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
Jay Ramirez
Jay Ramirez is a proud Aboriginal descendant of the Wailwan and Gamilaroi people from north-west New South Wales.
Jay has a background in health and fitness, business and in all levels of project management and development. Jay is a member of the senior management team at HealthWISE and he’s part of the committed Aboriginal Health Access teams: Integrated Team Care Programs; Indigenous Australians Health Programs; and Indigenous Mental Health Programs.
Embracing an organisational Aboriginal and Torres Strait Islander Cultural Inclusion Framework
We are committed to cultivating an organisation that embraces Aboriginal and Torres Strait Islander culture through authenticity and meaningful actions. As an organisation, we strongly believed the only way we could create a framework that values and utilises the contribution and experience from all levels and streams of the organisation was through pioneering the organisation’s own Aboriginal and Torres Strait Islander Cultural Inclusion Framework instead of replicating a tokenistic framework externally.
The initiatives, actions and targets in the organisation’s Aboriginal and Torres Strait Islander Cultural Inclusion Framework demonstrate our commitment to achieving an inclusive and culturally respectful organisation that values the contributions, skills and knowledge of all Aboriginal and Torres Strait Islander employees, clients and the communities we deliver a service to.
The Aboriginal and Torres Strait Islander Cultural Inclusion Framework working group includes frontline workers, team leaders, the Chief Executive Officer (CEO) and senior management. The organisation has also sub-contracted an Aboriginal identified coordinator to lead the working group.
A multidisciplinary approach ensures governance structures and processes are adequate to:
- build capacity of all staff to deliver culturally responsive and appropriate services
- value the contribution of Aboriginal and Torres Strait Islander peoples
- develop meaningful relationships and partnerships with, and be accountable for, quality and availability of service to Aboriginal and Torres Strait Islander individuals, families, organisations and communities.
During May, we partnered with a local Aboriginal-owned and -operated registered training organisation to provide updated training to all staff and Board members, to ensure current and extensive understanding of Aboriginal and Torres Strait Islander history, people and communities. This training was designed and delivered specifically for our organisation and undertaken in groups across our workplaces.
Participants have described the experience as ‘transformational learning’ and ‘in-depth and sobering … built a basis for honest and respectful discussion among the group’. Our CEO is committed to ‘embed learnings from this training into the Aboriginal and Torres Strait Islander Cultural Inclusion Framework working group’.
The Aboriginal and Torres Strait Islander Cultural Inclusion Framework aspires to develop a process to ensure our organisation:
- considers the impact on Aboriginal and Torres Strait Islander peoples in everything we do
- promotes organisation-wide that Aboriginal and Torres Strait Islander health care is everyone’s business
- models authentic and respectful co-engagement and co-design of strategies, policies and programs.
Our conversations and relationships are guided to better understand and work with community to identify and meet their needs through this framework.
Frances Rice
Frances Rice commenced as Senior Nursing and Midwifery Advisor to the Chief Nursing and Midwifery Officer (CNMO) in the Australian Government Department of Health and Aged Care in April 2020. In this role, Frances provides specialist and strategic policy advice to the Executive, the Minister and internal and external stakeholders on complex matters in nursing and midwifery, the health system, health workforce and education issues. Along with the CNMO, she takes a leadership role at national and international levels to build strong and enduring working relationships with a wide range of stakeholders.
Commonwealth Government Maternity Services Mapping Project
Rural and remote communities value the health professionals who live and work in their communities. The scaling back and/or removal of rural and remote maternity services over many years has been highly controversial to communities, with many campaigning for the return of the services. Restoration of these services requires collaboration between governments and primary care providers along with commitment to training and supporting a range of health professionals to work to their full scope of practice in an economically sustainable way. The intent of this project is to build a comprehensive description of maternity models of care across Australia, including the key workforce, resource and infrastructure elements together with information on patient choices that influence sustainability. Once built, these descriptions can be used by governments to make informed investment and programming decisions that will support and expand existing and new maternity models of care.
