integration with Hotel Dieu.

Jim has been a key figure in the success of the integration of KGH and HDH. Since the moment the boards decided on this route, Jim has rolled up his sleeves, worked indefatigably on the necessary steps that are required in bringing two organizations together, and used his profound knowledge of hospital operations to facilitate the integration. It is very true, that without Jim’s efforts, this very complicated process would not have gone as smoothly as it has. Jim will be retiring on March 31st, and I know that he will be looking forward to spending time with his family, especially his grandson.

Please join me in congratulating and thanking David and Jim by commenting on the blog, or better yet, please drop by their offices; David will be there immersed in his work, but if it’s Jim’s office you are going to, please hurry; he’s off for a brief holiday in a sunny and warm place in early April.

Richard

2017-03-13 Breaking down barriers for women in science

Just last week, the School of Rehabilitation Therapy shared the news that Heidi Cramm was honoured by Esprit de Corp for her work towards understanding and improving Canadian military families’ access to healthcare services. Heidi was named among 25 women in Canada’s defense sector for “Breaking Down the Barricades”

I’m sure that it was more than just a coincidence that the timing of the recognition was juxtaposed with Wednesday’s International Women’s Day. And these two events had me reflecting on all of the successes we’ve had in the Faculty of Health Sciences that can be attributed to the work of women. Indeed, we have much to celebrate.

But, as one of my female colleagues recently reminded me, we have to be conscious that there is still work to be done to break down barriers for women in the health sciences. It may be 2017, but women are still an equity-seeking group in Canada. In fact, in a recent report from the Canadian Centre for Policy Alternatives and Oxfam Canada, Making Women Count, it was noted that the gender wage gap has regressed from 74.4% in 2009 to 72% today.1

Although there are some professions, like the three in our faculty, where student population is equal or predominantly female, we still have an imbalance of women on our faculty compared to the general population, especially in leadership roles.

In thinking about why that is so, I took to google to explore some of the barriers that are keeping women out of careers in science. The most predominant themes were family considerations; the years when women have children often coincide with prime years in her career, and built-in or subconscious bias against women in science; this story about a man and woman switching names in the workplace went viral last week and illustrates how bias can be present in any profession. In survey results published by BioScience asking women to identify the most significant barriers that they faced, grants and funding, balancing life and career, gender biases, scarcity of job openings, having and rearing children, low pay, access to mentors, lack of role models, child care support, laboratory space, and elder care were all on the list.2

Last week’s International Women’s Day was not simply cause to celebrate. This year’s theme, #BeBoldForChange was a call to action to refocus our efforts to break down these barriers and continue to work towards equality.

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

 

  1. http://www.cbc.ca/news/business/wage-gap-oxfam-1.3478938
  2. https://academic.oup.com/bioscience/article/61/1/88/305102/Women-Face-M…

 

Thank you to Jen Valberg for her assistance in preparing this blog.

Renewed funding for research in frailty
2017-03-06 Renewed funding for research in frailty

What are the implications of a frail 90-year-old living at home? How will our healthcare system cope with an aging population that is estimated to grow by 30% in the coming years? What is frailty and how do we identify it?

These are important questions –the answers to which will have an impact on all of us at some point in our lives, whether for ourselves or our loved ones. And these questions are at the heart of the work of the Canadian Frailty Network (CFN). Hosted by Queen’s, the CFN, formerly known as Technology Evaluation in the Elderly Network (TECH VALUE NET), was established to improve health care for an aging population and position Canada as a global leader in providing the highest quality of care for the seriously ill elderly. Led by Scientific Director Dr. John Mescedere, the network supports original research and helps train the next generation of health care professionals and scientists to improve outcomes for older Canadians across all settings of care.

This past week the CFN celebrated a major milestone. The network received a renewal of its funding from the Government of Canada’s Networks of Centres of Excellence (NCE) program. Launched in May 2012, CFN will receive $23.9 million in renewal funding for the next five years, matched by $30 million in contributions from 150 partners. With the support of the NCE program, CFN brings together the collective expertise, knowledge, and talent in Canadian health-care research from experts, stakeholders, partners and network members across the country.

Over the past five years, CFN has had a number of successes, including a national partnership with the Canadian Foundation for Healthcare Improvement and Mount Sinai Hospital, which implemented elder-friendly models of care in 17 hospitals in Canada. To date, nearly 550 young scholars, students and trainees have developed enhanced specialized skills and knowledge through CFN. And across Alberta, a study testing out a screening policy for frailty has been rolled out.

The timing of CFN’s ongoing work couldn’t be more pertinent; there are now more Canadians over the age of 65 than under the age of 151, and more than 1 million Canadians who are medically frail. For this second term, CFN will prioritize standardizing how frailty is identified and measured in various care settings while continuing to build evidence on frailty to help health care professionals to make better decisions – ultimately leading to better care for patients.

“Implementing standardized ways to identify and measure frailty will support comparisons between jurisdictions and identify variations in care, outcomes and healthcare resource utilization,” says Dr. Muscedere. “This can increase value from healthcare resources by avoiding under use and overuse of care. Informed by evidence, our goal is the right care, delivered in the right setting, as determined by older frail individuals with their families and caregivers.”

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

  1. http://www.cbc.ca/news/business/statistics-canada-seniors-1.3248295
2017-02-28 The Power of Advocacy and Civic Professionalism

I am thrilled to share the following guest blog by Dr. Chris Simpson, Vice-Dean (Clinical), School of Medicine and Medical Director, Southeastern Ontario Academic Medical Organization (SEAMO) who profiles the important work of Dr. Elizabeth Eisenhauer who serves as Head, Department of Oncology.

“Medicine is a social science and politics is nothing else but medicine on a large scale. Medicine as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution; the politician, the practical anthropologist, must find the means for their actual solution” – Rudolf Virchow

 

It can be pretty easy to be cynical these days. Polarized politics in the United States had led to “fake news” and a new culture of political double-speak that many are calling the “post-truth” era. Here in Ontario, we are witnessing a particularly nasty fight between the Ontario Medical Association and the provincial government. In hospitals across Canada, we struggle with continuous “Code Gridlock” in an environment of increasingly restricted resources. True health care reform seems as far out of reach as ever.

And so it is nice sometimes to reflect on our successes; to shine a light on those in our midst who are providing positive, inspired leadership, driven by the noble ideals of the profession.

I have long admired Dr. Elizabeth Eisenhauer, our Head of Oncology here at Queen’s. Her voice around leadership tables is always so thoughtful and reflective, yet decisive. She is poised and eloquent, but also quite tenacious and driven. Most importantly, however, her heart is always in the right place. She is an authentic physician leader whose long list of achievements has not dulled her inner passion for doing the right things for the right reasons. People trust Elizabeth.

So it was not surprising to me when, about three years ago, she landed in my office with all of her trademark enthusiasm on display, declaring that she had come up with a “wonderful idea”.

That is how the Canadian Tobacco Endgame Summit was born. We talked for two hours, becoming increasingly excited about an idea whose time had come: mapping out a plan to chart the end of tobacco in Canada – a national end-game.

What happened next was truly remarkable, and I had a front row seat to the whole thing. Off the side of her desk, Elizabeth assembled a steering committee of key experts in medicine, tobacco control, law; representatives from the regulatory bodies, numerous stakeholder NGOs (including the CMA), and others. She secured funding, organized meetings, and planned the end-game summit. What makes all this so remarkable, I think, is that it was readily apparent to me and to all that no one but Elizabeth would have been able to pull this off. She is indefatigable. She is relentlessly positive and optimistic. She brings genuine authenticity as a sincere advocate who is doing this from the heart, but also tremendous credibility as an internationally renowned cancer researcher and respected medical leader. When she asked people to do something, they did it for Elizabeth more than they did it for the project. No one wanted to disappoint her. Her vision was clear, and no one doubted for a moment that what we were doing was something very special.

She is an inspiring figure; one who cloaks her brilliance in humility, who leads by example, whose eloquent oratory always seems to capture all the nuances of the moment and keeps everyone motivated and focused.

The very audacity of declaring that a tobacco endgame is something that Canada would be even remotely ready for had all its sharp edges filed down as Elizabeth exercised her highly effective personal leadership style, gently persuaded and chided, and leveraged her considerable intellectual assets.

The summit was a tremendous success. The participants were a “who’s who” of tobacco control, public health, and medical leadership, including Dr. Laurent Marcoux, the CMA President-elect. The background paper can be found here: Tobacco Endgame Summit

“Less than 5 by ’35” was the summit’s rallying cry – we aim to reduce the national smoking rate to less than 5% by 2035.

Last week was the icing on the cake. The federal government announced that it is redoubling its efforts in tobacco control (Seizing the Opportunity: The Future of Tobacco Control in Canada), launching public consultations enroute to a renewed plan that will aim to reduce smoking in Canada to less than 5% by 2035.

Inspired leadership. Powerful advocacy. Meaningful impact. Dr. Eisenhauer serves as an effective antidote to all the cynicism and negativity of our times by personifying civic professionalism at its very best.

 

2017-02-21 A Miracle of Modern Medicine at KGH

This past week, Toronto Star reporter Mary Ormsby, had a feature story that speaks to so many  important issues. The article, which details a miraculous medical event, speaks openly about mental health, speaks magnificently about the marvels of modern medicine, and speaks glowingly about Kingston General Hospital and its staff.  The full article is available online and I encourage readers to access it as Ms. Ormsby writes beautifully about the dramatic story.

https://www.thestar.com/news/insight/2017/02/19/this-queens-student-froze-to-death-on-a-kingston-pier-heres-how-he-came-back-to-life.html

In essence, the article details the saga of a Queen’s student, Tayyab Jafar, who last year was suffering from depression and other mental health conditions and attempted to take his life. And it’s a miracle that saved him. Having become unconscious in the middle of January from an overdose of sedatives in his system, he was found, what sounds like many hours later, with no vital signs and literally frozen; his core body temperature was 16°C lower than normal.

The first hero of the story was Queen’s student Alex Reid, who having found a suicide note, called 911 and started looking for his friend. The second heroes of the story were the team of paramedics, including Jonathan Andreozzi, Julie Socha, Andrew Liersch and Lise-Anne Lepage-McBain who started immediate CPR.

The next part of the story, is nothing short of amazing, and speaks to an incredibly dedicated team at KGH, and nothing short of a miracle of modern medicine. 

The hospital ER team dedicated themselves to an aggressive resuscitation plan, because even though Tayyab was not breathing and had no pulse, he was also incredibly cold, and brain and other organ functions, as we all know, can be preserved in the hypothermic state. The interventions were administered by a large team, including nurse Jane Lewis, E.R physician, Joey Newbigging, and cardiac surgeon Andrew Hamilton. The treatments were many. They included over an hour of CPR. Then there was insertion of tubes into the pleural space for warming. Then there was a bold attempt by Hamilton to use similar technology as one would for a heart bypass procedure, by instituting a procedure known as extracorporeal warming.

Tayyab also received approximately 100 units of blood or blood products. He subsequently was treated for “distressed lungs” using a sophisticated machine-based therapy known as ECMO, or extracorporeal membrane oxygenation.

Ultimately, a long period in the ICU, in part being treated by ICU nurses Vanessa Holmes and Jennifer Bird, and after a long period of rehabilitation, Tayyab has successfully recovered and has returned to Queen’s continuing his studies in mathematics.

If you can excuse the pun, this heartwarming story has many interesting elements; not the least of which is the whole issue of resuscitation after attempted suicide, which I think for health providers in the emergency situation, is an easy decision. Another interesting aspect to the story, is when do you “give up”. In reality, so many individuals in the “team” basically never gave up; his friend, the AMS team, the ER team, the surgical team, his ICU nurses and doctors…all were dedicated to providing a second chance to Tayyab. And finally, to me, the story speaks to how lucky we are that we live in a city which has such a great hospital system. There are not too many small cities like Kingston, which have an academic medical center. Without the quarternary care that Tayyab received, he may well not have survived. We should all be proud of the incredible work of our heath professional team here at KGH and Queen’s.

