Program
A PDF version of the program is now available here:
Keynote speakers
Lara Fuller
Associate Professor Lara Fuller, MBBS (Hons), FRACGP, GCME, AMusA, is Director of Rural Medical Education and the Rural Community Clinical School at Deakin University, Victoria. As an academic general practitioner, her teaching and research interests are in curriculum design for rural medical education, learning in longitudinal integrated clerkships, rural clinical training pathways and rural workforce outcomes. She is an active member of the Federation of Rural Australian Medical Educators (AusFRAME) and the International Consortium of Longitudinal Integrated Clerkships (CLIC).
Portland District Health services a community of almost 20,000 people. Compared to the rest of Victoria, Portland has greater socioeconomic disadvantage, a higher proportion of people of Indigenous status, and higher rates of hypertension, smoking, alcohol consumption, obesity and psychological distress.
The hospital has 69 registered inpatient beds with a 24-hour, seven-days-a-week Urgent Care Centre (UCC). The UCC is deemed one of the busiest in Victoria, per population.
On 14 June 2018, Professor Paul Worley, the then National Rural Health Commissioner, visited Portland. Portland’s shortage of general practitioners (now critical) was a familiar issue confronting him.
As a result of this visit, Portland decided to ‘grow its own’ rural workforce using the already existing infrastructure, beginning with longitudinal medical student training and ending with advanced skills training posts, eventually producing rural generalist general practitioners to meet the needs of the community.
With the hospital adversely affected, with limited access to International Medical Graduate Hospital Medical Officers due to the COVID-19 pandemic, the timing was opportune.
The outcome of this process is an innovative and collaborative rural generalist pathway with the achieved steps as follows:
- Novel longitudinal internship program. In 2021, interns commenced working for six months in ‘medicine’ and six months in ‘surgery’, but each week begins with a day in the UCC and finishes with a day in general practice. The intern may see a patient in UCC with a FACEM on Monday, follow up care in the general ward Tuesday to Thursday with a physician or surgeon and review or admit patients in general practice with their GP supervisor on Friday.
- PMCV accreditation for a Rural Generalist Year 2 stream. The program comprises a six-month blended community paediatric and obstetric experience, with placements within the hospital, general practice and Aboriginal Medical Service, followed by six months in UCC with support to enrol in ACEM Emergency Certificate and Anaesthetic experience in a JCCA-approved training position.
- Advanced skills training posts in anaesthetics and paediatrics accredited and in emergency currently under development. Partnerships established with Barwon Health and Western Health and South West Healthcare.
- The development of posts that facilitate rural generalist consolidation for each of the above disciplines
The significant beneficiaries of this integrated approach to rural generalist pathways will be the Portland community.
Margaret Garde
In 1985 Margaret Garde arrived in Portland, Victoria, to join her partner, now husband. Being the only female GP, and the youngest by at least 10 years, brought with it a sense of professional isolation.
The disciplines in which she worked included family planning, occupational health, Aboriginal health, public health, forensic medicine, adolescent health and mental health. Now she has a strong interest in teaching and supporting students and doctors who wish to live and work in a rural location, with a strong emphasis on giving them the preparation they need to feel confident and secure.
Thus followed the hosting of a string of medical students, John Flynn Scholars, and cousins, children of friends or anyone else who was remotely interested in medicine as a career.
As is now well recognised, none of these wonderful people returned to Portland to work.
In 2012 the opportunity to work in Portland’s GP SuperClinic presented and, together with this, the ability to host Deakin University students from a rural background who reside in Portland for their 12-month placement.
This, together with a visit from Paul Worley, the then National Rural Health Commissioner, provided the inspiration for our longitudinal rural vocational experience.
Portland District Health services a community of almost 20,000 people. Compared to the rest of Victoria, Portland has greater socioeconomic disadvantage, a higher proportion of people of Indigenous status, and higher rates of hypertension, smoking, alcohol consumption, obesity and psychological distress.
The hospital has 69 registered inpatient beds with a 24-hour, seven-days-a-week Urgent Care Centre (UCC). The UCC is deemed one of the busiest in Victoria, per population.
On 14 June 2018, Professor Paul Worley, the then National Rural Health Commissioner, visited Portland. Portland’s shortage of general practitioners (now critical) was a familiar issue confronting him.
As a result of this visit, Portland decided to ‘grow its own’ rural workforce using the already existing infrastructure, beginning with longitudinal medical student training and ending with advanced skills training posts, eventually producing rural generalist general practitioners to meet the needs of the community.
With the hospital adversely affected, with limited access to International Medical Graduate Hospital Medical Officers due to the COVID-19 pandemic, the timing was opportune.
The outcome of this process is an innovative and collaborative rural generalist pathway with the achieved steps as follows:
- Novel longitudinal internship program. In 2021, interns commenced working for six months in ‘medicine’ and six months in ‘surgery’, but each week begins with a day in the UCC and finishes with a day in general practice. The intern may see a patient in UCC with a FACEM on Monday, follow up care in the general ward Tuesday to Thursday with a physician or surgeon and review or admit patients in general practice with their GP supervisor on Friday.
- PMCV accreditation for a Rural Generalist Year 2 stream. The program comprises a six-month blended community paediatric and obstetric experience, with placements within the hospital, general practice and Aboriginal Medical Service, followed by six months in UCC with support to enrol in ACEM Emergency Certificate and Anaesthetic experience in a JCCA-approved training position.
- Advanced skills training posts in anaesthetics and paediatrics accredited and in emergency currently under development. Partnerships established with Barwon Health and Western Health and South West Healthcare.
- The development of posts that facilitate rural generalist consolidation for each of the above disciplines
The significant beneficiaries of this integrated approach to rural generalist pathways will be the Portland community.
