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Objective: The aims of this study are to assess nursing student satisfaction with their Northern Territory clinical placement; describe the characteristics of these students; and examine the relationship between student placements and future rural/remote work intentions. Background: Positive clinical placement experiences in a rural or remote setting can encourage student nurses to consider working in rural and remote locations after graduation. Study design and methods: The study is a cross-sectional survey of nursing students, and a review of placement data. Participants were studying a pre-registration Bachelor of Nursing course from a variety of Australian universities who undertook a clinical placement of usually four or more weeks in the Northern Territory from 2017-2019. The main outcome measures are overall satisfaction with their placement, and consideration of living and working in a rural or remote location after graduating. Logistic regression analyses examined the relationship between student placements and future rural or remote work intentions. Results: One hundred and sixty three undergraduate nursing students responded to the online survey. The majority (70%) of placements were undertaken in remote or very remote (18%) locations. Satisfaction with the placement was very high (94%), and 88% agreed/strongly agreed that the placement had encouraged them to consider working in a rural or remote setting. Satisfaction with educational resources and prior interest in working remotely were associated with overall placement satisfaction (p<0.10). Overall satisfaction with the placement and prior consideration of working regionally, rurally, or remotely were significantly associated with feeling encouraged to consider working rurally or remotely (p<0.05). Conclusion: This study supported the logical pathway of providing a satisfying clinical nursing placement in the Northern Territory to contribute to a higher likelihood of the student considering working in a remote or rural setting after graduation. Providing satisfying remote clinical placements is a strategy for growing a nursing workforce for remote and rural settings. [ABSTRACT FROM AUTHOR]

An editorial is presented on researchers to partner with participants in the research process. Topics include showing the co-design process looking like and contributing to co-design policy for rural and remote health research; and privileged education for projecting an Aboriginal voice into the research governance process where voice carries with it various notes of the lived experience.

Objective: The aim of the study is to determine the current work locations of allied health professionals and nurses who undertook a student placement in the Northern Territory of Australia from 2016‐2019. Design: An observational cohort study was conducted in October 2020, with students emailed a link to an on‐line survey, plus two reminders. Setting: Primary health care in the Northern Territory of Australia. Participants: All allied health and nursing students who undertook a student learning placement in the Northern Territory from 2016‐2019 (n = 1936). Main outcome measures: Practicing nurses and allied health professionals were asked about their work history and locations (coded using the Modified Monash Model of remoteness and population size). Results: The response rate was 14.2% (275/1936 students). Most respondents reported that their placement positively influenced them to consider working: in a rural or remote location (76%), in the Northern Territory (81%), and with marginalised or under‐served populations (74%). Of the respondents, 224 had graduated and 203 were currently working in their health profession. A total of 31.4% of respondents reported that they had worked in a remote or rural location after graduation. Conclusions: The student placement had a positive effect on the likelihood of students working in a rural or remote location. A focus on recruiting students with a remote upbringing/background and offering longer placements would likely be successful in helping build the health professional workforce in remote locations. [ABSTRACT FROM AUTHOR]

Australia responded to the emergence of the COVID-19 global pandemic in 2020 by initiating a border and bio-security zone lockdown and policies emphasising social distancing and hand hygiene. To understand the public response to this, Southern Queensland Rural Health commenced a two-phase research project exploring attitudes and practices towards the COVID-19 pandemic in Australia. An initial online survey foreshadowed 90 qualitative interviews with respondents to explore what the pandemic meant for everyday life. This paper details use of a qualitative approach by a national collaborative of investigators from 9 rural university departments in Australia who came together to research the qualitative phase of the project. Our methodological approach aligned with extant literature describing the management of large-scale interviewing and coding in the context of unfolding and dynamic contexts. The 'RITA' model (Rapid Identification of Themes from Audio recordings) entails a five-step process designed to progress from identifying research foci, through deductive and iterative coding to identify key concepts. We used a combination of coding templates, organisation and tagging of field notes and real-time sharing through a secure cloud drive to create a data set for immersive analysis and generation of ideas. Use of this method has added to the collective knowledge about successful rapid research investigations, recognising the inherent tension between speed and rigour. This is not a binary but a dialectic; trustworthiness is integral to qualitative research. However, use of fresh approaches is accommodated by new technologies and can preserve adequate rigour while enabling collaboration, research capacity building and increasing the pace of data collection and analysis. This project has presented methodological challenges and highlights some strengths of such an approach. It is hoped that reporting our approach and experiences is useful for the broader health and research community considering large-scale qualitative research. [ABSTRACT FROM AUTHOR]

