Leveling the Playing Field: An Interprofessional Rural Preceptorship Pilot for Students of Nursing and Medicine

Abstract

Despite the ubiquity of interprofessional education (IPE) in the health sciences, cultural barriers to collaboration and socialization across disciplines are pervasive and persistent. The Interprofessional Rural Preceptorship Pilot (IPRPP) was implemented over 18 months between 2014 and 2015, to deliver mutual, practice-based, collaborative experiences to students of nursing and medicine, and to capitalize on the multidisciplinary team ethos of rural settings in socializing these students into an interprofessional culture. Students; precepting nurses and physicians; unit managers; and faculty supplied qualitative research data through semistructured interviews and focus groups, to help determine the effectiveness of the IPRPP in achieving its ends. Thematic analysis of transcripts, field notes and memos revealed that the pilot: 1) induced all participants to reflect on cultural barriers to IPE, particularly in light of the more experienced, male physicians' apparent reluctance to buy into the pilot or the research study; 2) sensitized medical students to the scope of practice, roles and knowledge base of registered nurses and nursing students, whom they came to value as collaborators and teachers; and 3) inspired nursing students to take the lead in arranging interprofessional experiences, and to assert their viewpoints as equals within the multidisciplinary team. It was found that liminal (transitional) spaces and the frontline relaxation of traditional hierarchies-both widely acknowledged features of rural health care settings-contributed to these outcomes. The findings show that clinical settings have a significant impact on the interprofessional socialization of nursing and medical students, with implications for the design of future IPE initiatives.

Transforming Health Care in Remote Communities: report on an international conference

“…MacDonald and Berry 14 discussed challenges such as scope of practice constraints, high staff turnover, role ambiguity, and lack of training in inter-professional collaboration. Jackman 15 and colleagues described an innovative inter-professional preceptorship program at the University of Alberta whereby medical and nursing students were trained together in rural settings, and learned to communicate effectively and respect each other's professional roles. Urban-based educational institutions have the responsibility to reach out to and recruit students from remote communities, a case made by D'Hont 16 , a student from the Northwest Territories.…”