Christine Giles
Chris Giles is a senior executive with considerable experience leading and managing regional, rural and remote health services.
Chris has a strong clinical background as a nurse then midwife, which has proven very valuable in her recent executive roles. These executive roles include working in healthcare organisations in Western Australia, Victoria and Queensland.
Most recently, Chris has worked as the Chief Executive Officer of Portland District Health in south-west Victoria. Prior to this she spent three years living in the Torres Strait, working as a District CEO for Queensland Health.
Chris has a passion for finding solutions to wicked problems, often challenging the normal by finding innovative solutions to improve health service access and quality for rural and remote communities. Some of these solutions include extending scope of practice for clinicians, training cohorts of nurse practitioners and using technology such videoconferencing and electronic health records to overcome distance.
As a sideline, Chris is on the Board of the local catchment management authority, keen to ensure land and water resources are managed to ensure future generations can enjoy them as we do.
Portland District Health services a community of almost 20,000 people. Compared to the rest of Victoria, Portland has greater socioeconomic disadvantage, a higher proportion of people of Indigenous status, and higher rates of hypertension, smoking, alcohol consumption, obesity and psychological distress.
The hospital has 69 registered inpatient beds with a 24-hour, seven-days-a-week Urgent Care Centre (UCC). The UCC is deemed one of the busiest in Victoria, per population.
On 14 June 2018, Professor Paul Worley, the then National Rural Health Commissioner, visited Portland. Portland’s shortage of general practitioners (now critical) was a familiar issue confronting him.
As a result of this visit, Portland decided to ‘grow its own’ rural workforce using the already existing infrastructure, beginning with longitudinal medical student training and ending with advanced skills training posts, eventually producing rural generalist general practitioners to meet the needs of the community.
With the hospital adversely affected, with limited access to International Medical Graduate Hospital Medical Officers due to the COVID-19 pandemic, the timing was opportune.
The outcome of this process is an innovative and collaborative rural generalist pathway with the achieved steps as follows:
- Novel longitudinal internship program. In 2021, interns commenced working for six months in ‘medicine’ and six months in ‘surgery’, but each week begins with a day in the UCC and finishes with a day in general practice. The intern may see a patient in UCC with a FACEM on Monday, follow up care in the general ward Tuesday to Thursday with a physician or surgeon and review or admit patients in general practice with their GP supervisor on Friday.
- PMCV accreditation for a Rural Generalist Year 2 stream. The program comprises a six-month blended community paediatric and obstetric experience, with placements within the hospital, general practice and Aboriginal Medical Service, followed by six months in UCC with support to enrol in ACEM Emergency Certificate and Anaesthetic experience in a JCCA-approved training position.
- Advanced skills training posts in anaesthetics and paediatrics accredited and in emergency currently under development. Partnerships established with Barwon Health and Western Health and South West Healthcare.
- The development of posts that facilitate rural generalist consolidation for each of the above disciplines
The significant beneficiaries of this integrated approach to rural generalist pathways will be the Portland community.
Stan Grant
Stan Grant is the International Affairs Editor for the Australian Broadcasting Corporation (ABC), a multi-award-winning current affairs host, an author and an adventurer.
Well known for having brought the former Prime Minister Malcolm Turnbull to tears when interviewed about Indigenous affairs on The Point, Stan’s keynotes are insightful, engaging, always professional and, at times, controversial.
Stan’s Aboriginal heritage has shaped his dynamic, resilient personality. Born in Griffith in south-west New South Wales (NSW) in 1963, Stan Grant’s mother is from the Kamilaroi people and his father is of the Wiradjuri.
Stan spent most of his childhood on the road living in small towns and Aboriginal communities across outback NSW. His father was an itinerant saw-miller who worked when and where he could. Stan moved so often he attended 12 different schools before he was in his teens.
The early travelling gave Stan a love of adventure and stories. He grew up listening to the tales of his grandfather and uncles and aunts. Despite poverty and an early sporadic education, the security of his family and the larger Aboriginal community gave him a strong platform for life.
After attending university, Stan won a cadetship with the Macquarie Radio Network, launching a career in journalism that has spanned more than 30 years and more than 70 countries. In that time Stan has travelled the world covering the major stories of our time from the release of Nelson Mandela, the troubles in Northern Ireland, the death of Princess Diana, war in Iraq, the second Palestinian intifada, the war on terror, the South Asia tsunami, the Pakistan earthquake and the rise of China.
Stan has hosted major news and current affairs programs on Australian commercial and public television. He has been a political correspondent for the ABC, a Europe correspondent for the Seven Network based in London and a senior international correspondent for the international broadcaster CNN based in Hong Kong and Beijing.
Returning to Australia in 2013, Stan continued to cover international events for Sky News Australia and reignited his passion for telling the stories of his own Indigenous people. He has worked as the Indigenous editor for The Guardian Australia, managing editor for National Indigenous Television and international editor for Sky News. In 2016 Stan was appointed as special adviser to the then Prime Minister Malcolm Turnbull on Indigenous constitutional recognition.
Stan has won many major awards including an Australian TV Logie, a Columbia University Du-Pont Award (the broadcast equivalent of the Pulitzer Prize) and the prestigious United States Peabody Award. He is a four-time winner of the highly prized Asia TV Awards including reporter of the year.
Stan has written The Tears of Strangers and Talking To My Country (Harper Collins), and has published numerous articles and opinion pieces for The Sydney Morning Herald and The Australian.
Stan Grant is passionate about justice and humanity. His years of international reporting have given him a deep understanding of how the world works. He is deeply immersed in the politics and history of Asia and the Middle East. He can link the importance of leadership and the impact of history and, above all, believes in the power and resilience of people.