Objective: Assess nursing and allied health student satisfaction with their remote Northern Territory integrated learning placement and consideration of future rural/remote workDescribe the characteristics of these studentsExamine changes in student characteristics over time. Design: A cross‐sectional survey of students and a review of student placement data. Setting: Northern Territory, Australia. Participants: Former students having a work integrated learning placement of more than 1 week in the Northern Territory from 2017 to 2019. Main outcome measure(s): Agreement with the statements 'This placement has encouraged me to consider living and working in a rural or remote location after I graduate' and 'Overall, I was satisfied with my placement.' The administrative record review examined student numbers, and placement length over time. Results: A total of 341 students responded to the online survey. Overall satisfaction with the placement was very high (93%), and 84% agreed/strongly agreed that the placement had encouraged them to consider working in a rural or remote setting. High‐quality clinical supervision and educational resources were associated with overall placement satisfaction. Overall placement satisfaction, prior interest in working remotely and satisfaction with educational resources were associated with consideration of working remotely. The number of students having a placement increased by 29% in 2017 to 2019. The number of placement weeks also increased (35%). Conclusions: The number/placement time of nursing and allied health students has increased in the NT. Satisfaction with remote work integrated learning placements is an the important pathway to growing a local health professional workforce in remote and rural settings. [ABSTRACT FROM AUTHOR]

Aims: This commentary contends that research by higher degree research training is a sustainable strategy for capacity building the rural and remote health research workforce, provided they have equitable opportunity for access, participation and attainment. Context: The path for health professionals into academic roles, particularly in rural and remote areas, can be fraught. A strong research skill set might not form a significant component of a clinician's prior experience. Concurrently, university academic positions usually include the PhD as an essential qualification which is misaligned with the experience and skills of rural and remote applicants who are otherwise well‐qualified. Approach: Higher degree researches are one mechanism for extending the research expertise and capabilities. However, non‐traditional and remotely located cohorts such as the rural and remote health research workforce can face barriers to accessing, participating in and successfully completing formal research training. Barriers include the prevalence of the apprenticeship model of research training grounded in assumptions of colocation and face‐to‐face learning and supervision and a focus on the binary relationship between supervisors and students. In this commentary, the authors call for greater flexibility and equity in the higher degree research training system to cater for health professionals located in rural and remote practice contexts. Conclusion: Institutional investment in, and commitment to, a truly distributed higher degree research model would ensure a stronger rural and remote workforce who can aspire to a range of career options and thereby positively impacting on the health and research outcomes for rural and remote Australia. [ABSTRACT FROM AUTHOR]

