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
Kehinde Obamiro
Kehinde has a background in pharmacy and has undertaken training in public health. He is a lecturer at the Centre for Rural Health, University of Tasmania, and has led several population-wide surveys related to cardiovascular disease and bowel cancer. His main research interests include promoting an evidence-based rural health agenda, public health (epidemiology, biostatistics and disease surveillance) and clinical pharmacy.
Intention and barriers to cardiovascular disease health checks: a cross-sectional survey
Aims: To compare the intention and barriers to cardiovascular disease (CVD) health checks between participants living in bigger towns and rural Tasmania, and to identify factors associated with increased barriers to CVD health checks.
Relevance: Available data showed that Tasmania has a higher number of heart disease deaths per 100,000 people compared with the overall national rate. Tasmania also has the highest rate of obesity and the second-highest smoking rate. Tasmania’s population is highly dispersed, with a significant proportion living in rural and remote parts of the state, and it is important to ascertain whether this affects the intention to have a CVD health check and the impact of cost, location of the service and transport as barriers.
Methods. Participants were recruited for an online survey via Facebook. Intention and barriers to CVD health checks were measured using two subscales from the Determinants of Health Check Questionnaire. Statistical analyses were conducted to compare respondents based on their residential area using the Modified Monash Model (MMM) scale. Participants from MMM>2 areas were compared with those from MMM2 areas. Simple and multiple linear regressions using a stepwise approach were used to identify factors associated with increased barriers to CVD health checks.
Results: Of the 1,901 responses, 1,679 could be classified using the MMM scale. Participants from MMM>2 and MMM2 areas showed similar intention to undergo a CVD health check (17.3 vs 17.4; p=0.671). However, participants from MMM>2 areas reported a greater number of barriers to undergoing CVD health checks (10.2 vs 9.6; p<0.001). Specifically, participants from MMM>2 areas reported higher barriers related to distance to the location for a CVD health check and difficulty with securing transportation. Using an adjusted linear regression model, advancing age, education at university level and above, an annual income greater than $37,000 and having a family history of CVD were associated with lower barriers to CVD health checks. Conversely, living in MMM>2 areas, increasing BMI and currently smoking were associated with higher barriers to CVD health checks. One limitation observed is that the sample is well-educated.
Conclusion: The study suggests that, although intention for CVD health checks is similar between locations in Tasmania, participants living in rural areas experience more barriers related to distance and securing transportation. These findings may increase understanding of where interventions could be directed to improve CVD health checks in Tasmania. Further research using a random sample is recommended.
Susan O'Neill
Susan O’Neill is a PhD candidate at La Trobe University. Her thesis title is ‘Optimising Ear, Nose and Throat (ENT) care in rural Australia: investigation of the current issues around ENT care, and development, implementation and evaluation of a health intervention’. Susan holds a Bachelor of Science in Health Promotion and Masters of Science in International Health. Susan has lived and worked in rural and remote locations for the past seven years in Western Australia and Victoria. The following stages of Susan’s’ research will include a descriptive analysis of hospital presentation data for ENT conditions; a systematic literature review; GP focus group and ENT practitioner interviews; and evaluation of an ENT educational program for GPs.
Audiologists’ perspective on ear, nose and throat ‘hotspots’ in rural Victoria
Objective: To understand the experience of audiologists in managing and treating ear-related ear, nose and throat (ENT) conditions in rural regions of Victoria, and to identify the compounding factors that influence patient outcomes.
Relevance: The 2016 Grattan Institute report Perils of place identified four ENT hotspots in rural Victoria, highlighting the inadequate ENT care delivery in the primary healthcare setting in rural regions that results in a higher-than-average rate of preventable hospitalisations. Little is known about the experience of healthcare professionals in managing ENT conditions in rural Victoria. This study demonstrates the limitations in current care provision and provides alternative service delivery models, and warrants further investigation into ENT care delivery in rural regions.