Stan is married to ABC Sports broadcaster, Tracey Holmes, and has four children. He lives in Sydney.
Booked through: Celebrity Speakers www.celebrityspeakers.com.au
Mark Howden
Professor Mark Howden is Director of the Institute for Climate, Energy and Disaster Solutions at The Australian National University.
He is also an Honorary Professor at Melbourne University, a Vice Chair of the Intergovernmental Panel on Climate Change (IPCC) and the Chair of the ACT Climate Change Council. He was on the US Federal Advisory Committee for the Third National Climate Assessment, was a member of the Australian National Climate Science Advisory Committee and contributes to several major national and international science and policy advisory bodies.
Mark has worked on climate variability, climate change, innovation and adoption issues for over 30 years, in partnership with many industry, community and policy groups via both research and science-policy roles. Issues he has addressed include agriculture and food security, the natural resource base, ecosystems and biodiversity, energy, water and urban systems.
Mark has over 420 publications of different types. He helped develop both the national and international greenhouse gas inventories that are a fundamental part of the Paris Agreement and has assessed sustainable ways to reduce emissions. He has been a major contributor to the IPCC since 1991, with roles in the Second, Third, Fourth, Fifth and now Sixth Assessment Reports, sharing the 2007 Nobel Peace Prize with other IPCC participants and Al Gore.
Gabrielle O'Kane
Gabrielle O’Kane is Chief Executive Officer of the National Rural Health Alliance, the peak body for rural health in Australia. She is an Adjunct Associate Professor with the University of Canberra and Charles Sturt University. Gabrielle has extensive experience in the private and public health sector, which has contributed to her deep understanding of the need for collaborative partnerships to support the rural health workforce and achieve positive health outcomes for rural communities. She promotes solutions to the Australian Government to address the needs of rural communities and health professionals, through her position on many pertinent steering groups and committees.
Roland Sapsford
The Climate and Health Alliance’s new Chief Executive Officer, Roland Sapsford, has been working to respond to the challenge of climate change and the task of reducing emissions through public policy and activism for much of his professional life.
This work has ranged from being involved in New Zealand’s first study of the impacts of carbon taxes and work on energy efficiency and home insulation policy, through to getting solar panels installed on a local community centre and campaigning against major road projects.
Roland once completed four years of a medical degree and was a senior manager in public health for five years. He has also studied economics and systems ecology to postgraduate level, and has a strong commitment to Indigenous rights.
Rabia Siddique
Rabia Siddique is a history-making humanitarian, best-selling author and multi-award-winning international keynote speaker. She is a sought after transformational coach and mentor and speaks English, French, Spanish and Arabic.
Current work
Rabia’s powerful and engaging presentations on leadership, resilience, equality and diversity draw on her personal story of strength, courage and forgiveness, in addition to her legal, military and psychology training. Surviving a hostage crisis in Iraq, Rabia garnered global attention for making the British military accountable for silencing her about her ordeal and role as a military lawyer in releasing captured Special Forces soldiers. Standing up for justice in the face of public ridicule, Rabia’s brave action in suing the British Government for sexism and racism became a catalyst for policy change to ensure a fairer workplace for women and cultural minorities in the British military.
Rabia is an expert commentator, regularly appearing in newspapers and magazines, and on television, radio and online media in Australia and around the globe, including The Guardian, 60 Minutes and ABC television.
With her best-selling memoir Equal Justice also the focus of a feature film, she is now writing her second book.
Rabia is an Ambassador for 100 Women, Angelhands, Esther Foundation, Inner Ninja (mental health support) and Ishar (multicultural health service). She is a Board Member of the International Foundation of Non-Violence, Museum of Freedom and Tolerance, Wesley College and Calan Williams Racing.
Previous experience
Law: Rabia’s extensive career as a criminal, terrorism, war crimes and human rights lawyer has taken her to Europe, the Middle East, South America, South East Asia and Australia.
Military: Her military career includes serving as a British Army officer in England, Northern Ireland and the Middle East. Rabia was one of England’s first Armed Forces Employment Law Officers – a role which took her to Royal Military Academy Sandhurst where she ran equality and diversity training. Among her charges was Prince William, the Duke of Cambridge.
Keith Suter
Dr Keith Suter is considered one of Australia’s most influential global futurists and media commentators in national and foreign affairs. He has also held many strategic leadership roles. Dr Suter is an experienced, professional and awarded presenter renowned for explaining complex global and business issues in a way his audiences can digest and understand. He is in demand as an MC and conference facilitator. Keith’s tailored keynotes, workshops and facilitated sessions are entertaining, highly compelling and always captivating.
In 2019 Keith was proudly appointed as a Member (AM) of the Order of Australia (General Division), for significant service to international relations and to the Uniting Church in Australia.
Previous experience
Academic expert: Dr Keith Suter has achieved three doctorates. The first of these was about the international law of guerrilla warfare (University of Sydney), the second about the social and economic consequences of the arms race (Deakin University) and a third doctorate on scenario planning (University of Sydney).
Leadership roles: He has been appointed to many prestigious roles throughout his career, including Chairperson of the International Commission of Jurists (NSW), Director of Studies at the International Law Association (Australian Branch) and Managing Director of the Global Directions think tank. After 25 years, Keith recently retired from the role of Chairperson of the International Humanitarian Law Committee of the Australian Red Cross (NSW).
Global recognition: He has also been a member of the prestigious Club of Rome since 1993. The Club is ‘an informal association of independent leading personalities from politics, business and science, men and women who are long-term thinkers interested in contributing in a systemic, interdisciplinary and holistic manner to a better world. The Club of Rome members share a common concern for the future of humanity and the planet.’ The club has only 100 members, with Mikhail Gorbachev among them.