Introduction: Rural and remote communities face significant disadvantages accessing health services and have a high risk of poor health outcomes. Workforce challenges in these areas are multifaceted, with allied health professionals requiring broad skills and knowledge to provide vital services to local communities. To develop the expertise for rural and remote practice, the allied health rural generalist pathway (AHRGP) was introduced to develop and recognise specialist skills and knowledge required for rural and remote practice, however the experiences of professionals has not been explored. This study gained the experiences and perceptions of allied health professionals undertaking the pathway as well as their clinical supervisors, line managers, profession leads and consumer representatives. Methods: A qualitative study was undertaken drawing on pragmatic approaches across four research phases. This study was one component of a larger mixed methods study investigating the experience, impact and outcomes of the AHRGP across six regional Local Health Networks in South Australia (SA). Interviews, surveys and focus groups were conducted to explore the perceptions and experiences of participants. Data was analysed thematically across participant groups and research phases. Results: A total of 54 participants including 15 trainees, 13 line managers, nine clinical supervisors, six profession leads, four program managers and seven consumer representatives informed this study. Five themes were generated from the data; gaining broad skills and knowledge for rural practice, finding the time to manage the pathway, implementing learning into practice, the AHRGP impacts the whole team and confident, consistent, skilled allied health professionals positively impact consumers. Conclusion: The AHRGP is offering allied health professionals the opportunity to develop skills and knowledge for rural and remote practice. It is also having positive impacts on individuals' ability to manage complexity and solve problems. Findings indicated consumers and organisations benefited through the provision of more accessible, consistent, and high quality services provided by trainees. Trainees faced challenges finding the time to manage study and to implement learning into practice. Organisations would benefit from clearer support structures and resourcing to support the pathway into the future. Incentives and career advancement opportunities for graduates would strengthen the overall value of the AHRPG. [ABSTRACT FROM AUTHOR]

The article offers information on allied health service–learning student placements in remote northern Australia during COVID-19. Topics include the ultimate intention of these services has been to pave the way for the creation of fully funded, and the high-quality health services has delivered by qualified allied health professionals that are responsive to community need.

Context: The use of peer support as a faculty development technique to improve clinical teaching is uncommon in medical education, despite the benefits of situating learning in the workplace. The authors therefore conducted a broad search seeking theoretical and empirical literature describing peer support strategies for clinical teachers in health care workplaces. This included descriptive and non‐experimental studies that are often excluded from reviews. The review aimed to identify and assess existing initiatives and to synthesise key challenges and benefits. Methods: An integrative literature review was undertaken (2004–2017), based on searches of eight international electronic databases and targeted manual searches. Key concepts, elements and models were mapped using an iterative, constant comparative method. An evaluative framework, drawing on previous research, informed conclusions regarding the quality of evidence. Results: From a pool of 5735 papers, 34 met the inclusion criteria. The majority referred to studies conducted in the USA (59%) and in the medical profession (71%). Analysis revealed a trend towards using a collaborative model (56%), voluntary participation (59%), and direct workplace observation by a peer clinician (68%). Design features of the peer support strategy were commonly reported (65%), with half providing outcome measures (56%). Few papers reported on process evaluation (15%) or evidence of programme sustainability (15%). Despite logistical and time‐associated challenges, benefits accrued to individuals and the workplace, and included improved teaching practices. Embedding the peer support strategy into routine organisational practice proved effective. Conclusions: The results indicated that a workplace‐based peer support model is an acceptable and effective faculty development strategy for health care clinical teachers. Conceptualising workplace‐based peer support via a sociocultural model that acknowledges the significance of educational design, peers as collaborators and the importance of workplace context and culture is emphasised. Future research should focus on clarification studies informed by contemporary models of faculty development, in which factors impacting the health care workplace are considered. By reviewing the literature, Campbell et al. highlight how collaborative relationships and workplace connections with peers offer an under‐utilized resource for effectively improving teaching expertise. [ABSTRACT FROM AUTHOR]

While clinical workplace learning is complex for both students and supervisors, this commentary offers reflections on how negotiating and exploring roles and relationships can optimise its benefits. [ABSTRACT FROM AUTHOR]

An editorial is presented on the education in and for the rural and remote workforce which is critical to ensuring that people living in those regions have equitable access to sustainable high-quality health care. The article discusses that the accumulating evidence for rural and remote workforce retention emphasizes the importance of locally available educational options for initial training and ongoing career pathway opportunities.