Lauren Rice
Dr Lauren Rice is a research fellow at the Children’s Hospital Westmead Clinical School and the Brain and Mind Centre in the University of Sydney’s Faculty of Medicine and Health. She currently lives in the remote Fitzroy Crossing of Western Australia and works with Marninwarntikura Women’s Resource Centre, an Aboriginal community-controlled organisation. Lauren is passionate about improving the lives of people with developmental disabilities and people living in remote Aboriginal communities.
Longitudinal study of remote Indigenous children: the Bigiswun Kid Project
Introduction: Indigenous leaders in the Fitzroy Valley, Western Australia, were worried about the impact of alcohol on children. In 2009, they led the Lililwan (Kriol for little ones) Project with a focus on the prevalence of prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorder (FASD). In a population-based sample (all children born in 2002–03; aged 7–9), 55% had PAE (usually at high-risk levels) and 95% had experienced early life trauma. Comprehensive multidisciplinary neurodevelopmental assessments (n=108) showed that 19% had FASD, among the highest rates in the world. An individualised health management plan was provided to families, health services and schools for all children, and over 400 referrals were made to health, mental health and allied health services.
Community leaders are aware that some of the Lililwan cohort are doing well a decade later, while others are struggling. The community wants to identify adolescent needs and examine protective and risk factors for adolescent outcomes, and initiated the Bigiswun Kid (Kimberley Kriol for adolescent) Project.
Aim: The primary aim of the Bigiswun Kid Project is to improve health and wellbeing for adolescents in remote Indigenous communities.
Methods: Following consultation and consent, community leaders at Marninwarntikura Women’s Resource Centre partnered with University of Sydney researchers to follow up the Lililwan cohort (17–19 years) using the following methods.
- Through adolescent voices (interviews and validated tools) we will identify their current health and mental health status, cultural and community connections, and aspirations.
- Through families’ voices we will identify what the community needs to promote adolescent health and wellbeing, including in the health, community, vocation and education sectors.
- We will review Lililwan health management plans; document past/current service gaps and barriers to service use.
- Using Lililwan data from age 7–9 years we will examine predictors of adolescent outcomes.
- We will collect linked data on health, education, justice and child protection.
Aboriginal people participate in all aspects of the planning, conduct and reporting of this work and all interviews are conducted in partnership with local Aboriginal people.
Results: In this community-led project, preliminary results suggest that poor health, educational attainment and mental health (high rates of self-harm, suicidal ideation) are common in adolescence. Rates of contact with juvenile justice, early pregnancy and unemployment are high. However, adolescents are hopeful for the future.
Conclusions: This unique, longitudinal and population-based data will identify needs, and inform service and support development for remote-dwelling adolescents.
Nicolas Richardson
Nic is an experienced senior executive with demonstrated commitment, performance and leadership ability in the health industry. He is skilled in business strategy development and execution, external and internal stakeholder relations, with extensive not-for-profit Board experience. He is a dedicated professional driven by a passion for working with and supporting people in their roles to enhance their emotional and professional capabilities. He has a keen interest in innovation that better utilises existing healthcare resources to serve broader communities.
Nic is the General Manager of the medical deputising service, DoctorDoctor, a Sonic Clinical Services Subsidiary, and has worked in the healthcare sector for more than 22 years. Nic holds an MBA (Executive) with Distinction from RMIT and is a Graduate of the Australian Institute of Company Directors. He played a key role in the formation of the GP Deputising Association (GPDA) in 2017 and is the current Vice President and Secretary of the association. He was also a Director and the Secretary/Treasurer of the National Association for Medical Deputising Services (NAMDS) between 2005 and 2016.
Over the extensive time he has been involved in the healthcare sector, he has also participated on numerous committees related to after-hours health care. He has regular engagement with the Australian Government Department of Health regarding possible reform. In particular, he strongly advocates for the utilisation of metropolitan-based medical deputising services to provide much-needed support to rural GPs and the communities they serve.
