Virtual Pre-Symposium Session Presenters

Dr Alison Beauchamp is a senior lecturer in the School of Rural Health at Monash University (0.5 EFT) and a Medical Research Future Fund NHMRC TRIP Fellow at the University of Melbourne (0.5 EFT). She has a clinical background as a registered nurse and completed a NHMRC PhD scholarship in social epidemiology at Monash University in 2011. Between 2013 and 2015 she was Australian Research Council post-doctoral Fellow at Deakin University, where she managed the large Optimising Health Literacy (Ophelia) study in which she supported clinicians to implement health literacy interventions.

Dr Beauchamp has published 58 peer-reviewed articles and three book chapters. She has been invited or keynote speaker at seven international or national conferences, and lead or co-investigator on grants over AU$3.5 million. She currently co-supervises two PhD scholars and has co-supervised two PhD and three honours students to completion.

A key interest is understanding the factors underlying the maldistribution of nursing and allied health professionals in rural Australia. The Nursing and Allied Health Graduate Outcomes Tracking (NAHGOT) study is a longitudinal cohort study that follow students for ten years after graduation using data linkage and repeat surveys to identify why graduates practice in rural or metropolitan locations. 

Aim: There is limited understanding of influences on graduate practice location of nursing and allied health students in Australia. The Nursing and Allied Health Graduate Outcomes Tracking (NAHGOT) Study, a collaboration between the University of Newcastle (UON) and Monash University (MU) Departments of Rural Health, was designed to address this evidence gap. 

Methods: This longitudinal cohort study links data from:

• university enrolment and placement databases
• surveys of first and final year students, plus Student Experience Survey responses
• graduate surveys at 1 and 3 years, part of the Graduate Outcome Survey along with an internal survey over 10 years
• Australian Health Practitioner Regulation Agency (AHPRA) data.

Data collection is ongoing and survey data is pending. This presentation focuses on the research methods and retrospective data linkage for graduates of 2018. 

Relevance: In accordance with the RHMT Program funding requirements, the NAHGOT study will track student workforce outcomes, targeting entire annual cohorts of students enrolled in nursing and allied health at participating universities, allowing for multiple variables to be compared with graduate practice location. Findings will be relevant to universities, researchers and policy makers. 

Results: Data were linked for 1338 students from the 2018 graduate cohort, 911 from UON and 427 from MU. Nursing and midwifery accounted for 56.2%, with the remainder from eight allied health disciplines. Overall, 82.3% were female, 54% under 21 years of age at enrolment, and 23.8% of rural origin. More than half (54.4%) had at least one rural placement during their studies, with about half of those having had more than one (26.8%). A similar proportion (28.6%) had a total rural placement duration of six weeks or more. Rural placements varied considerably between the two universities and between disciplines. The UON had a greater proportion of rural placements than MU, and Nursing and Midwifery had the least graduates who had multiple rural placements or > 6 week placements.

Principal place of practice (PPP) data from AHPRA was dichotomised into metropolitan versus regional, rural and remote. There was no statistically significant relationship between PPP and age or gender. Graduates of rural origin were at least three times more likely to be practicing in a rural location; as were those who had done at least one rural placement (p < 0.0001). Those who had ≥ two placements or at least six weeks' rural undergraduate experience, were three to six times as likely to be working in a rural area (p < 0.0001).

Conclusion: Deakin University recently joined this research collaboration. This retrospective pilot demonstrates the feasibility of the data linkage components of the methodology, while the findings potentially reflect the positive impact of rural placements on graduate rural practice. Further analysis, addition of survey data, new partners and ongoing follow-up promise to shape the future. This work will support identification of graduates most likely to practice in a rural location. This will aid universities in their selection processes, improve targeting of student subsides, and quarantining of high quality rural placements that often require a substantial investment and planning.

