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The Michener Institute's integration with University Health Network will create a leading-edge training ground for tomorrow's medical professionals

It all started with an inquiry about renting space. Just over a year ago, clinical program leaders at Toronto's University Health Network − made up of four major hospitals −  came to The Michener Institute for Applied Health Sciences to discuss the possibility of renting space and exploring partnerships with the school.

What they didn't know at the time was that Michener's board of governors had just hired a new CEO to take the organization to the next level of planning for future health system needs, and the idea of a partnership was on the table. UHN's visit sparked an idea: why not connect one of the country's largest teaching hospitals with the only Canadian postsecondary school focused exclusively on applied health sciences education?

"When UHN came to talk about renting space, that was the entry point," says Maureen Adamson, former president and CEO at Michener, which trains health sciences professionals such as radiological technologists, magnetic resonance imaging (MRI) technologists, sonographers/ultrasound technologists and anaesthesia assistants. "Michener's board had a vision for transforming the school and reclaiming its position as the go-to school for applied health sciences. After looking at several options, we saw that UHN had the scope, scale and excellence in health care delivery that could help realize the new vision for Michener."

On January 4, UHN's CEO Peter Pisters welcomed Michener to the UHN family, which includes Toronto General Hospital, Toronto Western Hospital, Princess Margaret Cancer Centre and Toronto Rehabilitation Institute. The integration was a historic event for both organizations, but it was also noteworthy for another reason: by embedding an applied health sciences school within a hospital, UHN and Michener have created a first-of-its kind education model in Canada.

"We are doing something that is incredibly unique," says Dr. Pisters, who became UHN's CEO in January 2015. "When you look at the integration of a diploma-granting institution into a health care centre, you can easily see the many opportunities that can arise through the process of bringing together learners and practitioners."

Both UHN and Michener stand to benefit greatly from their partnership, says Dr. Pisters. As frontline workers, UHN staff are in a position to identify current and future health care needs. These insights will be useful in shaping Michener curricula and ensuring students are equipped to handle the ever-changing demands of the health care workplace.

THE RIGHT MODEL

At the same time, says Dr. Pisters, the integration gives UHN employees direct access to much-needed continuing education that can be tailored to up-to-the-minute learning needs.

"We can really optimize training for both Michener students and working health care professionals," says Dr. Pisters. "With this integration, our goal is to create the premier training site in Canada for applied health sciences professionals."

The UHN-Michener partnership is inspired by a decades-old model at the Mayo Clinic in Rochester, Minnesota. In the early 1970s, the renowned institution pioneered hospital-based postsecondary education for doctors. The Mayo Clinic now has five schools, including one for applied health sciences.

Dr. Brian Hodges, UHN's executive vice-president of education, says UHN and Michener executives paid several visits to understand the benefits of the school-in-a-hospital model. "Hospitals are often thought of as passive recipients of students sent to them for placement by colleges and universities," says Dr. Hodges. "With the Mayo Clinic model, the hospitals or clinics are partners in designing the educational model better adapted to the needs of patients and of the health care system."

With UHN and Michener working closely together, critical issues such as workforce planning can be addressed more adequately at the school level, says Dr. Hodges. As an example, he cites a shortage of medical laboratory technologists in Ontario with the expertise to perform complex testing, which he describes as a "tragedy waiting to happen" because there aren't enough students being trained for this essential health care function.

By preparing more students in UHN's more complex laboratories UHN and Michener will be helping the rest of the province, says Dr. Hodges. "We're not just here to serve the needs of UHN and Toronto," he says. "We want to enhance capacity across the province."

BLOOD WORK

As medical and technological advances make health care more complex and fast-changing, many hospitals will continue to struggle with the disconnect between school curricula and what's actually happening in clinical practice, says Sally Balmer, manager of the blood transfusion department at UHN. She hopes having a school right in the hospital will solve this problem.

For example, students who come to UHN for clinical rotation are not usually up to speed on new blood products, says Ms. Balmer. As a result, UHN staff who work as instructors during these clinical rotations spend considerable time teaching students about these new products.

"Students spend only four weeks with us in blood bank in the clinical phase of their training. The students are well prepared for their exams but not necessarily for the work force. My department invests six to eight months of training on top of the clinical year before a new employee is ready to handle the complex demands of blood banks at UHN.  Students graduating this spring will not be practicing independently until January of 2017," says Ms. Balmer.

"Real-time adjustments to the curriculum in the school would mean students come to clinical training with a broader, more up-to-date knowledge base, which allows us to focus the time spent in the clinical training on better preparing them for real work.

"What Michener and UHN are doing is putting together clinical practice, research and education in a real-time way," says Ms. Adamson. "This has never been done before with an applied health sciences school."

In addition to delivering more up-to-date and comprehensive education for students and better learning opportunities for working health care professionals, the UHN-Michener integration will also accelerate the transfer of academic research at Michener from the school labs and into clinical practice, says Ms. Adamson.

The result is a win-win for Michener students and health care professionals, and for that most important stakeholder: the patient.

"For patients, it ultimately means feeling confident that the person treating you has had the best education, anchored in current research and best practice in health care where patients are first, every step of the way," says Ms. Adamson. "This integration is really about putting the patient first and delivering the best care possible."


BACK TO WHERE IT ALL BEGAN

Its integration with the University Health Network is, in a way, a homecoming for The Michener Institute for Applied Health Sciences.

The Institute traces its roots back to 1958, when Dr. Diana Michener Schatz, a biochemist with a doctorate in physiology, was hired to lead a medical laboratory technology pilot program at Toronto General Hospital.

Dr. Schatz quickly recognized a dire need to provide education to applied health sciences professionals that went beyond the work-to-learn apprenticeships that were the norm at the time. She developed an applied health sciences education program that blended academic learning with clinical rotations and began offering continuing education courses in 1961.

In 1966, with funding from the province's health ministry, the program held its first formal classes. Six years later, the school moved to its present location on St. Patrick Street in Toronto. Its name was later changed to The Michener Institute, in honour of Dr. Schatz's father, the late Governor General Roland Michener.

During a recent town hall meeting at Michener, Dr. Schatz recalled how the leaders and practitioners at nearby hospitals began coming to teach at Michener.

"The hospitals all got on board − Women's College, Sick Kids, St. Michaels," she said. "Why? Because good people from all those hospitals could walk here and teach here.

So where you're going … is home again to a viable network that has been there and contributing significantly to health care."

Today, Michener boasts more than 850 full- and part-time and 4,000 continuing education students. More than 85,000 Michener graduates are working in the country's health care sector in a wide range of fields that include radiation therapy, medical laboratory science, nuclear medicine technology and respiratory therapy.

At a student awards ceremony last November, Maureen Adamson, former president and CEO at Michener, thanked Dr. Schatz for driving a vision that remains as relevant today as it was when the school launched its program 55 years ago.

Integrating with UHN is a natural evolution of this vision, says Ms. Adamson. "Teaching in the context of clinical practice − so students become professionals with the confidence to apply their knowledge safely in a real patient environment − is critical to patient health and safety."


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