Rural Remote Health
-
Rural Remote Health · Jul 2006
Educating to improve population health outcomes in chronic disease: an innovative workforce initiative across remote, rural and Indigenous communities in northern Australia.
Like Indigenous populations in other countries, an epidemic of chronic disease has swept across Australia's Indigenous communities in the past decade. The Northern Territory and Queensland health departments initiated preventable chronic disease strategies in 1999 and 2001, respectively. Yet finding innovative ways to translate this to the health workforce was challenging. Through support from the Australian Government, three universities, two health departments and two Indigenous organisations worked in partnership to improve workforce capacity in remote and rural communities through innovative education. ⋯ A practical curriculum framework now exists to integrate a population health approach for the prevention and early detection of chronic disease when educating the primary healthcare workforce. It is relevant to all health disciplines and is flexible in that it can be adapted, or adopted, depending on the educational needs of the disciplinary group. It is being imbedded into numerous undergraduate, postgraduate, and professional development programs in Australia. It includes: the core learning outcomes expected of any workforce, resources, and a self-assessment tool in chronic disease. These tools are assisting educators in the required paradigm shift required of the workforce to alter the single disease based practice model towards a comprehensive and integrated population based approach required for the workforce in the 21st century.
-
Rural Remote Health · Jul 2006
Comparative StudyConsultations in general practice and at an Aboriginal community controlled health service: do they differ?
Despite the widely acknowledged health disparities between Indigenous and non-Indigenous Australians, little is known about consultations in primary care with Indigenous people. In particular, the nature of consultations in the Aboriginal Community Controlled Health Service (ACCHS) sector has been rarely studied. Data collection about consultations in primary care has been steadily improving, with good quality data now available on an ongoing basis about patient demographics, risk factors and consultation content in private general practice. This study aimed to characterise consultations at Townsville Aboriginal and Islander Health Service (TAIHS) in terms of patient demographics and consultation content. These could then be compared with existing datasets for local consultations in mainstream general practice and from a geographically distant ACCHS. ⋯ The greater number of problems managed per consultation in ACCHS, compared with Indigenous patients in mainstream general practice, supports the assertion that ACCHS fill an important role in the health system by providing care for their largely Indigenous patients with complex care needs. The Medicare system as it was structured at the time did not encourage involvement of Indigenous health workers in provision of primary medical care. It remains to be seen whether introduction of the new enhanced primary care Medicare numbers will assist in this process. These findings have implications for ACCHS in other areas of the country and for other providers of primary health care for Indigenous Australians.
-
Rural Remote Health · Apr 2006
ReviewClinical simulators: applications and implications for rural medical education.
Medical education has undergone significant changes globally. Calls for the revitalisation of centuries old pathways of learning have resulted in innovative medical curricula. Didactic modes of teaching which involved the learning of copious amounts of facts have given way to curricula that focus on the horizontal and vertical integration of basic and clinical sciences. ⋯ This article reviews the literature on medical simulation and provides the contextual basis for the establishment of a Clinical Simulation Learning Centre (CSLC) in a rural clinical school in Australia. The educational program, as well as the design, layout and equipment of the CSLC are described, as well as implications for rural practitioners. The CSLC has been a major capital investment in a relatively under-resourced part of regional Australia and has provided opportunities for ongoing education across a range of healthcare professionals in the community.
-
Rural Remote Health · Jan 2006
Comparative StudyThe career aspirations and location intentions of James Cook University's first cohort of medical students: a longitudinal study at course entry and graduation.
James Cook University's School of Medicine enrolled its first cohort of 64 students in 2000. The School was established with the aim of increasing the number of medical graduates who understand rural, remote, Indigenous and tropical health issues and who would subsequently choose rural (non-metropolitan) practice. In December 2005, 58 students graduated the course. Several students left the cohort (either left the course or repeated earlier years of the course). In the early years, students who left the course were replaced by accelerated entry students. ⋯ The findings support the School's contention and that of others around the world that medical education undertaken in non-metropolitan settings is the best vehicle for increasing the rural medical workforce. This study provides support for the development of regional medical schools that focus on local recruitment and health care need issues.
-
The context for this study is a conversion program for enrolled nurses (ENs) or division 2 level nurses who want to further their career as a registered nurse (RN) or division 1 nurse. While the conversion program is available to both metropolitan and rural nurses, it is designed specifically for experienced rural ENs. The conversion program is able to offer an educational alternative that does not disrupt family life or adversely impact the rural nursing workforce. This alternative is necessary for both the rural EN's career opportunities and for the health outcomes of rural communities in particular. This article reports on the experiences of the first cohort to graduate from the EN to RN conversion program. The conversion program offers three semesters of advanced standing within a seven-semester Bachelor of Science (Nursing) degree. The advanced standing or recognition of prior learning is awarded to applicants with more than one year's clinical experience, regardless of the type of enrolled nurse course completed. Enrolled nurses with a technical college qualification or higher meet university entry criterion but students from a hospital-based program are required to complete a mature-age university entry test. The degree to which the three semesters of advanced standing within an external conversion course for ENs would adversely affect participants' transition to student status and course completion is not known. The conversion program: The two-year, fully external EN conversion program relies on learning centre partnerships with country hospitals and agencies. Teaching strategies consist of a mix of external-mode strategies, including fully web-based units, and a compulsory eight-day on-campus foundation study block at the beginning. The compulsory study block provides the opportunity for students to familiarize themselves with the various areas of the university they need to contact as an external student, prepare for expectations of their first unit, including assessment expectations, and to practise selected nursing skills that are not common to the EN role. With the program being delivered from the metropolitan area of a vast state that occupies one-third of the Australian landmass, a key feature is the establishment of rural learning centres to support students. Apart from two of the seven clinical units in their course, the designated rural academic mentors arrange clinical placements in school-approved health care agencies situated locally or in nearby towns. This later strategy avoids the necessity for students to relocate to the metropolitan area or larger towns to complete the clinical component of the course. The conversion program has enrolled a limited number each year since 2000 and continues to be in high demand. Rural ENs are given preference and metropolitan enrolled nurses are included when quota allows. ⋯ The transition experiences for participants in the external conversion program are generally positive although, as with other studies, the transition to student status is stressful. However, the course is able to facilitate the career aspirations of the study participants and to contribute to the retention of nursing staff in rural areas. Strategies to provide career opportunities for health-care professionals in rural areas are always a challenge. As one such strategy, the external mode EN to RN conversion program has proven to be effective for experienced ENs.