The Centre for Integrated and Advanced Medical Imaging solves clinical, educational and research challenges through deep institutional partnerships.

The new Centre for Integrated and Advanced Medical Imaging (CIAMI) will provide desperately needed MRI services in Hamilton, educate in demand MRI technologists through hands-on learning, foster innovation and new research discoveries.

Developed through a partnership between Mohawk College, McMaster University and affiliated hospitals, Hamilton Health Sciences (HHS) and St. Joseph’s Healthcare, CIAMI serves as a model for a new generation of healthcare.

It’s more than a place, CIAMI is an approach to improving MRI services in the community that addresses backlogs, educates the next generation of MRI technologists and conducts critical research.

Located at the Mohawk-McMaster Institute of Applied Health Sciences (IAHS) building on the university’s main campus, CIAMI includes a newly installed GE Healthcare Signa 3T advanced MRI suite, only the second of its kind in Canada. 

Long-time partnership

CIAMI builds on a long tradition of partnership in healthcare education between McMaster and Mohawk College that includes the province’s first collaborative degree in Nursing, the IAHS facility itself, which opened in 2000, and the first fully integrated diploma-degree program in Medical Radiation Sciences in 2004.

“Those early years of the Mohawk-McMaster partnership paved the way for exceptional successes in education and research. CIAMI is a great example of how strong partnerships and meaningful collaborations can succeed in amazing ways,” says Mohawk College President and CEO Ron J. McKerlie. 

“Both Mohawk and McMaster are committed to moving the region forward,” says David Farrar, President of McMaster University. “Individually, we have great capacity in that regard, but together we have massive power.”

According to Wendy Lawson, Associate Vice President Academic & Dean of the School of Health & Community Services at Mohawk College, CIAMI will revolutionize medical imagine training, discovery and care in the community.

“We envision a future in which front-line allied health professionals are actively engaged in research and one in which teams of clinicians, radiologists, academic researchers an technologists work together to solve problems and propel technological advances in the expanding field of diagnostic imaging,” she says. “Above all, we envision a future in which specialists collaborate across disciplines to train the healthcare professionals of the future, make exciting research discoveries, and provide better healthcare for all.”

Mohawk College’s commitment to producing Future Ready graduates through experiential learning, applied research and interprofessional education will flourish at CIAMI, says Lawson.

City-wide collaboration 

The partnership behind CIAMI is a true citywide collaboration, says Leslie Gauthier, Vice President of Clinical Support Services and Surgery at HHS.

“This will have a huge impact. It’s a different way of thinking about education and clinical needs.” 

Launching this initiative – which has been  about 10 years in the making – has taken the input of 19 working groups, more than 100 people and hundreds of meetings.

“With CIAMI, we are being responsive to community needs and we have connected with community partners on a level that is unprecedented,” says Laura Thomas, Associate Dean of Allied Health and Medical Radiation Sciences at Mohawk College. “

MRI: Standard of care

MRI provides a more in-depth anatomical picture than other forms of diagnostic imaging and is especially useful for imaging of the spine, joints and organs, such as the kidneys, liver and ovaries.

“There was just one MRI in Hamilton when I trained. It’s now a proven technology that many doctors rely upon for diagnosis,” says Dr. Karen Finlay, Chief of Diagnostic Imaging and Nuclear Medicine at HHS. Hamilton is now home to 10 MRIs, including the one at CIAMI.

But the need is much greater. Non-urgent patients are waiting up to a year to get an MRI.

The lack of health human resources, the most limiting factor, has long been one of the biggest challenges.

Under supervision of registered technologists, students get real-world training on clinical cases and the site will offer a space where existing healthcare staff in the city can train to add MRI to their skill set.

Mohawk College’s accelerated training for upskilling healthcare professionals – within the Centre for Professional Advancement – has already helped 82 existing diagnostic imaging staff fast-track their paths to learning MRI.

As well, Mohawk College’s first MRI technologist post-graduate certificate program launched this fall with a cohort of 24 students.

Improving efficiencies

The whole idea for CIAMI came about when  Mohawk College Chief Operating Officer Paul Armstrong, then Dean of Health Sciences, met McMaster University professor Mike Noseworthy for a coffee more than a decade ago. They hashed out a dream for an MRI at IAHS that would combine clinical, educational and research functions.