Keith is a Life Member of the United Nations Association of Australia in recognition of his service. At various times from 1978 to 1999, he served as the National President of the organisation and took on the roles of WA and NSW State President.
Strategic roles: Keith was the President of the Centre for Peace and Conflict Studies (1991–98) at the University of Sydney, and was a consultant on social policy with the Wesley Mission for 17 years. In addition, he served as a consultant for a number of other organisations with a focus on local and international issues. He is also an active member of the Australian Institute of Company Directors.
Media roles: He frequently appears on radio and television discussing politics and international affairs. He has been, for many years, the foreign affairs editor on Channel 7’s Sunrise program.
Renowned author: Among Keith’s many books are All about Terrorism: Everything you were afraid to ask, as well as Global Order and Global Disorder: Globalization and the Nation-State and 50 Things You Want to Know About World Issues … But Were Too Afraid to Ask.
Susan Wearne
Susan Wearne is a general practitioner (GP) and senior adviser to the Australian Government Department of Health and Aged Care regarding rural health and health professional education. She trained at Southampton University in England and completed general practice training in Northamptonshire and back home in Cheshire. She owned a practice in York, England, and worked at the Aboriginal Medical Service in Alice Springs and for the Royal Flying Doctor Service at Ayers Rock Medical Centre. She has extra qualifications in child health, women’s health, family planning, primary health care and medical education and now works as a GP in Canberra.
Susan is a Clinical Associate Professor at Australian National University and has published over 40 peer-reviewed articles on general practice and medical education. The fourth edition of her textbook Clinical Cases for General Practice Exams was published in 2019. She held educational leadership positions in the Northern Territory before taking on national roles for the Royal Australian College of General Practitioners and General Practice Education and Training. She works in the Health Workforce Division which manages general practice training and other programs that promote Australians’ access to qualified health professionals. She was medical lead for the soon to be released Australian National Medical Workforce Strategy.
Susan’s husband, Tim Henderson, is the eye surgeon at Alice Springs Hospital. Their daughter and her family live in England and their son works in Adelaide. Between flights home to Alice, Susan swims, makes clothes and enjoys the scenery on the lake as she learns to row.
Justin Yeung
Justin is a consultant emergency physician by training. He has had a number of leadership positions in WA Health – director roles in emergency medicine (Royal Perth Hospital, Albany Health Campus and WA Country Health Service) and medical services (Great Southern region of Western Australia). He is currently Medical Director of the WA Country Health Service Command Centre, which incorporates a number of 24/7 clinical streams in acute telehealth – emergency, inpatient medicine, mental health, obstetrics and midwifery, palliative care and acute patient transfer coordination. Justin splits his time between Perth and Albany, and still maintains clinical exposure working in the Emergency Telehealth Service and locums in regional Western Australia. To add some spice to the year, Justin has started postgraduate studies in health care leadership. He’s also an oft-stung beekeeper.
From humble beginnings as a limited-hours, weekend-only, single-doctor emergency consultation service for a handful of small country hospitals in Western Australia (WA), the WA Country Health Service Command Centre is approaching a 10-year milestone of providing specialist-led clinical consultation directly to rural patients using video-enabled technology. The Emergency Telehealth Service (ETS) has grown into a 24/7 virtual emergency department, managing more than 27,000 consultations in 2021. The range of clinical services available to support our regional clinicians using telehealth has expanded to include inpatient care (2018) and mental health (2019), obstetric and midwifery, palliative care and, most recently, transfer coordination (all commenced in 2022). We will present an overview of our 10-year journey, highlight areas of innovation and success, as well as outline challenges we have and continue to face.
Plenary sessions
Opening Session:
Julieanne Gilbert MP
Assistant Minister for Health and Regional Health Infrastructure, Queensland – Welcome to Brisbane
Emma McBride MP
Federal Member for Dobell, Assistant Minister for Rural and Regional Health
Plenary Session 1:
Russell Roberts
Australian Journal of Rural Health
Editor in Chief 2017–21 – AJRH 30 Years
Jason Waterford
HESTA Australia Ltd
Plenary Session 4:
Helen Haines MP
Independent Federal Member for Indi
Closing remarks:
Stephen Gourley
Deputy Chair, National Rural Health Alliance
Concurrent presenters
Konrad Kangru
Dr Konrad Kangru, BAppSc MBBS FRACGP, gained his MBBS from the University of Queensland in 2000. He has been in private rural general practice in the Whitsundays region of Queensland since 2005, where he has been a GP supervisor and medical educator since 2009. He has remained a very active advocate for improving the support of rural doctors, currently as Co-Chair of the Statewide Rural and Remote Clinical Network and also having served as President and prior Conference Convenor of the Rural Doctors Association of Queensland. Dr Kangru has also undertaken and presented his research on the self-care of rural doctors and has special interests in medical education and diabetes management, particularly in upskilling colleagues about this important condition.
Boosting access to national GP care with RACGP's Practice to Practice pilot
We know that rural Australia faces serious general practitioner (GP) workforce shortages.
At the same time, there are GPs who would like to support rural locations more – be it through regular rural placements or telehealth support – but do not feel they have the connections or confidence to do so.
To help bridge this gap, the Royal Australian College of General Practitioners launched an innovative pilot program with the aim to connect practices and GPs in diverse geographical areas to help grow locum pools, increase peer support, enhance professional development and provide a greater service offering for patients.
In doing so, the Practice to Practice pilot program helps improve access and quality of care for patients, particularly those in rural and remote communities.
Urban and regional practices and GPs will match with their counterparts in rural and remote Australia to share skills and support, and maximise quality services for patients across the country.