If you have any thoughts on this story, please respond to the blog, or better yet, please drop by the Macklem House, my door is always open.

 

Richard

1.      https://www.google.ca/search?q=extracorporeal+warming&biw=1366&bih=613&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiXruuSraHSAhVp64MKHRBoDr0Q_AUIBigB#imgrc=RsBzFdVcwhUjnM:

2.       https://www.google.ca/search?q=ecmo&biw=1366&bih=613&tbm=isch&source=lnms&sa=X&ved=0ahUKEwiG2o2hrKHSAhVj1oMKHb2_CLMQ_AUIBigB#imgrc=rDBX5Q0X6zkc-M:

The OMA in crisis; a sad day for the profession
2017-02-07 The OMA in crisis; a sad day for the profession

Yesterday the OMA executive resigned.

In my personal view, this is a sad day for the profession and one that leaves physicians in a fractured and disadvantageous position. It may well be true that it is the only way that we can move forward at this point. But that notwithstanding, we should never have been here in the first place.

The OMA’s relationship with the government is in terrible shape. The anti-government rhetoric emanating on a daily basis from OMA communications cannot be healthy. At some point, sooner than later, the inexorable goal of both parties must be that we get back to the table.

Groups such as the Concerned Ontario Doctors and the Coalition of Ontario Doctors have been effective in their advocacy and have expressed major concern in the OMA leadership. Ultimately, the leaders have resigned.  While it may be true that there is a lot to have been critical about with respect to the successes (or lack thereof) of the OMA in recent years, what has transpired cannot be good for the profession.

The Coalition of Ontario Doctors in their communications have indicated that their principal motivation is with respect to patient care: “this is really a fight about creating and funding a fair and stable system that let’s us provide better healthcare, the kind of healthcare you deserve.”1

I’m not so sure. It’s my observation that their movement is predicated on two essential perspectives. The first is that Ontario doctors have been hard done by financially, and that that needs to be reconciled. The second is a more elusive construct, but akin to the Trump/Brexit movements and other anti-establishment actions of the day.

It is certainly understandable how physician groups have become increasingly frustrated with government over the last few years. Unilateral decision-making, especially negative decisions that seem to be unfairly targeted at physicians, is problematic. But there will be only one vehicle in resolving this issue. And that vehicle is getting back to the table. This is why I personally have written in support of the TPSA (tentative physician services agreement) and was so disappointed to see it defeated this past summer.

One can only hope that sane minds will prevail and positive steps will be taken to rebuild the OMA. This will not be easy given the antics of the last year, however, my own view is that we need to search for some specific qualities in the next leadership group at the OMA. First and foremost, this includes a strong desire to find any means to get back to the table. Second, we must find leadership who would be adamantly opposed to any kind of job action. Third, we need reasoned leadership that can take a balanced perspective with respect to the issue of physician compensation, advocating appropriately for the profession, but working with government in acknowledgement of the fiscal reality that they are faced with. It really doesn’t matter why the government is in such bad financial shape, the fact is they are. Negotiations for the medical profession will have to take that as a given.

Yesterday was not a good day. I’m confident that if leadership emanates from groups that hold extreme views, at this juncture in time, the medical profession will take a great step backwards.

We absolutely must proceed with calm, moderate views, reason and most of all with a fanatical focus on what’s best for the patient as opposed to a preoccupation with the financial interests of physicians.

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

 

  1. https://www.facebook.com/notes/we-are-your-ontario-doctors/welcome-we-n…
2017-01-31 Renewed partnership in Mental Health Research

In 2012, building on the success of its Let’s Talk campaign, Bell Canada pledged funding to support research that tackled mental health stigma. Heather Stuart, an internationally renowned professor in community health and epidemiology here at Queen’s was a natural fit for the role, and was named the Bell Mental Health and Anti-Stigma Research Chair, the first of its kind in the world.

By the time this chair was established, Dr. Stuart had been listening for 15 years, both with the WPA and with the Mental Health Commission of Canada, which had also approached her for advice on how to eradicate stigma nationwide. “We had learned that knowledge isn’t the key to overcoming stigma. The key is to change behaviours.”

Following Dr. Stuart’s advice, the Opening Minds Anti-stigma initiative of the Mental Health Commission assembled a team of researchers from five Canadian universities to focus their efforts and affect change.

The initiative used an approach called “contact-based education,” in which people living with mental illnesses – not actors or researchers – deliver the message and answer questions. The result was an impressive record of intended behavioural change that garnered an Innovation Award from the international research community and put Canada at the forefront of the anti-stigma movement.

Shortly before accepting the Bell chair, Dr. Stuart met with Bell Let’s Talk representatives and senior Bell executives to discuss what a partnership could mean for broadening efforts against stigma. It quickly became clear that the Bell Let’s Talk initiative would be the ideal public platform to give Dr. Stuart’s research a national voice, and soon after, the “Breaking the Silence” discussion series was born.

Every year since the chair was unveiled, Dr. Stuart has joined Canadian celebrities and Bell Let’s Talk representatives in a public forum to inspire open discussions around mental health issues in Canadian cities, hosted in partnership with Queen’s University Alumni Association branches in Toronto, Montreal, Calgary, and Vancouver.

When she isn’t helping Canadians talk openly about mental illnesses, Dr. Stuart has been working to eradicate stigma by changing behaviours— among individuals and organizations. As part of her role with the Mental Health Commission of Canada, Dr. Stuart worked with Statistics Canada to include questions about stigma in its 2016 Canadian Community Health Survey.

As a result of this inclusion, the way national data is collected now takes into account reporting on stigma. “We now know how people experience stigma and what impact it has,” Dr. Stuart says. “We know how many people experience it and how severe it is. And now researchers all over Canada are analyzing it and producing knowledge around stigma.” It was an important addition to Canada’s national data practices and signalled a vital change in the way Statistics Canada reports on mental health.

While much of Dr. Stuart’s work has concentrated on healthcare providers, the media, workplaces, and youth, one of her most impressive accomplishments focused on the behaviours of all Canadians. In 2013, through the partnership between Queen’s and Bell Let’s Talk, Dr. Stuart introduced five simple ways all Canadians can reduce stigma— through language, education, kindness, listening, and talking.

Four years later, these five ways are at the forefront of the Bell Let’s Talk campaign, and have broken down barriers to allow Canadians to share their mental health stories during Bell Let’s Talk Day through social media with the hashtag #BellLetsTalk.

This past week, we celebrated the renewal of the Bell Mental Health and Anti-Stigma Research Chair. As she gets set to begin her second term, Dr. Stuart is looking forward to changing more behaviours. She is currently working on an online educational program to help deliver tailored learning experiences to high school students.

She has also worked with Bell and human resources consultant Morneau Shepell to develop an online certificate course for workplace supervisors. This collaboration has important implications for workplaces across the country.

Mostly, though, Dr. Stuart looks forward to building on the accomplishments of the last five years. “We tried a lot of things,” she says. “We feel we know what works most effectively. Now we have to be more tailored and specific and think about matching interventions to need. That’s the challenge for the next five years.”

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

Thank you to our alumni relations team for their assistance in preparing this blog.

New Partnership to Develop Transformational Leaders in Ethiopia
2017-01-16 New Partnership to Develop Transformational Leaders in Ethiopia

For this week’s blog, I am thrilled to share a guest post from Marcia Finlayson, Vice Dean (Health Sciences) and Director, School of Rehabilitation Therapy who shares some exciting news from the school.

One of the strategic priorities of the School of Rehabilitation Therapy is to make meaningful contributions to the work of our collaborators locally, nationally and internationally.  Today we are very pleased to announce that we have made a major step towards meeting this goal through a 10 year, USD$24.2 million partnership with Ethiopia’s University of Gondar and The MasterCard Foundation’s Scholars Program. This announcement represents the culmination of 18 months of collaboration grounded in our mutual expertise in and commitment to community based rehabilitation (CBR) and inclusive education.

The MasterCard Foundation partners with academic institutions and NGOs to educate and develop next generation leaders who are committed to contributing to their communities. Increasing access to post-secondary education for disadvantaged youth is vital to this effort. Our partnership will focus on one segment of this target population: youth with disabilities. Our longterm goal is to bring children with disabilities out of homes and into schools for primary and secondary education so that they can be represented in post-secondary education in the future. Transformational leaders are required to achieve this goal. Our partnership with the University of Gondar and The MasterCard Foundation will contribute to launching these leaders.

First, project staff at the two universities will develop and implement a training certificate in CBR that will provide experiential learning opportunities for The MasterCard Foundation Scholars at the University of Gondar. CBR is a multi-sectoral strategy that focuses on enhancing quality of life for people with disabilities and their families; meeting basic needs; and ensuring inclusion and participation. A major role of CBR professionals is to work with families and communities to identify children with disabilities and find ways to get them into school. Through the CBR certificate, Scholars at the University of Gondar will learn about the rights of people with disabilities and practical strategies to enable people with disabilities to access educational and other life opportunities. The certificate will provide participating Scholars at the University of Gondar with critical skills and experiences necessary for their development as transformational leaders.

Second, Queen’s will provide opportunities for up to 60 University of Gondar faculty to upgrade their credentials to a master’s or PhD, and to engage in research collaborations with Queen’s faculty to address issues related to inclusive education. Through these opportunities, faculty from both universities will contribute to developing the next generation of leaders in Ethiopia and Africa.

Finally, some of the University of Gondar faculty coming to Queen’s will complete the occupational therapy program in the School of Rehabilitation Therapy and then work with our faculty to develop and launch the first occupational therapy program in Ethiopia. Occupational therapists enable people of all ages and abilities to engage in the tasks and activities that are important and meaningful to them in the context of everyday life. This work involves building skills and abilities of individuals, families and communities; modifying environments to make them inclusive; and adapting the ways in which tasks and activities are performed to enable people to participate in them. Globally, occupational therapists play an important role in supporting access to education, classroom accessibility, inclusion, and human rights for people with disabilities. By developing an occupational therapy program at the University of Gondar, our partnership will create a new career path for transformational leaders in Ethiopia.

We are incredibly honoured and grateful for the opportunity to partner with the University of Gondar and The MasterCard Foundation.  We have a lot of hard work ahead of us and we are confident that our collective efforts will be transformative for current and future students and faculty at both universities, and the many people who they will work with in the future. The International Centre for the Advancement of Community Based Rehabilitation, based here in the School of Rehabilitation Therapy and led by Heather Aldersey, will be the hub of project activities here at Queen’s.  If you have questions about the project, please do not hesitate to reach out to Dr. Aldersey.

To learn more about the project, please see the following stories in the Queen’s Gazette:

The MasterCard Foundation $24M grant launches 10-year, int’l project

Queen’s-Gondar project an opportunity to push programming further

A mission to bolster the strength of Africa’s young people

2017-01-11 Queen’s graduate students are paying it forward

When PhD students Piriya Yoganathan and Mathieu Crupi learned that funding for the Queen’s Transdisciplinary Training Program in Cancer Research would be challenged in 2018, they couldn’t sit back and watch the program close.

“The Transdisciplinary Program is what attracted me to Queen’s,” says Piriya, “it’s such an invaluable program, and having been through it, Mathieu and I feel passionately about making sure that it continues.”

Piriya and Mathieu were already co-chairs of the Kingston Research Information Outreach team – a club affiliated with the Canadian Cancer Society – when they decided to work together to find a solution to the Transdisciplinary Program’s unstable future funding. Along with a group of their fellow students, they dreamed up the idea of a fundraising dinner that would bring in new funding for the program.

The Daffodil Gala, which is the product of months of hard work and planning, will take place on February 3rd at the Isabel Bader Centre and members of the Kingston and Queen’s community are welcome to attend. “I am astounded by the enthusiasm that our trainees feel for their work, their studies and their program,” says Lois Mulligan, Professor and founder of the Transdisciplinary program. “The Daffodil Gala, and the initiatives to support the Training Program have been completely driven by the current students. They are passionate about giving the next generation opportunities to experience what they have; they are an exceptional group in every way. The future of cancer research and cancer care is in good hands with these people.”