“It was a crazy idea but I’m elated to see what it’s become,” says Noseworthy, who is Director of Medical Imaging Physics and Engineering at St. Joseph’s Healthcare and a professor in McMaster’s Department of Electrical & Computer Engineering. “This is a unique model. McMaster and Mohawk College have a special relationship that has allowed this to happen.”

He’s been working MRIs for 35 years and always wished there was a dedicated MRI that could be used for research and education.

Noseworthy says the last piece of the concept came from radiologist Dr. Julian Dobranowski, who suggested the MRI should focus on nonurgent cases.

Dobranowski was chief of radiology at St. Joseph’s Healthcare and is now Chief of Medical Imaging at Niagara Health. He is also chair of medical imaging at McMaster University and an adjunct professor at Mohawk College. He serves as the provincial lead at Ontario Health for cancer imaging and for access to care for MRI and CT. His mission is to improve efficiencies and cut wait times.

The relevance of CIAMI is that it will cut wait times while still giving space for training and research.

“It’s important that CIAMI is outside the hospital system,” says Dobranowski. “The hospital is taking care of ICU, ER, ward patients and outpatients coming in for MRIs. We now have an option for lower acuity patients. When we take them out of the hospitals, it leaves more spaces for acute patients.”

The new MRI – a 3 Tesla unit that features a magnet 60,000 times more powerful than the magnetic pull of the Earth – has enhanced artificial intelligence features, an audio system, and a monitor that can stream television or a movie for patients who have to stay completely still up to an hour. It also features a wider bore that accommodates larger patients, along with those with claustrophobia.

When it’s in research mode, engineers and scientists can access the back end of the operating system to study and improve its operation and output, as well as design new components.

The MRI will be used to assess physiological processes such as muscle and brain activity or the behaviour of diseases. Researchers will be able to investigate new efficiencies within the MRI magnet as well as design hardware to support patient diagnosis.

Proof of concept

St. Joseph’s Healthcare’s MRI, which had been primarily used for medical research through the hospital’s Imaging Research Centre (IRC), stepped in to take clinical cases under the CIAMI program beginning in 2022.

“St. Joseph’s Healthcare was instrumental in the implementation of the proof of concept for CIAMI,” says Cheryl Livingston, Chief of Diagnostic Services at the hospital. “We worked out what patients would be suitable, the gains that could made through this model and the benefits to the overall hospital sector.”

By extending the working hours of the MRI and staff, St. Joe’s took on 1,500 to 2,000 hours of clinical MRI work a year or about 6,000 MRI scans under the CIAMI program, targeting those who had been waiting the longest.

As MRI proves to be increasingly useful as a clinical tool, that research directly leads to the growing demand for MRI services that far outstrips capacity and leads to long wait times. Dobranowski believes CIAMI will serve as a model of care for other communities struggling to manage demand. 

“The mindset here was our institutions coming together to do the right thing to solve a problem. All affiliations were just left at that door. There’s no reason this can’t be replicated across the country.”  

This story originally appeared in Momentum Magazine.

Mohawk College’s Applied Research Pathway, Centre for Emerging Research Initiatives and applied research training modules offer a suite of supports for applied researchers.

Fostering a culture of research is a key strategic priority of Mohawk College and that happens on a number of fronts: backing established researchers leading key campus centres of innovation; helping emerging researchers firmly get rooted in their field of inquiry; and growing the ranks of researchers by inviting new people into the fold.

The goals are to provide more opportunities for applied research to students, to collaborate with more industry partners and to improve the rigour and success of the research that is undertaken, says Cristina Gage, Dean of Applied Research.

Mohawk College is home to subject matter experts in a realm of fields, including remote sensors, internet of things, drones, artificial intelligence, cybersecurity, digital health, additive manufacturing and many others.

Converting that knowledge into an understanding of the demands, standards and rigours of research through Mohawk College’s Applied Research Pathway, a structured approach that builds the skills of new researchers – and the subsequent benefits to students and industry who can join that exploration – is a powerful model, says Andrea Johnson, who is general manager of the recently created Centre for Emerging Research Initiatives. 

“We know we have untapped resources of expertise amongst our faculty experts and we wanted to create more access to research training to develop their research skills and knowledge that can solve real-life challenges.”