The Practice to Practice pilot program also exposes GPs to the challenges and benefits of living in a different area. This is significant because the research has shown that GPs who gain exposure to work and life in a rural community are more likely to choose to go rural permanently.
This session will provide an overview of the pilot and share case studies on how practices and individuals across Australia are sharing skills and support and maximising quality services for patients.
Learning outcomes:
- Describe the Practice to Practice pilot program and its purpose.
- Identify situations for general practices or GPs to get involved and highlight the benefits.
- Explain how the program can help improve access to high-quality general practice care nationwide.
Future-proofing our rural and remote medical workforce in Queensland
The COVID-19 pandemic has brought into sharper focus many of the challenges that rural and remote communities face in the delivery of health services. The pandemic has disrupted medical workforce supply chains by restricting the immigration of international medical graduates and the movement of locums across state borders, and exacerbated an underlying tension in the sustainable supply of medical relief in both the private and public sectors and primary and secondary services.
The future-proofing our rural and remote medical workforce project was initiated as a response, by the Office of Rural and Remote Health (ORRH) in early January 2021, to an identified need to address the progressive decline of effective primary health care, largely based on traditional models of general practice, in rural and remote Queensland. The project commenced with a stakeholder roundtable, the establishment of a cross-sector reference group with key stakeholder organisations including the National Rural Health Commissioner, three focus groups and individual meetings with, for example, the Australian Government Department of Health, in order that issues were clarified and recommendations tested.
In June 2021, six key areas with accompanying recommendations were approved for release by the Director General. Queensland Health, and presented at the Rural Doctors Association of Queensland annual conference by the project’s medical advisers, Dr Ewen McPhee and Dr Konrad Kangru. The ORRH commenced implementing these recommendations with the medical advisers in August 2021.
This conference provides an opportunity to present to the participants an update on the implementation of these recommendations, with any early outcomes that show an improvement in supply of medical workforce to rural and remote Queensland.
Linda Kar
Linda Kar worked as a dietitian in community and private practice settings for many years. She then worked as a home-visit care coordinator for the Hospital Admission Risk Program. Linda is currently Coordinator of the Barwon Health Social Supports Program, managing three sites across the Geelong region. The program supports vulnerable aged and special needs clients to connect and socialise, and remain active in their community.
Connecting vulnerable people in our community during COVID-19 lockdowns
The purpose of a social supports program is to engage people in meaningful group social activities which draw on personal strengths, build capacity, encourage independence and involve them in their community. During each COVID-19 lockdown, the participants do not attend the centre and most are home alone. As a result, the service delivery was modified to keep participants connected and engaged with each other and their community.
The team adapted to work in innovative ways to support those most vulnerable and isolated. Staff initiated a community knitting project. The goal was to work together on a common cause that connected people during lockdown. The program worked in collaboration with various local businesses, which provided donations for the knitting project. Geelong Mums, a local charity that supports mothers in need, identified a lack of cot and pram blankets for the winter months.
Staff delivered instructions, wool and knitting needles to each person’s home. Participants worked from home knitting individual squares. As each square was completed they were collected and delivered to another participant, who sewed them together to form each blanket. Local kindergarten children enjoyed sorting the wool and knitted squares into colour piles. For the final part, a Barwon Health volunteer crocheted the edges on some of the blankets.
The ‘knit for a cause’ group project has produced eight beautiful, brightly coloured and unique blankets that were donated to the families supported by Geelong Mums.
One participant commented that ‘because of lockdown, it was something to keep our minds and fingers working. I love craft work, so knitting those squares was a pleasure.’
Another said ‘the blankets are so individual and colourful that they would brighten up any room and be a great comfort. If I was a mum handed one of them, I’d be thrilled to bits.’
The adaptability and resilience of the participants during the challenging times of isolation has been an inspiration. The staff enjoy when the program can reopen and welcome back the participants to socialise, share a meal and enjoy outings in their community.
Letecia Kearney
Letecia Kearney is a registered nurse from Armidale, New South Wales. Letecia has worked extensively within the health industry over a period of 30 years. She has worked in cardiac units and been heavily involved in patient care from diagnosis through to recovery and rehabilitation.
Delivering health messages in small communities: thinking creatively and locally
Each year, four primary healthcare nurses deliver health promotion activities to small towns and villages in an area spanning fourteen local government areas, and covering over 99,100 square kilometres. These small communities face numerous barriers to accessing health services and information – including isolation, lack of transport, poor internet access, higher than state and national levels of chronic disease, and low health literacy. Added to these challenges are those of recent drought, bushfires, mouse plague and the uncertainty of the COVID-19 pandemic. This program relies on the support and funding of our local primary health network.
In 2020–21, 1,545 people attended 215 health promotion activities in 59 towns and, of those, 176 identified as Aboriginal and/or Torres Strait Islander. These events lead to increased general practitioner (GP) appointments, increased health screening and improved access to services. We rely on meaningful community engagement and collaboration to deliver quality events.
Through trial and error, we have developed successful strategies and learnt the pitfalls in running community health promotion events. We use a variety of creative approaches to deliver important health messages.
We recently coordinated 14 comedy shows in 14 bushfire-affected communities – empowering communities to remain connected and to enjoy a laugh and meal. These events include important health messages and the opportunity to chat informally to trained staff. Communities talk about these events for months, and the feedback is positive.
On World Kidney Day in 2019, in a small community of a few hundred people, 62 rural women gathered to hear talks on the importance of screening for kidney disease. Forty health checks were completed and many women subsequently made appointments with their GPs to discuss their results. We also discussed cancer screening and the various financial supports available to rural people.
Feedback from a local GP, following a men’s night in a small community, confirmed GP appointments increased by over 30 per cent following our event.