I have already bought my tickets, and I invite you to join me in supporting this fantastic initiative. For more information or to purchase tickets to The Daffodil Gala, click here.

Founded in 2002, the Transdisciplinary Program is an incredibly unique program that brings together young cancer researchers who would not normally work in the same environment, and together they function as a multidisciplinary team. These young investigators, including undergraduate and graduate students and fellows, then receive interdisciplinary training including courses, professional skills development, and hands-on research experience that spans the breadth of cancer research today. The students also have the opportunity to work with faculty mentors, who could come from any of 11 departments at Queen’s and KGH, as well as from the School of Business and the Office of Global Health.

“Our students get the chance to learn from each other as well as faculty mentors and other cancer experts,” says Lois. “One of the most exciting aspects of the Transdisciplinary Program is having the students in one area of research explain to others in completely unrelated areas why their work is important and exciting. The cross fertilization is amazing and helps drive future collaborations and communication.”

The result is graduates who are exceptional researchers with a broad understanding of cancer. Because of the nature of the program, they are equipped to communicate their research ideas, and help to speed the application of scientific advances into clinical practice, patient care, and cancer prevention. According to Lois, 90% of graduates have gone on to further training or careers as clinicians, or in cancer research and cancer control. Mathieu plans to be a part of that statistic when he graduates this year: interested in lung cancer research, he plans to pursue a postdoc, and to eventually become a professor.

As always, please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

Thank you to Jen Valberg for her assistance in preparing this blog.

2017-01-09 A tragedy turns the spotlight to mental health

This past week, Canadians have been processing the devastating story of the deaths of military veteran Lionel Desmond, his wife Shanna, their 10-year-old daughter, Aliyah, and his mother, Brenda. In what the media is calling an apparent murder-suicide, it is believed that Lionel took the lives of his family members before taking his own.

Lionel, who had recently returned from a tour in Afghanistan, had been living with post-traumatic stress disorder (PTSD), a condition that had been with him since finishing his first tour in Afghanistan in 2007. “He would flip between being a loving husband and father and a shell-shocked veteran. He had nightmares, flashbacks and struggled to find a treatment that would help him,” said Lionel’s sister in law, Shonda Borden.1

While Lionel was receiving mental health treatment and support, that support ended upon his release from the military in 2015. Upon returning home to Nova Scotia, Lionel was unable to get the help with PTSD that he needed. According to Lionel’s family, he had been actively seeking treatment from St. Martha’s Regional Hospital in Antigonish, N.S., but had been turned away.2

Knowing that Lionel was struggling to get the support he needed brings up a difficult question: should he have had better support, could this tragedy have been prevented?

The Canadian Mental Health Association describes PTSD as a mental illness “that causes intrusive symptoms such as re-experiencing the traumatic event. Many people have vivid nightmares, flashbacks, or thoughts of the event that seem to come from nowhere… PTSD can make people feel very nervous or ‘on edge’ all the time. Many feel startled very easily, have a hard time concentrating, feel irritable, or have problems sleeping well. They may often feel like something terrible is about to happen, even when they are safe. Some people feel very numb and detached. They may feel like things around them aren’t real, feel disconnected from their body or thoughts, or have a hard time feeling emotions.”3 And the impact on our military and Veterans is widespread: based on statistics from Veterans Affairs and the Department of National Defence, “nearly one in 10 of the Canadian military personnel who took part in the mission in Afghanistan are now collecting disability benefits for post-traumatic stress disorder.”4

The incidence mental illness among Veterans is something that the Canadian Institute for Military & Veteran Health Research (CIMVHR), housed here at Queen’s, focuses on in its work. Made up of 42 collaborating universities, the institute acts as a focal point for research on the health and healthcare needs of the Canadian military, Veterans and their families. CIMVHR also acts as a conduit between the academic community, government organizations and industry. In building and fostering a body of research, CIMVHR is poised to disseminate the most current evidence, which can be used to educate clinicians and policy makers and to form recommendations that will improve the support and care that our military, Veterans and their families receive.

Out of a heart-breaking situation, the fact that the national spotlight has again been turned to mental health, the health of our Veterans and the ongoing struggles that they face when they transition to civilian life might be seen as one of the few positive outcomes. I hope that Lionel’s story serves as motivation for a focus on the need for augmented resources for mental health issues in general, and for those affecting our military, Veterans and their families in specific.

Please share your thoughts by commenting on the blog…or better yet, drop by the Macklem House, my door is always open.

 

  1. http://www.cbc.ca/news/canada/nova-scotia/lionel-shanna-aaliyah-desmond-murder-suicide-ptsd-veteran-1.3922287
  2. http://www.cbc.ca/news/canada/nova-scotia/lionel-desmond-veteran-ptsd-murder-suicide-inquiry-shooting-1.3922625
  3. http://www.cmha.ca/mental_health/post-traumatic-stress-disorder/#.WG_op7YrJTZ
  4. http://www.theglobeandmail.com/news/politics/one-in-10-canadian-vets-of…

 

Thank you to Jen Valberg for her assistance in preparing this blog.

2015-16 Dean’s Report: Looking back on a great year
2016-12-13 2015-16 Dean’s Report: Looking back on a great year

The 2015-16 Dean’s Report has just been sent to print and will be available both in print and online in the new year. The report serves as a retrospective on the year we’ve had and is full of successes across our three schools. In the interest of giving you a sneak peak, the following are my opening remarks, with mention of some of the stories that you’ll see highlighted in this year’s report.

2016 marks a huge milestone for Queen’s. It is the 175th anniversary of the University, and this year has seen a large number of celebrations across our faculties and many reminders of our rich history as an institution. And this is a very special time for the Faculty of Health Sciences. 2016 marked the 75th anniversary of the School of Nursing, and 2017 will mark the 50th anniversary of the School of Rehabilitation Therapy. Both schools have used their anniversaries as opportunities to hold celebratory events, and to unite alumni around the important work that our schools do in educating health professionals. 

This Dean’s Report marks a much newer anniversary: my fifth report, and the completion of my first term as Dean of the Faculty of Health Sciences. Reflecting back on my time here, much has been accomplished, and it is all thanks to a remarkable group of individuals who make up our faculty, staff and students. 

We have developed and launched 11 new educational programs, from the Queen’s Accelerated Route to Medical School to the continuously growing Master of Science in Healthcare Quality to a graduate diploma, Masters and PhD in Aging & Health. And as you’ll read in this year’s report, the Faculty of Health Sciences has launched a brand new online undergraduate degree: the Bachelor of Health Sciences. 

Despite a challenging research environment in Canada, we have focused on strengthening our research mission. Over the last five years we have seen the establishment of several new research chairs; we have built a clinician scientist recruitment program that led to the recruitment of 11 outstanding clinician scientists; we saw the Canadian Institute for Military and Veterans Health Research become the driving force behind military health research in our country. And as you’ll read in this report, we have seen some of our clinical trials from the Canadian Cancer Trials Group recognized as the best in the world. 

But what I am most proud of is the work that we have done to bring our three schools together. While each school has a distinct mission, five years ago we created a shared vision: In the Faculty of Health Sciences, we ask questions, seek answers, inspire change and advance care. Our three schools now work collaboratively at our executive table, in budget processes, in fundraising and in interdisciplinary programming and we are all better for this great partnership that we have forged. 

I would like to say a special thank you to Jen Valberg for all of her work in putting this year’s report together. I look forward to sharing it with you in the new year.

This will be my last blog post of 2016, and before I sign off, I would like to wish all of you a wonderful holiday and a happy new year. Please share your thoughts and holiday plans by commenting on the blog. And if you would like to drop by the Macklem house, I would suggest waiting until January 3rd….After that, as always, my door will be open.

All my best,

Richard

Building empathy through the First Patient program
2016-12-05 Building empathy through the First Patient program

One of the most unique aspects of undergraduate medicine curriculum is the First Patient Program. It offers students the opportunity to experience the healthcare process with a real patient; from the very beginning of their academic journeys.

At the start of the school year, each of our first year students is paired with a patient from the Kingston community. The student then accompanies the patient to treatments and appointments over the next 18 months. The program has three main objectives. The first, is to give students the opportunity to observe and assist, help to care for patients and buoy their spirits, while developing and honing diagnostic and treatment skills. The second is for our students to become holistically integrated into the lives of patients, in order to build the crucial skills every successful health care provider needs. And the third is to help students to develop an understanding that patient-care exists on a continuum, from prevention to diagnostics to treatment to wellness, across different services and specialties. Although the program officially runs until the end of their second year, many students often stay in touch with and continue to follow their patients even after the official period of the program is over.

Learning to be a good doctor is a personal as well as a professional task, and learning to deliver care patient-centered care is one of the keys to a successful practice. With that in mind, one of the biggest benefits to the program is that our students are developing something that cannot be taught in a classroom: empathy.

Alana Fleet and Jonathan Cluett are medical students who were paired with a patient, Bill, as part of the program. “While it’s easy to be interested in our medical findings, we should not see patients as specimens,” says Alana. “Rather, we need to see and act like they are people first, with a problem to attend to in the right way. We should be interested in them, but not only in what is “wrong’ with their body, since what we see as pathological is also their norm. What helps us to excel is by making connections between the small problem at hand and the whole person.”

Bill turned out to be a great pairing for Alana and Jonathan, not least because his wife Lorna was a constant companion, sharing her own healthcare story, creating a two-in-one situation for the students to respond to. “I now better appreciate that even when patients are positive and motivated, their healthcare experiences are complicated and varied,” says Alana. “In my first report I commented on the ease of developing a relationship with my patient. While this was the case with Bill, it’s not that way with all patients and professionals. Even for Bill, his relationships vary with his doctors and other providers. Subtle aspects of your personality or behaviours can strengthen a physician-patient relationship or break it down quite quickly. Thus, I have become much more self-aware and open to ask for feedback, to gauge my interactions with patients.”

Jonathan’s sentiments echo Alana’s. “Above all else, Bill and Lorna have taught me the simplest lesson: to care for the whole person. Again, this is not a novel concept. Medical students hear it from day one. But it doesn’t quite click until you see it firsthand. I feel humbled to have learned so much from this program. I will always remember Bill and Lorna my true ‘first’ patients.”

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

 

Thank you to Jen Valberg for her help in preparing this blog.

Transforming medical education through diversity
2016-11-27 Transforming medical education through diversity

In the fall of 2014, Dr. Mala Joneja was appointed to a brand new role in the School of Medicine: Director of Diversity and Equity. Dr. Joneja studied medicine here at Queen’s, completed her postgraduate training in Internal Medicine and Rheumatology at Western University and earned a Master of Education degree in Health Professions Education (theory and policy studies) from OISE, University of Toronto. She is an Associate Professor in the Division of Rheumatology and in addition to being active in both undergraduate and postgraduate education, she is currently serving as acting Division Chair for Rheumatology.

Diversity is an important standard for every medical school in North America these days. Over the last decade, we have seen an increased focus on enhancing the diversity of our student populations, our faculty members and those who work in healthcare. This focus is about representing and relating to the people who health care providers see as patients. As Dr. Joneja says in her blog post, Seeking Diversity and Inclusion in Medical Education, “there is a move to ensure that the students who are studying to become physicians are as diverse as the population they are going to serve when they graduate.” In other words, fostering diversity in the learning environment means that we will graduate better doctors. According to the Association of American Medical Colleges’ publication, Diversity and Inclusion in Academic Medicine: A Strategic Planning Guide, “in a recent study from Harvard and the University of California […] students reported that contact with diverse peers led to a more balanced exchange of information in classroom discussions, more serious discussions of alternative viewpoints about disease and treatments, greater appreciation of inequities in the health care system, and more cultural sensitivity.”