Mohawk College, through IDEAWORKS, its applied research and innovation division, provides resources, support, mentorship and services to faculty, staff and students across the spectrum of research experience.

“Mohawk College has developed a flexible toolbox that supports researchers. The majority of our researchers work within defined innovation centres that employ professional staff,” says Jeff McIsaac, Dean of Engineering Technology & Aviation.

The Applied Research Pathway, developed by Johnson and McIsaac, operates in five levels, beginning with novice researchers, then emerging researchers and working all the way up to established researchers who are leading large projects and building a career in the field.

Researchers complete training and research activities and hit key milestones to move through to the next stage.

“We have researchers across the spectrum of experience, from someone just starting out who needs training and skills development and assistance in finding partners and building relationships to undertake their first project to those who have completed dozens of projects and are managing 10 to 20 researchers and a multi-million dollar budget,” says McIsaac.

“Those two researchers have a completely different set of needs, so with the Applied Research Pathway, we can identify where in the research journey they are and align our supports with that of the needs of 
the researcher.”

An element of the research pathway is a series of applied research training modules that are now open for enrollment to anyone, including individuals, industry and other institutions, and provide the resources for those who want to take on research activities but may be intimidated.

“How do you start? How do you pose a research question? How do you get funding? These are questions that someone new to research would have,” says Gage. “We know there are faculty and staff who 
are interested in research but haven’t had dedicated training.”

The modules also cover research ethics, how to protect intellectual property, how to apply for grants and how to achieve research objectives that create value for the region, province and country.

“The idea is to give back to the entire applied research community with training and knowledge. More applied research knowledge is better for everyone and makes the sector stronger. We really believe in the value of applied research and what it brings to businesses, community organizations and start-ups.”

Babitha Thampinathan, who teaches cardiac sonography part-time at the Institute for Applied Health Sciences, took the applied research modules earlier this year. She is exploring the integration of AI technology, such as a simulation mannikins to evaluate the impact of simulation-based learning.

“I have always planned to do applied research at the school and coming out of the pandemic, I renewed my commitment. I have participated in some clinical research but that’s different from finding an industry partner and funding.”

She said the modules were accessible, sequential and systematic and included videos, hands-on “drag and drop” activities, readings and self-assessments.

“I now understand the terminology of applied research, along with budgets and working with deliverables to research partners. I have referred my colleagues who don’t have a research background and they found it really helpful, too.”

Thampinathan credits the modules with helping her secure two grants, one through the IDEAWORKS Catalyst Fund and the other through an external funder. “I think it’s great Mohawk College has opened this up to external researchers. That is forward thinking and it shows the strength and value of applied research at the college.” 

This story originally appeared in Momentum Magazine.

In this first of a series, Momentum invites a Mohawk College alumnus to speak with a current student in the same program to share advice, wisdom, and understanding of how things change and how they stay the same. In this kickoff Q&A, and in celebration of 50 years of nursing at Mohawk College, 1970 Nursing graduate Jan Brimer speaks with Practical Nursing student Jess Mills, who finished her program in December. She has been hired at Joseph Brant Hospital to work in complex and palliative care.

What has been your path to nursing?

Jan Brimer: I graduated in 1970 from the Hamilton and District School of Nursing (HADSON). That was just before the colleges got involved and took over the nursing programs in 1973 and four local nursing schools became part of Mohawk. I was strongly influenced by my grandmother who was a nurse here in 1918, during the Spanish Flu epidemic. I was fascinated by her stories. I don’t remember deciding to go into nursing, I feel I was born to be a nurse. I worked for 20 years full time and part time at Joseph Brant Hospital before cutbacks came along and I shifted to home care. I retired about five years ago but I still carry my licence and I still do consultations and private visits for a local pharmacy.

Jess Mills: I am a mom of five and I live in Grimsby. I did a Pre-Health upgrade program in 2021 before going into Nursing. High school me said, ‘Who needs science?’ Turns out I did. I have wanted to be a nurse since I was 18 (my grandmother was also a nurse) but I started my family young and I wasn’t able to go back to school until now. I’m not sure how I did it, especially since I was studying online while trying to homeschool some of my kids during COVID, but I blinked and here I am. I just want to be a help to people.

Jess to Jan: When you first started out, what did a day in the life look like?

