Learning for learning health systems: an environmental scan of training opportunities in Ontario, Canada

Abstract

Background: Integration of patient-oriented research evidence into decision-making around care, policy, and healthcare delivery is the foundation of learning health systems (LHS). Little is known about the nature and scope of training programs that aim to build capacity amongst researchers, trainees, patient partners and others relevant to supporting engagement in learning health systems. This study involved an environmental scan and key informant interviews to gather data regarding current training programs in Ontario and their fit with the various components of a learning health system model.   Approach: We identified, described and reviewed existing training programs in Ontario, and evaluated their alignment with the five ‘learning gears’ or dimensions of a LHS Action Framework (Reid et al, 2024), including: analytics and population insights; evidence synthesis; patient, caregiver, and provider co-design; implementation; and, evaluation, feedback, and adaptation, with equity as a key driver of the system.    We conducted a limited review of the existing literature, completed qualitative interviews with leaders and coordinators of the training programs, and reviewed publicly available information (published and grey literature) about the individual training programs. We adopted a systematic approach to the review and mapping of the programs to the LHS model, and applied a framework for describing interventions known as the TIDierR framework involving a 12-item checklist (Hoffmann et al, 2014). The project team included a patient partner, researchers, students and a member of the Ontario SPOR SUPPORT Unit (OSSU).   Results: A range of capacity building initiatives for patient-oriented research have been developed in Ontario, often supported through OSSU funding. Only ten of 74 training programs involved educational activities and topics that were relevant to enabling learning health systems. Only one training program addressed all five of the learning gears in the LHS framework. Implications: There are challenges with the implementation of learning health systems such as pervasive gaps in the generation and application of evidence relevant to healthcare systems, the role of patient partners, and the lack of relevant training programs. There is a need for investment in practical educational initiatives that engage all key stakeholders (researchers, patient partners, healthcare professionals, trainees and decision makers) to optimize potential improvements in care, policy, and service delivery through the adoption of a learning health system model.   Consideration of the attention to training activities that focus on the different components relative to the learning gears of a LHS will help to guide this investment to optimize training and its potential impact with the implementation of learning health system or equivalent models for health system improvement.