We also deliver health activities in small rural schools, recognising that health messages, including oral health, are important for all age groups. Other topics we deliver include bush kids’ first aid, farm safety and cooking. Some of these schools have only a handful of children.
This unique program is delivered by local nurses and their partners, who are passionate about the health of their small rural communities. Through health promotion activities, important health messages reach rural people and are delivered in a way that is meaningful and responsive to community needs.
Heather Keighley
Heather is a passionate rural and remote registered nurse and midwife with extensive experience in a range of clinical and executive roles across the Northern Territory health sector. Heather is currently employed as a Senior Policy Advisor for CRANAplus and as a Research Fellow with Flinders University working on the Remote Primary Health Care Manuals project. She is a member of the National Rural Health Alliance Board and Council, and was recently appointed as a Board Director for the Australian College of Nursing.
Rural and remote nursing and midwifery webinar project
Background: Poor health outcomes continue to exist for people living in rural and remote Australia and are influenced by shortages of nurses and midwives in these communities. Many nurses and midwives who have worked in rural and remote areas have significantly enjoyed their work and benefited personally and professionally from those roles. However, these stories and their voices are frequently not heard. Webinars have been used with some success to educate student nurses about cultural issues and is more recently becoming a preferred format for academic and professional discussion and exploration.
Methods: A series of webinars have been created based on a structure of interviewing a panel of rural and remote area nurses and midwives to showcase their stories for live participation through professional and academic networks across Australia, and for later distribution as a recording, aiming to encourage others to work in rural and remote areas. Each panel is to provide insight from a variety of participants ranging from early career nurses and midwives to educators and managers. The interviewer for each webinar was selected based on a similar background of positive working experiences in rural and remote nursing. Social cognitive career theory and appreciative inquiry informed the questions being asked. Each webinar addressed specific issues unique to rural and remote nursing and midwifery.
Results: Webinars have been professionally created with technical support and a group of rural and remote nurses and midwives with insight into issues and requirements of these communities and their workforce needs. Webinars will be conducted monthly from July to November 2021.
Conclusion: Feedback will be obtained after each webinar from participants and viewers of the webinar and analysed for impact.
Rural, regional and remote women and girls: climate change and health impacts
Climate change is affecting the health and wellbeing of every human around the world, but its impacts are not the same for everyone; they are highly gendered, and women and girls in rural and remote Australia are especially at risk. Worldwide, more women die or are injured in extreme weather events compared to men, are more likely to die in heatwaves, have poorer mental health, suffer partner violence, experience food insecurity, and have poor reproductive and maternal health outcomes that have far-reaching impacts for future generations. These impacts are additional burdens to the health inequalities rural women and girls already experience.
Emerging research also shows that climate change reinforces and magnifies existing gender inequalities and threatens to widen gender-based health disparities. At its heart, climate change is an intergenerational and intragenerational social and environmental equity issue. Women often face systemic barriers that can limit their ability to effectively prepare for and respond to climate impacts, lower participation in STEM education and jobs, and the lack of voice in policy decision-making, particularly when it comes to climate change. Despite the differences in social and health impacts of climate change on women and girls, many areas of policy and practice are rarely gender sensitive. Therefore, the potential impacts of climate change on rural and remote women and girls remain invisible.
Women and girls have a critical role to play in leading climate change action and act as agents of social change to improve mitigation and adaptation interventions. Drawing on national and international research, this presentation outlines the health impacts of climate change on rural and remote women and girls; explores best-practice examples of how rural women are working together to bridge the social distance that attitudes to climate change can create; and provides a set a of policy action areas to address the uneven impacts of climate change on women and girls in rural and remote Australia, to increase women’s empowerment and resilience to climate change impacts and place women at the centre of climate health decision-making solutions in Australia.
Alison Kennedy
Dr Alison Kennedy is a Behavioural Scientist who has lived and worked in Victoria’s rural farming community for the past 17 years. Her role at the National Centre for Farmer Health (NCFH) since 2010 has primarily focused on rural/farmer mental health and suicide prevention using a range of innovative techniques including digital interventions, digital storytelling, community education programs and peer-support models. She is passionate about co-designing the Centre’s research, education and services in collaboration with community and industry – to ensure the work of the NCFH continues to be effective, relevant and tailored to the needs of rural farming communities.
Primary Producer Knowledge Network: translating research into practice to support mental health
Primary producers (including farmers and fishers) are a vulnerable workforce whose industries are undergoing significant transition due to an ageing and decreasing workforce, rapidly increasing technological demands, exposure to global markets, climate change and increasing uncertainty. Primary producers face a number of specifically work-related mental health challenges and are at increased risk of mental injury, including distress and suicide.
This presentation describes an innovative project co-designed with Victorian farmers, fishers and industry partners, academics and health practitioners that draws on research evidence from multiple areas including:
- mental health risks for primary producers
- co-design strategies for working with vulnerable individuals
- work-related risks to mental health.
The primary prevention focus of the Primary Producer Knowledge Network is tailored to reflect the needs of a range of industry groups (such as fishing, dairy farming, cropping, livestock farming) and a range of age cohorts and technology literacy across Victoria. The holistic primary prevention approach addresses workplace-related risk factors that can positively or negatively impact primary producers’ physical and mental health, wellbeing and safety. The risk factors include:
- high work demand
- low levels of control
- poor workplace support
- poor organisational change management
- poor organisational justice
- low role clarity
- role conflict
- poor workplace relationships
- poor environmental conditions.
Through the development and evaluation of a chat-based interactive web platform, social media communications and targeted messaging through blogs, podcasts and in-person training. A wide range of topics have been addressed to date, with efforts made to extend producers’ thinking from supporting people experiencing poor mental health to actively preventing risk through changing the design and management of work systems. Solution-focused topics developed with input from subject experts and primary producers include:
- succession planning
- communication
- family business structures
- financial planning
- new to farming
- safety planning
- next generation issues
- aging on the farm
- farmer health
- zoonotic diseases
- environmental sustainability
- managing fatigue.
