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A student in NOSM’s new Master of Medical Studies program works to improve pain management for Northern trauma patients transported by air

Unfortunately, it’s a recurring story in the North. Serious accidents happen causing trauma, and the air ambulance is called to transport patients to hospital. For Dr. Sabrina Slade, most critical is the extreme pain many patients must endure during lengthier air transport—an experience she hopes to improve.

Dr. Slade is a second-year orthopedic surgery resident at the Northern Ontario School of Medicine (NOSM) and a graduate of the MD Class of 2019 at Queen’s University. She currently works part-time in the emergency department at Thunder Bay Regional Health Sciences Centre. She’s one year into the Master of Medical Studies (MMS) program at NOSM, working on her thesis titled “Alleviating pain for trauma patients transported by air in the North.” Dr. Slade recalls her firsthand experiences with emergency trauma patients transported by Ornge, Ontario’s provider of air ambulance and critical care transport services.

“I’ve been fortunate to ride along with Ornge while patients are being transported,” says Dr. Slade. “It’s a challenging environment in which to manage pain while being jostled around. The study is focused on patients who are being transported from remote areas after suffering a multi-system trauma. It’s not uncommon to have a patient arrive from a trauma after a four-and-a-half-hour flight and their pain is not well controlled. Our goal is to build upon the breadth of knowledge and skills of Ornge paramedics to improve pain management for our patients.”

She says improving pain management in the air is possible. Her challenge is to determine if it is feasible. The study is two-fold—the first portion assesses whether paramedics could independently administer a specific pain block medication which is frequently used in emergency departments for those who have suffered hip or femur fractures. The block lasts up to six hours, but is currently available to patients only if administered in consultation with a physician.

“We must first assess if it’s feasible for Ornge paramedics to administer the block using what we call a ‘blind technique’ when they first arrive on the scene; meaning without the consultation of a physician and without ultrasound,” says Dr. Slade. “There are good techniques to do this effectively.”

The second portion of her study is a chart review assessment of the experiences of previous trauma patients during air transport. Specifically, Dr. Slade is studying traumas that include multiple injuries to determine if the current standard of pain management during air transport is sufficient. Part of that work involves detailed chart re-evaluations of the medications that trauma patients received during their air transport time.

Dr. Slade considered programs at various universities across Canada before choosing NOSM’s Master of Medical Studies program. For her, it’s the program of choice because it was created to address pressing Northern health-care challenges. “The program really resonated with me because it highlights issues in communities and it is best suited to researching transport medicine and critical care.”

Working under the supervision of emergency physicians and NOSM faculty members Drs. David Savage, Rob Ohle, Sean Moore, Russell McDonald, the study will also cross-reference air transport pain management techniques in the US, Australia and New Zealand where air transport medics have a progressive scope of practice.

Dr. David Savage, research supervisor, NOSM Assistant Professor, and Emergency Physician at the Thunder Bay Regional Health Sciences Centre, says Dr. Slade has chosen a really important research topic for our northern and rural population. “Ornge plays a really important role in caring for sick and injured patients in the North. If we can improve a patient’s pain management, we hope that both their experience during transport and their medical outcome is improved.”

Dr. Slade’s personal goal is to have the research completed by spring with a paper in progress by June 2021. “I’m hoping more learners and supervisors see the program as an opportunity to both address critical health issues and expand our academic health network. There are excellent researchers in the North who are able to broaden our scope of practice and research.”

Visit the NOSM website to learn more about the Master of Medical Studies program, including a flexible program schedule which allows for full- and part-time options for learners to complete between two to six years. Applications for the 2021-2022 academic year are currently open until February 26, 2021.

 

The ‘Scopes’ of Academic Leadership

Microscope, Telescope, Stethoscope, Periscope and Kaleidoscope

“The new dawn blooms as we free it.
For there is always light, if only we’re brave enough to see it.
If only we’re brave enough to be it.”  

~Amanda Gorman

Watching Amanda Gorman’s delivery of The Hill We Climb during the historical American inauguration last week was awe inspiring. Hearing her say “the norms and notions of what just is, isn’t always justice” had me thinking again about social justice. In my last blog I stressed the four essential principles of social justice: human rights, access, participation, and equity.

The School recently asked for volunteers for a vaccination rollout in remote First Nations communities. Within days, more than 300 NOSM faculty, residents, and medical students volunteered. I am overwhelmed by your sense of social justice, citizenship and responsibility. This is what health care is all about. I know we’re brave enough to be it.

NOSM is supporting Ornge, Ontario’s provider of air ambulance and critical care transport services, in this roll out with the leadership of Chiefs, community partners, Nishnawbe Aski Nation (NAN) and the Weeneebayko Area Health Authority. Being part of a collaboration like this is a demonstration of our commitment to the School’s mandate of social accountability.

We know one’s location often determines one’s access to timely health care. Reciprocity and responsibility are the focus. Northern Ontario’s remote First Nations communities are steadfast supporters of NOSM. It is our opportunity—our responsibility—to reciprocate the care and support we receive.

The enthusiasm demonstrated by our volunteers speaks loudly to my belief that NOSM is made up of the ‘right stuff.’ It’s our people, their commitment, courage and self-sacrifice. Thank you all. And for those who are unable to participate for various reasons, don’t worry, there is plenty of work and time for most of you to be involved in other kinds of collaborative leadership opportunities to come.

For me personally, this project is drawing upon and reinforcing my own skills and ability to use what I refer to as my own various ‘scopes’ in my personal leadership toolkit. They are the different lenses through which leaders need to view their actions. As educators, and clinicians or researchers, we have several lenses through which we view our work. The challenge is we must choose the right lens for the right situation.