Medical deputising services for regional, rural and remote Australia: a road less travelled
Background: Medical deputising services (MDS) have provided after-hours support to general practice in metropolitan areas of Australia for more than 50 years. The continuity-of-care benefits they provide to patients, and the administrative support general practitioners (GPs) and practice staff are provided, continues to be valued. However, for a multitude of reasons, MDS have not established operations in regional, rural and remote Australia, despite GPs and the communities they serve facing difficulties that may be lessened if such support was available.
Aims/purpose: This research seeks to identify the barriers and enablers that need consideration to overcome the current metropolitan limitation of MDS provision, particularly in light of changes in the healthcare system, both positive and negative, as a consequence of the COVID-19 pandemic. It aims to provide key stakeholders with a realistic and cost-effective pathway to establish MDS, to provide much-needed support to regional, rural and remote communities.
Methods: Key stakeholders, including but not limited to the Australian Government Department of Health; the GP Deputising Association; MDS personnel; Primary Health Networks; regional, rural and remote GP interest groups; and GP practices and the communities they serve, will be engaged to share their experience and ideas. Previous research papers will be utilised to support assertions made.
Results: Stakeholder feedback, report findings and medical deputising operational experience indicate that recent changes to MBS-funded telehealth, e-scripting capabilities and access to contemporary shared health records, provide new opportunity for the establishment of MDS to address exasperated need in regional, rural and remote communities. Carefully considered reform of existing regulatory barriers in a time-efficient manner is required to enable this to occur.
Conclusion: Metropolitan-based MDS have the potential to expand their areas of operations to provide support to regional, rural and remote GPs and their patients at a time where the need for further support is only increasing.
Through timely reform of existing after-hours practice incentive payment regulations and the recent implementation of MBS-funded telehealth, electronic prescribing and shared health record access, MDS, through a trusted deputising relationship, may effectively co-manage patients and relieve at least some of the burden facing GPs in these areas.
It is suggested that capitalising on recent healthcare reforms and innovations, and a rewording of regulations to enable GPs to utilise an MDS in these circumstances, would not increase costs, would assist GPs and their communities in regional, rural and remote areas, and also better utilise existing MDS services.
Kelly Ridley
Dr Kelly Ridley is an addiction psychiatrist based in Albany, Western Australia. Her special areas of interest are in smoking care, methamphetamine dependence and rural psychiatry. A keen teacher, Dr Ridley is a clinical lecturer for the local rural clinical school, for local health care providers and provides the addiction education lectures for trainee psychiatrists. In 2017 she won the RANZCP Addiction Psychiatry award and in 2019 the WACHS Rising Star Award and was Albany Junior Doctor of the Year. In 2020 she completed her Masters in Public Health and is working on her Graduate Certificate in Rural and Remote Medicine.
Implementing a GP psychiatry phone line in the Greater Southern: preliminary results
Aims: A general practitioner (GP) psychiatry phone line has been operating in Western Australia’s Great Southern since February 2021. The service has three objectives:
- to support GPs practising in the region to better provide primary mental health care
- to enhance primary mental health care through reducing unnecessary referrals to specialist mental health services
- to enhance workflow efficiency for specialist mental health services.
The service is available from Monday to Friday. The calls are managed by consultant psychiatrists and the Clinical Director at Albany Hospital’s Mental Health Unit.
Methods: The evaluation of the service will adopt a mixed-methods approach. Data for the quantitative component will be gathered from a contact database recording data for each call, hospital data, and a GP-evaluation survey. Data for the qualitative component will be gathered through semi-structured interviews conducted with GPs, including users and non-users of the service.
This paper reports on preliminary process evaluation results on service use and impact on workflow corresponding to the first six months of operation of the service.
Relevance: Unlike other GP psychiatry support lines, this innovative service is provided by local consultant psychiatrists who have contextual knowledge of the local mental healthcare environment. This localised expertise helps strengthen relationships and cross-sectoral collaboration, which are critical in a regional mental healthcare ecosystem.
Results: A total of 217 calls were received during the period February to July 2021. Mood disorders were the most common mental health issue of concern, and the majority of calls related to medication issues (77.9%), followed by service information (15.2%) and risk management (15.2%). With regard to patient characteristics, the 11–20 age group was the most frequently discussed (23.0%), followed by the 31–40 and 21–20 age groups (21.7% and 19.8% respectively).