The main areas of focus during the conference presentation will include analysis of the delivery and evaluation of an entirely online co-design process (during 2020–21 COVID-19 restrictions) and the design, piloting, operation, development and evaluation of an interactive digital platform called ‘Campfire’ aimed at preventing workplace mental injury. Challenges and recommendations will be discussed for application to a range of industries and population groups (including rural and remote) where mental health and safety are of concern.
Steering Straight: co-designing a farming community self-managed resource for maintaining mental wellbeing
Although people in rural and urban Australia experience similar rates of diagnosed mental illness, a smaller proportion of rural people seek professional help to manage poor mental health. Key barriers preventing help-seeking include: (i) concerns about confidentiality and judgement, particularly within close-knit communities; (ii) a desire to self-manage mental distress; (iii) limited availability of mental health services in rural areas; and (iv) distrust of, and a perceived lack of understanding from, available mental health services.
A body of work is currently being developed to help address these barriers. One aspect of this work includes collaborating with the farming community to develop innovative, ‘farmer-friendly’ methods of improving mental health – including both preventive and support-based services and resources. As part of this broader project, this research team has taken the concept of the Safety Planning Intervention – a short document originally designed to help prevent people at risk of suicidality from future suicide attempts – and adapted it as a prevention-focused resource, to support general mental wellbeing, in all farming community members, regardless of current levels of psychological distress. ‘Steering Straight: My Plan to Keep on Track’ embraces the pragmatism often noted in farming communities, and enables individuals to identify strategies for maintaining their own wellbeing, as well as introducing wellbeing support resources tailored to farming communities.
This presentation will detail the co-design process used to develop ‘Steering Straight’, and share findings from the evaluation of a community pilot testing phase. The presentation will highlight what people from rural and farming communities find useful in mental health resources, and provide further insight into effective ways of engaging with this population on issues relating to wellbeing.
Santosh Khanal
Dr Santosh Khanal started as a clinical researcher in the United Kingdom and subsequently moved into health services and educational research and evaluation. He has published over 30 papers in international peer-reviewed journals and was the recipient of Sax Institute’s inaugural Research Actions Award for his work on New South Wales’ statewide community-based childhood obesity program. Since joining the Royal Australian and New Zealand College of Ophthalmologists (RANZCO), Santosh has been involved in identifying and implementing strategies to improve the selection process and training program including examinations. He is also actively involved in enhancing rural training and outreach opportunities for trainees.
Virtual accreditation of rural medical specialist training sites
Background: All medical specialist colleges in Australia and New Zealand have standards and policies against which they accredit sites where specialist training is delivered. Most colleges carry out periodic inspections to determine whether accreditation requirements continue to be met. The requirement for physical inspections could be a potential barrier for setting up remote and regional training posts in a timely manner because of limited travel and accommodation options. Further, inspectors in our college, most of whom are senior clinicians in public hospitals, in some instances needed to travel four days for a 3–4-hour inspection. The purpose of this study was to evaluate the suitability and acceptability of virtual training site accreditation visits.
Methods: An ethnographic study was conducted in which the investigators attended virtual accreditation visits at two sites (one each in Australia and New Zealand) as observers. These visits were conducted by accreditation teams independent of the investigators. An open-ended observation proforma was used by the investigators to independently record their observations, which were later compared and discussed until consensus was achieved. All participants completed an online survey. A document analysis of accreditation documents was also conducted. Observation data was broken down into themes and triangulated with online survey and document analysis results. Quality assurance data from a subsequent virtual accreditation visit was used to explore the usefulness of video and photographic evidence of facilities and equipment.
Results: We observed that the accreditation interviews adequately addressed all relevant issues with high levels of robustness and reliability. However, participants found it more difficult to discuss complex issues virtually compared with face-to-face. We also found that the interim and final reports from virtual accreditation would not be any different to that of a physical accreditation visit. However, a video tour of facilities during the virtual inspection did not help determine the appropriateness of facilities and clinic layout to support and facilitate trainee learning and supervision.
There were no limitations observed for the accreditation team during the interviews with senior executives to advocate for improved specialist services in disadvantaged and underserviced areas.
Quality assurance data showed that pre-recorded video and photographic evidence of facilities and equipment presented to the accreditation team during the inspection was sufficient to determine the suitability of the site as a training post.
Conclusions: Virtual accreditation of training sites in medical specialist training is viable in limited circumstances where there are no known complex training-related issues.
Tracy Kidd
Tracy Kidd is a nurse educator at Alfred Health for the Rural Urgent Care Nursing Capability Development Program (RUCN-CDP) which is a Victorian Department of Health funded education program for nurses working in Victorian Urgent Care Centres. Tracy was instrumental in shaping the program content from the initial stages and now provides educational support and workshop delivery for the program. With a background in emergency nursing and a passion for rural and regional health care, Tracy has provided nursing education in tertiary and clinical settings across the Loddon Mallee region in Victoria since 2000. She has completed a Master of Nursing Science focusing on nursing education for nurses working in rural health care and has also represented the Australian College of Nursing on the Australian Resuscitation Council since 2013.
Rural Urgent Care Nursing Capability Development Program
The Rural Urgent Care Nursing Capability Development Program (RUCN-CDP) is a multi-year, Victorian Department of Health funded project providing standardised, accessible and tailored education to ~600 nurses working in Urgent Care Centres across Victoria.