Leigh has become highly regarded in Australia for her contribution as a social worker to the field of paediatric bereavement. Leigh held the inaugural position of Bereavement Coordinator, Paediatric Palliative Care Service, at the Queensland Children’s Hospital Brisbane between 2010 and 2018 while also completing her PhD exploring the experience and needs of parents whose child has died from cancer. In collaboration with Redkite, and drawing on her PhD themes, Leigh developed two educational and advocacy resources: By My Side—stories of parents whose child has died from cancer and Walking Alongside: a guide for health professionals caring for a dying child. Leigh has been a long-term advocate for a hospital-wide response for bereavement care for families following the death of a child and, in 2017, Leigh was awarded a Churchill Fellowship to visit international hospital, hospice and community-based bereavement programs with the aim to inform guidelines for bereavement care in tertiary children’s hospitals in Australia. In 2019, Leigh became the inaugural Bereavement Coordinator for Children’s Health Queensland and is currently developing an innovative, responsive and compassionate program of care for families whose child has died, and the formal and informal caregivers who walk alongside them.

Aims: The Quality of Care Collaborative Australia (QuoCCA) has provided education for health professionals in paediatric palliative care (PPC) across Australia since 2015 with an aim to improve the quality of services in regional areas.

Relevance: The lessons learnt from the QuoCCA Project will be applied to the context of building capability of the future rural and remote workforce.

Methods: National education in PPC through QuoCCA has been achieved through a collaboration of six tertiary PPC services, funded by the Australian Government Department of Health. Informed with learning needs analyses, the education was evaluated through:

• Impact surveys completed before and after the session with responses related to knowledge and confidence across 9 domains. These were analysed against 8 independent variables which were education and participant related.
• Outcome surveys completed more than 6 months following their QuoCCA education session regarding the value of different aspects of the education and any changes in practice or care of patients and families they had implemented as a result.

Results: The first QuoCCA Project 2015–17 provided 337 education sessions, consisting of 767 hours and attended by 5773 professionals (medical, nursing, allied health, and others). Education was provided in every state and territory in Australia, with 203 provided in major cities, 117 in regional areas, and 16 in remote areas.

The analysis of paired impact surveys completed by 969 participants showed that all participants had a significant increase in knowledge and confidence for all measures. Factors that predicted an increase in confidence/knowledge were:

• Previous experience caring for a child with a life limiting condition—participants with previous experience had significantly higher scores before and after education. Those with no previous experience were more likely to improve in confidence and knowledge.
• Previous PPC education—those with previous education had significantly higher scores before and after education. Those with no previous education were more likely to improve in confidence and knowledge.
• Length of education session—participants in longer education sessions were more likely to improve in confidence and knowledge.
• Regional and remote participants were more likely to improve than city participants in confidence in the management of nausea and seizures and knowledge of resources that can assist in providing care.

In the outcome survey completed more than 6 months following education, QuoCCA education was rated by 98% of surveyed participants as valuable (36%) or extremely valuable (62%) (n=90) and 74% said it was extremely or very helpful in making a difference to their practice and care of patients (n=57).

Conclusions:

• Dosage of education was an important factor in predicting improvement in knowledge or confidence, including prior attendance and the length of the education session.
• Although those with no previous experience in caring for a child with a life limiting condition showed a greater improvement following education, both novice and experienced providers moved to higher levels of knowledge and confidence.
• The next steps for the project are simulation, interactive training and improving access to training through the national website www.quocca.com.au

Steve Gilbert has been a consultant in anaesthetics and pain medicine for 22 years. He moved to Queensland from Scotland in 2016. His interests include: explaining and demystifying pain for patients and doctors; developing community and primary care pain management; and education at undergraduate level to promote a biopsychosocial approach to health. Since arriving in Townsville, he has been working on establishing a patient support group and a group-based opioid reduction program.

Persistent or chronic pain is a common problem, affecting 1 in 5 of the population and it is one of the most common reasons for GP consultations. Despite the prevalence of pain and its effect on patients’ quality of life, there is little undergraduate or postgraduate education on pain management. The resources that do exist often focus on pain as a symptom of a disease, investigations and pharmacological treatment.

The epidemiology of persistent pain, however, suggests that most persistent pain is not necessarily related to underlying tissue damage or disease and that pharmacological treatment has limited effectiveness as well as carrying risks. The prime example of this is chronic low back pain, which was found to be the leading cause of years lived with disability in the Lancet Global Burden of Disease survey. The Lancet back pain papers of 2018 outline the research evidence for treatment with reliable information, physical rehabilitation and psychosocial interventions. Despite this knowledge, the first intervention in primary care is usually pharmacological and there are rising rates of imaging, interventional techniques and spinal surgery—all of which have limited evidence for effectiveness. The development of the opioid prescribing epidemic is partly a result of this lack of understanding. We aim to help GPs to have a deeper understanding of the nature of persistent pain, the use and limitations of pharmacological treatment, and how to help patients with non-pharmacological treatments. We will also address aberrant drug-related behaviour, dependence and how to help patients to reduce ineffective or harmful treatments.