Design: A qualitative study was conducted using a focus group. Responses were audio-recorded, transcribed and thematically analysed. A phenomenological approach was employed due to the exploratory nature of the study, and an inductive analysis was utilised to search for patterns in the text. This information was classified and arranged into themes, and the relationships among data examined. For the reporting of the results, the COREQ standard was used.
Setting: The focus group was conducted in the rural town of Mildura in the state of Victoria.
Participants: A sample of 19 audiologists from rural locations in the state of Victoria participated. Audiologists were identified as relevant informants given their exclusive focus on the treatment of ear conditions and their wider interactions with ENT practitioners and primary care general practitioners.
Results: Access to care, long waitlists and a lack of locally-based ENT practitioners were identified as barriers, while pathways for open communication between health services and continuing professional development programs were believed to support the treatment and management of ear-related ENT conditions. Additionally, primary healthcare education was noted to impact on the diagnosis and treatment of ear conditions (in particular sudden sensory neural hearing loss), and inappropriate referrals to secondary services. Providing audiologists with expanded scope of practice would alleviate the burden in primary health care and support appropriate secondary referrals.
Conclusion: These findings are consistent with the literature on ENT care issues in rural areas nationally and internationally. Improving referral pathways for treatment of ear-related ENT conditions, and providing education about ENT assessment and treatment in primary healthcare settings could increase appropriate referrals, improve patient outcomes and reduce wait periods for treatment.
Dayle Osborn
Dayle has worked across both private and public sectors in nursing, midwifery, management, mental health and education. Dayle is a registered nurse, midwife, credentialed mental health nurse and accredited mental health first aid trainer. For the past three years, Dayle has been with Southern Queensland Rural Health (SQRH) as a clinical educator for nursing and mental health nursing, based in their Toowoomba training facility. Dayle is also clinic coordinator for the SQRH Health and Wellness Clinic in Toowoomba, supporting health students to deliver a wellness program for people with rising risk for chronic disease.
Working in rural areas across Queensland for the past 30 years, Dayle is passionate about rural health and creating change to support an increase in the quality and quantity of undergraduate student rural clinical placements, with the aim of supporting the growth of the rural workforce.
Using virtual reality as an innovative approach to imminent birth rural education
Background and aims: Women in rural and remote areas may present to a hospital without a designated maternity service when birth is imminent. The Queensland Health Imminent Birth program for non-midwifery health professionals provides online theoretical education and a face-to-face workshop with simulation scenarios. Virtual reality offers an innovative way to deliver simulated learning experiences, bridging the issues of distance and timely attendance at face-to-face workshops. This pilot randomised controlled trial (RCT) aimed to examine the feasibility and effectiveness of an immersive virtual reality (IVR) simulation as an alternative to the Imminent Birth program’s face-to-face simulation workshop.
Methods: Twenty-three undergraduate health students were recruited to participate in the pilot RCT. All students were first invited to review and complete the online theoretical modules from the Queensland Health Imminent Birth program, after which they were randomly allocated to participate in either the existing face-to-face simulation (N=12) or an IVR simulation of the same scenario (N=11). Measures of knowledge retention, clinical reasoning and self-reported confidence in clinical practice were completed at three time points: prior to provision of theoretical modules, after completion of simulations and at two-week follow-up. The System Usability Scale (SUS) was also administered to the intervention group immediately following the completion of the IVR simulation to evaluate the usability and acceptability of the IVR equipment.
Results: Knowledge and clinical reasoning increased significantly for both intervention and control groups immediately after simulations, and these improvements were retained at two-week follow-up. Confidence followed a similar pattern and, although a significant decrease was observed in confidence scores for both groups between post-test and two-week follow-up, scores continued to remain considerably higher than at pre-test. The mean SUS score of 70.7 (SD=10.1) indicated that the IVR simulation was rated as ‘good’ by participants.
