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Educating and motivating rural and remote allied health professionals: Learning from experience and evidence Educating and motivating rural and remote allied health professionals: Learning from experience and evidence Wendy Ducat B. A. , BPsych (Hons), Ph. D. ¹, Vanessa Richardson BSc, MSc(Nutr&Diet), MPH, MHA ¹ and Saravana Kumar Ph. D. ² ¹Cunningham Centre, Darling Downs Hospital and Health Service ²International Centre for Allied Health Evidence, University of South Australia

Overview • • Background Why the AHRRTS program? Two year evaluation Core learnings Spotlight: Overview • • Background Why the AHRRTS program? Two year evaluation Core learnings Spotlight: Qualitative descriptive study Barriers Enablers Implications for educating and motivating Cunningham Centre Slide 2

Background The Cunningham Centre is Queensland Health’s largest Registered Training Organisation The Allied Health Background The Cunningham Centre is Queensland Health’s largest Registered Training Organisation The Allied Health Education and Training department launched the Allied Health Rural and Remote Training and Support (AHRRTS) program in 2010 as a two year pilot trial The International Centre for Allied Health Evidence conducted a comprehensive two year external evaluation of the AHRRTS program in 2012 Cunningham Centre Slide 3

Why the AHRRTS program? Principles of safety, efficiency and effectiveness in healthcare paramount A Why the AHRRTS program? Principles of safety, efficiency and effectiveness in healthcare paramount A confident and competent health workforce is key • Rural and remote specific challenges • Allied health profession diversity Coordinated, relevant and effective continuing education and professional support is essential Cunningham Centre Slide 4

Distances from Brisbane Charleville………………. . 744 km (8 hrs 30 mins driving) Longreach………………. . Distances from Brisbane Charleville………………. . 744 km (8 hrs 30 mins driving) Longreach………………. . 1177 km (13 hrs) Mount Isa………………… 1824 km (20 hrs) Thursday Island…………. 2192 km (2 flights & a ferry. . ) Cunningham Centre Slide 5

AHRRTS program design Tailored, flexible, needs based assessment and follow up with individual health AHRRTS program design Tailored, flexible, needs based assessment and follow up with individual health practitioners and teams Coordination and delivery of accessible, capability based training and support for rural and remote allied health • • Videoconferencing Face to face delivery Online/blended learning Referral to existing providers Matching with professional supervisors or mentors Funding to support supervision/mentoring arrangements Annual rural skills symposium Cunningham Centre Slide 6

Two-year evaluation Ethics approval received from Queensland Health and the University of South Australia Two-year evaluation Ethics approval received from Queensland Health and the University of South Australia Broad objective to determine the accessibility and impact of the AHRRTS program • Mixed methods design incorporating longitudinal follow up of participants • Pre, post and 3 -month evaluation of workshops • Semi-structured interviews – Participants and key stakeholders with at least 6 months experience in the program http: //qheps. health. qld. gov. au/cunningham-centre/html/ah-ahrrts. htm Cunningham Centre Slide 7

AHRRTS participants 175 allied health professionals (from an eligible 380 staff) participated in the AHRRTS participants 175 allied health professionals (from an eligible 380 staff) participated in the overall program during the two year trial District/Hospital & Health Service Cunningham Centre Slide 8

Classification Level Allied Health Disciplines Cunningham Centre Slide 9 Classification Level Allied Health Disciplines Cunningham Centre Slide 9

Complex and evolving rural and remote context (2) AHRRTS Critical success factors (3) 13 Complex and evolving rural and remote context (2) AHRRTS Critical success factors (3) 13 core learnings from the AHRRTS evaluation Data capture, sustained evaluation and dissemination of findings (3) Barriers, enablers and ongoing Improved access, knowledge, confidence and skills (2) recommendations (3) Cunningham Centre Slide 10

Spotlight on one component of evaluation Qualitative descriptive study • Standardised protocols • Thematic Spotlight on one component of evaluation Qualitative descriptive study • Standardised protocols • Thematic analysis Semi structured interviews with 55 key stakeholders • 9 managers • 4 professional supervisors/mentors • 42 allied health professional “AHRRTS participants” Themes of “enablers” and “barriers” have ongoing implications for educating and motivating the rural and remote allied health workforce Cunningham Centre Slide 11

The increasing darkness of the colour is associated with increasing occurrence of themes from The increasing darkness of the colour is associated with increasing occurrence of themes from the data The increasin g darkness of the colour is associate d with increasin g occurrenc e of themes from the data Cunningham Centre Barriers and enablers Slide 12

Barriers 1. TIME “. . . Again it's just that clinical time…” “…A lot Barriers 1. TIME “. . . Again it's just that clinical time…” “…A lot of other demands…” 2. ORGANISATIONAL “…We avoid going anywhere long enough that would require backfill…” “…Accessing a videoconference machine. . . ” 3. TRAVEL “…Basically just budgets…” “…Not being drilled about why you are doing it…” “. . . really it is the travel and the distance that I haven't…” “…you lose two days and you’ve got accommodation and travel…” Cunningham Centre Slide 13

1. ORGANISATIONAL Enablers “…. it’s well supported in our district for people to have 1. ORGANISATIONAL Enablers “…. it’s well supported in our district for people to have protected time…” “…(AHRRTS coordination) just makes things a lot more efficient which means that we can do client services. ” 2. TRAVEL “The best training that I find is to really get away from the workplace to actually do it. ” “…nice to be able to travel as a team and we got to know each other quite well…” 3. PRESENTATION MODE “The use of videoconferencing and teleconferencing is just, it’s vital. . . ” “…still able to do almost a full day in the office…” Cunningham Centre Slide 14

Educating and motivating strategies 1. Complex barriers cannot be eliminated but can be moderated Educating and motivating strategies 1. Complex barriers cannot be eliminated but can be moderated 2. Organisational strategies are key enablers • • • Support for PD coordination & implementation Engage with line managers Communicate organisational policy Financial support Facilitate time management and prioritisation strategies Focus on enhancing access/impact of distance based training 3. Evaluate and publish to grow the evidence base Cunningham Centre Slide 15

A final quote…. “…. . and from a professional point of view, I think A final quote…. “…. . and from a professional point of view, I think a rural caseload is so rewarding just full stop. The diversity, the autonomy and all of those sorts of things, but just having the support from AHRRTS and being part of the bigger OT district, I think it just validates what you're doing in a role where often you don't get that validation. So it really is the icing on the cake in terms of your job satisfaction and feeling like you're making a valuable contribution. ” Cunningham Centre Slide 16

Acknowledgements Thank you to the AHRRTS participants, Allied Health Directors, Managers, Professional Supervisors and Acknowledgements Thank you to the AHRRTS participants, Allied Health Directors, Managers, Professional Supervisors and Mentors who have participated and provided feedback on the AHRRTS program Contact Details: Wendy Ducat Senior Program Coordinator Allied Health Education and Training / AHRRTS Cunningham Centre Darling Downs Hospital and Health Service [email protected] qld. gov. au (07) 4616 5545 Cunningham Centre Slide 17

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