In her role as Director of Diversity and Equity, Dr. Joneja’s goal is to “have an inclusive environment and an environment of respect for all students, staff and faculty members.” And the terms of her role lay out specific responsibilities related to promoting diversity:

  • Identify areas of priority need for diversity, equity and social accountability
  • Conduct a regular review of our Social Accountability and Diversity Statement
  • Establish formal linkages with the First Nations populations in the region, including Four Directions
  • Work with the Registrar’s Office to identify schools in our region and work to develop pipeline programs to attract members of our target groups to Queen’s
  • Work with the Admissions Committee to link the pipeline program to the admissions process for the School of Medicine
  • Develop collaborative programs with our regional partners and high schools to increase their exposure to Queen’s School of Medicine and promote admissions for students with low socio-economic status
    • On campus summer programs
    • Peer mentorship programs
    • Promote possibility of becoming a Queen’s medical student
  • Chair the Diversity Committee to promote increased awareness and knowledge of diversity issues, promoting and sponsoring diversity projects amongst medical students
  • Facilitate or conduct educational programs and/or special events related to Diversity
  • Collaborate with the staffing office to promote Diversity and ensure hiring processes are compatible with the Equity Office regulations
  • Collaborate with the Faculty Development office to ensure all incoming faculty have the knowledge and skills to operate effectively within a diverse organization
  • Develop annual processes to assess and report on diversity target group representation in the School of Medicine

Dr. Joneja has been busy these last two years, implementing and supporting a variety of initiatives towards these objectives.

Early in her role, Dr. Joneja identified a need for a strategic plan for diversity and inclusion in the School of Medicine. She chairs a diversity panel, made up of students, faculty members, representatives from the equity office and education developers. The panel meets monthly and works to create partnerships, incite discussion and ultimately build what will be the school’s strategic plan for diversity.

More and more, social accountability is becoming a part of accreditation standards, and schools are expected to have specific goals related to promoting and enhancing diversity outcomes among its students, faculty and leadership. This includes the appropriate use of policies and practices, programs and partnerships and achieving diversity among qualified applicants for medical school admission. Dr. Joneja is helping the school to achieve these goals by working with the education leadership and the admissions committee.

Diversity in student recruitment has been another focus for Dr. Joneja. This year, Ann Deer, Indigenous Access and Recruitment Coordinator, was hired to connect the School of Medicine with potential indigenous students who are interested in applying to medical school, and to share knowledge about Queen’s and Kingston. With Dr. Joneja’s help, this role has now become part of a recruitment program that includes student support and connecting students across faculties. Dr. Joneja also sits on the Truth and Reconciliation Commission of Canada (TRC) Task Force for the Faculty of Health Sciences, which will make recommendations to be implemented within the school, its curriculum and policies.

But diversity doesn’t end with our student population; Dr. Joneja is also spearheading an initiative to assess and increase diversity amongst our faculty members. Dr. Joneja is promoting the use, amongst Department Heads within the School of Medicine, of the Diversity and Equity Self-Assessment and Planning Tool (DEAP) developed by the Queen’s Equity Office. The DEAP tool allows leaders to identify gaps and areas needing improvement, and then to develop and execute plans for enhanced diversity. Changing the diversity of our faculty members is a slower process than our student population; with much less frequent turnover, this is a long-term initiative. But seeing a faculty population that is reflective of the diversity of our student population and the population at large is no less important to fostering a culture of inclusivity within the School of Medicine.

I am extremely proud of the momentum that Dr. Joneja has created through her initiatives so far, and I look forward to seeing the effects of this important push to enhance diversity and inclusion in the School of Medicine. There is no doubt that this process is enriching for our leadership, students, trainees and faculty members.

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

And if you are a student, resident or faculty member and have an issue that Dr. Joneja can be of assistance with, she would be interested in hearing from you. Please contact her at: mj6@queensu.ca

 

Thank you to Jen Valberg for her assistance in preparing this blog.

2016-11-21 Stephen Archer earns top honour in heart research

This past week, Dr. Stephen Archer travelled to New Orleans to accept a very special honour from one of the world’s most important organizations for cardiovascular health and research: he received the Distinguished Scientist Award from the American Heart Association.

The Distinguished Scientist designation was created in 2003 to honor American Heart Association members who have made extraordinary contributions to cardiovascular and stroke research. The American Heart Association’s Distinguished Scientists are a prominent group of scientists and clinicians whose work has advanced the understanding of cardiovascular diseases and stroke. This prestigious honour is a celebration of Dr. Archer’s lifetime of ground-breaking research and a long list of discoveries that have advanced care for patients with pulmonary hypertension and cancer.

Now a world-renowned cardiologist and scientist, Dr. Archer grew up on the east coast of Canada. He came to Queen’s to study medicine and graduated in 1981. Dr. Archer completed his Internal Medicine Residency and Cardiology Fellowship at the University of Minnesota. He then was a Faculty Cardiologist at the University of Minnesota for ten years. Moving back to Canada in 1998, Dr. Archer served as Chief of Cardiology at the University of Alberta for nine years before moving on to the University of Chicago. After four years serving as Chief of Cardiology there, he returned to Queen’s to take a position as Head of the Department of Medicine at Queen’s. And in his role as head, Dr. Archer has had a transformational impact on the Department of Medicine and its research portfolio. In a few months’ time, the Queen’s CardioPulmonary Unit (Q-CPU) – a state of the art international research unit spearheaded by Dr. Archer – will open its doors on campus.

Dr. Archer holds a Tier 1 Canada Research Chair in Mitochondrial Dynamics and Translational Medicine. He recently received a $4 million CIHR Foundation Award to support a project examining the mechanism of mitochondrial fission with a focus on understanding the interaction between an enzyme called dynamic relate protein 1 (Drp1) and its four binding partners. To learn more about his research read his recent blog post: Targeting Mitochondrial Dynamics to Treat Cancer and Pulmonary Hypertension.

Please share your words of congratulations and thoughts on this award by commenting on the blog, or better yet, drop by Dr. Archer’s office in Etherington Hall…his door is always open.

 

 

Competency Based Medical Education at Queen’s: Change FOR us, BY Us
2016-11-08 Competency Based Medical Education at Queen’s: Change FOR us, BY Us

Guest blog by Dr. Jena Hall, PGY 2/CIP Obstetrics and Gynecology, on behalf of the CBME Resident Subcommittee

For some time, there has been a buzz around Competency Based Medical Education (CBME) at Queen’s – that it’s coming soon, it means more assessment, and potentially shorter residencies? … Let’s look at the facts.

CBME will be implemented across Canada by 2021 on slightly differing schedules depending on specialties. The Royal College (RC) granted Queen’s a ‘fast track’ implementation (i.e. all of our programs are implementing CBME at the same time). On July 1 2017, all incoming Queen’s residents will begin their residencies in CBME curricula. Although current Queen’s residents will remain in standard curricular models, we can contribute to CBME related changes and take advantage of improved assessment practices as they roll out.

CBME does not mean residencies will be shorter, as the RC version of CBME is a hybrid model using competency and time. However, residents who excel in CBME models may have opportunity to pursue more electives. Alternatively, residents requiring more time in one area will be identified earlier and enhanced learning plans will be tailored to meet their learning needs, with the goal of avoiding formal remediation.

So why can we not just change the way we assess residents without such an overhaul? The reason is, CBME is more than just better assessment. CBME is an entire paradigm shift to rethink the way we teach and learn modern medicine. It moves the focus of residency curricula away from short term, rotation based objectives and towards long term residency outcomes. This reform stems from a societal need for increased accountability and quality improvement in medicine; a need to redesign residency training to meet the standards of modern health care systems.

For residents, incoming and current, there are a number of perks that come with CBME. First, clinical rotations and formal teaching sessions (academic half day, grand rounds, etc.) will have clear and specific objectives, with actionable steps for improvement in performance along a continuum towards achieving the ‘competent’ or ‘entrustable’ level. You may be asking, “What is wrong with the objectives we have now?”. Nothing… except that they are often vague, reflect only the highest level of performance, and provide no information about how to improve.

For example, performance of a caesarean section may be a procedural objective for both a junior and senior obstetrics (OB) rotation. A junior OB resident will not perform a C-section at the same performance level as a senior resident. They will likely need more support and only do certain portions of that procedure. Does this mean that the junior resident ‘fails’ to achieve that objective? Or, does it mean that they are successfully performing the activity for their level of development, but ‘not yet achieving’ competence? CBME helps make that transition from ‘failure’ to ‘not yet achieved’ while providing specific descriptions of observable behaviours at each performance level. These descriptions provide concrete stepping-stones for residents to strive towards.

Second, with increased direct observation, comes more specific and timely feedback. How often has resident feedback read, “no concerns”, “read more”, or “solid resident”? It is not easy to give specific, helpful feedback, particularly since most physicians get little, if any, training in how to do so. Those qualitative performance stepping-stones I described above will also help here. They will provide supervising physicians with better descriptions of performance at different levels, and help cue more specific feedback.

With all of this said, there will be challenges that come with this change. As assessment practices change, adjustments will be required. As training objectives change, rotations will require modification, and the results of all of this are yet unknown. It will take time to adjust to this paradigm shift involving more direct observation, more frequent and specific assessment, and learning driven by residents and faculty together. This will all take time, calculated trials, and open-mindedness. But, while it is new in practice, CBME is supported by substantial literature grounded in educational theory, unlike our current model for residency education.

I am excited to be a resident entering this era of educational reform. I am also realistically aware that with change come many challenges, which residents, faculty, and administrators will have to work together to overcome. The accelerated CBME integration at Queen’s means that we, as residents, now more than ever, have an incredible opportunity to be involved in the improvement of Canadian and international residency education. This is change for us, by us.

 

Join the discussion!

CBME Town Hall
Dr. Richard Reznick and the CBME Executive Team invite you to share your perspective and ask questions regarding CBME transition at Queen’s via an open-dialogue format

November 14th, 4:30pm to 5:30pm, SOM Lecture Hall 132A

Everyone welcome to attend.

2016-10-31 The Poet of My Generation Wins the Nobel Prize

Each year I have the privilege of addressing the first year class the day they start medical school. I try to give them a sense of the quality of the medical school they are joining, the rigors that the next four years will bring, and the marvelous opportunities a career in medicine provides. I emphasize that I want them to be restless, to pay attention to the important roles physicians play in our society, and to strive to be involved in our health care system. Most importantly, I tell them that it’s critically important that they strive to do something special. In the last few years, I have ended my speech by leaving them with a poem. I say to them, let me finish with a small gift from me to you, the words of the poet of my generation. Some of you may have heard of him; his name is Bob Dylan. In his wonderful song,Forever Young, Dylan says:

May your hands always be busy 
May your feet always be swift
May you have a strong foundation
When the winds of changes shift
May your heart always be joyful
And may your song always be sung
May you stay forever young

I have been a Dylan fan for as long as I can remember, well at least since 1964 when The Times They are a-Changin’ was released. I have seen him live many times, have dozens of his records, own countless CD’s and have a few Dylan books on my shelf. I’ve studied his lyrics, sang his songs, strummed his tunes, and embedded many of his words in my presentations.

So you can imagine how thrilled I was on October 13th when it was announced, to a somewhat shocked crowd at the Royal Academy Hall in Stockholm, that Dylan will be this year’s recipient of the Nobel Prize in Literature, for “having created new poetic expressions within the great American song tradition”.1 Dylan joins Pearl Buck, T.S. Eliot, William Faulkner, Ernest Hemmingway, John Steinbeck, Saul Bellow, Isaac Bashevis Singer, Toni Morrison, and others, as American greats who have won the prize.2

The Rolling Stone magazine applauded the fact the award, the first ever won by a musician, was given to Dylan. They said: “The Nobel committee got this right – Dylan’s ongoing achievement in American song is a literary feat to celebrate in this gaudiest of ways. The fact that he’s won this award – yet another scandalous international incident to add to his resume – is something to celebrate as well.”3

Famous novelist, Salmon Rushdie wrote on why the lyrics in Dylan’s songs equated to literature. He said, “We live in a time of great lyricist-songwriters – Leonard Cohen, Paul Simon, Joni Mitchell, Tom Waits – but Dylan towers over everyone. His words have been an inspiration to me ever since I first heard a Dylan album at school, and I am delighted by his Nobel win.”4

The decision, however, was not received well by everyone, with Trainspotting author Irvine Welsh labeling it an “ill conceived nostalgia award”. The Scottish novelist and playwright tweeted: “I’m a Dylan fan, but this is an ill conceived nostalgia award wrenched from the rancid prostates of senile, gibbering hippies.”5

U.K. Telegraph historian Tim Stanley “accused the committee of attempting to “please the crowd” in a column headlined, “A world that gives Bob Dylan a Nobel Prize is a world that nominates Trump for president.”6

All that said, I am pleased! Think about it…the magic of the words.