Conclusions: Findings from this pilot RCT indicate that IVR simulation is equally effective to the established face-to-face simulation in the Queensland Health Imminent Birth program in producing improvements in knowledge, clinical reasoning and confidence in practice. As such, IVR technologies may present an innovative solution for bridging concerns of distance experienced by rural health professionals. Moreover, use of IVR simulations with the addition of augmented reality may be a viable means of improving access to other forms of continuing professional development for health professionals practicing in rural and remote communities.
Regina Osten
No biography provided.
Friendly Faces Helping Hands: improving the rural patient journey in NSW
Each year, on average, 600 rural New South Wales (NSW) families are impacted by trauma requiring health care a long way from home, kin and country. The Friendly Faces Helping Hands website – originally created by CEO of the Friendly Faces Helping Hands Foundation, Kelly Foran, after her lived experience requiring seven hospital stays across two states 17 years ago – was re-launched during National Carer’s Week in October 2020. It is a ‘go to’ place for rural families, providing practical support and information for 38 hospitals in NSW and cross border: www.friendlyfaces.info
The website is easy to navigate and contains information including:
- a hospital directory for services available
- accommodation nearby
- parking and public transport
- food, retail and cheap eats
- support workers
- charities
- parks and playgrounds close-by
- resources and support organisations.
An Aboriginal co-design group was convened from January to June 2021 to review the website content, resources and promotional material from an Aboriginal perspective, for distribution to Aboriginal and multicultural communities and organisations. This included commissioning an Aboriginal artist to create a culturally engaging patient/carer checklist and promotional material for social media, TV monitor screens in waiting areas and newsletter inserts.
At July 2021, the refreshed website has seen a 66 per cent sustained increase in usage, from 697 total users in the three months pre-launch (July to September 2020) to 1,673 total users in the previous three months (April to June 2021). In addition, free calls to the hotline have halved, suggesting that the website is providing the information rural families are looking for. Google analytic reports in June 2021 showed that individual valid web pages indexed in Google search have grown from 40 in February to 150 in May and that the website now has a firm foothold in Google.
This presentation outlines the processes, from July to December 2021, to embed the Friendly Faces Helping Hands website and resources across carer and consumer groups and major metropolitan and regional referral hospitals, including NSW Ambulance. The aim is for rural patients and their families to have more control of the situation BEFORE transfer from a rural area to a larger hospital and to decrease the hardship and vulnerability experienced when health care is required in unfamiliar territory. Efforts are also underway to include the promotional flyer as part of the pre-admission process for rural patients requiring planned admissions to city hospitals (such as cardiac, transplant).
Help at your fingertips!
Alice O'Sullivan
Dr Alice O’Sullivan is a young doctor working at St Vincent’s Hospital Sydney and now at Prince of Wales Hospital in Randwick, New South Wales. She graduated in 2019 from Notre Dame University with a Doctor of Medicine, as well as a Bachelor of Medical Science from Sydney University and a Bachelor of Science-Psychology from Macquarie University. She has a strong interest in Indigenous health and wellbeing and was the Notre Dame representative for the Indigenous Health Project Advocacy Team with the Australian Medical Students’ Association and in association with the Australian Indigenous Doctors’ Association. Her main research is focused on Indigenous suicide in rural and remote Australia including the contributing factors and the ways in which resources are allocated within these communities.
Indigenous suicide in rural and remote Australia: are all suicides preventable?
Suicide remains a leading contributor to premature mortality and community morbidity among Indigenous Australians, especially in rural and remote areas. Despite considerable attention and government funding with multiple suicide prevention programs, suicide rates continue to rise.
Aims:
- To review the current literature relating to Indigenous suicide in rural and remote Australia.
- To interview mental health service providers in north-west Queensland in Mount Isa, Doomadgee, Cloncurry, Normanton, Camooweal and Mornington Island.
- Identify any common themes and the driving forces which contribute to the risk of Indigenous suicide.
- Recommend potential improvements in current suicide prevention services.
Methods: Relevant academic literature was reviewed. Then, based upon direct clinical observations and structured enquiry, two composite case studies were formulated: a typical or representative Indigenous patient presentation; and an Indigenous mental health worker’s perspective.
