Rural Remote Health
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Rural Remote Health · Oct 2015
James Cook University's rurally orientated medical school selection process: quality graduates and positive workforce outcomes.
The regionally based James Cook University (JCU) College of Medicine and Dentistry aims to meet its mission to address the health needs of the region by using a selection policy favouring rural origin applicants and providing students with early and repeated exposure to rural experiences during training. This study seeks to determine if the JCU medical school's policy of preferentially selecting rural and remote background students is associated with differing patterns of undergraduate performance or graduate practice location. ⋯ Some significant differences were noted between rural and remote origin students and metropolitan or inner regional origin students in terms of academic achievement in the first 3 years of the course and length of time taken to complete the course. However, this group of rural and remote-origin students seems to do just as well in the exams in the clinical years (years 4-6) and are much more likely to practise in rural and remote areas. These data suggest that JCU's selection process favouring rural origin applicants does not compromise academic standards, but does produce graduates whose patterns of practice accord with the mission of the school.
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Rural Remote Health · Oct 2015
Evaluating the impact of a community developed collaborative project for the prevention of early childhood caries: the Healthy Smile Happy Child project.
To determine the effectiveness of the Healthy Smile Happy Child (HSHC) project, a community-developed initiative promoting early childhood oral health in Manitoba, Canada. Specific aims were to assess improvements in caregiver knowledge, attitudes, and behaviours relating to early childhood oral health, and the burden of early childhood caries (ECC) and severe ECC (S-ECC). ⋯ Follow-up study results suggest that the HSHC initiative may have contributed to improvements in caregiver knowledge, attitudes, and behaviours towards early childhood oral health and subsequently modest yet statistically significant reductions in caries scores and the prevalence of S-ECC.
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Rural Remote Health · Oct 2015
Comparative StudyComparison of rates of emergency department procedures and critical diagnoses in metropolitan and rural hospitals.
Emergency medicine (EM) workforce studies show low rates of board-certified/residency-trained emergency physicians practising in rural emergency departments (EDs) in the USA. Rural ED rotations for EM residents may lead to increased numbers of residency-trained EM providers in rural areas. There is concern that residents trained in rural environments will not get sufficient procedural experience or patient acuity. The current literature contains only one single-residency study that provides procedural experience and patient acuity comparison between metropolitan and rural EDs. The purpose of this study is to utilize the Nationwide Emergency Department Sample (NEDS) to compare the rate of selected procedures and critical diagnoses at rural and metropolitan EDs in the USA. ⋯ The rates of critical diagnoses are similar, but are still lower in rural EDs as a recent single-site study has shown. The lower rates of procedures and critical diagnoses in rural EDs confirm the concern that residents receiving a substantial portion of their training in rural EDs may not get sufficient experience in certain procedures or critical diagnoses. The benefits of a rural ED rotation must be weighed against the risk of lower procedure and critical diagnosis rates. The impact of a 1-3 month rotation in a rural ED on overall procedural competency and clinical experience cannot, however, be extrapolated, and further study is required to quantify this effect.
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Rural Remote Health · Oct 2015
Measuring organisational-level Aboriginal cultural climate to tailor cultural safety strategies.
Australian medical schools have taken on a social accountability mandate to provide culturally safe contexts in order to encourage Aboriginal and Torres Strait Islander people to engage in medical education and to ensure that present and future clinicians provide health services that contribute to improving the health outcomes of Aboriginal and Torres Strait Islander peoples. Many programs have sought to improve cultural safety through training at an individual level; however, it is well recognised that learners tend to internalise the patterns of behaviour to which they are commonly exposed. This project aimed to measure and reflect on the cultural climate of an Australian rural clinical school (RCS) as a whole and the collective attitudes of three different professional groups: clinicians, clinical academics and professional staff. The project then drew on Mezirow's Transformative Learning theory to design strategies to build on the cultural safety of the organisation. ⋯ Through tailored approaches to cross-cultural training opportunities we are likely to ensure participants are able to engage with the material and reflect upon implications of a challenging cultural climate on the health and wellbeing outcomes of Aboriginal people.
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Rural Remote Health · Oct 2015
'Achievement, pride and inspiration': outcomes for volunteer role models in a community outreach program in remote Aboriginal communities.
There is growing support for the prosocial value of role modelling in programs for adolescents and the potentially positive impact role models can have on health and health behaviours in remote communities. Despite known benefits for remote outreach program recipients, there is limited literature on the outcomes of participation for role models. ⋯ Effective role model programs designed for remote Indigenous youth can have positive outcomes for both role models and the program recipients. Cultural safety training is an important factor for preparing role models and for building their cultural competency for implementing health and education programs in remote Indigenous communities in Australia. This will maximise the opportunities for participants to achieve outcomes and minimise their culture shock.