Regarding impact on workflow, the average call time was 5.95 minutes (SD 3.14), and the average time spent after the call was 4.05 minutes (SD 4.12), resulting in a total work time per call of approximately 10 minutes. Wednesdays are the busiest days, accounting for 35.9% of all calls, and the calls are spread throughout the day, with two peaks between 12noon–1pm and 2–3pm.
Approximately 125 referrals have potentially been avoided.
Conclusions: Results so far are encouraging. This model has the potential to enhance patients’ outcomes, improve workflow efficiency for specialist mental health services, and strengthen regional mental health support ecosystems, while being congruent with general practice clinical and business models.
Milena Rizovski
Milena Rizovski is a pharmacist practising in public and private hospital settings, with experience in regional and metropolitan hospitals. She holds a Bachelor in Pharmaceutical Science and a Bachelor of Pharmacy with Honours from the University of South Australia. With an interest in research, she is involved in various drug evaluation use projects.
Characterising psychotropics prescribing in regional South Australian hospitals
Background: The final report of the Royal Commission into Aged Care Quality and Safety, issued in 2021, highlighted the need for further investigation into the usage of antipsychotics, particularly indications not supported by the Therapeutic Goods Administration (TGA). A considerable body of work has been published in residential aged care facilities but little can be found in acute care, where prescribing may start with poor reviewing and transfer of care on discharge. There is an identified deficiency in studies regarding the use of antipsychotics in acute care settings across Australia.
Aim: This study aims to characterise the prescribing of psychotropic medications in acute regional hospitals in South Australia, and identify ‘off-label’ practices.
Method: A retrospective audit of medical records of patients admitted from March 2021 to September 2021 was implemented in five regional sites. Data was collected through an adapted version of the Australian Commission for Quality use of Medicines indicator for acute mental health care (2014). Data was collected for regular, PRN and on-discharge medications. Participants were identifed for inclusion by clinical ward pharmacists which reviewed patients‘ medical records.
Results: Preliminary data analysis of the five aggregated sites reflect demographics of ages from 22 to 92 years, and gender distribution of 65 per cent female and 35 per cent male. A segment of the sample included three per cent identifying as Aboriginal. The average length of stay was six days. Seventy-nine per cent of regular psychotropic prescribing indications were in line with TGA-approved indications. Meanwhile 41 per cent of prescribed psychotropic doses were consistent with electronic Therapeutic Guideline (eTG) recommendations. The most prescribed antipsychotic was quetiapine, while for benzodiazepines diazepam was most common.
Discussion: Suboptimal documentation of indications (20 per cent of charted orders documented) brings about the question of medication errors, non-evidence-based ‘off label’ use and medico-legal implications. Similar findings were evidenced from discharge summary documentations (64 per cent had a discharge summary). Australian practice guidelines also specifically recommend against the use of some ‘off-label‘ indications; for example eTG does not support the use of psychotropics for insomnia, due to limited supportive evidence and adverse effects, including increased risk of stroke and death in the elderly. Prescriptions of antipsychotics were characterised as ‘off-label’ in 20 per cent of charted orders and for the benzodiazepines the frequency of inappropriate prescribing was 22 per cent. No clear documentation could be found regarding discussion with patients about ‘off-label’ prescriptions and usage; no side effects or harm was identified in patient medical records.
Helen Roberts
No biography provided.
All aboard: COVID-19 mobile vaccination buses Jabba the Bus and Maxine Vaccine
The Goulburn Valley Public Health Unit (GV PHU) encompasses eight local government areas in northern regional Victoria. The GV PHU COVID-19 Vaccination Program consists of six fixed vaccination sites, across five local government areas. The program expanded its model of care to include two mobile outreach buses: ‘Jabba the Bus’ and ‘Maxine Vaccine’.
These vaccination buses provided an alternative model of care by helping lessen barriers that people face when considering vaccination options. We considered issues such as geographical distance from a fixed site, transport availability (access and timetabling for both public and private), health literacy limitations, diversity within the population, and acknowledged the unforeseen everyday barriers that members of our community may face.
