Building rural health care teams through interprofessional simulation-based education

The Rural Inter-professional Program Emergency Retreat (RIPPER) uses interprofessional learning and simulation together as educational strategies to prepare final year nursing, medical and pharmacy students for effective rural health care delivery. The program provides students with the opportunity to learn and work as a team using authentic and relevant situational learning and skill building. Now in its third year, 31 final year students participated in the 2008 program. The simulated practice environment provides opportunities for students to develop requisite competencies while learning about health care in rural contexts. In RIPPER, simulation based strategies include role play, low fidelity task trainers, and high fidelity simulation with a computer programmable mannequin. Emergency and community based scenarios specific to the rural context are used as the curriculum for the RIPPER weekend. Students are required to work collaboratively in small interprofessional teams and apply their different professional skills and knowledge to respond to a variety of emergency situations. Such collaborative models of care reflect actual rural health care practice. By working through issues of disease and injury prevention, immediate acute care and aftercare, students extend their knowledge of holistic rural health service delivery. Learning is facilitated by academics and expert rural health clinicians in a supportive environment as students rotate through the different scenarios and skill stations. A pre and post test quasi-experimental design was used to evaluate student learning outcomes relating to rural interprofessional practice. Data were collected using a questionnaire comprising attitudinal statements on a 5 point Likert scale, and open ended questions. A mixed methods approach, combining quantitative and qualitative techniques, provided an integrated analysis of the data. Results show a positive shift in students’ understanding of interprofessional practice. Students identified teamwork and collaboration as vital components of maximising rural health care outcomes. They acknowledged that in order to improve clinical outcomes and promote a more satisfied rural health workforce a collaborative clinical culture is required. The evaluation concluded with the students’ recognition that in rural practice each discipline does not work in isolation. Each profession plays a significant role in a team that is working towards the delivery of safe and effective rural health care. The positive evaluation of RIPPER reinforces the need for sustainable and embedded, rigorous, interprofessional rural health education as part of the core undergraduate health science curriculum.