An editorial is presented on the strengthening the integrity of qualitative research in the Australian Journal of Rural Health. Topics include guiding academic principles is to support researchers to publish research that is high quality, the highest standards in the reporting of the findings, and the research, whether good or bad, ultimately influences health care policy and patient care.

An editorial is presented on the Australian Journal of Rural Health (AJRH) has ranked as a Quartile journal by Scopus, meaning that aside from being well ranked, it receives many submissions from all over the world and particularly from within Australia. Topics include the journal relies on good-quality reviews from volunteer reviewers, the important therefore for people who have agreed to review for the journal to understand review requirements and processes.

Purpose: Allied health workforce recruitment and retention in remote areas is a global problem. Using case studies from the Australian allied health workforce, this paper adds new information by combining personality trait information with a detailed understanding of how the cases construe the demands of remote work, which may be useful in addressing this problem. Methods: Four cases (two urban, two remote) are presented from a mixed methods study (n = 562), which used (1) the Temperament and Character Inventory to investigate personality traits of allied health professionals; and (2) repertory grid interviews to reveal quantitatively and qualitatively how the cases construed their Ideal work role compared with their Current and a Remote role. Cases also self-assessed their fit (‘suited’ or ‘not suited’) with remote. Findings: Differences in the way cases construed their fit with remote work was related to prior experience. However all were satisfied with their work, perceiving their Current role as similar to their Ideal. All saw remote work as requiring generalist expertise and a reliance on relationships. Personality traits, especially Novelty Seeking and Harm Avoidance, fit with how allied health professionals perceived their role. Conclusions: The combination of two distinct lines of investigation, illustrates what more can be revealed about allied health professional’s career choices by taking into account the fit or lack of fit between their personality tendencies, their construing of remote work and their life circumstances. Understanding the combined influence of perceptions and traits on an individual toward or away from remote work may enhance recruitment and retention internationally. [ABSTRACT FROM AUTHOR]

The article discusses the development of webinars in tandem with workplace-based peer practice for the clinical supervision of healthcare professionals as of 2021. Topics covered include its mechanics and enabling of clinical supervisors to directly apply what they learnt in the webinar to a role-play activity in their own context, and to build a closer peer connection. Also noted is the strategy's enhancement of participants' full engagement and application of their learning.

Objective. Allied health (AH) includes many diverse professions, each with a unique contribution to healthcare, making it possible to consider these professions as person oriented (PO) or technique oriented (TO). This paper explored the personality traits of AH professionals from the perspective of both the PO or TO orientation and the individual professions. Methods. AH professionals (n = 562) provided demographic data and completed the Temperament and Character Inventory. Examination of the literature and a consultation process resulted in nine professions classified as PO and 10 classified as TO. Multivariate analyses compared levels of personality traits and demographic variables between the PO (n = 492) and TO (n = 70) groups, and the professions within the groups. Results. Professionals in the PO group showed significantly higher levels of traits that emphasise person orientation attributes, such as being sociable, empathic and cooperative, compared with AH professionals in professions with an emphasis on TO. Conclusions. Trends in personality traits among AH professionals were congruent with the PO and TO aspects of their chosen profession. This supports the usefulness of the PO and TO concepts in describing AH professions and may provide new clues for policy aiming to enhance job satisfaction, retention and career development. [ABSTRACT FROM AUTHOR]

