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Healthcare in a rural setting

January 2005
Board of Science

Interprofessional education (IPE)
Healthcare professionals need education and training to enable them to successfully work in collaboration with colleagues. The UK Centre for the Advancement of Interprofessional Education states that IPE occurs when two or more professions learn from and about each other to improve collaboration and the quality of care. [go to reference 116] IPE can occur at any level of education and appears to be most effective when it occurs throughout. [go to reference 112]

Undergraduate curriculum
In 1993, the General Medical Council called for a ‘mutual respect and understanding of roles, and a capacity for teamwork that should begin to develop during the undergraduate years’. [go to reference 117] The DH began funding four projects in 2002, involving 10 universities in collaboration with Workforce Development Confederations, to implement an integrated model of IPE at undergraduate level. The impact of teamworking on practice will be tracked and assessed over a number of years. The New Generation Project, involving the University of Southampton, the University of Portsmouth and the Hampshire & Isle of Wight Workforce Development Confederation commenced in October 2003. This gives students studying medicine, midwifery, nursing, occupational therapy, pharmacy, physiotherapy, podiatry, radiography or social work the opportunity to work and learn together, through the Common Learning Curriculum. [go to reference 118]

The curriculum has four interprofessional learning units.
• Collaborative learning: introduces students to the concept and practice of collaborative learning and team working and develops the knowledge management and IT skills needed to participate in collaborative learning supported by online methods.
• Interprofessional team working: provides students with an opportunity to apply their team working and negotiation skills in an interprofessional context.
• Enabling change in practice: helps students gain an understanding of the need for role flexibility and the complexity of introducing change into interprofessional service provision.
• Interprofessional problem solving: provides students with the opportunity to work as a team to build an interprofessional understanding of a complex ethical issue or service failure. [go to reference 118]

Rural IPE placements
An important method of learning interprofessional skills is to observe and interact with collaborative practice. [go to reference 112] This can be achieved during student placements and it is suggested that some of these placements occur in a rural area, as recommended previously. IPE in a rural setting has particular advantages, for example in demonstrating extended roles, generalism and the functioning of small teams.

Case study – IPE learning in a rural context (Australia)
The Rural Interprofessional Education project in Victoria selects mixed groups of nursing and medical students for placements in rural primary care. The students are educated in the field by nursing and medical tutors. The learning objectives include understanding the principles of collaboration, teamwork and various roles in the healthcare team within a rural primary healthcare framework. The project has created important links between health education providers and rural primary healthcare providers. An education programme that reflects the diversity of rural practice is beginning to emerge and is challenging the traditional model of education. [go to reference 112]

Recommendation 14
Doctors should carry out part of their training in association with other healthcare professionals to create respect and trust between team members and to allow professionals to work across boundaries of traditionally defined roles. [go to reference 113] IPE should be part of the complete undergraduate curriculum and IPE in a rural setting has particular advantages, for example demonstrating extended roles, generalism and the functioning of small teams. However, this educational potential requires planning and resources to make it effective.