Delivering online theoretical deep-learning, face-to-face workshops and clinical placements, all supported by experienced Clinical Nurse Educators, the RUCN-CDP primary objective is to increase the confidence of nurses working in the remote and low-resource settings of an urgent care centre. Secondary, but highly impactful objectives, include strengthening the statewide emergency and urgent care system, enhancing collaboration and, of course, improving patient outcomes.
Our presentation will explore the learnings of an extensive urgent care sector consultation and demonstrate how this environmental scan and high-level learning needs analysis shaped the program design. We will share key metrics, as well as qualitative and quantitative data collected which demonstrates the ability of this program to improve the confidence of nurses working in urgent care. We will outline some of the innovative education tools utilised to reduce barriers for nurses in rural and remote Victoria to access education, and summarise the redefinition of project scope and impact of the COVID-19 pandemic which occurred within the first six months of the project timeline.
Nicole Kilby
Nicole Kilby is the Principal Policy Officer at the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP).
Nicole is a proud Wiradjuri and Ngemba woman from central-west New South Wales. She has worked in various sectors and, more recently, held roles with the Lowitja Institute, the Australian Competition and Consumer Commission and Reconciliation Australia. This has allowed her to obtain a range of knowledge and skills which she strives to continue developing and contributing towards creating positive outcomes for all Aboriginal and Torres Strait Islander peoples.
Nicole graduated from the Indigenous Australian Government Development Program (IAGDP) in 2018 and is currently finishing her Degree in Arts, majoring in Indigenous Studies. She joined NAATSIHWP in August 2021 and enjoys contributing to the dynamic work of the team, to help strengthen the Aboriginal and Torres Strait Islander Health Worker and Health Practitioner workforce and address the impacts of Aboriginal and Torres Strait Islander disadvantage.
Improving Aboriginal and Torres Strait Islander health through multidisciplinary models of care
A report released by the New South Wales Bureau of Health Information in June 2021 found that embedding Aboriginal and Torres Strait Islander Health Workers or Health Practitioners into multidisciplinary models of care directly translates into higher levels of Aboriginal and Torres Strait Islander patient satisfaction and care.
The report provides further demonstration that:
- the Aboriginal and Torres Strait Islander Health Worker and Health Practitioner workforce is integral to the delivery of culturally safe and responsive care
- implementing measures to increase and facilitate the professional deployment of the workforce across the healthcare system is key to meeting future population health needs, embedding cultural safety and facilitating improved health and wellbeing outcomes.
The findings are significant for healthcare administrators and practice managers across the healthcare system.
Yet, despite the vital role the Aboriginal and Torres Strait Islander Health Worker and Health Practitioner workforce plays it continues to be under-supported, under-recognised and under-utilised nationally. Support to strengthen professional standards, to utilise the workforce to their full potential or to embed this workforce within multidisciplinary healthcare teams is typically not provided due to the perceived cost pressures this places on already stretched health service budgets.
It is important for administrators and practice managers to understand that, contrary to these perceptions, investment in this workforce can be achieved without adding costs to their budgets, by implementing models of care that more effectively utilise the provider claims process available for these professions through the Medicare system.
Caroline Koedyk
Caroline Koedyk is a dental therapist and clinical educator at the Melbourne Dental School and also coordinates the Rural Dental Program for the school. She holds a Master of Clinical Education and is research active around oral health in rural communities, which includes experience in rural Nepal. With nearly 40 years’ clinical experience, she has now applied her passion to educating and training the next generation of oral health therapists. Her special interest is to encourage dental students to take up rural practice upon graduation.
Is clinical experience and enjoyment enough for dental students on a rural clinical placement?
Objectives: Melbourne Dental School’s (MDS) rural dental clinical placement program operates in two Victorian rural areas and offers final-year dental students an integrated program of practical clinical experience and rural lifestyle exposure. The objective of this study was to understand the students’ experiences to determine whether they increased the likelihood of them seeking rural employment after graduation.
Design: The University of Melbourne final-year dental students attended five-week mandatory rural clinical placements in 2018 and 2019. At the completion of their placements, students were invited to complete an anonymous questionnaire about their experiences, which had both quantitative and qualitative questions. This study examined the qualitative data using thematic analysis to identify common themes.
Results: Of the 129 students who completed the survey, 116 completed the open-ended questions and four themes were identified: rich clinical experience, social capital, rural life and infrastructure. High levels of satisfaction were reported across all themes.
Conclusion: This study demonstrated the rural clinical program to be a positive and enjoyable placement which increased dental students’ clinical practice experience and their interest in considering rural practice upon graduation. Exposure to rural lifestyle and supportive clinical and social relationships were shown to be important influences. The current survey can benefit from refinement and further research; following up MDS graduate workplace outcomes is recommended.
Govind Krishnamoorthy
Dr Govind Krishnamoorthy is a mid-career researcher with the Regional Australia Mental Health Research and Training Institute and a clinical psychologist and senior lecturer at the University of Southern Queensland, Australia. Dr Krishnamoorthy’s research and clinical practice focuses on improving mental health and educational outcomes for children, youth and families from priority populations. His research areas are trauma-informed education and recovery-oriented care.
Trauma-informed and culturally responsive behaviour support practices in a regional primary school for NT First Nations students
There is growing awareness of the impact of mental health, intergenerational trauma and community disadvantage on the educational achievement of Aboriginal and Torres Strait Islander (First Nations) children in Australia. The presentation will describe the preliminary results of a mixed-methods evaluation of co-designed, multi-tier trauma-informed and culturally responsive behaviour support practices in a regional primary school in the Northern Territory with a large population of First Nations students. The findings of the four-year implementation will highlight key considerations in partnering with First Nations communities, challenges and opportunities in implementing programs, and research methods utilised to understand the impact of the practices on the school community.