Objective To describe the personality (temperament and character traits) of remote Australian allied health professionals ( AHPs) . Recent research shows that health professionals can be differentiated by personality traits but little is known about the personality traits of AHPs. Design Cross-sectional (online) survey design with snowball sampling of participants. Setting and Participants Australian AHPs ( N = 561; women, n = 502) classified into Remote ( n = 266), Not Remote ( n = 295). Main outcome measure(s) Demographic variables and the Temperament and Character Inventory ( TCI R-140). Results Remote AHPs were higher in novelty seeking ( P = 0.037) and self-transcendence ( P = 0.042). Remote women were lower in harm avoidance ( P = 0.042). Older remote AHPS were lower in reward dependence ( P = 0.001); younger remote AHPs were lower in self directedness ( P = 0.001) and higher in harm avoidance ( P < 0.001). Women were more reward dependent ( P < 0.001) and cooperative ( P = 0.008) than men. Conclusions The sample demonstrated personality trait levels aligned with research on rural doctors and nurses and which might be advantageous for working in a challenging environment. Exploring the more stable nature of temperament traits coupled with the modifiable potential of character traits provides new insight into people who choose to work as a remote AHP. These findings might contribute to a better understanding of the personality trends in these AHPs which might provide clues to improve recruitment and retention strategies. [ABSTRACT FROM AUTHOR]

The article provides information on a novel health-themed escape room developed to scaffold participants into an educational workshop with a curriculum focus on teamwork and interprofessional practice. Topics include components of the debrief and interactive workshop participated by the teams after completing the escape room, overall ratings given by fifty participants from seven disciplines that completed the session, and comparison between escape room and traditional small group tutorials.

Background: Maintaining a health professional workforce in rural and remote areas poses a significant challenge internationally. A range of recruitment and retention strategies have had varying success and these are  generally developed from the collective experience of all health professions, rather than targeted to professional groups with differing educational and support contexts. This review explores, compares and synthesises the evidence examining the experience of early career rural and remote allied health professionals and doctors to better understand both the profession specific, and common factors that influence their experience.Methods: Qualitative studies that include early career allied health professionals' or doctors' experiences of working in rural or remote areas and the personal and professional factors that impact on this experience were considered. A systematic search was completed across five databases and three grey literature repositories to identify published and unpublished studies. Studies published since 2000 in English were considered. Studies were screened for inclusion and critically appraised by two independent reviewers. Data was extracted and assigned a level of credibility. Data synthesis adhered to the JBI meta-aggregative approach.Results: Of the 1408 identified articles, 30 papers were eligible for inclusion, with one rated as low in quality and all others moderate or high quality. A total of 23 categories, 334 findings and illustrations were aggregated into three synthesised findings for both professional groups including: making a difference through professional and organisational factors, working in rural areas can offer unique and rewarding opportunities for early career allied health professionals and doctors, and personal and community influences make a difference. A rich dataset was obtained and findings illustrate similarities including the need to consider personal factors, and differences, including discipline specific supervision for allied health professionals and local supervision for doctors.Conclusions: Strategies to enhance the experience of both allied health professionals and doctors in rural and remote areas include enabling career paths through structured training programs, hands on learning opportunities, quality supervision and community immersion.Systematic Review Registration Number: PROSPERO CRD42021223187. [ABSTRACT FROM AUTHOR]

Background: Maintaining a health professional workforce in rural and remote areas poses a significant challenge internationally. A range of recruitment and retention strategies have had varying success and these are generally developed from the collective experience of all health professions, rather than targeted to professional groups with differing educational and support contexts. This review explores, compares and synthesises the evidence examining the experience of early career rural and remote allied health professionals and doctors to better understand both the profession specific, and common factors that influence their experience. Methods: Qualitative studies that include early career allied health professionals' or doctors' experiences of working in rural or remote areas and the personal and professional factors that impact on this experience were considered. A systematic search was completed across five databases and three grey literature repositories to identify published and unpublished studies. Studies published since 2000 in English were considered. Studies were screened for inclusion and critically appraised by two independent reviewers. Data was extracted and assigned a level of credibility. Data synthesis adhered to the JBI meta-aggregative approach. Results: Of the 1408 identified articles, 30 papers were eligible for inclusion, with one rated as low in quality and all others moderate or high quality. A total of 23 categories, 334 findings and illustrations were aggregated into three synthesised findings for both professional groups including: making a difference through professional and organisational factors, working in rural areas can offer unique and rewarding opportunities for early career allied health professionals and doctors, and personal and community influences make a difference. A rich dataset was obtained and findings illustrate similarities including the need to consider personal factors, and differences, including discipline specific supervision for allied health professionals and local supervision for doctors. Conclusions: Strategies to enhance the experience of both allied health professionals and doctors in rural and remote areas include enabling career paths through structured training programs, hands on learning opportunities, quality supervision and community immersion. Systematic review registration number: PROSPERO CRD42021223187. [ABSTRACT FROM AUTHOR]

