UBC Reports | Vol. 50 | No. 1 | Jan. 8, 2004

Health Students Fan Out Across B.C.

Program the first of its kind in Canada

By Hilary Thomson

For the past four years, Monika Milewski has been pursuing a degree in nursing -- sitting in campus lecture halls, tutorials, labs and study groups with other nursing students and faculty.

That all changed last summer. That's when she got involved in the Interprofessional Rural Program of BC (IRPbc) and found herself working in a small hospital in Bella Coola on B.C.'s west coast, part of a team of students in disciplines that included medicine, occupational therapy, pharmacy, physical therapy and social work.

The first program of its kind in Canada, the IRPbc seeks to improve health-science students' capacity to collaborate in patient care.

"I was motivated by being with other IRPbc students interested in working with the same population that I was," says Milewski, who has returned to Bella Coola to fill a temporary nursing position. "Besides learning from the other students, I felt lucky to learn from nurses and other health professionals experienced in the field."

IRPbc students complete placements of 4-12 weeks under the supervision of a local health-care professional. Phase I of the program began in the summer of 2003 with students working in Bella Coola and Hazelton and Port McNeill on Vancouver Island.

"We're trying to transform the health-care system with this program," says Grant Charles, assistant professor at UBC's School of Social Work and Family Studies and part of the IRPbc team. "We're teaching students how to interact differently -- how to understand patient care from the perspective of other health-care providers. This type of program has never been done before."

Kathy Copeman-Stewart, IRPbc program manager, advises that this month, 18 students from seven post-secondary institutions, including 10 fourth-year UBC students, will be going to the original sites and to Fort St. John in northeastern B.C. and Trail in the southeast of the province. They will work in teams at hospitals that range in size from 15-80 beds. Activities include flying in to remote communities with a visiting health professional and shadowing health-care professionals.

Students in occupational therapy and physiotherapy took their first trip in a helicopter to accompany Dr. Granger Avery, a UBC clinical associate professor of family practice, to Kingcome, a remote village 290 km northeast of Vancouver.

While there, they completed an on-the-spot assessment for several patients with diabetes and other health problems.

"The patients were delighted to get attention they would not otherwise have received," says Avery, who works in Port McNeill at the northern end of Vancouver Island. "There is an immediacy to these situations that allows for an enormous learning potential. Students learn to think on their feet and get on with the job because if they don't do it, no one will. That's the major value of rural teaching."

Students also learn first-hand about the primitive level of health services in some parts of the province and what life is like in remote communities, he adds.

Before their placement, students are given a two-day orientation that looks at interactive behaviour, ability to resolve conflicts within a group and learning how to work with aboriginal communities.

The placement curriculum also addresses the challenges of maintaining personal and professional boundaries in towns where everyone knows everyone and health-care professionals are highly visible members of the community.

Pharmacy student Charlotte Suttie will be working at Kootenay Boundary Regional Hospital in Trail, about 15 minutes from her hometown of Fruitvale, population 2,000.

"In a small, isolated community the dynamic is totally different than in the city. The responsibilities of the practitioners are much greater," says Suttie. "I'd like to see first-hand how the health-care community interacts within a rural community."

Students work side by side and learn from and about each other. They spend a minimum of three hours per week with teammates discussing patients and diagnostic and treatment issues from a variety of perspectives. They also learn how to solve problems collaboratively and set team goals.

Medical student Naomi Dove says that in addition to offering a greater understanding of the perspective and skills of other health-care professionals, the program "helped to make me aware of some of the misconceptions existing between professions and the limitations of my own profession."

"It's critical that one health-care professional knows the responsibilities and competencies of the other," says John Gilbert, chair of IRPbc's implementation committee and principal of UBC's College of Health Disciplines. "That way, no one falls between the cracks and the right hand has a pretty good idea what the left hand is doing."

IRPbc is overseen by the BC Academic Health Council in partnership with health authorities, post-secondary institution and rural communities, with support from the Ministry of Health Planning.