When I was really new, I was responsible for six or seven patients a day on the short-stay surgery ward. So many of those surgeries are day surgeries today. One of the big differences today is that drugs are administered through IV pumps. When I was starting out, nurses didn’t do intravenous, so we were giving analgesics intramuscularly (needles). It was time-consuming to deliver that way but I prided myself on the fact that patients didn’t feel it too much. Also, we worked eight-hour shifts, first seven days in a row, with two days off, and then five days in a row with four days off. We didn’t have 12-hours shifts like today.

Nurses are now thought of as part of the team but when I was starting out, there was a huge gap between doctors and nurses. Now nurses get the respect they deserve.

Jan to Jess: What has been your most challenging experience so far?

The confidence on placements to ask questions of the doctors and the seasoned nurses. They are rocking their jobs and it’s intimidating as a brand-new nursing student to talk to them. In school, it was the workload and the volume of material to cover in such a short time. Many times, I was up to 2 or 3 a.m. reading and trying to grasp the concepts.

Jess to Jan: When you were first going into nursing, what areas did you want to go into and were there any you never wanted to do?

I didn’t really know what I wanted to do coming out of training but I did know that I didn’t want to do psychiatric nursing. I wasn’t comfortable with that. I loved the surgical ward and the fast turnover there. I just always wanted to do hands-on care.

Jan to Jess: Where do you see your career in five to 10 years?

I know I have found my passion in complex and palliative care. There are so many options in nursing and I do also love mental health work. It’s a difficult but rewarding path there. I do know that I don’t want to be stagnant and stop learning. I see some people who are robots and don’t want to learn new ways of doing things.

Jess to Jan: What has been the hardest thing about nursing?

I never dreamed I would be laid off. It was sudden, devastating and very shocking. I had always been a nurse and I didn’t know what else I would do. I had a couple of odd jobs until a former co-worker got hired for home care and convinced me to apply. Home care staff don’t get enough pay or respect but I took every part-time course at Mohawk College about home care and I found I loved it. So, get experience in hospitals but look at other opportunities, too. There are so many things nurses can do.

Jess to Jan: In a career full of burnout, what’s your advice for a long-lasting career?

If you feel stuck or burned out, go somewhere different or go into something else. Look after yourself. Rely on your colleagues to help you through the tough times. Lean on each other. I still keep in touch with a lot of people I went to school with or who I nursed with early in my career. And make sure you take time to enjoy your family and your time off.

What inspires you about working with patients?

Jess: We see people on their worst day and when they feel their worst. But as a nurse, I am there for them and will do whatever I can to make them feel better. I just think of the patients and their perseverance and I know I can do whatever I have to do, too.

Jan: To see their appreciation at the end. They may not have always liked what you were doing at the time, but they know it was for the best. In palliative, I always just wanted to make it the best it could possibly be for the patient and for the families.

What advice would you give to others considering nursing?

Jess: There is no shame in asking for help when you need it. I was doing my placement at Brantford General Hospital and my child was sick. I had to ask for help. I had to ask for help when I needed a study group. We have to swallow our pride and ask for help. And also, when it’s your passion, you just keep going. I would tell myself it doesn’t matter how much I have to read or write, I’m going to get it done because this is what I want to do.

Jan: Don’t ever stop learning. When I moved to home care, I didn’t like it because I had to work on my own. But I took specialization courses in wound care and I really loved to see patients through their journey from pre-op to post-op and back home again. I did a lot of palliative care, too. And I found that very rewarding. But when I first studied wound care, I felt so intimidated. There was so much I didn’t know. Then I took an ostomy course and that was worse. At that time, I was working and dealing with my kids. But I got through somehow.

What sets a nurse apart in the health care system?

Jess: For me, I have a huge passion for advocating for my patients. Nurses have an ability and drive to advocate because they have the knowledge and spend the time with the patients. If we have to repeatedly go to a doctor or a manager, then we will.

Jan: I was also going to say advocating. In a home care setting, we are always trying to get more services and resources for patients and families at home. It’s always about getting your patients the care they need. If you have to step on some toes or tick someone off, so be it. You have to know how to get what the patient needs. Whether it’s 52 years ago when I graduated or this year when you are, the nurse is at the heart of the system.