When the pandemic began, the media environment was focused on terrible health outcomes and negative predictions about the course of the pandemic. For many sectors of society the COVID-19 pandemic has been devastating, but the disruption it generated and our response to it in our University College has had substantial benefits. [Extracted from the article]

Background: The COVID-19 pandemic increased the use of telehealth consultations by telephone and video around the world. While telehealth can improve access to primary health care, there are significant gaps in our understanding about how, when and to what extent telehealth should be used. This paper explores the perspectives of health care staff on the key elements relating to the effective use of telehealth for patients living in remote Australia. Methods: Between February 2020 and October 2021, interviews and discussion groups were conducted with 248 clinic staff from 20 different remote communities across northern Australia. Interview coding followed an inductive approach. Thematic analysis was used to group codes into common themes. Results: Reduced need to travel for telehealth consultations was perceived to benefit both health providers and patients. Telehealth functioned best when there was a pre-established relationship between the patient and the health care provider and with patients who had good knowledge of their personal health, spoke English and had access to and familiarity with digital technology. On the other hand, telehealth was thought to be resource intensive, increasing remote clinic staff workload as most patients needed clinic staff to facilitate the telehealth session and complete background administrative work to support the consultation and an interpreter for translation services. Clinic staff universally emphasised that telehealth is a useful supplementary tool, and not a stand-alone service model replacing face-to-face interactions. Conclusion: Telehealth has the potential to improve access to healthcare in remote areas if complemented with adequate face-to-face services. Careful workforce planning is required while introducing telehealth into clinics that already face high staff shortages. Digital infrastructure with reliable internet connections with sufficient speed and latency need to be available at affordable prices in remote communities to make full use of telehealth consultations. Training and employment of local Aboriginal staff as digital navigators could ensure a culturally safe clinical environment for telehealth consultations and promote the effective use of telehealth services among community members. [ABSTRACT FROM AUTHOR]

Purpose:Resilience, coping with uncertainty and learning from mistakes are vital characteristics for all medical disciplines – particularly rural practice. Levels of coping constructs were examined in medical students with and without a rural background or an interest in rural practice. Methods:Cross-sectional surveys identified two personality profiles, and their association with levels of Tolerance of Ambiguity, Resilience, Perfectionism-High Standards and Concern over mistakes as constructs indicative of coping. Medical students (N = 797) were stratified by rural background and degree of rural interest. Mediation analysis tested the effect of personality profile on levels of the coping constructs. Results:More (72%) rural background students had Profile 1 which was associated with higher levels of Tolerance of Ambiguity, High standards, and Resilience, but lower Concern over mistakes. Non-rural background students reporting a strong rural interest also had Profile 1 (64%) and similar levels of coping constructs. Personality profile mediated the association between rural interest and levels of coping constructs regardless of background. Conclusions:Having a rural background or strong rural interest are associated with a personality profile that indicates a better capacity for coping. Personality may play a part in an individual’s interest in rural practice. Rural workforce initiatives through education should encourage and nurture students with a genuine interest in rural practice – regardless of background. [ABSTRACT FROM PUBLISHER]

