Innovative collaboration: QEII team and Dalhousie medical student enhance accessibility

When RJ Roggeveen arrived at Dalhousie Medical School, Nova Scotia Health staff and physicians at the QEII Health Sciences Centre knew they had an important responsibility - to ensure RJ had the support and accommodations needed to fully participate in his medical education. Now in his second year at Dal, RJ's use of a standing power wheelchair presented some unique challenges, but the team was determined to find solutions.

An interdisciplinary team worked closely with RJ to understand his needs. The first step was assessing the various spaces he would need to access, from the anatomy lab to the operating room (OR).

“As a medical student it’s important to participate in surgery because I need to know what my future patients are experiencing,” said RJ. “The OR was the place that I was most nervous to visit because I didn’t know how it could be made accessible. But we all contributed our knowledge and answered some pretty unique questions with unique solutions.” 

In the anatomy lab tables were modified: lowered to a height that allowed RJ to be in a sitting position and interact with the specimens comfortably. In the OR, an intricate process was developed to thoroughly clean and disinfect RJ's power chair before each surgical procedure.

With the guidance of QEII infection control experts and clinical nurse educators, a standard operating procedure is now in place for the interdisciplinary team to follow with anyone using a power chair. It includes steps for getting changed, storing belongings, scrubbing in, and outlines the chair cleaning process. An “accessibility toolkit" was created to make the chair’s disinfection process efficient and consistent. The labelled kit includes feet covers, alcohol-based hand rub, bleach wipes, bristle brushes, gloves and a track mat to clean the chair’s wheels.

“In a very busy surgical environment, time is extremely essential, so we've developed this kit to stay with the patient attendants who will be doing the cleaning when RJ is here for his surgical rotation,” said Angela Rosa, a perioperative quality leader for the Central Zone. “Now he can call the attendants, and they will come with the kit and get his equipment cleaned for the OR.”

The team's efforts go beyond physical spaces – they also recognized the importance of RJ being fully integrated and supported as a medical student. Surgeons and other clinicians took the time to understand how RJ's power chair could be maneuvered in the OR, ensuring he could actively participate in procedures alongside his peers.

RJ, who lost significant leg movement due to a fall in 2021, has been sharing his journey with nearly 30,000 followers on Instagram, educating people about life as a medical student with a disability. He quickly came to realize his story is inspiring others to pursue the same path.

“So many students who want to go to medical school and have had a disability – either their whole life or more recently – ask me what they should do to get there,” said RJ. “Reading those messages has been pretty amazing… and I love jumping on a call with someone because I know that it's important to see someone else in the field showing that it is possible. It might take some extra work or extra steps, but it's worthwhile if it's your dream.”

Dr. Sam Jessula, a vascular surgeon at the QEII, first met RJ while tutoring medical students. During his early conversations with RJ, the pair became concerned about the accessibility challenges RJ might face in the operating room as part of his medical training.

"Being in a wheelchair should not limit you, so we have to make sure that the right infrastructure is in place,” said Dr. Jessula. “Going through this process, everyone here was extremely motivated, extremely keen, and was willing to put time, effort and resources behind making sure that we can make that happen."

Dr. Jessula and RJ worked to ensure the operating room was accessible, not just for RJ, but to pave the way for other students who use wheelchairs in the future. Dr. Jessula was pleasantly surprised by how smoothly RJ’s first surgery went.

"RJ just happens to use a standing power chair, and that faded into the background as the day progressed. I was surprised by how little I thought about it throughout the day."

Staff have helped create an inclusive environment that fosters RJ's resilience, determination and passion for medicine. Their work sets a new standard for accessibility in medical training for future students with disabilities. It was a true collaborative effort, driven by a shared commitment to equity and excellence in healthcare.

“Working with the QEII team showed me that it is possible to make health care accessible when we work together,” said RJ. “The space I was most nervous about became the space I am most proud to be in now and I’m able to successfully participate in surgery and gain the same experience as my fellow classmates.”

Photo of RJ Roggeveen (centre) with members of a QEII interdisciplinary team who worked to ensure accessibility to all medical students. Pictured (L-R) is vascular surgeon Dr. Sam Jessula, perioperative quality lead Angela Rosa, RJ Roggeveen, second-year medical student, Beth Kingsbury, clinical nurse educator, Wanda Vacon, infection prevention and control officer and Erin Sitland, perioperative RN.