The workshop will be based on an interactive case-based discussion, with the opportunity to discuss the challenges of managing patients in remote and rural settings as well how cultural and societal factors can be addressed to be able to help patients with the resources of state-of-the-art, multidisciplinary pain management.

Ornissa Naidoo is a registered occupational therapist, health educator and researcher. She is a lecturer of Rural Health at the Western Australian Centre for Rural Health (WACRH), University of Western Australia, based in Karratha. Her current research areas are falls prevention programs suitable for the Aboriginal population and enhancing pre-writing skills in the Pilbara. She has strong clinical and management experience of more than 20 years over a range of areas including hospitals, schools and community settings.

Ornissa currently manages occupational therapy paediatric and adult placements for WACRH across the Pilbara. She is also the research coordinator for the Developmental Occupational Therapy Network of Western Australia. Her other research interests include leading an international research project on the Kawa Model which is a culturally specific model that uses the river as a metaphor of life. In addition, she enjoys educational research, in particular evaluative judgement, which looks at students assessing the quality of their work as well as others.

Background: According to the Australian Early Development Census, approximately 12.5 per cent of children across the Pilbara are developmentally vulnerable in the physical health and wellbeing domain. Aboriginal and Torres Strait Islander children are more than twice as likely as other children to be developmentally vulnerable at transition from kindy to school.

Pre-writing skills are foundational skills children need to develop before they are able to start learning to write and they contribute to school readiness. They require an integration of sensory and motor skills that contribute to a child gaining mastery in a range of activities including holding and using a pencil, the ability to draw, copy and colour. A review of the literature suggests that there is a paucity of Aboriginal-specific pre-writing skills programs. Occupational therapists are frequently requested to assist in the remediation of handwriting difficulties in the classroom.

In 2019, a pilot project of a kindergarten play-based pre-writing skills program was implemented at two schools in the Pilbara. Teachers were trained to implement the program and a training package was left at each school. Preliminary evaluation was conducted after this pilot. The evaluation used focus groups and interviews with teachers and education assistants to explore their perceptions of the contribution of the play-based pre-writing skills program to improved learning outcomes in their children. The results are positive in terms of teacher uptake and satisfaction with the program. They report that children’s skills improved and their ability to help children develop pre-writing skills also improved.

Successful transitioning into school is important to both children and families as it is predictive of long-term academic achievement. The authors now plan to scale up this program across multiple schools in the Pilbara and implement an evaluative research project to generate evidence for its efficacy. It is hoped that this research will influence the development of a regional approach to promoting early literacy for children in rural and remote locations.

Aim: This research aims to evaluate the implementation of a kindergarten play-based pre-writing skills program and its impact on literacy (pre-writing skills) outcomes for children in multiple schools in the Pilbara.

Proposed methods: For the next phase of this research project we are considering an action research study using mixed methods. This will integrate qualitative stakeholder perspectives with data-driven quantitative outcomes.

Issues/dilemmas: Feedback from the pilot study suggests that the program be modified to include elements like a home program. For people who have used action research, how many cycles might be used?

As we hope to deliver the program across the primary schools in the Pilbara, discussion on how to scale up this research is sought. Recommendations for selecting quantitative measures to progress this mixed methods study would be welcomed.

Advice on how to translate the results of the study to inform early learning curriculum development would also be welcomed.

Dr James Purnell is an Assistant Professor with Northern Medical Services through the University of Saskatchewan, Canada, providing clinical services to Northern Saskatchewan communities and investigating ways to enhance care using virtual care. At home in Saskatoon he does in-house coverage for internal medicine and obstetrics as well as locums throughout Saskatchewan and the Yukon Territory. He has recently commenced his MPhil through the University of Queensland looking at expanding virtual care to augment and deliver services to rural and remote populations.

