The rapid response to the coronavirus pandemic has highlighted the importance, breadth and dynamic nature of health care. Global measures of self-isolation, travel restriction and physical distancing were implemented in just a few months to restrict the spread of Coronavirus. COVID-19 has threatened workforce, service capacity and clinical education, and nowhere is this more apparent than in rural and remote Australia.
The pandemic quickly changed the ways in which health care is provided, including where it is provided, how it is accessed and how it is staffed by health professionals. These changes have implications for student learning, how nursing and allied health placements are reconfigured, and how students develop the clinical skills needed to join the workforce. This has created uncertainty about teaching students during COVID-19 and many rural and remote placements, particularly in allied health, were postponed.
While safety is paramount, an unpredictable and rapidly changing health care environment creates opportunities for new ways of learning. Continuing clinical placements during a pandemic provides learning opportunities, workforce support, maintains our workforce pipeline, and facilitates final year students to progress to graduation so they enter the workforce on time—graduates of 2020 can provide some relief for fatigued rural and remote staff at the end of the year.
Resolving the challenges of student learning during COVID-19 requires new approaches to student placements that can utilise the skills of students and adapt traditional supervision requirements. Existing models of work-integrated learning, service learning and telehealth have been utilised and adapted to integrate students into health and community sectors for mutual benefit (see Jacoby, 2003). There is potential to further adapt these models during the COVID-19 recovery phase and in what becomes the ‘new normal’ across rural, remote and urban Australia.
University Departments of Rural Health (UDRHs) have adopted work-integrated learning, service learning and telehealth models in student placements for over a decade in rural and remote regions of Australia (ARHEN, 2020). These placements have been effective where workforce is lacking, where health and community services are limited, and where particular groups have increased need. Using long-arm, local or multi-modalities of supervision, nursing and allied health students undertake assessments, reviews, provide routine care or implement a range of services and interventions in rural, remote and virtual environments for clients who would otherwise not receive such services. Contexts for these student placements are widely diverse and can include rural hospitals, primary care settings, primary and secondary schools, kindergartens, aged care centres, disability services and human services. Students often contribute important project work for rural and remote health services or communities that provide evidence, resources and planning for the future. In recent months, UDRHs have reconfigured allied health placements to provide online exercise programs, physiotherapy, tele community rehabilitation and other interventions to the elderly, people with disability and primary aged children as they isolate in their homes.
While students may be challenged by the independence required of these placements, UDRHs have found such placements develop work-readiness, critical thinking, and collaborative, organisational, telehealth and interprofessional skills. Students have identified significant personal and professional satisfaction from using their skills to actively contribute to service provision and health outcomes (Jones, 2015a, 2015b).
There has been much re-thinking and innovating in health care in the past few months and transitioning to new models of student placements can be another shift in contemporary health care. Learning from rural and remote settings, work-integrated learning, service learning and telehealth placements provide opportunities to address unmet needs in flexible and sustainable ways (Stetton, 2019). Adapting these models can teach students how to work during extreme events while responding to significant community need and enhancing the health workforce.
References
ARHEN (2020). Australian Rural Health Education Network. ARHEN, https://arhen.org.au.
Jacoby, B., Ed (2003). Building Partnerships for Service-Learning. San Francisco: Wiley.
Jones, D., McAllister, L. & Lyle, D. (2015a). Stepping out of the shadows: Allied health student and academic perceptions of the impact of a service-learning experience on student's work-readiness and employability. Graduate Employability 6(1), https://doi.org/10.21153/jtlge2015vol6no1art574.
Jones, D., McAllister, L., & Lyle, D. (2015b). Interprofessional Academic Service-Learning in Rural Australia: Exploring the impact on allied health student knowledge, skills, and practice. A Qualitative Study. International Journal of Practice-Based Learning in Health and Social Care 3(2), 1-16. https://doi.org/10.18552/ijpblhsc.v3i2.217.
Stetten, N. E., et al. (2019). Interprofessional service learning experiences among health professional students: A systematic search and review of learning outcomes. Journal of Interprofessional Education & Practice 15: 60-69.
About the authors
Lisa Bourke, Director University Department of Rural Health, The University of Melbourne
Associate Professor Monica Moran, Western Australia Centre for Rural Health, University of Western Australia
Dr Deb Jones, Senior Lecturer, Broken Hill University Department of Rural Health, University of Sydney
Ms Danielle White, Lecturer, Broken Hill University Department of Rural Health, University of Sydney
Dr Narelle Campbell, Academic Lead, Rural and Remote Health, Flinders Northern Territory
Associate Professor Geoff Argus, Director, Southern Queensland University Department of Rural Health, University of Queensland
Ms Christine Howard, Director Three Rivers University Department of Rural Health, Charles Sturt University
Ms Robyn Fitzroy, Program Director of Multidisciplinary Health, University Centre for Rural Health, University of Sydney
Professor Sabina Knight, Director, Mount Isa Centre for Rural and Remote Health, James Cook University
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