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: Qualitative descriptive study

• Barriers

• Enablers

• Implications for educating and motivating

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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

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Why the AHRRTS program?

Principles of safety, efficiency and effectiveness in healthcare are 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

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Distances from Brisbane

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Charleville……………….. 744 km (8hrs 30mins driving)

Longreach……………….. 1177 km (13hrs)

Mount Isa………………… 1824 km (20hrs)

Thursday Island…………. 2192 km (2 flights & a ferry....)

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

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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

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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

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Allied Health Disciplines

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Classification Level

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13 core learnings from

the AHRRTS evaluation

Improved access,

knowledge, confidence and

skills (2)

AHRRTS Critical success factors

(3)

Barriers, enablers and

ongoing recommendations

(3)

Data capture, sustained

evaluation and dissemination of findings (3)

Complex and evolving rural and remote context (2)

Spotlight on one component of evaluation

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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

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associated with

increasing occurrence

of the themes from the

data

The increasin

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Barriers and enablers Slide 12Cunningham Centre

Barriers

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2. ORGANISATIONAL“…Basically just budgets…”

“…Accessing a videoconference machine...”

“…Not being drilled about why you are doing it…”

1. TIME“...Again it's just that clinical time…”

“…A lot of other demands…”

“…We avoid going anywhere long enough that would require

backfill…”

3. TRAVEL“...really it is the travel and the

distance that I haven't…”

“…you lose two days and you’ve got accommodation and travel…”

Enablers

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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…”

1. ORGANISATIONAL“….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…”

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

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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.”

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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 DucatSenior Program CoordinatorAllied Health Education and Training / AHRRTSCunningham CentreDarling Downs Hospital and Health ServiceWendy_Ducat@health.qld.gov.au

(07) 4616 5545

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