How many ears must one man have before he can hear people cry? Yes, and how many deaths will it take ’til he knows that too many people have died?

I was so much older then, I’m younger than that now.

You better start swimming or sink like a stone, cause the times they are a-changing.

The answer my friend, is blowin’ in the wind, the answer is blowin’ in the wind.

Let us not talk falsely now, the hour is getting late.

Heard ten thousand whispering and nobody listening. Heard one person starve, I heard many people laughing. Heard the song of a poet who died in the gutter.

You don’t need a weatherman to know which way the wind blows.7

I will continue to share Dylan with my students. In fact, as I finish this blog, I am going downstairs, pulling Blonde on Blonde from my record collection, and dimming the lights, I will listen quietly to the beauty of Visions of Johanna.

If you have any thoughts about Dylan’s Nobel Prize, respond to the blog, or better yet, please drop by the Macklem House and we’ll share a song or two.

Richard

  1. https://www.nobelprize.org/nobel_prizes/literature/laureates/2016/press.html
  2. https://tomastranstromer.net/nobel-prize/american-nobel-laureates-in-literature/
  3. http://www.rollingstone.com/music/features/why-bob-dylan-deserves-his-nobel-prize-w444799
  4. http://guardian.ng/art/divided-house-of-literature-for-bob-dylans-nobel-prize-wina
  5. http://www.independent.co.uk/news/people/bob-dylan-nobel-prize-latest-literature-win-speechless-silence-a7386051.html
  6. http://www.washingtontimes.com/news/2016/oct/13/bob-dylans-nobel-prize-sets-off-literature-debate/
  7. http://rockwisdom.com/dbcategories/zbobdylan.asp
2016-10-24 The Horse Has Left the Barn

Guest post by Dr. Karen Smith, Professor, Physical Medicine & Rehabilitation and Associate Dean, Continuing Professional Development

“The horse has left the barn”

This thought crosses my mind when I hear people talk about recognizing the signs and symptoms of concussion. This is not to minimize the importance of recognizing and responding appropriately when one occurs, something that could have helped rugby player, Rowan Stringer who died in 2013 after suffering 2 concussions within one week. Since 2015, Ontario has an education policy on concussion awareness, prevention, identification and management in publicly-funded schools in Ontario. In my opinion, however, we still need to maintain our vigilance towards prevention of concussion and there is much that can be done.

My clinical practice is in Physical Medicine and Rehabilitation, specifically acquired brain and spinal cord injury rehabilitation. In my almost 30 years of practice, I have felt at least some of my time needs to be spent trying to put myself out of business! That is why I have served on the Board of the Kingston Chapter of ThinkFirst for many years.  ThinkFirst was started by Canadian Neurosurgeon, Dr. Charles Tator, who had a vision to prevent injury in children and youth. ThinkFirst Canada has joined with Safe Communities Canada, SMARTRISK, and Safe Kids Canada to become a National charitable organization dedicated to preventing injuries and saving lives under the name Parachute.

The bottom line message in injury prevention is not to discourage but to encourage activity while practising safe behaviours including taking smart risks, wearing the right gear, getting trained, driving sober (which includes any substances as well as not driving while distracted, angry or sleepy).

The three pillars of injury prevention can be described as the 3 E’s: Education, Environment and Enforcement. Education includes providing evidence informed recommendations on safe play, use of appropriate safety equipment, concussion recognition and management amongst many others.  Environment refers to how the built environment can reduce injury such as bicycle lanes that are totally separate from other vehicular traffic.  Enforcement refers to the bringing in laws and regulations to reduce injury such as the mandatory wearing of helmets under age 18 in Ontario, child seat legislation and others.

“Research shows that a properly fitted helmet can decrease the risk of serious head injury by over 80 percent. Head injury rates among children and youth cyclists are about 25 per cent lower in provinces with helmet laws, compared to provinces without. Only four provinces in Canada currently have cycling legislation in place that cover all ages. Legislation, in conjunction with ongoing education and enforcement programs, is necessary to make helmet use the norm. Both helmet use and cycling should be promoted to keep kids healthy, active and safe.”  www.parachute.org/policy/item/246

With all this evidence supporting the use of helmets, the coordinator for our Kingston Chapter of ThinkFirst spent one hour at the corner of Union St and University Ave one fine October morning from 11:15 am until 12:15 pm.  He counted the number of students on bicycles and on skateboards and counted the number of students wearing helmets.  None of the 18 students on skateboards were wearing any helmet! The recommended helmet for skateboards is a multiple impact helmet which gives more protection to the back of the head than a bicycle helmet.

Only 22 of the 140 students on bicycles were wearing a helmet!  That means 86 % of students were not wearing a helmet. Eighty-six percent of this great University’s future leaders, innovators and scholars are not protecting their greatest asset…….their brain.

There are many helmets available for bicycle riding and they do not need to be the top of the line or the most expensive ones to give protection from lacerations and brain injury.  They should be certified and you can look for a number of different logos as evidence that the helmet has been tested including Canadian Standards Association (CSA) among others.  Also the helmet needs to fit properly. Fitting and safety standards can be found on the following website.  http://www.parachutecanada.org/active-and-safe/item/engineering-equipme…

If you are under 18 years of age helmets are required by law and you risk a fine if you are not wearing one.  In addition, there are a number of other guidelines ands regulations that you should be aware of such as the use of lights, reflectors, bells and rules of the road.

If you can’t afford a helmet or you’ve recently dropped or damaged yours or you just don’t know where to get one in Kingston…….please contact our office at thinkfirst.kingston@gmail.com  or maybe you are interested in helping us reach out to the children and youth in our region. We have worked over the years with a number of bright and engaging Queen’s students from a variety of Faculties, your passion is always welcomed. Just remember if you ride your bike to come meet with us……….wear your helmet.

2016-10-18 Celebrating Queen’s Homecoming 2016

This past weekend we welcomed back Queen’s alumni from the Schools of Medicine, Nursing and Rehabilitation Therapy. We had the honour of hosting members of the Tricolour Guard including Meds ’56, Meds ’61 and newly inducted Meds ’66. Also returning were classes from 1971 through 2016: Meds ‘71, Meds ’76, Meds ‘81, Meds ’86, Meds ’91, Meds ‘01, Meds ’06, Meds ’16, Nursing ’76, Nursing ‘86, Nursing’91, Nursing ’96, Nursing ‘11, Nursing ’16, Rehab PT ‘76, Rehab OT ‘81, Rehab OT ’86, Rehab PT ’86, and Rehab PT ’91.

As always, Homecoming weekend was an opportunity to celebrate the spirit of Queen’, and an opportunity for friends, old and new, to meet and reconnect with during  class dinners, receptions, tours, open houses, and award ceremonies.

This year’s was a particularly special Homecoming with the official celebration of the Initiative Campaign, the first Homecoming football game in the newly revitalized Richardson Stadium and the celebration of the University’s 175th Anniversary.

For the Faculty of Health Sciences, the weekend began with a symposium attended by over 80 alumni, students, faculty and staff who gathered to learn about the advances we have made to A Call to Caring through research and fellowship activities funded by the AMS Phoenix Project.

Professor Emeritus Duncan G. Sinclair, PhD’63, LLD’00, former Vice-Principal (Health Sciences) and Dean of Medicine, introduced the AMS Phoenix Project and the keynote address was given by Mr. Jeffrey Simpson, Arts’71, LLD’05, Globe and Mail award winning journalist and author of Chronic Condition.

Following the AMS Phoenix Project Symposium, I hosted a reception for alumni from the Schools of Medicine, Nursing and Rehabilitation Therapy. Held in the David M. C. Walker atrium of the School of Medicine Building, over 150 alumni attended the reception where I gave everyone an update on the Faculty and provided an opportunity for alumni to reconnect and celebrate Homecoming weekend together.

On Saturday morning we heard from students, past and present during the presentations at the CPD Symposium for Alumni. The sessions were themed around “Advancing Care…Inspiring Change” and included presentations by Gray Moonen (Meds ’19), and alumni including Dr. John Kostuik (Meds ’61), Dr. Tony Sanfilippo (Meds ’81), Dr. Chris Booth (Meds ’01) and Dr. Damon Dagnone (Faculty Lead, Competency Based Medical Education).

I was also pleased to speak to the Class of Meds ’66 about the Changing Face of Medical Education. Following my presentation, Tony Graham and Gavin Shanks [left] presented on behalf of the class their 50th Reunion Class Gift totaling $102,568 in donations in support of the Faculty of Health Sciences.

The School of Nursing also celebrated Homecoming weekend with an open house and brunch hosted by Dr. Jennifer Medves. Returning alumni ranging from Nursing ’56 to Nursing ‘16 were given tours of the Simulation Lab and shared memories & stories while enjoying brunch in the School of Nursing Building. In addition to this year’s Homecoming the School of Nursing celebrates their 75th anniversary which was highlighted at the Open House.

The School of Rehabilitation Therapy hosted its 4th Annual Homecoming Brunch and Distinguished Alumni Awards presentations. Under the leadership of Dr. Marcia Finlayson, this event has grown in popularity. The Distinguished Alumni Awards, established in 2013 by Diana Hopkins-Rosseel (MSc 1993 RHBS) and John Rosseel (Artsci’81), recognize one graduate annually from each of the Occupational Therapy, Physical Therapy, and Rehabilitation Science programs who have exhibited exceptional contributions to their chosen professions, fields and communities.

This year’s recipients include [left, from left to right], Lynne Sinclair (PT Class of 1991), Karin Carmichael (OT Class of 1984), and Monica Maly (RHBS Class of 2000 (MSc) & 2005 (PhD)), along with Professor Diana Hopkins-Rosseel, all exemplify the School’s focus on advancing knowledge, inspiring practice, and transforming lives.

Over the weekend I also had the opportunity to visit with many of the returning classes which is always enjoyable, seeing the smiling faces of alumni, hearing them reminiscing, sharing stories and seeing the impact that Queen’s Faculty of Health Sciences has had on so many students.

Class reunions could not be possible without the leadership and hard work of so many class volunteers including class presidents, reunion coordinators, and class giving volunteers. I would like to extend my heartfelt thanks to everyone who helped organize events for another successful Homecoming weekend.

If you would like to share your story about this past weekend or would like to get more involved in organizing your next reunion, I encourage you to comment on the blog, or better yet, drop by the Macklem House. My door is always open.

Richard

Med Students to Host Health and Human Rights Conference
2016-10-11 Med Students to Host Health and Human Rights Conference

Guest post by Daniel Korpal, Meds ’19, on behalf of the 2016 Health and Human Rights Conference

For the past 15 years, medical students at Queen’s have been involved in facilitating a critical conversation on health and human rights. This year we are looking forward to carrying on this tradition and exploring the intersection of health and security as human rights in a diversity of contexts. We hope to expand on the successes of previous years and aim to engage with faculty, students from all departments at Queen’s and community members. Increasing diversity in attendance at the conference has been a priority for our executive planning committee – which includes students from various professional and academic graduate and undergraduate programs – diversity breeds wisdom. We are also very excited to be funding a contingent of medical students from across Ontario as a result of a generous contribution from the Ontario Medical Association. These factors, in conjunction with the Queens’175th anniversary celebrations, uniquely position this year’s conference to involve a broad population and foster an environment of compassionate dialogue and catalyze change regarding Human Rights here at Queen’s and around the world.