James lives in Saskatoon, Canada, with his two children. He enjoys outdoor activities including skiing, biking, and hiking as well as doing home renovations in his spare time.

Virtual care has the potential to augment primary care service access in remote Indigenous communities, improving continuity of care with the same provider and increasing access to services. Canada, like Australia, has a large land mass with many rural and remote populations that have limited access to local health resources due to their geographic and sociocultural and economic barriers. The lack of primary care services for a few months to a remote northern Canadian Indigenous community (Wollaston Lake, population ~ 1500) prompted the introduction of an innovative service delivery model of primary care clinics. Weekly clinics were delivered via virtual care with access to a Bluetooth stethoscope, otoscope, opthalmascope, and dermatoscope and once per month the same physician would fly into the community for a few days to deliver in-person primary care clinics.

Now I am conducting in-depth research about this model, with the hope of informing its wider adoption, including in places like Australia. On this note, I hope to use this rogano to discuss what sort of research about remote primary care telehealth models would most usefully inform the adoption of these models for other Indigenous communities. Does this research simply need to provide evidence of service continuity? Or what other barriers and assumptions must it test to show that virtual primary care can be a viable model for remote Indigenous communities? The audience will provide critical reflections on:

1. policy assumptions that need to be broken down
2. compensation systems for practitioners
3. real cost to communities
4. actual care outcomes
5. infrastructure
6. culture.

The findings of the rogano will assist with structuring the design of my thesis to build a useful platform to advocate for the adoption of more viable virtual care supported primary care models in Australia and other countries.

Caroline is the Associate Professor, Podiatry, and Associate Head of School of Community Health at Charles Sturt University (CSU). Previously she has worked as a course director and developed experience in quality assurance for curriculum, learning and teaching across a range of undergraduate and postgraduate health courses. Caroline’s collaboration with the School of Indigenous Australian Studies and the Gulaay Indigenous Australian Curriculum and Resources Team at CSU, informs her work in scaffolding Indigenous Australian content in courses to facilitate the students' cultural competence journey. As a non-Indigenous academic, Caroline’s cultural competence journey has been enabled and enriched by collaboration with Aboriginal and non-Aboriginal colleagues; participation in an on-country immersion at Menindee Lakes, NSW; completion of the 'Aboriginal Sydney' MOOC, University of Sydney; participation in the LIME VII and LIME VIII conferences (2017 and 2019); and completion of the CSU Indigenous Cultural Competence training program. Her interests include whole of course assessment in relation to the Indigenous curriculum and also the concept of 'care' in health curricula. Caroline’s current research is related to academic staff cultural competence in relation to learning and teaching, and developing cultural competence for allied health students.

The importance of educating culturally capable health and social care practitioners must not be underestimated and should be perceived as a core responsibility for all educators whether in academic institutions or in clinical practice. Avoiding or sidelining this responsibility risks the perpetuation of culturally unsafe practice in health and social care, and continuing cultural exclusion of Aboriginal and Torres Strait Islander peoples. Pitama et al (2018) identified a range of actors and events that work to disrupt or support the implementation of an Indigenous health curriculum. These include external influences driving the curriculum, limited leadership capacity, hidden curricula, and insufficient institutional investment to support a comprehensive curriculum and the appropriate development of faculty staff. Workforce development and training is one of six domains that underpin culturally respectful health service delivery and is the focus of the work presented here.

This paper presents the preliminary outcomes of a cross-sectional survey of 101 health and social care academics representing 15 disciplines at Charles Sturt University (CSU), NSW. The purpose of this online survey was to gain insight into academics’ knowledge of and experiences with Indigenous cultural competency, in order to identify the need for continuing support and professional development. The survey was developed by an interdisciplinary team in consultation with the Gulaay Indigenous Australian Curriculum and Resources team and reviewed by a reference group which included Wiradyuri Elders. Anonymous data was collected relevant to four headings: CSU context; personal cultural competence; professional development; and demographic information.

Participants who completed the survey represent a range of academic experience, from ‘currently on probation’ to ‘more than 20 years’. 61 of the academics (61%) indicated that they were at the stage of ‘cultural sensitivity’ as compared to 21 who considered that they were at a level of ‘cultural competence’ (21%). 83 of the participants (83%) reported being capable or highly capable in evaluating their own cultural values and world view. The barriers which this group of academics had experienced in progressing their own cultural competency journey include: self-limitations; developing intercultural relationships; institutional factors including racism and discrimination; cultural privilege and the ignorance of others; and workplace cultures.

