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Nielsen I1, Hulcombe J2
1Queensland Government, Allied Health Professions' Office Queensland, Cairns, Australia, 2Queensland Government, Allied Health Professions' Office Queensland, Brisbane, Australia
Background: Rural and remote Australians experience a higher burden of disease and disability compared to urban dwellers, but have relatively poorer access to health services including physiotherapy. Rural recruitment and retention challenges described in the literature include professional isolation, and limited access to professional development and career progression.
Purpose: A multi-stage project undertaken between 2013 and 2018 aimed to define, develop, trial and evaluate a rural generalist training pathway for physiotherapy and six other allied health professions. The project sought to address the disincentives for recruitment, support workforce capability and sustainability, and improve access to care in rural and remote areas of Queensland, Australia.
Methods:
Phase 1: define rural generalist practice and education requirements.
Clinical task mapping was undertaken in five teams in rural and remote regions of northern Australia. The composite task list and a literature review informed a draft Education Framework that described clinical and non-clinical/service requirements of early career practitioners. Extensive stakeholder consultation and expert review by national professional leaders refined and finalised the Education Framework.
Phase 2: develop, trial and evaluate rural generalist training positions.
Thirty-three designated early career allied health training positions were implemented for one or two-year terms in rural and remote areas across Queensland, including nine physiotherapists. Positions had:
Results: Focus areas for rural generalist development in non-clinical domains of the Education Framework included: service development, evaluation and planning; project management; evidence-based decision-making; education; applied research; service delivery models including delegation and telehealth; cultural competence; and community engagement. Clinical focus areas for physiotherapy were paediatrics; women's health; subacute/rehabilitation; musculoskeletal; prevention and self-management; and skill sharing.
The Phase 2 trial confirmed the components of the training role, including designated development time and supervision, were critical success factors for recruitment and development of graduates in rural locations. The training roles were identified as change enablers with host teams producing tangible service improvements. All survey respondents described the strategy as 'valuable and successful'. Challenges included implementing robust supervision and project governance processes. Employment location twelve months after separation from training roles was 64% regional, rural or remote, 18% metropolitan and 18% unknown.
Conclusion(s): The project has defined the scope of rural generalist practice and tested a model of employment and training of early career physiotherapists in public sector service settings in Queensland, Australia. The model shows promising outcomes for rural and remote workforce attraction, development and sustainability, that are critical factors for consumers' access to physiotherapy care. Evaluated trials in other jurisdictions and sectors are indicated.
Implications: The employment model and resources including the online education program, can be adopted in other rural and remote settings and areas that require a workforce with a generalist physiotherapy skill set.
Keywords: Rural, Generalist, Training
Funding acknowledgements: Individual projects funded by: Queensland Health, Queensland Government; and Australian Government through the Greater Northern Australia Regional Training Network.
Purpose: A multi-stage project undertaken between 2013 and 2018 aimed to define, develop, trial and evaluate a rural generalist training pathway for physiotherapy and six other allied health professions. The project sought to address the disincentives for recruitment, support workforce capability and sustainability, and improve access to care in rural and remote areas of Queensland, Australia.
Methods:
Phase 1: define rural generalist practice and education requirements.
Clinical task mapping was undertaken in five teams in rural and remote regions of northern Australia. The composite task list and a literature review informed a draft Education Framework that described clinical and non-clinical/service requirements of early career practitioners. Extensive stakeholder consultation and expert review by national professional leaders refined and finalised the Education Framework.
Phase 2: develop, trial and evaluate rural generalist training positions.
Thirty-three designated early career allied health training positions were implemented for one or two-year terms in rural and remote areas across Queensland, including nine physiotherapists. Positions had:
- four hours/week training time,
- co-located profession-specific supervision,
- a formal, online, university-based rural generalist education program,
- engagement in local service development projects.
Results: Focus areas for rural generalist development in non-clinical domains of the Education Framework included: service development, evaluation and planning; project management; evidence-based decision-making; education; applied research; service delivery models including delegation and telehealth; cultural competence; and community engagement. Clinical focus areas for physiotherapy were paediatrics; women's health; subacute/rehabilitation; musculoskeletal; prevention and self-management; and skill sharing.
The Phase 2 trial confirmed the components of the training role, including designated development time and supervision, were critical success factors for recruitment and development of graduates in rural locations. The training roles were identified as change enablers with host teams producing tangible service improvements. All survey respondents described the strategy as 'valuable and successful'. Challenges included implementing robust supervision and project governance processes. Employment location twelve months after separation from training roles was 64% regional, rural or remote, 18% metropolitan and 18% unknown.
Conclusion(s): The project has defined the scope of rural generalist practice and tested a model of employment and training of early career physiotherapists in public sector service settings in Queensland, Australia. The model shows promising outcomes for rural and remote workforce attraction, development and sustainability, that are critical factors for consumers' access to physiotherapy care. Evaluated trials in other jurisdictions and sectors are indicated.
Implications: The employment model and resources including the online education program, can be adopted in other rural and remote settings and areas that require a workforce with a generalist physiotherapy skill set.
Keywords: Rural, Generalist, Training
Funding acknowledgements: Individual projects funded by: Queensland Health, Queensland Government; and Australian Government through the Greater Northern Australia Regional Training Network.
Topic: Service delivery/emerging roles; Education; Professional issues
Ethics approval required: Yes
Institution: 1. Southern Cross University; 2. Gold Coast Hospital Health Service
Ethics committee: 1. Southern Cross University; 2. Gold Coast Hospital Health Service
Ethics number: 1. ECN-14-218; 2. HREC/14/QGC/168
All authors, affiliations and abstracts have been published as submitted.
