Rural and Remote clinical placements - considerations for confidentiality and boundaries
Students need to be aware of professional boundaries and ethical practice. Living and working in a rural community presents additional challenges in maintaining confidentiality. Typically, rural communities are smaller in population and that increases visibility. For example, a person’s car parked outside of the clinic identifies them as a user of the service. Students may encounter family members or friends of the client who enquire about their friend. It is important that you think about strategies to ensure that your student can confidently maintain the confidentiality of the client and all the information that they gather when providing a service to the client.
It is possible that you/your student may develop out of work connection to clients (e.g. seeing people at the supermarket, sporting teams, and social occasions like the races). Again, it is important that the students are aware of how to manage that situation with clients and staff. Professional standards and image need to be maintained and this should be discussed at the start of placement with the student.
Services for Australian Rural and Remote Allied Health (SARRAH) provides a learning module titled "Transition to rural and remote practice", which provides content relating to confidentiality and professional boundaries unique to a rural and remote setting.
Understanding scope in a rural and remote health practice context
In the rural or remote setting, allied health professionals may work in a Rural Specialist Generalist position, which has a broader scope of practice. The caseload may include clients of all ages and with different cultures. The health professional will assess and treat a wide range of conditions (e.g. developmental, acquired, chronic disease, cardiac, rehabilitation, neurodegenerative) and may use a number of different modes of service delivery (e.g. inpatient, outpatient, community based, home visiting, telehealth, outreach service).
If a student supervisor works in a rural specialist generalist position, it is important that the student attending the placement only completes tasks that fall within the scope of practice for that particular allied health profession.
A rural or remote placement usually includes the additional dimension of social interface. It is quite common for student supervisors and their students to meet at functions outside of the workplace. It is important to be clear about your boundaries and maintain them.
In this video, Sarah Jackson, Physiotherapist, Clinical Educator and North West Community Rehab Project Manager at the Mount Isa Centre for Rural and Remote Health (MICRRH) has some suggestions on how to maintain a work-life balance when hosting students on placement in a rural and remote setting.
- Webster, S., Lopez, V., Allnut, J.,Clague, L., Jones, D. & Bennet, P. (2010). Undergraduate nursing students’ experiences in a rural clinical placement. Australian Journal of rural Health, 18 (5), 194-198.