This survey explored a range of topics in regard to Indigenous cultural competency journeys. It is important to illuminate the barriers that health and social care academics experience, as this knowledge provides a foundation to inform professional development planning at CSU. If academics are not well-supported to develop their own cultural capabilities, their efforts to progress cultural competency journeys for their students, communities and workplaces will be compromised. The outcomes of this pilot survey will inform a larger study across CSU which aligns well with a whole of university approach. The development of academics’ cultural capabilities is foundational to enabling the timely implementation of CSU’s Indigenous Australian Content in the Curriculum (IACC) policy and, more broadly, assisting the institution in addressing the National Best Practice Framework for Indigenous Cultural Competency in Australian Universities and the Universities Australia Indigenous Strategy 2017–20.

Penny Slater is program manager for the Oncology Services Group at Queensland Children’s Hospital, including the Queensland Paediatric Palliative Care, Haematology and Oncology Network. In that role, she manages planning, evaluation, projects, quality and safety, and consumer engagement. She has been project adviser for the Quality of Care Collaborative Australia Project (delivering national paediatric palliative care education) since its commencement in 2014, and manages the evaluation of that project. Penny has been with Queensland Health since 1990 in various research, planning and evaluation positions related to diabetes, aged care, suicide prevention and oral health.

Aims: The Quality of Care Collaborative Australia (QuoCCA) has provided education for health professionals in paediatric palliative care (PPC) across Australia since 2015 with an aim to improve the quality of services in regional areas.

Relevance: The lessons learnt from the QuoCCA Project will be applied to the context of building capability of the future rural and remote workforce.

Methods: National education in PPC through QuoCCA has been achieved through a collaboration of six tertiary PPC services, funded by the Australian Government Department of Health. Informed with learning needs analyses, the education was evaluated through:

• Impact surveys completed before and after the session with responses related to knowledge and confidence across 9 domains. These were analysed against 8 independent variables which were education and participant related.
• Outcome surveys completed more than 6 months following their QuoCCA education session regarding the value of different aspects of the education and any changes in practice or care of patients and families they had implemented as a result.

Results: The first QuoCCA Project 2015–17 provided 337 education sessions, consisting of 767 hours and attended by 5773 professionals (medical, nursing, allied health, and others). Education was provided in every state and territory in Australia, with 203 provided in major cities, 117 in regional areas, and 16 in remote areas.

The analysis of paired impact surveys completed by 969 participants showed that all participants had a significant increase in knowledge and confidence for all measures. Factors that predicted an increase in confidence/knowledge were:

• Previous experience caring for a child with a life limiting condition—participants with previous experience had significantly higher scores before and after education. Those with no previous experience were more likely to improve in confidence and knowledge.
• Previous PPC education—those with previous education had significantly higher scores before and after education. Those with no previous education were more likely to improve in confidence and knowledge.
• Length of education session—participants in longer education sessions were more likely to improve in confidence and knowledge.
• Regional and remote participants were more likely to improve than city participants in confidence in the management of nausea and seizures and knowledge of resources that can assist in providing care.

In the outcome survey completed more than 6 months following education, QuoCCA education was rated by 98% of surveyed participants as valuable (36%) or extremely valuable (62%) (n=90) and 74% said it was extremely or very helpful in making a difference to their practice and care of patients (n=57).

Conclusions:

• Dosage of education was an important factor in predicting improvement in knowledge or confidence, including prior attendance and the length of the education session.
• Although those with no previous experience in caring for a child with a life limiting condition showed a greater improvement following education, both novice and experienced providers moved to higher levels of knowledge and confidence.
• The next steps for the project are simulation, interactive training and improving access to training through the national website www.quocca.com.au

Emma Taylor is a research officer with the WA Centre for Rural Health, at the University of Western Australia. Recently Emma’s research has focused on developing and supporting the Indigenous health workforce, specifically the factors affecting the retention of Indigenous health professionals and students. Emma is also involved in a national study to identify how cancer services are working to meet the needs of Indigenous cancer patients. Prior to joining the WA Centre for Rural Health, Emma worked as a librarian for 10 years in university and corporate libraries.

