The Challenge of Prevention
An emergency room rotation proved impactful for U of I WWAMI student
Melissa Liner did CPR for the first time on a patient experiencing a drug overdose at Clearwater Valley Hospital and Clinics in Orofino.
“My job as a medical student is to stand back and not get in the way, but I ended up in the rotation for doing chest compressions,” she said. “That was the first time I’ve ever done CPR, even though I’d been certified for years. There’s a lot of adrenaline.”
The patient died, but the experience stuck with Liner, who is a student the University of Idaho’s WWAMI Medical Education Program.
“I wondered if there's something as a community we could be doing to prevent this in the future,” she said.
Liner was assigned to Orofino in 2017 as part of the Rural/Underserved Opportunities Program, designed to expose WWAMI medical students to rural health care. The Salmon, Idaho, native became interested in rural medicine because she doesn’t like urban settings, she said. As she progressed through her medical studies at U of I, Liner found more reasons to commit to practicing medicine in small towns.
“I can do full scope medicine — work in the clinic, work in the hospital, ER shifts, deliver babies. Through this program I realized that,” she said.
During her time in Orofino, she was able to meet with people to get an idea of a program the community could benefit from.
“I was talking with several different people and three brought up, ‘Well we have a drug problem in Orofino and we would love something to be done with students in Orofino,’” Liner said. “That was the starting point and the population that would be most affected.”
Her experience in the emergency room confirmed what she heard.
Liner researched the best methods for drug education. Working with the Orofino students presented a challenge. Liner returns to Orofino in April and school ends just a few months later.
Additionally, Orofino’s Monday through Thursday class schedules means there is very little extra time in the school day.
“They’re having a hard time condensing their curriculum into four-day week, so that’s a lot to ask,” she said.
Implementing a drug-education program would also require training for the teachers and shifting lesson plans. Liner has considered working with the local teen center to ease the burden on classrooms.
“My hope is to get students involved with this,” she said. “I think if you make this something that’s their project, they would learn a lot from it and make it theirs and be more open to participating.”
Liner said her time in the RUOP and TRUST programs has cemented her desire to work in rural medicine.
“We’re going to have a lot of influence and we can be good advocates for our patients,” she said. “RUOP showed me you can do that and people will appreciate your efforts.”
WWAMI is a partnership between the University of Washington School of Medicine and five Western states — Washington, Wyoming, Alaska, Montana and Idaho. In Idaho, 40 medical students complete their first and second year of medical training on the Palouse. The students then have the opportunity to complete their Clinical Phase and Explore & Focus Phase of medical education in Idaho, Seattle or across the five-state WWAMI region.
The Rural/Underserved Opportunities Program (RUOP) is a four-week immersion experience in community medicine for students in between year one and two of medical school. The students live in underserved rural or urban communities during a four-week rotation, working with local physicians. The Target Rural Underserved Track (TRUST) builds on this experience with student completing community health projects within their RUOP communities.
Published in March 2018
Article by Tess Fox, University Communications & Marketing