A clinic where students run the shop

Patients eager for rehab services

After a career of guiding students through the thickets of political science at Douglas College, Marlene Hancock now finds herself on the receiving end of instruction.

And her instructor, appropriately enough, is a student. The subject, however, isn’t politics. It’s her own recovery.

Hancock stands between two parallel bars in a rehabilitation clinic at Royal Columbian Hospital in New Westminster, leaning against one rail with both hands, and sidestepping her way between the two—all while trying to keep her feet straight, her head up and her shoulders back. Standing next to her, watching every move and correcting every misstep, is Ryan Hik, a second-year UBC physical therapy student.

“You have to keep that foot nice and straight,” he says. Aware that he is repeating the same thing over and over, he jokes, “I’m going to crack the whip on you.”

Hancock, for her part, doesn’t mind a bit.

“He’s teaching me to think how to make my body work again,” says Hancock, who was bedridden for five weeks during a coma brought on by kidney problems.
“I was eager to have a student work with me. They tend to be very keen and interested in what they’re doing.”

Hik is one of scores of physical therapy and occupational therapy students who have been fortunate to land a placement at the Student Rehabilitation Outpatient Clinic, perhaps the first of its kind in Canada. Here, the students pretty much run the shop, and have helped hundreds of people in the Fraser Health region recuperate from or grapple with the effects of stroke, bone fractures, hip or knee replacements or other conditions that hinder their mobility.

Created two years ago, the clinic provides an authentic clinical experience for students pursuing two-year master’s degree programs in either physical therapy, which focuses on helping people regain functional movement, or occupational therapy, which helps people regain independence with everyday tasks.

Typically, students in those programs are assigned to work with therapists in hospitals, either in wards or outpatient clinics, or in private clinics. In these one-to-one placements, students may be assigned certain patients but usually don’t have much control over their caseload, and they often have little contact with other students or professionals.

Here, however, every patient is seen by a student, and often by students of both physical therapy and occupational therapy. The students are closely monitored by a clinical instructor in each field, who must approve the students’ initial assessments and treatment plans, and who often assist in the early stages of treatment.

“As they’re able to demonstrate that they’re able to do more, we delegate more to them, until they’re just checking with us and running things past us,” says Corey Stock, the clinical instructor in occupational therapy.

During their six or so weeks in the clinic, students also get a feel for scheduling patients and managing caseloads—crucial skills they will need in a few months, when they are working professionals.

“It’s liberating, actually,” says Ewa Kowalska, a second-year occupational therapy student.

Also, by working in such close proximity to students from another discipline, often on the same patient at the same time, students gain a better appreciation for the goals, techniques and challenges of each others’ fields— something not usually possible in a conventional placement.

The model of a student-run clinic, imported from Australia, is catching on. G.F. Strong Rehabilitation Hospital in Vancouver started its own in the spring, as an adjunct to its own professionally-run clinic. And the University of Alberta, after sending a delegation to observe the activity at Royal Columbian, has received approval to do the same in Edmonton.

The benefits to the students, meanwhile, are rivaled if not surpassed by the benefits to the patients. Before the clinic came along, residents of New Westminster had no outpatient rehabilitation services nearby, so they would have faced long waiting lists or overly restrictive eligibility criteria at the region’s hospitals—or they would have had to pay out-of-pocket at a private clinic.

“My guess is 80 to 85 per cent of these people would not have been seen,” says Hyman Gee, the clinical instructor in physical therapy.

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