Collaborative relationships were established with community health organisation providers, fundholders of High-Risk Accommodation Response, and key organisations including the Ethnic Council of Shepparton and District.
Unexpected success factors included staff seeking opportunities to be rostered on the buses, overwhelming positive community interest, social commentary and media promotion – it far exceeded expectations.
Russell Roberts
Professor Russell Roberts is a Chief Investigator with the Regional Australia Mental Health Research and Training Institute and a Professor of Leadership and Management at Charles Sturt University. He is National Director of Equally Well, Chair of the Australian Rural and Remote Mental Health Symposium, and on the Board of the Australia and New Zealand Mental Health Association. He served as Editor in Chief of the Australian Journal of Rural Health from 2016 to 2021 and as Executive Director of a large rural mental health service in New South Wales covering 550,000 square kilometres with over 1,100 FTE staff. He began his career as a clinical psychologist in Port Pirie, South Australia.
Equally Well. Rural mental health consumers’ experiences of physical health care: results of a national survey and in-depth interviews
People living with mental illness die, on average, 20 years earlier than the rest of the population. Every year 10 times more people with mental illness die of preventable chronic diseases than suicide. For instance, while the incidence of cancer in people living with mental illness is the same or lower that the general population, their rate of premature death due to cancer is over eight-times higher. While lifestyle factors and medication side-effects account for a small part of this life expectancy gap, most of these deaths are preventable through the provision of equitable access and integrated care. It has been hypothesised the stigma, cost, structural discrimination and accessibility challenges may all contribute to the poor health and premature death of people living with mental illness. This presentation examines the key findings from research into consumers’ perspectives and experiences of contact with physical healthcare services across Australia. It also proposes a simple, practical approach that can be employed by all healthcare and social support providers regardless of their discipline.
Q & A Panel – Rural mental health research and training: challenges, opportunities and next steps
Sharnie Roberts
Sharnie Roberts is a Widjabyl Wia-Bul woman from the Bundjalung Nation with a bachelor’s degree in social sciences, working on the WellMob project at the University Centre for Rural Health in training and navigation.
Sharnie has a wealth of understanding of social and health determinants that impact the mental health wellbeing of First Nations people in Australia and is passionate about walking alongside First Nation young people to empower the reconnection to their cultural identity for generational healing.
WellMob: a digital library of online wellbeing resources for our deadly mob
e-Mental Health in Practice (eMHPrac) is a support service funded by the Australian Government to build digital mental health awareness and skills in primary care practitioners across the country. One of eMHPrac’s recent initiatives is the development of WellMob, a website that brings together online social and emotional wellbeing (SEWB) resources for Aboriginal and Torres Strait Islander people.
The WellMob website is this country’s first online library of over 200 videos, apps, podcasts and other websites on Aboriginal and Torres Strait Islander SEWB. It’s been designed to help our diverse health and wellbeing workforce to find and share online wellbeing resources with our mob. This includes school counsellors, youth workers, family support, D&A and NDIS workers, GPs, psychologists and other allied health professionals.
The website was designed for mob by mob. The website development process had Indigenous governance and leadership to ensure it was culturally safe and engaging, user friendly and accessible for both workers and community users. The project was led by Indigenous staff at the University Centre of Rural Health (part of University of Sydney) in collaboration with the Australian Indigenous HealthInfoNet.
The website layout and content is centred around a holistic model of Indigenous SEWB. It recognises that our connection to country, culture, community and kin are instrumental in our wellbeing and differentiates WellMob from more mainstream mental health websites.
Launching the WellMob website in mid 2020, amid the COVID-19 pandemic and associated lock-downs, was critical timing. Many counselling and community wellbeing services couldn’t be delivered out in the community and wellbeing workers had to rely on virtual forums to engage with clients, including recommending online resources that our mob could download on their mobile devices to integrate into their wellbeing practices.
