The New 'Learning Village'

• By Stephen Phillips
• 05/01/10

Longer life spans are resulting in more complex medical problems, with patients presenting with multiple conditions that impact each other and require different treatment programs if treated in isolation as opposed to within a coordinated care program. In the healthcare world, doctors, nurses, technicians, physical therapists, and other medical practitioners work together, sharing information about patients and consulting with each other on the best course of treatment. But in academia, that collaborative atmosphere has been difficult to achieve within the physical space traditionally designed for health sciences education. Within colleges and universities, outdated and non-integrated space has placed limits to this emerging collaborative model.

Recognizing this paradigm shift, colleges and universities across the continent are undergoing revitalization to achieve an “interprofessional education,” or IPE, learning model and are creating the new physical space to accommodate it. In the IPE philosophy, students from various but related disciplines learn and work together, whether that’s in formal classroom and lab training or in more casual study sessions or simple conversations in lounge areas. In other words, students from different programs may take certain classes together, share simulated training experiences, or team up on research projects. The goals are to train and educate students to work in a collaborative atmosphere and to support that kind of shared knowledge, which improves care solutions for patients.

Connective Tissue
The shared learning environment requires pulling out the special features, functions, or spaces of a program that are normally buried within the department’s own walls and creating more open, flexible, and transparent areas where students, faculty, and visitors alike can see and hear the activities within.

At the University of Alberta in Edmonton, a building of collaborative classrooms, simulated learning labs, offices, and collaborative research spaces, designed by HOK in association with Stantec Architecture, is bringing together the health sciences faculty, staff, and students under one roof. Departmental offices, research space, and classrooms are on the same floors, with primary corridors serving as a sort of “Main Streets” for the academic “village.” That classroom building is attached to a clinical learning building — again, shared by all departments — and both connect to the university hospital, allowing students nearly direct access to real-world professionals, observation opportunities, and clinical situations.

At Stantec Architecture’s new Health Sciences Building at Conestoga College in Kitchener, Ontario, these kinds of observation opportunities will be the focus. The building is nearly entirely transparent with a primary corridor working through it. This main corridor — or “Exploratorium,” as it’s called — allows anyone passing by to watch and listen to what’s happening inside without interrupting. The idea is that by being able to see and hear what other students and staff are working on — whether in their own discipline or not — students will become more engaged in the overall learning process and the discoveries they make while on campus.

Out-of-Body Experience
This shared sense of discovery carries through to specific room uses as well. The hands-on, practical nature of most health-related education curricula requires many of the rooms to have specific equipment and purposes, such as laboratories and simulated patient rooms. In these simulation areas, the IPE model comes to life as students work together on a problem or project, such as diagnosing the illness of a patient or connecting patients to the proper monitoring systems.

A pioneer in this type of simulated learning was designed for the University of Toronto in 2005. The University of Toronto facility features medium- and high-fidelity patient simulators that are programmed to react to all kinds of medical situations, including breathing, coughing, and even bleeding. Students use these mannequins to learn how to inject medicines, conduct surgeries, and birth babies — nearly everything they could encounter in their jobs. Designed shortly after the SARS crisis, this facility had the first simulated negative pressure environment in North America, providing health practitioners the opportunity to practice outbreak treatment scenarios within a safe environment. Not only do these simulation centers provide individual students with realistic hands-on experience, but it also allows classmates to watch, learn, and contribute to the activity at the same time. At the University of Toronto, their simulated environment also provides ongoing professional education to doctors and nurses, a critical element of health care services.

One of the key challenges within health sciences education is getting students realistic hands-on experience so they are prepared when they enter a practicum. At Conestoga College, the “open access” laboratory allows students to practice on what they’ve learned on their own time. These labs are shared by all of the health sciences students — nursing, paramedical, and dental — encouraging the different areas of study to continue their interdisciplinary discovery. For example, a student in the nursing program can work with a student in the respiratory therapy program to discuss the patient’s issues and how they could treat him. In many cases, students are able to film their practice so it can be reviewed at their own convenience or with classmates to discuss what went well or poorly.

Conestoga also includes a full ambulance drop-off, allowing paramedic and nursing students to collaborate on a fully simulated patient arrival, assessment, and treatment cycle using either high-fidelity mannequins or standardized live patients. The instructors are able to “spring” these simulations on students in drill situations, fully simulating the emergency and stressful condition of an emergency situation.

The Heart of the Matter
In addition to these hands-on, task specific spaces, IPE-inspired facilities equally require spaces for learning outside of the classroom/laboratory walls. This is accommodated through the provision of accessible spaces for lounging, studying, meeting, and at times, a combination of all three. For example, The Learning Library Resource Commons at George Brown College Waterfront Health Sciences Campus in Toronto employs a zone classification system, clearly categorizing by noise level what types of activity the various areas are designed to accommodate. These spaces are further defined for individual or group use through scale, materiality, and furniture systems. These same techniques are applied throughout the building at large, particularly in non-assignable areas such as stairs and corridors. Such spaces have been widened, elongated, and softened, allowing for student occupation of a variety of types. Lounges offer comfortable chairs, couches, small tables, and sitting areas; group study zones provide larger tables and gathering spaces; while quiet, private study areas feature individual workstations.

At George Brown, these learning spaces are also designed to encourage public interaction and connection. Part of the Waterfront Toronto East Bayfront revitalization plan, the campus’s east side faces a new large-scale public park. Precinct plan design standards make necessary a high level of ground floor animation, thus, a transparent façade and legible building interior invites the public to witness what’s going on inside and take advantage of the campus’s café, bookstore, and most notably, a multifaceted health clinic. People within the community are encouraged to make use of the College’s wide range of “healthy living” services in the areas of dental, hearing, and fitness. The overall openness of the building plan, the visual connection between inside and out, and the building’s prominent location all work to create a community that goes beyond the student population and revitalizes the neighborhood within which it sits.

As medical fields continue to advance, more collaboration and integration between specialty care providers will become even more important to the comprehensive health and well-being of patients. With more schools taking on this interprofessional education model to produce skilled, trained, and knowledgeable staff, it’s exciting to envision the advancements in educational facility design that will come along with it.

Stephen Phillips, OAA, FRAIC, LEED-AP, is a senior principal and architect at Stantec Architecture in Toronto. He can be reached at [email protected].