Aims: The aim of this systematic literature review was two-fold: to identify factors affecting the retention of Indigenous students across all tertiary health disciplines, and the strategies used to support Indigenous students to remain with, and successfully complete, their studies.

Methods: Eight electronic databases were systematically searched between July and September 2018. Articles were screened for inclusion using predefined criteria and assessed for quality using the Mixed Methods Assessment Tool and the Joanna Briggs Institute Checklist for Text and Opinion.

Relevance: With increasing remoteness, the proportion of Indigenous people increases, as do the challenges in ensuring a sustainable health workforce appropriate for the local population. Indigenous Australians are under-represented in the health workforce for every health profession, including nursing, medicine and all allied health professions. Indigenous patients have long requested to have Indigenous practitioners involved in their health care, with this increasing the likelihood of culturally safe care. Encouraging people raised in rural and remote areas to take up health careers is one strategy to reduce rural health workforce turnover. To address the shortage of Indigenous health professionals, it is important to not only recruit more Indigenous people into health science courses, but also to support them throughout their studies so that they graduate as qualified health professionals.

Results: Twenty-six articles met the criteria for inclusion. Key factors reported by students as affecting retention were: family and peer support; competing obligations; academic preparation and prior educational experiences; access to the Indigenous Student Support Centre; financial hardship; and racism and discrimination. The most successful strategies implemented by nursing, health and medical science faculties to improve retention were multi-layered and included: culturally appropriate recruitment and selection processes; comprehensive orientation and pre-entry programs; building a supportive and enabling school culture; appointing Indigenous academics; embedding Indigenous content throughout the curriculum; developing mentoring and tutoring programs; flexible delivery of content; partnerships with the Indigenous Student Support Centre; providing social and financial support; and ‘leaving the university door open’ for students who leave before graduation to return.

Conclusions: Universities have an important role to play in addressing rural health workforce challenges, including low numbers of Indigenous people in the health workforce which contribute to health inequities. The literature provides insight into the suite of measures which if implemented concurrently to provide support, can enable talented Indigenous people to overcome adversities and graduate as health professionals. These need to start with recruitment and pre-entry preparation programs, then continue throughout the student’s time at university. Rural and remote areas seeking to support local Indigenous people to enter the health workforce may be able to assist around the financial challenges and personal/family issues that occur and can impede Indigenous students' progress through to graduation.

Dr Sharon Varela is Senior Clinical Lead/Senior Lecturer with the Centre for Rural and Remote Health, James Cook University. She completed her PhD at the University of Queensland, researching resilience in youth. Sharon is the current Chair of the ARHEN Mental Health Academic Network, a network of academics contributing to the national conversation on mental health through research, policy input, student placements and workforce development. She is located in Longreach and has a passion for rural and remote practice. Sharon has extensive experience in the training and supervision of provisional and student psychologists, and with other allied health professions through collaborative and professional practice models. Her research interest areas are resilience, youth, mental health, wellbeing, clinical supervision and ethical practice.

Background: Developing the rural and remote psychology workforce presents unique challenges: higher workloads, more complex cases, less resources, and limited collegial support compared to their metropolitan colleagues. Further, rural and remote psychologists experience increased professional isolation, role strain, scope of practice concerns, ethical conflicts related to boundaries, and multiple and dual relationships. These challenges of rural and remote practice can lead to impaired clinical decision making, ethical violations and burnout, with the burden of support often being placed on the Board-approved supervisor. Rural and remote practice is further impacted by the idiosyncrasies of training the psychologist workforce. Psychology is unique in the health disciplines, with an absence of clinical placements in the undergraduate degree and postgraduate training being predominantly designed for on-campus teaching with a metropolitan-centric focus. Not only is there a serious shortage of psychologists in rural and remote Australia, there is an urgent need to adequately prepare our supervisor workforce to address the unique demands of rural and remote psychology practice.

Aims: This research will inform practice by identifying evidence-based models, training and tools that are designed for supervisors of the rural and remote trainee psychologist workforce. It aims to develop skills training that focuses on the needs of rural and remote supervisors, and to identify and develop sustainable pathways to ongoing mentoring and support for supervisors of the rural and remote trainee psychologist workforce.