However, there can be challenges. As a medical student, it can be difficult to actively engage with these topics. As with practicing health care workers, the demands on our time can be menacing and it is tempting to leave such issues to politicians and pundits. However, I would encourage you to consider the privileged role of rehabilitation therapists, doctors and nurses. Time and again public opinion polls have ranked health as one of — if not the most important — priority in our society. As a result, we, as current and future health practitioners, have a right to be heard. Bear in mind a right is composed of two things, an entitlement and an obligation. Therefore, an onus is placed on us to engage in these uncomfortable questions. We need to consider how contextual factors like race, culture and security affect the health of individuals in Canada and beyond.  In the words of our Dean, “It’s not an administrator or politician’s problem. It’s up to health professionals to take charge …” (Dr. Richard Reznick, Welcome Speech to the Class of 2019 Aug 24, 2015).

The first step is dialogue. On October 21st and 22ndof this year the Health and Human Rights Conference will bring together policy experts and practitioners to share ideas and challenge current and past approaches to providing health and security in the midst of conflict in our communities, country and globe. We hope you will join us!

For more information about the conference find us on Facebook, or visit our website.

Special Thanks to Dr. Reznick for his support of the Health and Human Rights Conference.

2016-10-03 A Celebration of Blood

Guest blog by Dr. David Lillicrap, Professor, Department of Pathology & Molecular Medicine

As a hematologist, of course I’m biased, but I would propose that there are many reasons to celebrate the importance and distinct nature of blood. At Queen’s, we unashamedly impart this message to our medical students through Jackie Duffin’s annual 1st year lecture entitled “Why is Blood Special?”.

On September 12th, at the Canadian Museum of Nature in Ottawa, I had the privilege of attending an event that reminded me once again how special blood is. The National Honouring our Lifebloodrecognition ceremony is an annual event organized by Canadian Blood Services to celebrate the contributions of people and organizations who make our country’s blood system, stem cell network and transplant organization a national treasure. Canadian Blood Services evolved from the Krever Commission Report on the Blood System in Canada, and this year marks the 18th anniversary of this outstanding organization.

The collective altruism of the ~120 people attending this event was remarkable and humbling. The individual blood, stem cell and organ donors, donor recruitment volunteers and Canadian Blood Services staff members honoured during the evening all ensure that our volunteer blood system provides a safe and effective infrastructure for medical care in Canada. Just one example of the amazing honorees receiving awards was a gentleman from Nova Scotia who has a lifetime donation count of >1,050 units.

At this year’s Honouring Our Lifeblood event the Queen’s Faculty of Health Sciences was well represented by recipients of the two foremost honours that the organization bestows; the 2016 Schilly Award for excellence in recruitment and promoting awareness of the need for blood, stem cells, or organs and tissues, and of the Lifetime Achievement Award.

Mackenzie Curran, a 1st year Queen’s nursing student was this year’s Schilly Award honouree. At age 16, Mackenzie was diagnosed with myelodysplastic syndrome (preleukemia) at KGH. This is a very unusual diagnosis for someone so young, and it took the combined expertise of Drs. Farmer, Good and Rauh to confirm the early evolution to acute myeloid leukemia in Mackenzie. Dr. Mariana Silva has since managed Mackenzie’s clinical care that ultimately required a stem cell transplant performed at SickKids in Toronto. The search for a stem cell donor resulted in the recruitment, in Kingston, of thousands of new donors, and eventually an unrelated donor was found who Mackenzie subsequently got to meet last year.

Following the recovery from her transplant, Mackenzie felt inspired to give back to the blood system and her goal is to replace the 1,000 blood donations she received during treatment. Over 400 units of blood have been collected to date, and 2,000 potential donors have been added to the stem cell registry. In the past month, she has already started to recruit new donors from her Queen’s student peers. Mackenzie advocates for blood and stem cell donation, appearing on television, radio and at numerous events including speaking to members of Parliament about the Canadian blood system. In short, she is an impressive young woman, and we are fortunate in recruiting her to our nursing program.

I would like to thank David for this guest blog, and also offer my congratulations. David didn’t tell you this in his blog, but he was also an award recipient at the National Honouring our Lifeblood recognition ceremony. That night, David received the Canadian Blood Services’ Lifetime Achievement Award in recognition of his longstanding engagements with the research portfolio of the Canadian blood system, and the Queen’s Hemostasis Group’s landmark contributions to the field of hemostasis, and to improving the lives of patients with bleeding disorders. Dr. Paula James and all members of the Queen’s Hemostasis Group should also be congratulated for their invaluable contributions, which led to this award.

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

Remembering Dr. Ron Wigle
2016-09-28 Remembering Dr. Ron Wigle

“Laugh a lot. A good sense of humour cures almost all of life’s ills”

-Ritu Ghatourey

On Wednesday September 21st, the Queen’s and Kingston communities lost a very special individual. Dr. Ron Wigle passed away with his family by his side at the age of 74.

Ron was a proud graduate of Queen’s Medicine (1965), and completed his internship, residency and fellowship training in respiratory medicine both at KGH and at Columbia Presbyterian Hospital in New York. In 1971, Ron returned to work at Queen’s and KGH, where he founded the division of respirology alongside his colleague and dear friend, Dr. Peter Munt.

Ron served many roles at Queen’s from Director of the Residency Training Program, to Service Chief to Associate Dean, Postgraduate Medical Education. Ron’s leadership also extended to the provincial and national stage; he served as president of the Ontario Thoracic Society and served on the Board of the Canadian Thoracic Society. He was a key figure in the early days of critical care in Ontario, serving as a Founding Member and Chairman of Ontario Critical Care Program.

Ron was a highly skilled clinician who was admired for his talent and ability, but what we will remember most is his incredible sense of humour. This jovial nature was part of what made him an outstanding – and memorable – teacher. He approached every interaction with a joke or something humourous to say, and found great pleasure in making others smile.

Ron will also be remembered for his outstanding mentorship. He imbued confidence in others, and his trainees and mentees always knew that he had their backs. Along with his late wife Barbara, Ron welcomed hundreds of students in to his home and put a tremendous amount of energy into building strong personal relationships with his trainees.

 

Late in his career, Ron was honoured with the establishment of a School of Medicine award in his name. The award was created in recognition of his role as an outstanding mentor, and the professional values he epitomized throughout his career. The purpose of the award, as written in the Terms of Reference, characterizes the wonderful person that he was:

“Dr. Wigle was committed to promoting the success of others to the ultimate benefit of the medical community at large. Throughout his exemplary career at Queen’s University, numerous faculty, undergraduate and graduate students flourished through his wise guidance and encouraging leadership. This award, named in his honor, will help to perpetuate these important virtues by recognizing those who embody them.”

We were fortunate to have such an incredible person here in the Faculty of Health Sciences, and Ron will be deeply missed.

Please share your stories about Ron by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

Thank you to Dr. Leslie Flynn, Dr. Stephen Archer and Jen Valberg for their help in preparing this blog.

Dr. Ron Wigle’s obituary can be found here: http://yourlifemoments.ca/sitepages/obituary.asp?oid=977194

2016-09-18 Celebrating five years in the School of Medicine building

This September marks five years since the opening of the School of Medicine building. This new home for the School of Medicine was made possible by tremendous generosity from our alumni, friends and donors. Leveraging investments from both the Federal and Provincial Governments, our alumni and friends contributed over $19 million to build a state-of-the-art home for the School of Medicine to expand teaching and student learning facilities all under one roof.

The Queen’s community came together in ways that inspired generosity from our students, our faculty, our alumni and our friends. The spirit is exemplified in the story of the pledge of $1.5 million from the Clinical Teachers’ Association in support of the building construction.  Their gift was recognized through the naming of the Clinical Teaching Centre. The unprecedented gift from our clinical faculty inspired the medical students of the day to pledge $500,000. The students chose to have their gift recognized by dedicating the main floor atrium in honour of former Dean of Medicine David M.C. Walker. These are just two of many stories the building encapsulates.

The hallways of the building are filled with artifacts, photos, art and displays that convey the unique history of one of Canada’s oldest medical schools.  The unique Connell door from the old house of former Deans of Medicine Dr. Walter Connell, MD1894, LLD’41 and his son, Dr. W. Ford Connell, MD’29, LLD’73 was rescued from demolition and donated by Richard and Sarah Jane Dumbrille, Arts’65 for display that serves as a reminder of this rich history.

Now five years later, we have grown into our 11,600-square-metres of teaching and learning space with determined focus on the implementation of the School’s patient-focused competency-based curriculum. Nearly every feature of the building was designed to facilitate teamwork and case-based learning. Instead of mainly sitting and taking notes in lectures, students spend much more time working together to solve clinical problems. Our curriculum ensures students become fully rounded practitioners.

Appreciation for the abundance of generosity can be seen in every corner of the building. We are grateful for all of the gifts that were made; from classes and alumni, in memory of friends and family, and from stakeholders and partners.  Along with our donor wall, you can find our benefactors proudly recognized in:

  • The Howard W Justus Grand Corridor
  • The Britton Smith Foundation Lecture Theatre
  • The Clinical Teachers’ Association Clinical Teaching Clinic
  • The David M. C. Walker Atrium
  • The Aesculapian Society Student Lounge
  • The John T. M. Fraser Lecture Hall
  • The Joan and Donald McGeachy Lecture Room
  • The Rita Friendly Kaufman and Nathan Kaufman Lobby
  • The Abramsky House
  • The GlaxoSmithKline Inc. Patient Simulation Lab
  • The William James Henderson Foundation Anatomy Museum and Learning Centre
  • The Connell 3rd Floor Lantern Room
  • The Ontario Medical Association 2nd Floor Lantern Room
  • The David Cook and Margaret Cook Lantern Area
  • The Christopher Lui Information Commons
  • The B’NAI BRITH Lodge 1191 Seminar Room
  • The Dr. Charles Sorbie Seminar Room
  • The John Wing-Chung Wong Seminar Room
  • The Annie Seminar Room
  • The M. Sullivan and Son Seminar Room
  • The Empire Life Insurance Company Seminar Room
  • The Arthur F. W. Peart Seminar Room
  • The Dr. Michael F. C. Walker Seminar Room
  • The Dr. Ruth (Bell) Tatham and Class of Medicine 1954 Seminar Room
  • The Wayne S. Rosen Seminar Room
  • The James Howard Goudie Seminar Room
  • The Mark Fisher Seminar Room
  • The George Sampson and L. Bruce Cronk Seminar Room

Led by Meds ’74 and Meds ’66, many medical classes supported the new building and the following spaces have been named in their honour:

  • The Class of Medicine 1960 Seminar Room
  • The Class of Medicine 1961 Seminar Room
  • The Class of Medicine 1966 Seminar Room
  • The Class of Medicine 1971 Seminar Room
  • The Class of Medicine 1972 Seminar Room
  • The Class of Medicine 1974 Seminar Room
  • The Class of Medicine 1981 Seminar Room
  • The Class of Medicine 1985 Seminar Room
  • The Class of Medicine 1986 Seminar Room
  • The Class of Medicine 1980 Seminar Room
  • The Class of Medicine 2010 Seminar Room

Thank you to those who have helped create a home for the School of Medicine that we can all be proud of.  To celebrate this milestone we have created an impact report that we hope our donors and friends will enjoy.  I welcome every opportunity to show off this unparalleled facility, so if you haven’t already, I encourage you to drop by 15 Arch Street…the School of Medicine’s doors are always open.

2016-09-12 Queen’s Nursing PhD student recognized for research and education leadership in skin tears

t’s been an award-winning year for Kimberly LeBlanc, an experienced nurse and educator who is currently pursuing her Nursing PhD at Queen’s. Along with receiving a prestigious Order of Merit from the Canadian Nurses Association, LeBlanc was also recently presented with a Leadership award from the Registered Nurses Association of Ontario and she was one of three individuals shortlisted for an International Leadership in Nursing Education award from the World Union of Wound Healing Societies, which will be awarded in Florence later this month. These accolades bear testimony to LeBlanc’s dedication to research and education in Enterostomal therapy and the prevention, assessment and treatment of skin tears.

The incidence of skin tears, which are defined as wounds caused by shear, friction and/or blunt force resulting in the separation of skin layers, is global and most common in the very young or very old, as well as critically ill patients. In Canada, they are found in approximately 15% of long-term care patients; globally, this number can range from 15 – 54% of patients in these settings.

