Evaluation of rural general practice experiences for pre-vocational medical graduates
- McGrail, Matthew, Chhabra, Jasleen, Hays, Richard
- Authors: McGrail, Matthew , Chhabra, Jasleen , Hays, Richard
- Date: 2023
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Introduction: Despite substantial investment in rural workforce support, sustaining the necessary recruitment and retention of general practitioners (GPs) in rural areas remains a challenge. Insufficient medical graduates are choosing a general/rural practice career. Medical training at postgraduate level, particularly for those ‘between’ undergraduate medical education and specialty training, remains strongly reliant on hospital experience in larger hospitals, potentially diverting interest away from general/rural practice. The Rural Junior Doctor Training Innovation Fund (RJDTIF) program offered junior hospital doctors (interns) an experience of 10 weeks in a rural general practice, aiming to increase their consideration of general/rural practice careers This study aimed to evaluate the educational and potential workforce impact of the RJDTIF program. Methods: Up to 110 places were established during 2019–2020 for Queensland’s interns to undertake an 8–12-week rotation (depending on individual hospital rosters) out of regional hospitals to work in a rural general practice. Participants were surveyed before and after the placement, although only 86 were invited due to the disruption caused by the COVID-19 pandemic. Descriptive quantitative statistics were applied to the survey data. Four semistructured interviews were conducted to further explore the experiences post-placement, with audio-recordings transcribed verbatim. Semi-structured interview data were analysed using inductive, reflexive thematic analysis. Results: In total, 60 interns completed either survey, although only 25 were matched as completing both surveys. About half (48%) indicated they had preferenced the rural GP term and 48% indicated strong enthusiasm for the experience. General practice was indicated as the most likely career option for 50%, other general specialty 28% and subspecialty 22%. Likelihood to be working in a regional/rural location in 10 years was indicated as ‘likely’ or ‘very likely’ for 40%, ‘unlikely’ for 24% and ‘unsure’ for 36%. The two most common reasons for preferencing a rural GP term were experiencing training in a primary care setting (50%) and gaining more clinical skills through increased patient exposure (22%). The overall impact on pursuing a primary care career was self-assessed as much more likely by 41%, but much less by 15%. Interest in a rural location was less influenced. Those rating the term poor or average had low pre-placement enthusiasm for the term. The qualitative analysis of interview data produced two themes: importance of the rural GP term for interns (hands-on learning, skills improvement, influence on future career choice and engagement with the local community), and potential improvements to rural intern GP rotations. Conclusion: Most participants reported a positive experience from their rural GP rotation, which was recognised as a sound learning experience at an important time with respect to choosing a specialty. Despite the challenges posed by the pandemic, this evidence supports the investment in programs that provide opportunities for junior doctors to experience rural general practice in these formative postgraduate years to stimulate interest in this much-needed career pathway. Focusing resources on those who have at least some interest and enthusiasm may improve its workforce impact © 2023, Rural and Remote Health.All Rights Reserved.
- Authors: McGrail, Matthew , Chhabra, Jasleen , Hays, Richard
- Date: 2023
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Introduction: Despite substantial investment in rural workforce support, sustaining the necessary recruitment and retention of general practitioners (GPs) in rural areas remains a challenge. Insufficient medical graduates are choosing a general/rural practice career. Medical training at postgraduate level, particularly for those ‘between’ undergraduate medical education and specialty training, remains strongly reliant on hospital experience in larger hospitals, potentially diverting interest away from general/rural practice. The Rural Junior Doctor Training Innovation Fund (RJDTIF) program offered junior hospital doctors (interns) an experience of 10 weeks in a rural general practice, aiming to increase their consideration of general/rural practice careers This study aimed to evaluate the educational and potential workforce impact of the RJDTIF program. Methods: Up to 110 places were established during 2019–2020 for Queensland’s interns to undertake an 8–12-week rotation (depending on individual hospital rosters) out of regional hospitals to work in a rural general practice. Participants were surveyed before and after the placement, although only 86 were invited due to the disruption caused by the COVID-19 pandemic. Descriptive quantitative statistics were applied to the survey data. Four semistructured interviews were conducted to further explore the experiences post-placement, with audio-recordings transcribed verbatim. Semi-structured interview data were analysed using inductive, reflexive thematic analysis. Results: In total, 60 interns completed either survey, although only 25 were matched as completing both surveys. About half (48%) indicated they had preferenced the rural GP term and 48% indicated strong enthusiasm for the experience. General practice was indicated as the most likely career option for 50%, other general specialty 28% and subspecialty 22%. Likelihood to be working in a regional/rural location in 10 years was indicated as ‘likely’ or ‘very likely’ for 40%, ‘unlikely’ for 24% and ‘unsure’ for 36%. The two most common reasons for preferencing a rural GP term were experiencing training in a primary care setting (50%) and gaining more clinical skills through increased patient exposure (22%). The overall impact on pursuing a primary care career was self-assessed as much more likely by 41%, but much less by 15%. Interest in a rural location was less influenced. Those rating the term poor or average had low pre-placement enthusiasm for the term. The qualitative analysis of interview data produced two themes: importance of the rural GP term for interns (hands-on learning, skills improvement, influence on future career choice and engagement with the local community), and potential improvements to rural intern GP rotations. Conclusion: Most participants reported a positive experience from their rural GP rotation, which was recognised as a sound learning experience at an important time with respect to choosing a specialty. Despite the challenges posed by the pandemic, this evidence supports the investment in programs that provide opportunities for junior doctors to experience rural general practice in these formative postgraduate years to stimulate interest in this much-needed career pathway. Focusing resources on those who have at least some interest and enthusiasm may improve its workforce impact © 2023, Rural and Remote Health.All Rights Reserved.