Results: Key themes associated with Indigenous suicide were: (i) the disproportionate impact of alcohol and other drugs on this community; (ii) the specific difficulties in preventing all suicides; and (iii) the personal and professional difficulties of mental health workers servicing rural and remote Australia.
Conclusions and recommendations: From this study, the following recommendations are made.
- Policymakers and academics would benefit greatly from taking into account the individual perspectives of current service care providers and the populations they serve.
- Current government and non-government services remain fragmented and they require far better integration.
- Indigenous services should take account of sociocultural differences amongst the different Indigenous communities across Australia and align services with those communities.
- Indigenous participation should be encouraged and supported in further policy development and training programs, and in providing those health services from within their own local communities.
- Access to drug and alcohol detoxification and linked rehabilitation services needs to be vastly improved, both in terms of the numbers of programs available as well as their accessibility by regional communities.
- Greater attention and support should be directed towards reducing mental health worker ‘burnout’ and in preventing staff losses and the concomitant loss of their accumulated local knowledge and clinical skills.
- Further research needs to be done on the links between risk factors, protective factors and outcomes, as well as the biopsychosocial vulnerability experienced by Indigenous people to alcohol dependency, alcohol-induced psychosis and impulsive high-lethality suicidal behaviour. This understanding is important if there is to be any hope of making all suicides preventable in the future.
Brendan O'Sullivan
Brendan O’Sullivan has worked as a consulting psychiatrist for some 10 years in rural and remote areas of Queensland including Mount Isa and its associated remote centres, as well as Cairns and Mackay. He has had direct clinical input and responsibility for a large number of both Indigenous and non-Indigenous patients who have complex mental health needs and who suffer disproportionately from drug and alcohol problems.
Indigenous suicide in rural and remote Australia: are all suicides preventable?
Suicide remains a leading contributor to premature mortality and community morbidity among Indigenous Australians, especially in rural and remote areas. Despite considerable attention and government funding with multiple suicide prevention programs, suicide rates continue to rise.
Aims:
- To review the current literature relating to Indigenous suicide in rural and remote Australia.
- To interview mental health service providers in north-west Queensland in Mount Isa, Doomadgee, Cloncurry, Normanton, Camooweal and Mornington Island.
- Identify any common themes and the driving forces which contribute to the risk of Indigenous suicide.
- Recommend potential improvements in current suicide prevention services.
Methods: Relevant academic literature was reviewed. Then, based upon direct clinical observations and structured enquiry, two composite case studies were formulated.
- A typical or representative Indigenous patient presentation.
- An Indigenous mental health worker’s perspective.
Results: Key themes associated with Indigenous suicide were: (i) the disproportionate impact of alcohol and other drugs on this community; (ii) the specific difficulties in preventing all suicides; and (iii) the personal and professional difficulties of mental health workers servicing rural and remote Australia.
Conclusions and recommendations: From this study, the following recommendations are made.
- Policymakers and academics would benefit greatly from taking into account the individual perspectives of current service care providers and the populations they serve.
- Current government and non-government services remain fragmented and they require far better integration.
- Indigenous services should take account of sociocultural differences amongst the different Indigenous communities across Australia and align services with those communities.
- Indigenous participation should be encouraged and supported in further policy development and training programs, and in providing those health services from within their own local communities.
- Access to drug and alcohol detoxification and linked rehabilitation services needs to be vastly improved, both in terms of the numbers of programs available as well as their accessibility by regional communities.
- Greater attention and support should be directed towards reducing mental health worker ‘burnout’ and in preventing staff losses and the concomitant loss of their accumulated local knowledge and clinical skills.
- Further research needs to be done on the links between risk factors, protective factors and outcomes, as well as the biopsychosocial vulnerability experienced by Indigenous people to alcohol dependency, alcohol-induced psychosis and impulsive high-lethality suicidal behaviour. This understanding is important if there is to be any hope of making all suicides preventable in the future.