Objectives: To co‐create a culturally responsive student‐implemented allied health service in a First Nations remote community and to determine the feasibility and acceptability of the service. Design: Co‐creation involved a pragmatic iterative process, based on participatory action research approaches. Feasibility and acceptability were determined using a mixed‐method pre/postdesign. Setting: The service was in Nhulunbuy, Yirrkala and surrounding remote First Nations communities of East Arnhem Land, Northern Territory, Australia. Participants: Co‐creation of the service was facilitated by the Northern Australia Research Network, guided by Indigenous Allied Health Australia leadership, with East Arnhem local community organisations and community members. Co‐creation of the day‐to‐day service model involved local cultural consultants, service users and their families, staff of community organisations, students, supervisors, placement coordinators and a site administrator. Findings A reciprocal learning service model was co‐created in which culturally responsive practice was embedded. The service was feasible and acceptable: it was delivered as intended; resources were adequate; the service management system was workable; and the service was acceptable. Health outcome measures, however, were not appropriate to demonstrate impact, particularly through the lens of the people of East Arnhem. Recommendations for the service included: continuing the reciprocal learning service model in the long term; expanding to include all age groups; and connecting with visiting and community‐based services. Conclusion: The co‐created service was feasible and acceptable. To demonstrate the impact of the service, measures of health service impact that are important to First Nations people living in remote communities of northern Australia are required. [ABSTRACT FROM AUTHOR]

Objectives: To explore the process of learning for allied health students providing a student‐implemented service for older Yolŋu in remote East Arnhem, Northern Territory, Australia. Design: An exploratory qualitative study following an 8‐week student‐implemented service. Setting: Nhulunbuy and Yirrkala and surrounding remote Aboriginal communities of the East Arnhem Region of the Northern Territory. Participants: Data were collected from: 4 students who implemented the service; 4 professional supervisors, 3 placement coordinators, a Yolŋu cultural consultant and a care manager from a local community organisation, all of whom supported implementation of the service; and 7 older Yolŋu and their families who were recipients of the service. Interventions: A student‐implemented service for older Yolŋu delivered by allied health students from James Cook University. Clinical, cultural and pastoral supervision and support was provided by Flinders University, James Cook University, Indigenous Allied Health Australia and 2 Yolŋu cultural consultants and 2 local community organisations. Main outcome measures: Semi‐structured interviews with those who implemented, supported and received the service. Data were analysed thematically using an inductive approach. Results: 'Learning to connect and connecting to learn' described how allied health students were learning to provide a service for older Yolŋu. Four interrelated processes connected their learning: 'preparing and supporting', 'bonding and responding', 'growing and enriching' and 'working and weaving'. Conclusion: The co‐created student‐implemented service provided a unique learning opportunity for allied health students on how to provide a culturally safe service in a remote Aboriginal community in northern Australia. [ABSTRACT FROM AUTHOR]

The article presents the discussion on mitigating climate change. Topics include rural Australia requiring a policy framework focusing on the whole population, new ways of working, embracing technology, prevention and rural autonomy; and communities in terms of loss of human life, damage to property, destruction of crops, loss of livestock, and environmental and infrastructural damage.

Background: Attracting and retaining sufficient health workers to provide adequate services for residents of rural and remote areas has global significance. High income countries (HICs) face challenges in staffing rural areas, which are often perceived by health workers as less attractive workplaces. The objective of this review was to examine the quantifiable associations between interventions to retain health workers in rural and remote areas of HICs, and workforce retention.Methods: The review considers studies of rural or remote health workers in HICs where participants have experienced interventions, support measures or incentive programs intended to increase retention. Experimental, quasi-experimental and observational study designs including cohort, case-control, cross-sectional and case series studies published since 2010 were eligible for inclusion. The Joanna Briggs Institute methodology for reviews of risk and aetiology was used. Databases searched included MEDLINE (OVID), CINAHL (EBSCO), Embase, Web of Science and Informit.Results: Of 2649 identified articles, 34 were included, with a total of 58,188 participants. All study designs were observational, limiting certainty of findings. Evidence relating to the retention of non-medical health professionals was scant. There is growing evidence that preferential selection of students who grew up in a rural area is associated with increased rural retention. Undertaking substantial lengths of rural training during basic university training or during post-graduate training were each associated with higher rural retention, as was supporting existing rural health professionals to extend their skills or upgrade their qualifications. Regulatory interventions requiring return-of-service (ROS) in a rural area in exchange for visa waivers, access to professional licenses or provider numbers were associated with comparatively low rural retention, especially once the ROS period was complete. Rural retention was higher if ROS was in exchange for loan repayments.Conclusion: Educational interventions such as preferential selection of rural students and distributed training in rural areas are associated with increased rural retention of health professionals. Strongly coercive interventions are associated with comparatively lower rural retention than interventions that involve less coercion. Policy makers seeking rural retention in the medium and longer term would be prudent to strengthen rural training pathways and limit the use of strongly coercive interventions. [ABSTRACT FROM AUTHOR]

