The Centre for Rural and Northern Health Research (CRaNHR) at Laurentian University celebrated its 25th anniversary earlier this year.

Originally known as the Northern Health Human Resources Research Unit (NHHRRU), CRaNHR is an academic and applied research centre that conducts interdisciplinary research on rural health, with a focus on improving health services, access to health care in rural and Northern communities, as well as enhancing stakeholders’ knowledge of the health-care system.

Though it predates the founding of the Northern Ontario Medical School, CRaNHR and NOSM have developed a strong partnership because of their shared mission, says Dr. Alain Gauthier, Director of CRaNHR.

“The research questions that we seek to answer are directly derived from the needs of the communities that we work with, and not necessarily our general curiosity, so our objectives and NOSM’s social accountability mandate align very well,” he says.

CRaNHR was originally established to study questions related to health human resources in Northern Ontario. However, as the needs of the population have evolved, so has CRaNHR’s scope.

“Over the past 25 years, we’ve evolved from a health human resources research centre to a rural and northern health equity research centre,” says Gauthier. “The Centre was primarily focused on resource issues, such as shortages of physicians, whereas we’re now focusing on much more diverse topics including Indigenous health issues, French language health services, access to services for marginalized individuals, and similar topics.”

CRaNHR has five “pillars” of research: Health Human Resources, Francophone Health, Indigenous Health, Virtual Care Research and NOSM Integrated Impact Investigations.

As part of their research on the impact of NOSM in the North, researchers at CRaNHR are conducting a multi-year tracking study of the students and graduates, evaluating the experiences of family medicine graduates practising in Northern Ontario, as well as the contribution of the School to the number of physicians and surgeons practising in Northern Ontario and its economic impact in the region.

In its early stages, CRaNHR also conducted a number of studies that, while not directly linked to the establishment of NOSM, demonstrated the need for a long-term solution to health inequity in the North, and provided evidence that a medical school could be a viable option. Studies included an evaluation of existing rural medical education programs, and an exploration of the link between rural medical education and rural practice location.

The reciprocal relationship between the two institutions extends to faculty and students too, says Gauthier. CRaNHR has been a partner for NOSM’s faculty investigators, providing them with a place to conduct their research, and has housed many researchers who have become NOSM students.

“It’s great to see our researchers become learners, because that background provides them with the necessary skills and tools to be physician researchers, as well as a better understanding of rural and Northern Ontario as they prepare for medical training,” he says.

Overall, Gauthier says the 25th anniversary signifies that the founding vision of CRaNHR has stood the test of time.

“In research, you’re often forced to reinvent yourself based on the opportunities that exist, and that we are still here 25 years later, with a vision for improving health care in the North, is quite something,” he says. “We’ve created a sustainable venue for knowledge production in the North, and my hope is that will continue to do so for the next 25 years and beyond.”

Read more stories like this one in the latest edition of The Scope.

A group of researchers at the Northern Ontario School of Medicine is studying the dynamics of concussion management in interprofessional team settings.

The team is lead by co-investigators Dr. Tara Baldisera, a family physician and associate professor of clinical sciences at NOSM; Dr. Jairus Quesnele, a clinical chiropractic specialist and associate professor at NOSM; and, Shannon Kenrick-Rochon, a nurse practitioner, professor of nursing at Cambrian College and Laurentian University and a lecturer at NOSM. It also includes Dr. Sylvain Grenier, Professor of Human Kinetics and Michelle Laurence, Laboratory Technologist and Registered Kinesiologist, both faculty in the School of Human Kinetics at Laurentian University, and Matthew Baker, a research assistant and student at Laurentian University.

Concussions affect many systems of the body. For that reason, an interprofessional approach is widely considered best practice, and is the recommended standard of care of the Ontario Neurotrauma Foundation and Concussion Ontario.

The team is exploring how factors like communication and collective competencies of an interprofessional health-care team can affect a patient’s recovery.

Over the past two years, the team has been following both male and female athletes from multiple varsity teams at Laurentian University, tracking and treating their concussions. They are looking specifically at the effectiveness of interprofessional concussion management teams in diagnosing and treating injuries from both return-to-play and return-to-learn perspectives by measuring recovery rates and progression to post-concussion syndrome, according to Baldisera.

Though their research is still ongoing, they have already seen some promising preliminary results, says Quesnele.

“We’re seeing the athletes return-to-play sooner overall, and seeing fewer protracted or long-lasting cases in our second year of follow-up versus our first-year of follow up,” he says. “We’re currently trying to figure out why that is, but our initial thoughts are that as we become more proficient and more collaborative in our approach, it’s translating into better recovery rates for some of our athletes.”

Quesnele also credits expanding the team in the second year of tracking, as well as more formalized communication with the university’s accessibility office and the athletes themselves for the positive results.

“We were able to add key members to the team, which allowed us to develop tailored treatment strategies, giving us a better approach for targeting these concussion deficits more effectively,” he says.

The cohesiveness of the team itself and the rapport they have developed may also have an effect on the progress the athletes make, according to the researchers.

They have added patient satisfaction as an evaluation tool in their research to better understand the effect of an interprofessional concussion management team in this context, says Baldisera.

“We’re looking at both the internal team dynamics and how we operate within our community setting,” she says. “What both makes us a better team and helps enhance patient-centred care?”

With the help of two Dean’s Summer Medical Student award recipients, Eve Boissoneault and Emily Aleska, the team has also been able to explore how sex differences can factor into recovery rates, as well as other elements of the recovery process.

Whichever elements of the team dynamic are found to affect the results of an interprofessional concussion management strategy, the ultimate goal is to be able to provide patients with the best care possible, says Baldisera.

“Not every patient needs every health-care provider that can treat concussion to be involved in their care,” she says. “We want our team to operate in a way that allows patients to get the specific care they need.”

Read more stories like this one in the latest edition of The Scope.