50 years of Nursing at Mohawk College

The Mohawk College Nursing program began in 1973 when four schools of nursing – Brantford General School of Nursing, Hamilton Civic Hospitals School of Nursing, St. Joseph School of Nursing and the Hamilton and District School of Nursing (HADSON) – came under the College’s oversight.

That move, initiated across the province by the Ontario government, had the support of the College of Nurses. It reflected the growing belief that nurses would have more professional status and career opportunities with a post-secondary college education.

Those predecessor schools had been training nurses for more than 100 years. Three were directly attached to hospitals, while HADSON was an independent school sponsored by the Hamilton Health Association (formerly the Mountain TB Sanatorium) and was located on the Hamilton Mountain brow.

It was an enormous task to bring those four schools, still operating in their existing locations, into one program, says Rosemary Knechtel, who was teaching at the HADSON school at the time of the transition.

She went on to be Mohawk’s Dean of Health Sciences and Human Services and then Vice President Academic before retiring in 2010 after a 39-year career at the College.

“All of the schools had very good reputations. The programs were rigorous and nurses took a lot of pride in where they had gone to school, so there was a sense of loss and a grieving process at first. But bringing the programs together with Mohawk College meant building on all their strengths to create something new and highly successful.”

In 1978, a newly renovated HADSON facility became home to all of Mohawk College’s Hamilton-based nursing students and was named the Chedoke campus. The Brantford site continued until it was eventually closed.

Faculty and staff from all the predecessor nursing schools established careers at Mohawk College, says Knechtel.

She was a graduate of HADSON and took advantage of a “sandwich” program in which students went to Western University for a year, then to HADSON for two years and then back to Western for a final year. They earned a nursing diploma, along with a bachelor’s of science in nursing.

“It was a very innovative program and there were only a few of them in Ontario at the time,” says Knechtel, who went on to earn a master’s degree at McMaster University.

The merger of the four schools into Mohawk College built on their great programs and paved the way for what came later, including a problem-based curriculum, new programs in Practical Nursing and Personal Support Worker, a Practical Nursing partnership with Six Nations Polytechnic, and a great deal of global outreach to improve nursing programs.

It also laid the foundation for a partnership with McMaster University on a Nursing degree program – the first in Ontario – and a new joint facility in the Institute for Applied Health Sciences that is home to Mohawk’s nursing programs, says Knechtel.

“It has been a very deep and productive relationship between McMaster and Mohawk and it’s been a model for others,” she says.

“The Nursing programs at Mohawk College are well recognized and so respected for graduates who provide top-notch care because they were founded on these strong predecessor schools, the enthusiastic support of Mohawk College and later on the partnership with McMaster University in 2001.” 

This story originally appeared in Momentum Magazine.

Targeted, rapid on-demand training for health care workers through Mohawk College’s new Centre for Professional Advancement (CPA) is helping hospitals locally, provincially and nationally cope with ongoing staff shortages and care backlogs amid pandemic recovery. 

The CPA is the formalized structure that has resulted from dozens of training partnerships with health organizations over the last several years. 

Project by project since the COVID-19 crisis began, the CPA within the School of Health and Community Services has worked to close skills gaps and increase capacity in the workforce through a new model of on-the-job training that prioritizes innovative, responsive, accelerated and specialized instruction to address fast-emerging and future employer needs. 

“This came out of a desire to respond to an acute situation in our community. We needed solutions and this was an innovative way to help solve problems,” says Wendy Lawson, Dean of the School of Health and Community Services. 

“We recognized that there are challenges facing our community in health care that cannot be ignored. This was catalyzed by the pandemic but not caused by it. The crisis forced everyone to be innovative.” 

The CPA provides flexible, high-quality learning solutions online, in-person, or using a blended approach with a mix of self-study and facilitated instruction. In collaboration with employer partners, Mohawk’s team of curriculum developers and subject matter experts develop and deliver customized training solutions designed to address specific competencies and desired learning outcomes. 

Mohawk College faculty then support the delivery of clinical training by clinical educators and mentors at the learner’s home site. 

“What makes this approach transformative is that it is a real partnership with the hospitals and clinical employers to create something specifically for them that answers their needs,” says Associate Dean Nicole Barron. 

Training has been delivered to cohorts as small as five and as large as 138. The team at the CPA continues to work with partners and governments to identify labour gaps that can be addressed through laddered training, extended roles, skills specializations and bridging. 