Proposed methods: A mixed methods design will be employed using qualitative interviews, focus groups and surveys. Experienced supervisors and ‘new to supervision’ supervisors will be targeted through separate phases of the research. The interviews and focus groups will be semi-structured, asking supervisors to share their opinions on key areas of rural and remote practice. The surveys will collect more information about supervisors’ experiences in working and supervising in rural and remote regions, rural origin and confidence in supervising rural and remote professionals/students. A thematic qualitative analysis will be employed to understand the key themes and issues raised through the focus groups, interviews and surveys. Ethics approval has been granted by the HREC at JCU (approval number H7961).

Issues/dilemmas: This presentation will discuss the research design in detail, with preliminary data presented from the focus groups. There is a significant gap in the research regarding the supervisory needs of rural and remote psychologists, with the frameworks employed being mandated by the Psychology Board of Australia. This research project will contribute to the conversation on the training needs of supervisors and trainee psychologists and aims to influence policy around training and support provided to supervisors of rural and remote trainee psychologists. Advice is sought from conference delegates on the following: issues or concerns with the design of the research project: whether the project should be extended to include the views of supervisees and/or other allied health professions; whether it is important to include a comparative (ie health professionals supervising metropolitan-based supervisees); and any other general advice or comments on the research project.

Leesa Walker is a rural general practitioner working in general practice in Hamilton, Victoria. She is Discipline Head of Flinders University Rural and Remote Health South Australia where she leads the rural programs and staff that are distributed across South Australia and Victoria. Previously she has been academic coordinator of the Parallel Rural Community Curriculum (PRCC), an internationally recognised longitudinal integrated clerkship where penultimate year medical students learn from rural doctors based in general practice. In this role she has overseen the expansion of the Rural PRCC sub quota selection process expansion and the implementation of programmatic assessment for learning into the rural program. She has led the Progress Test for the Doctor of Medicine as academic coordinator since 2018 and chairs the Progress Test Item Review Committee. Her academic interests include the wellbeing of students and clinicians, community-engaged medical education, progress testing and medical school selection processes.

Australian Government Rural Clinical School (RCS) programs were developed as rural workforce initiatives to provide experiences that positively influence medical graduates to choose rural careers. The RCS program has a mandate for 25% of all domestic medical students to spend a year or more of their clinical training based in a rural location. Flinders University were pioneers in community-engaged rural medical education with the introduction of Parallel Rural Community Curriculum (PRCC) in 1997 (Worley 2001). Over the years, the PRCC developed to be an internationally renowned, patient‐centred, community‐based and educationally sound, rural medical curriculum, based in Australian rural general practice. The consequence and impact of the PRCC on rural careers of their students was improbable to comprehend at the beginning, but now after 20 years it's possible to view the tangible impact of the program. This data-linkage study aims to compare the medical graduates who have undergone training in the city (Adelaide Flinders Medical Centre) with those who participated in PRCC program based in rural towns of South Australia and Victoria between 1999 and 2016 on their registration type, speciality and current location of practice in 2017, using the Australian Health Practitioner Regulation Agency (AHPRA) database. Ethics approval was obtained from Flinders University Social and Behavioural Ethics Committee.

The study tracked 1921 Flinders medical graduates who completed their undergraduate course between 1999 and 2016. 367 (19.1%) participated in the PRCC Rural Clinical School program. More women graduated through the PRCC program (n=228, 62.1%) compared to graduates from the city campus (n=766, 49.3%). PRCC graduates were more likely to report a speciality in general practice (56.2%), compared to city-based graduates (33.6%). We analysed the current location of medical practice by transforming postcodes to Modified Monash Model (MMM) categories. Flinders PRCC rural campus graduates were 2.5 times more likely to practise in a rural location (MMM 3–7) in the year 2017, compared to Flinders graduates from the main campus (odds ratio 2.6 [95% CI 1.9–3.4], p<0.001).

The study clearly illustrates the positive impact of the rural training program in the translation of rural medical workforce, especially in rural general practice. The study contributes to the evidence base on the contribution of rural undergraduate medical training in addressing the medical workforce challenge in rural areas.