Skin tears in the elderly can occur for a number of reasons – for example, they can occur from a fall, from bumping into objects, or as a result of aggressive behaviour due to dementia or other conditions. As a person ages, their skin’s elasticity and strength decreases, and they become more vulnerable to trauma. Skin tears are often regarded as minor wounds, but can cause significant pain and further health complications if not treated promptly.

LeBlanc’s PhD work is focused on the modifiable risk factors that can have an impact on the prevalence of skin tears. “We can’t change the fact that aging skin gets drier, but we can implement processes to keep the skin moisturized,” she says. “We can examine our practices around how we approach patients with cognitive impairments while dressing or bathing them, so that we reduce the risk of a skin tear occurring.”

As the President of the International Skin Tear Advisory Panel, LeBlanc was instrumental in validating a global skin tear classification system and an assessment and treatment toolkit that’s currently being used in 14 countries. The toolkit provides guidance for classifying skin tears in order to apply the most appropriate treatment, but also recommends an educational program to increase awareness and help health care professionals assess potential risks in order to minimize these wounds.

Along with her research, LeBlanc is an active educator who spends a great deal of time teaching and supervising student projects. Now, as a student herself, she is excited to be working with Dr. Kevin Woo, an assistant professor at the School of Nursing and her supervisor at Queen’s.  “Dr. Woo is an amazing supervisor, and the reason I came to Queen’s,” she says. “He is a superb mentor and has provided the support and research environment that I need to take my work to the next level.”

Please share your thoughts on Kim’s work by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

How would Steve Jobs reengineer medical school?
2016-09-06 How would Steve Jobs reengineer medical school?

The following is a guest blog by Dr. Sanjay Sharma, Professor, Ophthalmology and Epidemiology, Queen’s School of Medicine.

A few years ago, I was stopped cold in my tracks by the response delivered to my question posed to our second year medical students:  “What disease needs to be ruled out in an elderly woman who presents with sudden visual loss and jaw claudication?” A cat’s meow, emitted from a student computer, was apparently the answer – instead of the “giant cell arteritis” that I sought. It was at that precise point in time that I realized that many students used precious class time to contribute to “Ouch Charlie’s” YouTube-financed college fund, reconnect with long-lost kindergarten classmates on FB and hammer out 140 character observations to their legions of eagerly-anticipating followers.

While driving home, I remember thinking, “what is wrong with today’s Snapchatting, Instagram-posting, GOT-loving students? Don’t they know that how hard we work on our lectures?” As these thoughts were zipping through my brain, I glanced down at my iPhone and was, once again stunned by its elegant design and simplicity.

In my driveway, I thought how Steve Jobs, might have interpreted the day’s event. How would he re-engineer our current system founded on the 1-hour didactic lecture to meet the expectations of today’s digital generation?

Once home, I was stopped in my tracks for a second time in the day, as I saw a series of wet, blue footprints that had been freshly applied to our white kitchen floor. Following them, I found our, then 10-year old son, Evan, delicately balanced on the top of his stepladder, applying another layer of vibrant blue acrylic paint to the top of his 72-inch canvas. As I watched him expertly apply layer after layer, I asked him where he learned how to do this (I certainly hadn’t taught him), to which he simply responded, “YouTube.”

And with that response, the reality of modern education became clear. It was no longer about Cecil’s and Harrison’s, or thoughts conveyed on Gates’s default blue powerpoint slides. And it certainly was not about the fact that we put five hours into developing a great lecture a decade ago. Quite simply, it is about what they want, how they are wired and how they learn.

That night, I designed the blueprint for medskl.com – an open-access medical education site. I considered how it would look, what it would do, and how it would serve the needs and wants of a new generation of medical students.

Now some 3 years later, thanks to the efforts of a small team of dedicated editors, animators, videographers and coders to support 180+ leading global faculty – we have just formally launchedmedskl.com.

What exactly is medskl.com? It is a FOAMed (free open access medical education) platform that will provide digital lessons to the next generation of physicians. Our content library, once completed, will consist of 200 modules, roughly paralleling the MCC objectives. Each module is taught by an award-winning medical professor from a leading medical school.  Here Queen’s professors teach side-by-side with those from Harvard, Hopkins and Stanford to an audience of global students, 24/7.

And to appeal to visual, text-preferred and auditory learners, alike, medskl.com’s lessons are delivered in 2-minute white board animations, written summaries, and Ted Talk-length lectures.  Eighty-five modules are now live and all 200 will be complete by the end of the year.

We are thrilled with the initial response to medskl.com. Most Canadian and many US medical schools have expressed interest in incorporating our lessons to support their flipped classroom strategy which sees students consuming content outside of the classroom, allowing more value-added interaction to be delivered in traditional class time. In the short 6 weeks since launch, users from over 50 Universities have logged on to start consuming our lessons to augment their medical education.

As we anticipate the continued rapid uptake of medskl.com, we also look back and thank all the forward-thinking advisors and content providers who took our early calls, gave us real and crucial feedback, and who above all provided fuel to nurture the idea. Our hope is that medskl.com will one day have significant impact on medical education – globally. I hope that Steve Jobs would have approved.

2016-08-29 Our Thanks to Iain Young

After seven years of senior decanal leadership in the Faculty of Health Sciences, Dr. Iain Young, Executive Vice Dean and Medical Director of SEAMO, is stepping down from these administrative positions. Probably the best place to start this blog, is to say thanks. And thanks are indeed appropriate, but for sure insufficient. For the last seven years, Iain has dedicated his significant administrative, intellectual, and strategic talents to serving virtually every member of this faculty.

Iain has an incredible skill set that will be truly impossible to replace. His vast knowledge of Queen’s, and the way both the university and the faculty operate is staggering. As an academic pathologist, his knowledge of the clinical world has enabled him to stickhandle and manage literally hundreds of problems over his term. He served as a mentor to dozens of administrative leaders and department heads, and he’s been a respected and trusted colleague to me. Not a week has gone by in the last six years when I haven’t sought Iain’s advice and benefited from his wisdom.

Iain’s accomplishments in his decanal roles are many; too many to capture. However, to give you a flavour of some of his accomplishments, I will touch on a few examples of Iain’s stellar achievements.

Iain played the central role in amalgamating five basic science departments into what is now known as the Department of Biomedical and Molecular Sciences. As you can imagine, being the chief engineer of a merger of five departments was a Herculean task. It required skill, diplomacy, and at the time, extreme dedication to the collective decision making of the School of Medicine. Without Iain’s leadership and skill, this amalgamation might not have happened.

Another example of Iain’s talent is seen in his role as the Medical Director of SEAMO. Over the last five years, Iain has been the principal architect of a deliverables framework that has served SEAMO extremely well. This framework instantiates in policy and action, mechanisms to ensure that SEAMO departments are able to demonstrate to any stakeholder the responsible use of the funding they receive. This was by no means a glamorous task, nor an easy one! But one of Iain’s most important assets is the trust he has earned across our collegium, a trust that has served him well in implementing this framework which, for alternate funding plans across Ontario, is now looked at as leading edge.

Iain has assisted the university in the collective bargaining process. He has overseen the promotions, tenure, and renewal process for the faculty. He has been the key figure in the faculty recruitment process. He has orchestrated the School of Medicine’s academic reviews and served as chair of innumerable search committees. He has been a key player in hospital-university liaison. He has been the administrative lead on new faculty positions, CRCs, and other academic chairs. He has handled a myriad of delicate and complex personnel issues. And the list goes on.

But much more than all this, Iain has served as an advisor, a teacher and compassionate listener to hundreds of individuals during his long service as a senior administrative leader. His office door has always been open to the many who have sought his advice, and benefited from his sage counsel. And for me, he has been a greatly appreciated colleague and trusted confidant.

Iain will be sorely missed. Not just by me, Danielle Claus and her staff at SEAMO, Andrea Sealy and the staffing office, but by all from across our faculty, across the hospitals and across the university who have benefited from his wisdom.

If you have any kind words to add about Iain, please drop him a line or respond to the blog. We all wish Iain the best in the next chapter of his professional career.

Richard

2016-08-04 Signing off for summer vacation

It’s been a great year – we have lots of successes across the faculty to celebrate. But it has also been a lot of work, and I am looking forward to my summer vacation as I’m sure many of you are too. As I have done in the past, after 48 weeks of blog writing, I’m going to take a break until September.

We don’t have any major plans for this year’s vacation; I will spend some time in Kingston decompressing, some time in Toronto visiting with friends and family, and Cheryl and I plan to take my mother on a road trip to our favourite Inn which is an old historic arts & crafts inn called the Roycroft. We will also spend some time with Cheryl’s dad who lives in Cambridge, and who, unfortunately, is ill.

We will also be spending lots of time with our new puppy Sophie who is now seven months old. Shortly after I introduced her here on the blog, I nicknamed her Taz (short for Tazmanian Devil) but I must admit that she’s growing on me and her Taz-like episodes seem to be decreasing in frequency.

I hope to throw in a little golf and lot of sunshine, and I am especially looking forward to a few weeks of not being glued to my cell phone or my computer.

There are so many great things going on in the faculty, and I am looking forward to charging up my batteries for the busy fall ahead.

I would love to hear what your summer plans are, so please let me know by commenting on the blog. Or better yet, drop by the Macklem House…I won’t be there, but my door will be open and some of our wonderful staff will be there to say hello.

Richard

2016-07-25 OMA and government reach potential agreement

I’m very pleased that after what seemed like an eternity (but was probably more like two years) without an agreement, the Province of Ontario and the Ontario Medical Association (OMA) are tabling a potential agreement. The tentative agreement is now being communicated out to the OMA’s 33,000 member physicians who will vote on whether to ratify it in the coming weeks. This is a long time coming, and is a very welcome turn of events. To say that the relationship between the OMA and the government over the last two years has been frosty is an understatement. It’s critical for our patients and for our health system that strong relationships characterized by open lines of communication exist between these two entities.

Some of the highlights of the tentative agreement are:

  1. A 2.5% increase in funding per year for the remainder of the contract (4 years).
  2. One-time payments ranging from $50M to $120M per year, with the caveat that those dollars cannot be used if the total physician compensation budget is exceeded.
  3. The OMA and the government will work together to identify $100M of savings in each of the years 2017 and 2019 based on a hard look at the fee schedule.
  4. There will be co-management of the agreement which includes a co-management process looking at health human resources.*

*The Deans have clarified with the OMA that they will be consulted during any HHR discussions.

From the vantage point of Queen’s, where we have a comprehensive alternate funding plan (AFP), exactly how these elements will be reflected in the AFP has not yet been clarified. However, one anticipates that it’s likely that payment to physicians in an AFP will echo the general arrangements that are being proposed in the agreement.

Of particular significance is the agreement to look at the two planned $100M carve-outs from the fee schedule. I predict this is going to be done largely based on the issue of relativity. Relativity, simply defined, is the issue of the tremendous variability we have in our fee schedule with respect to how we financially reward different types of specialists. For example, a young trainee who goes through three years of internal medicine training followed by two years of training in a subspecialty, will earn significantly more if he or she chooses a subspecialty in the areas of cardiology or nephrology as compared to geriatrics or rheumatology. The training times for those four subspecialties are the same, and yet the swing in income between the higher and lower can be hundreds of thousands of dollars. 

These discrepancies are largely an artifact of a historical fee schedule that really hasn’t changed with the times and does not recognize that changing technologies has impacted significantly on the time that is necessary for certain procedures. In the same vein, some of the fees within the surgical specialties were set for procedures that used to take several hours, yet now take just a fraction of the time.

I’m hopeful that the agreement will be ratified by the OMA membership. In my own personal view, it’s important that we move on from the chill that we’ve experienced in the last few years, to a more constructive relationship between the OMA, which represents our physicians and our government, which is responsible for the overall health of our population. Once the issue of physician compensation is addressed and an agreement is ratified, we can shift our attention to the challenges that our healthcare system faces with an aging demographic that’s requiring more demands for services and new technologies emerging that might materially improve the lives of our patients.