“This is a sustainable and scalable model of training that contributes to a highly skilled and agile workforce. Our partners are committed to this and the successes of this approach are clear,” says Lawson. 

“The need has been most acute in health care, but this model can be applied in any sector with human resources challenges. Mohawk College and its executive team has been universally supportive of this vision.” 

The model is now gaining attention from health care providers across Canada. 

“It helps employers create a culture of learning and career progression,” says Barron. 

Training can be delivered in a full-time or part-time model. In some cases, learners get a leave and are paid to take the training. 

“That really removes the barriers to ongoing training for many employees. The earn-while-you-learn model is a best practice that we recommend to our partners.” 

The partnership with the CPA has helped HHS take a logical approach to filling areas of need, says Leslie Gauthier, Vice President of Clinical Support Services and Surgery. 

“In the case of MRI technicians, a radiology tech has had to take a year off work to get the training that will give them an extra couple of dollars an hour. It didn’t make sense.” 

Ten HHS employees took the MRI training – paid for by the hospital – that finished in late spring. 

Gauthier says there are needs in many areas, including anaesthesia assistant and pharmacy technician, that can be addressed through the approach at the CPA. 

“We are learning as we go and correcting course where we need to but this is a great partnership that will help us address our needs.” 
The strengths of the approach are that Mohawk can work with a partner anywhere at any time, can offer the accelerated training to multiple organizations at once, and it addresses both immediate needs and long-term human resources planning. 

The Operating Room Assistant (ORA) clinical training was delivered simultaneously in five labs over two Saturdays to staff from six different hospitals. It is a common role in the United States but it is a pilot in Ontario. 

OR Assistants are not intended to replace RNs or RPNs during surgery but by playing a supporting role and acting as an additional resource in the OR, including setting up the operating room for the patient, ensuring all the tools are sterile and in place and handing tools to the doctor during the surgery, they are able to increase the capacity of the RNs to do the highly skilled and regulated nursing work. 

Kate Cook and Dulce Isorena from the Greater Niagara General Hospital were among the ORA trainees. Both worked in the hospital’s medical device processing department that handles sterilization of instruments used in the OR. 

They each jumped at the chance to add to their skills and take on a new challenge. It was an intense, exhausting experience. 

Over 10 weeks, they took nine courses and had to achieve a minimum of 80 per cent in order to get the ORA job. They studied 14 to 16 hours a day at least six days a week and they still study each surgery the night before. But it’s worth it. 

“It was exhilarating to be in the OR for the first time,” says Cook. 

“I really love doing this,” says Isorena, even though she worried she couldn’t stomach being in a surgery. “Instead, I was intrigued and curious.” 

OR manager Jen Law says 50 per cent of the OR staff at Niagara Health’s three sites are eligible for retirement within the next five years. 

CPA training won’t fill the gap on its own but it will allow more flexibility in handling human resources challenges. 

“This is such a great collaboration between Mohawk, HHS and us. Everyone is committed to facing down the challenges and doing what is needed and doing it quickly.” 

The pandemic deepened an existing talent crisis in health care, says Jen Plant, Director, Professional Practice and Ambulatory Care at Queensway Carleton Hospital in Ottawa. Critical care nursing has been particularly hard hit. 

Mohawk’s accelerated critical care nursing program is designed for RNs looking to prepare for a career in a critical care setting or those currently employed in a critical care setting who wish to improve their knowledge and skills. This 300-hour program aligns with specifications of the Critical Care Services Ontario and will also prepare nurses to challenge the Canadian Nurses Association national certification exam in critical care. 

“Queenston Carleton Hospital has worked in partnership with Mohawk College to leverage the flexible, hybrid model to combine didactic learning with clinical mentorship to provide a wonderful foundation to nurses working as part of a skilled critical care team. The innovative design of this program integrates the online course and clinical experience through self-directed, asynchronous virtual learning, allowing students to integrate new knowledge into their practice on an ongoing basis.” 

The hospital has a seven-point plan to stabilize its workforce through recruitment and retention, says Plant. 

“Increasing opportunities for mentorship and professional development is key to our strategy. The accelerate critical care program will provide learners with the advanced knowledge, specialized skills and abilities to practice competently and safely within a fantastic team.”  

This story originally appeared in Momentum Magazine.