The WellMob website has made it easy for workers and mob to find culturally relevant online resources that support our mental health and wellbeing. The WellMob team will present on the website demonstrating its functionality, showcasing some deadly resources and illustrating examples of how frontline workers and other health professionals can use it in their work with our diverse communities.
Kelly Rogerson
Kelly Rogerson is a registered nurse with postgraduate qualification in critical care. She is currently the Chief Executive Officer of Palliative Care South East and has spent many years of her career working in areas focused on end-of-life care. She holds a Master of Nursing and Master of Business Administration and an Adjunct Associate Professor role at Monash University in clinical practice. With broad strategic, operational and management experience within complex environments, her experience includes being the General Manager Specialty Medicine, cancer and critical care at Monash Health, commissioning Casey Hospital at its inception and leading elements of the expansion, Director of Nursing at Jessie McPherson Private Hospital and Director of Nursing and Operations with Donate Life Victoria. She has strong governance, quality, safety and risk management skills demonstrated in her experience assessing against national and state accreditation frameworks as an Assessor with the Australian Council on Healthcare Standards for over a decade.
As a graduate of the Australian Institute of Company Directors, she is the current Board Chair of Palliative Care Victoria and a Director at Maryvale Private Hospital in regional Victoria.
Partnership in preparing nurses for palliative care
The perceived capabilities and confidence of returning to study, undertaking online postgraduate education coupled with financial commitment and the geographical impediment to further education were identified as key challenges to nursing staff formalising their skills and practice with specialist qualifications. To address the identified gap in specialist palliative-care-educated nurses, the Gippsland Regional Palliative Care Consortium and Palliative Care South East partnered with the Australian College of Nursing (ACN) to develop the course ‘Transition to Specialty Palliative Care’. By responding to the identified challenges, this unique partnership has provided a hybrid model of education to support access to nurses living in regional and outer suburban areas.
The Transition to Specialty Palliative Care course is for registered nurses working in a community or acute setting wanting to advance their palliative care knowledge. It is a supportive bridge for those who may wish to pursue postgraduate study but have not progressed the aspiration yet.
The pilot program was run over seven sessions (each six weeks apart) in a face-to-face format. Mentoring and support for participants was provided from leaders across the palliative care sector. The face-to-face sessions were complemented by an accredited online component coordinated by ACN. Completion of the course rewards one subject toward the Graduate Certificate of Professional Practice. Further study options are available for individuals who wish to advance their education, with the goal for participants to complete a postgraduate qualification following the initial program.
Evaluation of the program illustrated a high level of interest with feedback identifying the original hypothesis of returning to study was challenging for many nurses. A supported program with peer support and mentoring from senior nurses enabled individuals to advance their studies in a positive, assisted environment as an introduction to further postgraduate studies.
Claire Ronaldson
Claire Ronaldson is a medical registrar working at the Latrobe Regional Hospital in Gippsland, Victoria. She has a close knowledge of the surrounding communities and the rural challenges of the patients who present there. Following the completion of secondary school, Claire moved to Queensland to attend university, first as a physiotherapist, she then spent two years on the mid-north coast of Queensland working in a rural town before returning to medical school. In her third year of medical school Claire once again returned to a rural location with a 12-month rotation to Dalby in the Darling Downs region.
Claire grew up on a rural property in Gippsland and, following her graduation from medical school, has enjoyed returning to the area to provide care for the locals. Claire has an interest in dermatology and acknowledges a significant lack of dermatology services in the Gippsland area. She has set about starting research on this patient group in an effort to understand the dermatology needs of the community and translate that into the recruitment and practise of a local dermatologist. In addition, she is hoping to provide a rural dermatology service herself in the future.
Dermatology presentations to a regional Victorian hospital
Research focused on dermatological presentations to emergency departments (EDs) has been primarily completed in tertiary metropolitan hospitals. Our literature search did not discover any studies with similar aims that were carried out in a regional hospital. Given the lack of dermatological services in rural areas, the profile of dermatological patients presenting to a regional ED may be different.