Please share your thoughts on the tentative agreement by commenting on the blog, or better yet, drop by the Macklem House… my door is always open.

 

Richard

Transforming research in Lyme disease
2016-07-18 Transforming research in Lyme disease

In the last few years, Canada has witnessed a surge in cases of Lyme disease. “In 2015, there were 700 new cases of Lyme disease reported to the Public Health Agency of Canada (PHAC), up from 140 cases in 2009. Lyme is now being diagnosed in southern B.C., Manitoba, Ontario, Quebec, Nova Scotia and New Brunswick.”1

Lyme disease is caused by a bacterium Borrelia burgdorferi, which is transmitted to people and animals through tick bites. Ticks are small arachnids, the nymphal stage of which can be as small as a poppy seed, so the tick and its bite often go unnoticed.

The disease may be difficult to diagnose. It often presents with symptoms including chills, fever, headache, muscle and joint pain, and swollen lymph nodes; symptoms that are sometimes associated with the flu. History of a tick bite can help narrow the diagnosis, but not all patients know with certainty if they have been bitten or exposed. Left untreated, Lyme disease may lead to arthritis, heart and nervous system disorders and recurring neurological problems.

The Kingston, Frontenac, Lennox & Addington region had the highest rates of Borrelia-infected blacklegged ticks in the country between 2006 and 2013,  and rates are expected to rise with ongoing changes to the climate and other contributing factors. Going forward, there is a substantial risk to Kingston’s population. 2

In response to this growing health concern, Dr. Kieran Moore, the Associate Medical Officer for the KFL&A Public Health Unit and Professor in our Departments of Family Medicine and Emergency Medicine teamed up with Dr. Anna Majury, Clinical Microbiologist at Public Health Ontario and Assistant Professor in our Department of Biomedical and Molecular Sciences, and Dr. Gerald Evans, Chair of our Infectious Diseases Division to create a National Lyme Disease Research Network. In April, they hosted their inaugural meeting which brought together over 40 clinicians, scientists and public health officials from across the country.

The Lyme Disease Research Network is a first for Canada; until now, a forum for collaboration and knowledge sharing around this disease did not exist. Although still in its early stages of development, the network already has a wealth of expertise around the table: epidemiologists, entomologists, clinical microbiologists and basic scientists with the hope that this network will continue to grow, bringing Canada’s best minds and Lyme researchers to the table in collaboration.

The network stretches across the country, includes 19 research laboratories and has engaged federal, provincial and municipal levels of government. This broad scope of expertise and access to shared knowledge puts the network in an excellent position to generate new strategies to address the ongoing threat of this elusive and challenging disease.

I am thrilled about this initiative and very encouraged by their efforts to date. The Faculty of Health Sciences at Queen’s stands firm with our goal of creating a tick-borne illness pan-Canadian research group that strives for a better understanding of Lyme disease.

Please share your thoughts on the Lyme Disease Research Network by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

 

Thank you to Jen Valberg and Seth Chitayat for their help in preparing this blog.

  1. http://www.thecanadianpress.com/english/online/OnlineFullStory.aspx?filename=DOR-MNN-CP.fd2ecc20e5e940b0949cc42df19946ef.CPKEY2008111303&newsitemid=37426763&languageid=1
  2. KFL&A Public Health, KFL&A Public Health: Action Plan on Lyme disease. 2015, 12 p.
2016-07-12 Fostering new ideas to give back to the community

The following is a guest blog from Angela Luedke, PhD student, Centre for Neuroscience Studies.

Beginning a new graduate program in a new city can be challenging. Getting to know your peers and settling into your research program is both exciting, and intimidating. Luckily, when I started as a young Master’s student at the Centre for 

Neuroscience studies (CNS) over 5 years ago, I heard about The Neuroscience Outreach Program (NOP), went to my first meeting, and I’ve been involved ever since. Being part of the NOP served as a great way for me to connect with fellow students, as well as being a part of an environment that fosters new ideas, and gives back to the community. Given the interdisciplinary nature of the CNS, the outreach program provides both new and current graduate students with a way to connect with each other, as well as a platform for graduate students to take something they are passionate about and translate it into a community program, allowing students to give back to the public in a social, informed, and meaningful way.

The NOP is a student-run initiative that began in 2005 as a means for graduate students in the CNS at Queen’s to engage Kingston and surrounding communities about neuroscience. Our hope is to create sustainable community projects ranging from both educational to social, and of course, all of them are fun!

The objectives of the NOP are far reaching, from getting young kids motivated and excited about neuroscience through interactive activities, to keeping adults and seniors informed about scientific findings and brain health. Our partnership with the community currently includes eleven diverse programs and activities that take place in schools, hospitals, and public spaces.

Several of our initiatives engage a younger audience, from as young as 2 – 10 years old in Sparks, Brownies, Beavers, and Cubs participating in Brain Badge, to grade 4 -5 students receiving classroom based sessions led by neuroscience students culminating in a day-long visit to CNS laboratories on Brain Awareness Day. In partnership with Queen’s Enrichment Studies Unit, we also host a course for grade 7 and 8 students whereby they take the role of neuroscience investigators and use various research tools they learn about through hands-on activities. New this year, CESAP (Concussion Education Safety and Awareness Program) educates elementary and high school students, as well as athletes and coaches about concussion. Another event available for high school students is Brain Bee, an international competition focused on neuroscience facts and structured like a spelling bee. Apart from schools, we have also developed programs alongside local hospitals.

In partnership with Kingston General Hospital, neuroscience students visit the adolescent psychiatry ward twice a week to engage youth in a social program based on exercise and crafts. Yet another program, held at St. Mary’s of the Lake Hospital, our Social Club program invites patients to participate in various crafts and games on a monthly basis.

We are also involved in initiatives aimed at the general public, including Science Rendezvous, led by the Faculty of Education, and our Public Lecture Series. Our booth at Science Rendezvous displays fun and interactive neuroscience demos and experiments. The Public Lecture Series disseminates the research behind various hot topics, changing yearly. For example, this year we had experts discuss autism, concussion, and stroke.  In order make our outreach efforts available to everyone, we offer a lecture series focused on topics of interest to seniors at a retirement residence.

I am very proud to be part of such an exceptional organization. Together with enthusiastic team members and amazingly supportive staff, we are able to offer an impressive breadth of programs both in terms of variety of topics and target audiences to Kingston and surrounding communities. The NOP has recently been recognized for our outreach efforts, winning first prize for best local SfN chapter from the Canadian Association for Neuroscience Advocacy Committee, as well as honorable mention for student initiative, Allen Champagne, the lead of CESAP. We have also been the recipients of a CIHR Outreach Award and a Community Foundation Grant.

Please visit http://neuroscience.queensu.ca/outreach for more information about our programs.

2016-07-07 Saving Rainforest with a Stethoscope

Most of you probably don’t know Dr. Andrew Winterborn, mostly because you don’t have a need for contact with our university veterinarian. Educated at l’Université de Montréal followed by a three year residency in Comparative Medicine at the University of Rochester Medical Centre, Andrew has been the Queen’s University veterinarian for almost 8 years. Andrew takes enormous pride in contributing to our research mission through his work as a veterinary scientist, and anyone who interacts with Andrew understands just how lucky we are to have him at Queen’s.

A few weeks ago, Andrew told me about a recent initiative where he worked with a team from the Seneca Park Zoo, Rochester NY to bring medical supplies to residents of Borneo.

The supplies were put together by Health Partners International, which solicits donations from pharmaceutical companies to go into ‘Humanitarian Medical Kits.’ Customized to the community’s health needs, each kit is filled with medications and supplies.

In this case, Andrew and his colleagues were bringing $16,000 in supplies (which equated to one hundred pounds) to “ASRI klinik,” a community clinic in Borneo’s rainforest. Upon its arrival at the clinic, the supplies were immediately unpacked and within the day were being used to treat patients. “Jesse, a volunteer physician from Stanford University, shared with us a success story from that morning of a patient’s condition improving significantly because of the new supply of pharmaceuticals.”1

I thought that this story would make a great ‘good news’ piece for the blog, and I asked Andrew if I could share it. What I didn’t realize at the time was that the delivery of medical supplies was part of a greater initiative; a project to preserve Indonesia’s rainforests.

We know that forests are an important part of any ecosystem. They regulate the air we breathe, our water, and the climate; and they are essential to the well being of humans.

In Borneo, however, the local economy relies heavily on the rainforest as a natural resource. “Many families are forced to make the impossible choice between short-term survival and future well-being,” because they rely on logging for their income. Without this income, they cannot access things like healthcare.2

The Alam Sehat Lestari Foundation saw an opportunity in this tension between short term and long term survival. They decided to dramatically improve health care access for these communities. This, in theory, would alleviate the pressure to cut down trees:

“Alam Sehat Lestari Foundation established ASRI Clinic that serves the local communities that dwell in one of the remotest Indonesian rain forests. ASRI Clinic is strategizing conservation through health care access improvement to protect the threatened rain forests of Gunung Palung National Park…The pay-through-labor program is just one element of this project that is empowering the communities around Gunung Palung to preserve the park, on their terms. Clinic prices keyed to the local economy are helping to break the cycle that pits human needs against nature.”3

And the program has done just that. Since 2007, the clinic has treated tens of thousands of patients, and there are now plans – through a partnership with Health in Harmony – to build a community hospital and training centre. This hospital will offer surgical, intensive care and emergency services to further meet the healthcare needs of these communities.4

And the rainforest is benefiting too. According to Health in Harmony, over 50% of the area’s former illegal loggers have received training in sustainable agriculture, and now earn an income through farming.

Andrew, supported by the Seneca Park Zoo keeper chapter of the Association of Zoos and Aquariums, is also involved with the Goat’s for Widows program. He has visited Borneo four times to train animal health workers in the husbandry of goats that have been provided to widows in villages surrounding Gunung Palung National Park. The goats provide valuable manure as well as an alternative income source. Since working in Borneo, Dr. Jeff Wyatt, Director of Wildlife Health & Conservation-Seneca Park Zoo, and Andrew have been able to improve the health of the goats within the program. Whereas in 2013, only 35% of the goats were in an ideal body condition, this has improved to 67% in 2016. Most importantly, they have built local capacity so that this can become a self-sustaining program.

And so Andrew’s donation of medical supplies was not as simple as it first seemed. I am proud to highlight the important work that is happening in Borneo: from goats for widows to saving the rainforest with a stethoscope.

Please share your thoughts by commenting on the blog, or better yet, drop by the Macklem House…my door is always open.

Richard

Thank you to Jen Valberg for her assistance in writing this blog.

 

  1. http://senecaparkzoo.org/zoo-team-successfully-delivers-16000-life-savi…
  2. http://www.healthinharmony.org/category/conservation/
  3. http://healthmarketinnovations.org/program/klinik-asri
  4. http://www.healthinharmony.org/programs/asri/health-care/
2016-06-28 Reading week in Japan: A cultural and clinical exchange for rehab therapy students

The following is a guest blog by three Occupational Therapy students who recently represented the Queen’s School of Rehabilitation Therapy in Japan. Faculty member Setareh Ghahari and students Casandra Boushey, Charlotte Larry and Gowshia Visuvalingam travelled to the Niigata University of Health and Welfare as part of a formalized a relationship between the two schools to foster cultural and academic exchange and research collaboration between the two institutions. 

For occupational therapy students, each encounter broadens horizons whether it is through assessing a new client, a case discussion with colleagues and preceptors, or a conference keynote presentation. The School of Rehabilitation Therapy, however, provided us with a chance to gain unique perspectives by fully immersing ourselves in the health care system of another country, halfway across the globe. Over the reading week in February, an invaluable opportunity was given to three students -Charlotte Larry, Casandra Boushey and Gowshia Visuvalingam. We were selected as members of the occupational therapy student delegation to visit Niigata University of Health and Welfare (NUHW) in Japan, along with Dr. Setareh Ghahari, Assistant Professor from the Occupational Therapy Department at the School of Rehabilitation Therapy. The purpose of the trip was to exchange information about occupational