UBC Reports | Vol.
50 | No. 1 | Jan.
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
"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
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.