Dermatologists are almost exclusively concentrated in metropolitan areas, with 92 per cent in major cities (AFHW, 2017). Poor access to dermatologists in rural and remote areas can adversely affect patients. For instance, there could be delays in recognition of dermatological emergencies, a delay in skin cancer diagnosis and higher risk of morbidity from skin cancer (Wilkinson & Cameron, 2004). For the benefit of our rural communities, it is particularly important to ensure we have good strategies in place to manage patients with dermatological concerns, despite the lack of dermatology services.
We aimed to explore these differences to contribute to a larger knowledge framework. This may be used to guide how rural dermatology services can be translated into practice for the regional population in the future.
We utilised an audit method to review dermatological presentations to our regional ED in 2020. Presentations were determined via a coding system and electronic medical records (EMR) were then reviewed for data collection. Data such as triage category, investigations, diagnosis, treatment and admission or discharge were collected. Data has been analysed descriptively and strength of associations between factors has been measured using Chi-Square tests.
Our data showed a high number of patients presenting to our ED with dermatological issues that could be well-managed by a dermatologist as an outpatient. There was also a number of times when the patient could not travel the distance to see their dermatologist or the wait time for an appointment was too long, meaning a severe exacerbation of their dermatological condition required admission.
We are reflecting on how this data can inform strategies for our regional hospital that will enhance the health of our community. New approaches being considered include a rapid-review dermatology clinic run by a visiting dermatologist, attracting a dermatologist to our local community to provide a regular public outpatient clinic and consult on admissions where required, education of ED staff in how to recognise and manage commonly presenting dermatological conditions, and a streamlined plan for expediting treatment for urgent dermatology matters to a tertiary centre.
Heather Russell
Heather Russell is a general practitioner and a lecturer at the University of Sydney School of Rural Health, based in Orange. The School of Rural Health is a multi-professional academic unit which undertakes rural health research, builds rural research capacity and supports medical students on extended rural placement. Heather has particular interests in primary health research, mental health and adolescent health.
Marginalised rural and urban youth: use of online health programs and apps
Background: Rural young people experience higher disease burden and face greater challenges accessing health care compared with metropolitan young people. The virtual health revolution has seen an increase in young people’s use of online programs and apps to support their health. While the potential of these technologies for rural communities is profound, little is known about whether, how and which online programs and apps rural young people are using.
Methods: The Access 3 study explored how 12- to 24-year-olds in New South Wales accessed health care and used technology to find health information and services. Marginalised young people were purposively sampled (including rural, homeless, sexuality and/or gender diverse, of refugee and/or Aboriginal and/or Torres Strait Islander background). This analysis used data from the Access 3 cross-sectional questionnaire to explore differences by location of residence (‘urban’ versus ‘rural’) and need for health care.
Results: Questionnaires were completed by 1,416 young people during 2016–17, including 34 per cent (478) living rurally. Physical and mental health were similar between urban and rural respondents, however urban respondents were significantly more likely to have visited a doctor or GP in the six months prior (83% vs 79%, p<0.05). Rural respondents were significantly less likely to have internet access (93% vs 98%; p<0.001) or own a mobile phone with internet access (81% vs 90%; p<0.001).
Twenty-seven per cent (383) of young people reported using an online program or app to manage their health during the six months prior. Of those who commented on the type of online program or app, the most common were related to mental health (14%), fitness (8%), nutrition (7%) and period tracking (7% of females). There were similar overall rates of health app use between rural and urban respondents (26% vs 28%), but consistent trends of lower use of particular online programs/app types among rural respondents. Three-quarters (74%; 281/380) of the sample who had recently used online programs or apps agreed they were useful, and a similar proportion that they would recommend them (73%; 277/379).
Discussion/conclusions: Uptake of online programs and apps among marginalised Australian adolescents is lower than observed in other representative samples, but the types of apps accessed are similar. There does not appear to be lesser uptake in rural young people, despite lower rates of internet access and lower mobile phone ownership. Patterns of use of online health tools by young people remain relatively unknown, despite the need for an evidence base to inform policy and guide health providers.