The experience of women from rural Australia with a preterm infant in a neonatal intensive care unit
- Laidlaw, Kerrie, Prichard, Ivanka, Sweet, Linda
- Authors: Laidlaw, Kerrie , Prichard, Ivanka , Sweet, Linda
- Date: 2023
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Introduction: This study aimed to understand the experiences of women from rural areas who have had a preterm infant admitted to a neonatal intensive care unit. The study population comprised five women aged 29–36 years who birthed a premature infant of less than 32 weeks gestation within the previous 6 months at the time of recruitment. The setting was in rural areas of Australia, in the states of Victoria, New South Wales, Queensland and Western Australia. Methods: Semi-structured interviews using video-conferencing explored the experiences of the women and were analysed using thematic analysis. Results: Four key themes were identified from the data: emotional trauma, social displacement, external coping resources and craving continuity of care. Social displacement further impacted the emotional trauma already experienced by women who birthed a preterm infant by temporarily relocating to the city to be near to their infant in the neonatal intensive care unit. This led to the utilisation of additional socioeconomic resources including support from extended family and rural community members. The women highly valued yet struggled to find appropriate peer support and continuity of health care for their infant within their rural community after discharge from the neonatal intensive care unit. Conclusion: Health professionals have an opportunity to explore ways to address social displacement, particularly in relation to socioeconomic support and the involvement of extended family into a family integrated care framework within the neonatal intensive care unit. The long-term effects of this on the mother– infant dyad and the lack of appropriate community support also require further examination © 2023, Rural and Remote Health.All Rights Reserved.
The experience of women from rural Australia with a preterm infant in a neonatal intensive care unit
- Authors: Laidlaw, Kerrie , Prichard, Ivanka , Sweet, Linda
- Date: 2023
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 23, no. 1 (2023), p.
- Full Text:
- Reviewed:
- Description: Introduction: This study aimed to understand the experiences of women from rural areas who have had a preterm infant admitted to a neonatal intensive care unit. The study population comprised five women aged 29–36 years who birthed a premature infant of less than 32 weeks gestation within the previous 6 months at the time of recruitment. The setting was in rural areas of Australia, in the states of Victoria, New South Wales, Queensland and Western Australia. Methods: Semi-structured interviews using video-conferencing explored the experiences of the women and were analysed using thematic analysis. Results: Four key themes were identified from the data: emotional trauma, social displacement, external coping resources and craving continuity of care. Social displacement further impacted the emotional trauma already experienced by women who birthed a preterm infant by temporarily relocating to the city to be near to their infant in the neonatal intensive care unit. This led to the utilisation of additional socioeconomic resources including support from extended family and rural community members. The women highly valued yet struggled to find appropriate peer support and continuity of health care for their infant within their rural community after discharge from the neonatal intensive care unit. Conclusion: Health professionals have an opportunity to explore ways to address social displacement, particularly in relation to socioeconomic support and the involvement of extended family into a family integrated care framework within the neonatal intensive care unit. The long-term effects of this on the mother– infant dyad and the lack of appropriate community support also require further examination © 2023, Rural and Remote Health.All Rights Reserved.
The pharmacy community apgar questionnaire : a modified Delphi technique to develop a rural pharmacist recruitment and retention tool
- Terry, Daniel, Peck, Blake, Hills, Danny, Bishop, Jaclyn, Kirschbaum, Mark, Obamiro, Kehinde, Phan, Hoang, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2022
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 22, no. 4 (2022), p. 7347
- Full Text:
- Reviewed:
- Description: INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.
- Authors: Terry, Daniel , Peck, Blake , Hills, Danny , Bishop, Jaclyn , Kirschbaum, Mark , Obamiro, Kehinde , Phan, Hoang , Baker, Ed , Schmitz, David
- Date: 2022
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 22, no. 4 (2022), p. 7347
- Full Text:
- Reviewed:
- Description: INTRODUCTION: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ). METHODS: A modified Delphi technique was employed to develop the PharmCAQ. A panel of experts were purposively selected. Eight representatives were from organisations with rural experience relevant to the study including the Society of Hospital Pharmacists of Australia, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Pharmacy Board of Australia, and a representative of a government health agency, who also leads a hospital pharmacy. Three additional participants included local and international academics with health policy and rural health workforce expertise. All participants participated in three separate focus groups of 45-60 minutes duration, where the review and refinement of factors that drive recruitment and retention of pharmacist were discussed. Face and content validity was achieved through the representatives, while internal consistency was achieved when the tool was piloted among 10 rural pharmacists in rural Victoria. RESULTS: Fifty key factors that impact the recruitment and retention of pharmacists were identified, developed and succinctly described. All factors were grouped into five classifications: (1) geographic, (2) economic and resources, (3) practice and scope of practice, (4) practice environment and (5) community practice support. After final consensus, the factors and their definitions formed the final questionnaire. Lastly, the reliability of PharmCAQ was determined, with a Cronbach's alpha coefficient of 0.852. CONCLUSION: While the development and use of the Apgar questionnaire for the recruitment and retention of health professionals is not a novel idea, seeking to specifically focus on pharmacists is unique. However, 10 factors were similar to factors associated with rural recruitment and retention of both physicians and nurses; they encompassed geographic, community support, and economic and resource factors. Regardless of similarities or differences between health professions in terms of recruitment and retention, as a mechanism for addressing the worsening health professional shortage currently experienced in rural areas, the PharmCAQ was developed to support the recruitment and retention of the pharmacist workforce in rural areas.
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