Courage Begins Here: Investing Boldly in Local Education and Research

In community hospitals, courage does not begin with scale or surplus. It begins with responsibility – to patients, team members, learners, and the communities that depend on us.

At Lakeridge Health, we have chosen to invest in education and research not because conditions were perfect, but because the need was clear. Community hospitals make up over 90 per cent of hospitals in Canada ¹, 84 per cent in Ontario, and account for more than 70 per cent of hospital beds ², yet they are often underrepresented in research and academic activity. Concentrating knowledge creation in a small number of hospitals limits system-wide learning and the ability to generate evidence and educational experiences that reflect the populations we serve.

If we are serious about quality, safety, and equity, then knowledge creation cannot be confined to a small subset of institutions. Expanding programs in community hospitals strengthens system-wide learning, ensures findings and education are locally relevant, and builds the knowledge needed for an equitable, effective Learning Health System.

This is what courageous leadership looks like in a community hospital.

Building Academic Medicine Where Care Is Delivered

In 2023, Lakeridge Health became the home site for the Queen’s–Lakeridge Health MD Family Medicine (MDFM) program as a Queen’s University Satellite Campus. Since then, we have implemented a new Clinical Teaching Unit (CTU), co-led by both General Internists and Family Medicine Specialists, embedding undergraduate and postgraduate medical education within a non-traditional academic setting.

This was never intended to replicate an academic health sciences centre model. Instead, it reflects an innovative new model and deliberate commitment to train future physicians (and clinicians) in the settings where most Canadians receive care – strengthening workforce pathways, community connection, continuity, and community-responsive practice.

Re-Establishing a Coherent Academic Network 

Over the past four years, under the leadership of the Academic Affairs and LHEARN program,  the Lakeridge Health Education and Research Network (LHEARN) – “Quality Care Starts Here” – has evolved into a coordinated academic and learning platform – integrating simulation, health sciences library services, education, and training services.

Rather than isolated initiatives, LHEARN now functions as an enabling system: supporting clinicians, learners, and teams with access to evidence, training, and innovation tools that translate directly into safer, higher-quality care.

Leading on Culture and Leadership Design

Courage also means examining how leadership systems are designed and experienced. In partnership with Dr. Notisha Massaquoi and the Black Health Equity Lab (BHEL) at University of Toronto, Scarborough, we are preparing to lead the RULES Study – Rewriting the Rules of Leadership: A Gender-Informed Study of Credentialed Staff Leadership in Community Hospitals to better understand how leadership structures, norms, and gender and identity dynamics shape professional culture and decision-making.

By generating evidence in this area, we are helping to build a stronger foundation for leadership in community hospitals - leadership that is more inclusive, more effective, and more sustainable.

Growing Research While Delivering Care

In a resource-constrained setting, Lakeridge Health has expanded its research capacity through a determined “build while delivering” approach.

Over the past two years, this model has driven a 21.7 per cent growth in our research portfolio, creating more opportunities for patients to access novel therapies and innovation close to home. Today, the organization supports more than 140 active studies, including clinical trials and investigator-led projects, advancing care locally while contributing to national scientific forums. This momentum reflects disciplined investment in governance, ethics, and operational support, even in the face of constraint.

Strengthening Research Culture and Capability

Research and Innovation Rounds have been re-launched as a powerful educative avenue that highlights local ingenuity, strengthens continuous learning, and encourages clinicians and learners to pursue meaningful inquiry. These sessions make it unmistakably clear that discovery and improvement belong in community settings – not only large academic centres.

In parallel, Lakeridge Health has launched its first investigator-led, Health Canada–regulated clinical trial in sepsis care. This milestone expands patient access to cutting-edge treatment and positioning community-based clinicians as active contributors to new evidence generation. It marks a decisive shift in what community hospitals can lead and achieve.

Partnering to Extend Impact

Recognizing that collaboration accelerates progress, Lakeridge Health partners with provincial and national networks, including Clinical Trials Ontario, the Canadian Critical Care Clinical Trials Group (CCCTG), the Canadian Cancer Trials Group (CCTG), the Canadian Cancer Clinical Trials Network (3CTN), Network to Networks (N2), and Building Capacity for Research in Community Hospitals (RICH‑Canada). Together, these partnerships create a coordinated, pan‑Canadian ecosystem that strengthens hospital-based research capacity and amplifies the reach and impact of locally led studies.

In the fall of 2024, we also launched the Partnership for Advanced Technology in Health Care (PATH) with Ontario Tech University, advancing AI-driven research, enhancing patient care, and providing hands-on learning opportunities for future health-care leaders.

Courage, With a Long View

None of this work waited for perfect conditions. It demanded conviction, partnership, and careful stewardship of limited resources.

Community hospitals may differ from academic health sciences centres, but different does not mean secondary. It means responsive, embedded, and essential. As the health system evolves, the structures that support education and research must evolve with it, especially in the places where most care is delivered.

Courage is choosing to lead now – building knowledge, capability, and trust so that communities are stronger tomorrow.

¹ Peckham A, Merry G, Chan SPS, et al. The research activities of Ontario’s large community hospitals: an updated scoping review. BMC Health Serv Res. 2024.

² Gehrke P, Binnie A, Chan SPT, Cook DJ, Burns KEA, Rewa OG, Herridge M, Tsang JLY. Fostering community hospital research. CMAJ. 2019 Sep 3;191:E962–6.