Rural social histories: evaluation of an innovative learning program
Background: Patients’ stories are at the heart of every clinical encounter. A good social history can assist practitioners to understand people’s lives and build stronger therapeutic relationships. This is particularly important for rural patients who face unique social, economic, cultural and environmental factors which influence their health and wellbeing. Understanding these factors enables practitioners to provide individualised care and improve rural patient outcomes. Despite this, social history education is minimal in pre- and postgraduate teaching and rural health is frequently taught exclusively at the population level.
Methods: A blended learning module was developed to improve students’ expertise in building social histories in rural contexts. Specifically, the program focused on enhancing students’ knowledge of the social determinants of health and translating that knowledge to the individual care of rural patients. Medical students at the School of Rural Health, The University of Sydney, have been involved in the pilot of the program. Qualitative and quantitative data will be collected from participants and volunteer patients through surveys and focus groups in early 2022.
Results: An innovative learning package consisting of an online module, face-to-face workshop and evidence-based guide to social histories in rural contexts was collaboratively developed by experienced rural clinicians and an educational designer at the School of Rural Health, The University of Sydney. A pilot workshop undertaken with a group of medical students based at the School of Rural Health, Orange, indicated a relatively rudimentary understanding of the social determinants of health in rural contexts at baseline. Students’ growth in understanding was evident after undertaking, presenting and reflecting on a social history in a rural context.
Discussion: Medical education emphasises individualised and person-centred care yet there is little formal teaching for health and medical students on building more comprehensive and sensitive social histories. Students based in rural settings require formal instruction to enhance their expertise in building social histories. The social histories learning module developed by the School of Rural Health, The University of Sydney, offers opportunities for interprofessional learning, can be applied in multiple rural settings and extended to postgraduate learning including hospital- and community-based medical, nursing and allied health practitioners.
Kate Ryan
For the past five years Kate has been working as a senior program coordinator at the Cunningham Centre in Toowoomba, working with rural and remote X-ray operators. She has been a radiographer for 12 years, working in many rural facilities across Queensland, and is currently also working for Dalby Hospital. She is passionate about rural and remote health care and collaborates with numerous stakeholders in the organising and delivery of X-ray operator training.
Embracing collaboration and change in rural and remote X-ray operator training services
In rural and remote locations across all Australian states non-radiographer X-ray operators (XOs) who have no formal radiography qualification, can be licenced under State Radiation Control legislation to perform a limited range of plain radiography examinations. The licencing of XOs provides rural and remote patients with access to medical imaging services that would otherwise be unavailable without travelling long distances, often at substantial cost. The benefit of improved service access, however, should not come at the cost of lesser-quality radiographic services for patients. It follows that the education and ongoing support of XOs should be of a high standard.
In seeking to provide high-quality training to XOs across Queensland, the Cunningham Centre began a collaboration with the University of Newcastle’s Department of Rural Health in 2017, sharing online educational resources for the introductory XO course. This training is supplemented by face-to-face workshops at the completion of the online component. Despite the challenges of differing licence conditions and target course participants, the collaboration has been highly successful, demonstrating a willingness to overcome local legislative and professional practice variations.
Even with improved online educational resources, XOs were still concerned about a perceived lack of support. XOs felt alone. At the same time, financial and staffing resources at the Cunningham Centre were stretched and COVID-19 meant that travel was, at times, impossible. It was important to find a more sustainable way to provide ongoing support and guidance.
With only a small team based at the Cunningham Centre, courses rely on the statewide network of local radiographers to provide ongoing support and guidance to XOs within their own community. As such, the Cunningham Centre has sought to actively foster these relationships through the introductory course, various communication platforms and in-services, and plans to provide further support and training to radiographers to ensure that XOs remain well-supported.
Videoconferencing tools have also been utilised to conduct the annual training and assessment workshops remotely, which has allowed the Cunningham Centre to continue to provide support and training using minimal resources and without the need to travel. This training has been well-received.
The Cunningham Centre and XOs in Queensland have already benefited greatly from embracing collaboration and change, perhaps especially in challenging circumstances. This serves to promote ongoing collaboration and innovation and raises prospects of a national curriculum and standard for XO education.