Faculty development (FD) supports health professions educators to develop knowledge, skills, and expertise. Whilst formal FD is a focus in the health professions education (HPE) literature, little is known about how FD occurs informally. We sought to identify opportunities and constraints for informal FD amongst health professions educators in the academic (university) setting and understand how they engage with these opportunities. This exploratory study was conducted in one Australian university. Interviews and focus groups were conducted with undergraduate and postgraduate teachers and assessors (teachers) (n = 10); teaching team and program leaders (mid-level leaders) (n = 8); and senior (university-level) leaders (n = 2). We analysed data thematically and applied situated cognition theory. We identified three everyday educational practices that provide opportunities for informal FD in the academic setting: (1) applying evidence to; (2) evaluating; and (3) sharing, educational practice. Engaging with these opportunities was shaped by individuals' motivation and proactivity to engage in professional learning (effectivities) and organisational culture and structures (constraints). Applying evidence to, evaluating, and sharing educational practice provide valuable contexts for ongoing learning in the academic setting. Assisting educators and organisations to recognise and leverage these 'in situ' FD opportunities is vital in fostering a continuous learning culture. [ABSTRACT FROM AUTHOR]

Context Longitudinal integrated clerkships ( LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. Objectives This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. Methods Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. Results Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs; Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. Conclusions Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on individual programme or context. [ABSTRACT FROM AUTHOR]

Medical Education 2012: 46: 1028-1041 Context Longitudinal integrated clerkships (LICs) have been widely implemented in both rural and urban contexts, as is now evident in the wealth of studies published internationally. This narrative literature review aims to summarise current evidence regarding the outcomes of LICs for student, clinician and community stakeholders. Methods Recent literature was examined for original research articles pertaining to outcomes of LICs. Results Students in LICs achieve academic results equivalent to and in some cases better than those of their counterparts who receive clinical education in block rotations. Students in LICs are reported to have well-developed patient-centred communication skills, demonstrate understanding of the psychosocial contributions to medicine, and report more preparedness in higher-order clinical and cognitive skills in comparison with students in traditional block rotations (TBRs). Students in LICs take on increased responsibility with patients and describe having more confidence in dealing with ethical dilemmas. Continuity of supervision reportedly facilitates incremental knowledge acquisition, and supervisors provide incrementally progressive feedback. Despite early disorientation regarding the organising of their learning, students feel well supported by the continuity of student-preceptor relationships and value the contributions made by these. Students in LICs living and working in rural areas are positively influenced towards primary care and rural career choices. Discussion A sound body of knowledge in the field of LIC research suggests it is time to move beyond descriptive or exploratory research that is designed to justify this new educational approach by comparing academic results. As the attributes of LIC alumni are better understood, it is important to conduct explanatory research to develop a more complete understanding of these findings and a foundation for new theoretical frameworks that underpin educational change. Conclusions Longitudinal integrated clerkships are now recognised as representing credible and effective pedagogical alternatives to TBRs in medical education. [ABSTRACT FROM AUTHOR]