The Microscope

There are times when we must pay attention to the details and use a microscope before it gets out of control. Going deep means understanding, at a cellular level, that our students, our curricula, our school organization, our pedagogy can often be the difference between ordinary and extraordinary teaching and leadership.

The Telescope

There are times when we need to view our work through a telescope and keep our eyes fixed on our greater goals, even though they seem far away. There are situations where we need to hold onto our vision and our big, purposeful question to answer “why?” in order to move past the temporary setbacks and frustrations. The telescope allows us to maintain a healthy perspective and an unwavering faith that we will reach our goals.

The Periscope

As Dean with the overview of the entire school, I know that we will face obstacles from time to time, but I use the periscope to look over and around obstacles. A periscope helps me look beyond what is in the way and navigate past what may be blocking us. For example, major changes like expansion, curricular reform, new pathways and even the vaccine project may be perceived by some as threats. It is my job to illustrate the opportunities, dispel the myths, inform and inspire by working through these obstacles.

The Stethoscope

Regardless of the issue, with kindness and compassion top of mind, there are times when we need to feel our work through a stethoscope. We need to listen to our hearts and the hearts of those we serve. We need to check in with our own hearts to make sure that we are doing the right work the right way. We need to check in on the hearts of others to make sure that we are serving them in a way that honours them. I am guided by the culture of respect, kindness and compassion, and lead with my heart.

NOSM’s Strategic Plan and all the projects we are undertaking in addressing climate change and social justice this year will be guided by these four scopes. And there is one more…

The Kaleidoscope

This is an optical instrument with internal beads of glass. When held loosely at the end of the rotating tube, the glass creates stunning and continually changing symmetrical forms that are reflected in two or more mirrors. With a continually changing pattern of shapes and colors and a continually shifting pattern, our kaleidoscope reflects equity, diversity and inclusivity.

Kaleidoscope thinking is not easy to achieve, but we are making tremendous progress at NOSM. In fact, our entire strategic plan is based on the notion of multiple perspectives and stakeholders. Balancing all of the interests at NOSM, from students to partners, faculty and staff, researchers and communities, involves guiding the School by way of “Leadership as a Collective.” Let’s unleash and harness the collective genius of NOSM by using the right scope and by employing Kaleidoscope thinking.

I am proud to report that I have received a couple of creative and ‘dangerous’ ideas. This is the type of out-of-the-box, innovative thinking that I encourage and invite. Keep sending them in. I want to hear from you. Follow me on twitter @ddsv3.

Thank you to the 200+ participants who joined the NOSM whole school webinar this morning. There’s fantastic engagement, support and planning taking place at the School. A special thank you to learners, faculty, and staff who continue to do amazing work during COVID-19.


Resident Doctors Wanted

NOSM’s new, eye-catching Wanted marketing campaign to attract resident doctors to Northern Ontario has launched. Help spread the word with MD graduates across Canada. At NOSM you are wanted. “Be seen and have a voice in your learning. Enjoy a breadth of clinical experiences at a faster pace.” Visit wanted.nosm.ca for more info.


Acknowledging Great Leaders

NOSM acknowledges the recent loss of two great leaders. Dr. Diarmuid (Dermot) McLoughlin was a doctor for more than 50 years, with much of that time spent in Sioux Lookout. He was a founding Board Member at NOSM and Associate Professor Honorarius. Dr. Thomas Dignan was one of Canada’s first indigenous physicians, a founding member of the Indigenous Physicians Association of Canada, and had dedicated his life to the mentorship of Indigenous youth and physicians.

NOSM Staff and Board Ratify a New Four-Year Collective Agreement

The Northern Ontario School of Medicine (NOSM) and the Ontario Public Service Employees Union (OPSEU) Local 677 (Unit 2), representing 132 staff, are pleased to announce the ratification of their fourth collective agreement.

Both OPSEU Local 677 (Unit 2) Members and NOSM’s Board of Directors (Executive Committee) voted in favour of ratifying the new collective agreement on Tuesday, January 19, 2021.

The agreement covers four years and is in effect from May 1, 2020 to April 30, 2024. Negotiations were subject to Bill 124, which limits overall compensation increases to the agreement. Both parties also agreed to enhancements of pension and benefits, all in compliance with Bill 124. In addition, in light of COVID-19 measures requiring staff to work from home, both parties agreed to work together to establish a new Alternative Working Arrangements Policy during the term of this agreement.

The term of the last contract ended on April 30, 2020 and due to the pandemic, both parties agreed to defer negotiations of a new collective agreement until a future date when parties could meet in person. As the pandemic situation did not improve, both parties agreed to commence negotiations in November 2020.

This was the first time that a NOSM collective agreement was negotiated via video-conferencing.

The negotiations were led by chief negotiators Mr. Garth O’Neill (NOSM) and Mr. Len Mason (OPSEU). NOSM and its Board of Directors look forward to the continuation of a strong and productive partnership with OPSEU Unit 2 over the next four years, and are appreciative of their Members’ contributions in advancing the School’s growth and innovation through its new Strategic Plan, The NOSM Challenge 2025.

On behalf of the Northern Ontario School of Medicine Board of Directors, Dr. Robert Haché, Chair, would like to thank the members of both negotiating teams for their hard work in reaching an agreement that will ultimately benefit learners and communities across the North. Jason Lind, Bargaining Chair and Vice-President of OPSEU Unit 2, also extends his appreciation for the work of the teams and the support of Members in reaching an agreement.

For more information, kindly contact:

For OPSEU:
Jason Lind
Bargaining Chair and Vice-President
NOSM Staff Union Unit 2
OPSEU Local 677
705-561-1121

For NOSM:
Joanne Musico
Director, Communications and External Relations
Northern Ontario School of Medicine
705-662-7169

NOSM University