The Selkirk College Rural Pre-Med program is an innovative preparedness program for aspiring rural and remote physicians and health care professionals. PACC collaborated with five third-year students on their community-oriented research projects.  Projects focused on improving patient engagement practices, youth mental health, and payment preferences for graduating medical students. We’re proud to collaborate within their learning journeys and pleased to invite you to explore their project summaries + findings. Read more below.

Partnering with Selkirk College Rural Pre-Med Students on Health Care Research

The PACC, which includes two members who are also members of the Lower Columbia Community Development Team Society (LCCDTS), collaborated with five third-year students from Selkirk College Rural Pre-Med Program on their community-oriented research projects this past year. This is a required part of their training; the PACC submitted proposals asking for interested students to work with them. The projects focused on improving patient engagement practices, youth mental health, and payment preferences for graduating medical students – the latter two issues of particular relevance to the LCCDTS as they look towards developing a local Community Health Center. The students began work in September 2021 with literature reviews, study design and seeking Ethics Review Board approval. Data collection took place in February and March 2022. 

The students presented their project results in April 2022. Summaries and results of those projects follow:

Megan Cousins’ project:  “Improving Patient Engagement through Exploring Patient and Family Caregiver and Healthcare Partner Relationships and Experiences”.

In this study, telephone interviews were conducted with 8 patient and family caregiver partners and 7 healthcare partners who work together on healthcare committees or boards. Survey questions for patients focused on why they became patient partners, conduct of meetings, and how much responsibility and power they had in the group. Questions for healthcare partners asked about their work with patient partners and the value that they bring, including how their input is used in decision-making. 

She identified 5 major themes, four of which were voiced by both groups:

  • Purpose: The purpose of patient and family caregiver engagement was clear. Healthcare partners said that it was beneficial on boards, projects and research groups, grounding them.
  • Communication: There was a gap in the feedback loop to patients on where their input went, whether there was impact on policies, and lack of clarity on why they were there.
  • Common Best Practices: Both sides agreed that a good facilitator is make-or-break; regular meetings, an orientation, and feedback are also important.
  • Opportunities for Improvement: Covid impacted engagements as virtual platforms didn’t always work, no compensation was provided for patient partner’s time, feedback was often minimal. 
  • Health Care Experience (patient group only): most of the patient partners were already integrated into the healthcare system (e.g., retired nurses, long-term patients) and were already familiar with the system. This experience and lack of diversity creates bias.

Hollie Arsenault & Brianne Richter’s project: “Lower Columbia Youth Mental Health (MH) Survey”

This study used an online survey of youth 18-25 years who live or have lived in the Lower Columbia region to assess mental health needs. The survey was advertised to Selkirk College students through posters and instructors. Questions asked about barriers youth face in accessing mental health services and the types of services of interest to them. They had 13 respondents.

Reasons for youth not accessing mental health care included the following:

  • Cost of treatment.
  • Lack of time for accessing services.
  • Not knowing where to go to access services.
  • Stigma, shame (e.g., embarrassment around negative views of mental health conditions), and discrimination.
  • Struggles with motivating themselves to seek treatment.
  • Participant’s desire to handle issues on their own.
  • Not being satisfied with available treatments and/or previous treatment didn’t help.

Recommended changes included more flexible hours for accessing services, group services, online services, more client-centered care, more options for psychiatric services, and an overall need for information on how to contact and what services are available. Respondents also noted a need for more medical mental health professionals, assistance with the cost of treatment, accessibility outside of regular hours, finding ways to destigmatize mental health issues and motivate youth.  They emphasized feeling lost due to a lack of medical professionals. 

The investigators recommended that a Community Health Center (CHC) consider including psychiatric services, flexible hours, financial support and online services, education campaigns and information sessions targeting youth, and include bilingual and minority staff and dedicated outreach workers.

Alex Laing & Brian Martin’s project: ”Preferred Payment Models of Medical Students in Western Canada and Work in Community Health Centres (CHCs)”

This study was an online survey of 4th year medical students from UBC and U of Alberta. The survey link was distributed by Rural Medicine and/or Family Medicine Interest Groups and alumni of the Rural Pre-Medicine programs at each institution. Survey questions included career/specialty choice, desired practice location, payment models and their influence on specialty choice or work location, and confidence in their knowledge about payment models. They had 25 respondents.  

  • Most (76%) respondents planned to practice family medicine in some manner including enhanced skills or practicing as a locum. 
  • Many (44%) were considering or intending to practice in a CHC and 52% were unsure. 
  • The vast majority (92%) reported a preference for a salary model. In ranking preferences, a hybrid model (salary combined with fee-for-service) was ranked first, salary second, fee-for-service third, and capitation was fourth, with only 8% indicating preferences for the last two models. 
  • Most (64%) reported that the payment model had a moderate to significant influence on choice of career/specialty preferences and the vast majority (88%) reported that the payment model was moderately to extremely important in determining where they would work. 

The investigators recommended that the developing CHC offer an alternative payment model and that a hybrid model supports both quality and quantity of care.

June 2022 | Contributor: Mindy Smith, MD, MS; PACC Chair