ORCID Profile
0000-0001-7804-4319
Current Organisations
Northern Ontario School of Medicine
,
University of Waikato
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Publisher: BMJ
Date: 07-2015
Publisher: WHO Press
Date: 13-08-2010
Publisher: AMPCo
Date: 08-2017
DOI: 10.5694/MJA17.00502
Publisher: CSIRO Publishing
Date: 2002
DOI: 10.1071/AH020104
Abstract: This study aimed to identify and explore the factors that are crucial to the successful operation of rural after-hoursmedical services. It sought to determine the attributes that contribute toward the successful operation of after-hours medical services in rural towns. It drew on computer-assisted telephone interviews with stakeholders, and operational, demographic and financial data. The findings were brought together and analysed within an integrated framework for the guidance of policy makers.In a rural setting, the most important factors for a successful after-hours medical service are related to, 'place', 'process','people' and 'time'. These need to be integrated through effective management of relationships.
Publisher: Emerald Group Publishing Limited
Date: 10-12-2016
Publisher: Wiley
Date: 26-03-2001
DOI: 10.1046/J.1440-1622.2001.02062.X
Abstract: The collection and measurement of colorectal surgical workload, case management and clinical indicators have been mainly based on metropolitan specialist institutions. The aim of the present study was to examine the workload and standards of colorectal surgery in rural Australia. Sixty-nine rural general surgeons in Victoria, Albury and South Australia were invited to complete a questionnaire for each transabdominal colorectal operation performed over a 12-month period from 1 May 1996. Data were collected on comorbidity, operation detail, pathology, complications and intention to use adjuvant cancer therapy. Sixty-two surgeons contributed 877 data forms. The patient average age was 65 years with 60% having pre-existing disease. One-third of operations were emergency presentations of which bowel obstruction was the most common. An anastomosis was performed in 675 patients of whom 22 (3.3%) had a clinical anastomotic leak. For low rectal anastomosis the leak rate was 8.9%. Two-thirds of patients had colorectal cancer and 42% of these cancer patients had advanced (Australian clinicopathological stage C or D) disease. The perioperative mortality rate was 4.6% but in the presence of more than two comorbidities it was 16.4%. Mortality was higher with emergency presentations (8.3%), particularly in patients older than 80 years (15.2%). The study s led a very high percentage of rural colorectal surgery performed during the audit period. Colorectal surgery clinical indicators were comparable to other Australian studies. Anti-thrombotic and adjuvant therapy were identified as two areas requiring further education. Major surgery is being performed regularly in south-eastern rural Australia at a consistently high standard by surgeons who live and work in their rural community.
Publisher: Informa UK Limited
Date: 15-03-2013
Publisher: Longwoods Publishing
Date: 22-07-2016
Abstract: The transition from hospital to home is a vulnerable period for patients with complex conditions, who are often frail, at risk for adverse events and unable to navigate a system of poorly coordinated care in the post-discharge period. Care transition interventions are seen as effective care coordinating mechanisms for reducing avoidable adverse events associated with the transition of the patient from the hospital to the home. A study was undertaken to evaluate the effectiveness of a care transition intervention involving a hand-off between a hospital-based care transitions nurse and a community-based rapid response nurse. Two focus groups were held, one involving rapid response nurses and the other involving care transition nurses. In idual interviews were conducted with the managers (
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1016/J.ANNEPIDEM.2007.11.016
Abstract: This article, based on our collective experience of conducting population-based and industrially based health research in partnership with northern, rural, and remote communities in Canada and Australia, will convey the related challenges and opportunities, and provide recommendations. (1) The role(s) of northern, rural, and remote communities (2) ethics requirements (3) study budgets and contracts (4) questionnaire design, response rates, and the collection of biological specimens and (5) preparation and presentation of results, their impact, knowledge translation, and future studies were considered. In our experience, it is important to be collaborative, respectful, and have a regular physical presence in such communities. Academic and community ethical review of the proposed research may be required. Written research proposals, contracts, and a communication plan for the results are strongly recommended. Questionnaire construction and acceptable methodology impact study success. Regular in person feedback to the communities is essential. It is important to collaboratively establish future related research priorities. Although academic evaluation can promote the desire for the conduct of more rapid health research, successful research with northern, rural, and remote communities should build community capacity and requires time, a continuing presence, collaboration, respect, and active community involvement.
Publisher: Laurentian University Library
Date: 21-06-2017
Abstract: This study evaluates whether three definitions of rural and urban residence predict prostate cancer progression. People were classified as urban or rural using three definitions: rural and small town (RST), Beale's rural-urban continuum codes, and the Rurality Index of Ontario (RIO) 2008 score. This was a chart-based cohort study of males with prostate cancer who underwent external beam radiation therapy (EBRT) in the Regional Cancer Program at Health Sciences North in Sudbury, Ontario from 1996 to 2003. Data indicative of each of the three definitions were used as predictors in Cox regression analysis for the period of 1,000 to 3,000 days after initial diagnosis and as the basis for dichotomous strata in a log rank test. Complete data were acquired from 629 charts. There was no significant association between any of the three definitions of rurality and prostate cancer progression. However, a Beale-based dichotomization led to survival differences using the log rank test. Beale stratification was potentially sensitive to relevant differences in populations that were not represented by the other two definitions. Given the moderate correlations between the different rurality scores, there may be merit to considering multiple rurality scores as they may lead to different cancer progression outcomes in some situations.
Publisher: CMA Joule Inc.
Date: 08-06-2015
DOI: 10.1503/CMAJ.150266
Publisher: Informa UK Limited
Date: 11-2004
DOI: 10.1080/01421590412331285397
Abstract: As medical schools make use of an increasing variety of clinical teaching settings, it is of interest to find that that there is very little published research that explores the actual learning activities undertaken by students in different environments. This study was designed to describe and analyse a typical week for students learning the same curricular material in one of three Australian settings: an urban tertiary teaching hospital, a remote secondary referral hospital and a rural community-based programme. Twenty-eight students completed week-long learning logs in weeks 9 and 35 of a 40-week academic year. Each student recorded his or her activity in 15-minute intervals for each week. Analysis of these data revealed that, compared with the hospital-based students, the community-based students reported greater patient contact, more time spent in clinical settings and increased time supervised by experienced clinicians. Whilst the community-based students valued their learning in clinical settings more highly than the learning they undertook at their home, the opposite was found for the tertiary hospital-based students. This study, the first to compare student activity in these three prototypical settings in the medical education literature, provides empirical evidence supporting community-based programmes as credible alternatives to traditional teaching hospital-based environments.
Publisher: Informa UK Limited
Date: 16-02-2021
Publisher: Annual Reviews
Date: 18-03-2016
DOI: 10.1146/ANNUREV-PUBLHEALTH-032315-021507
Abstract: Compared to their urban counterparts, rural and remote inhabitants experience lower life expectancy and poorer health status. Nowhere is the worldwide shortage of health professionals more pronounced than in rural areas of developing countries. Sub-Saharan Africa (SSA) includes a disproportionately large number of developing countries therefore, this article explores SSA in depth as an ex le. Using the conceptual framework of access to primary health care, sustainable rural health service models, rural health workforce supply, and policy implications, this article presents a review of the academic and gray literature as the basis for recommendations designed to achieve greater health equity. An alternative international standard for health professional education is recommended. Decision makers should draw upon the expertise of communities to identify community-specific health priorities and should build capacity to enable the recruitment and training of local students from underserviced areas to deliver quality health care in rural community settings.
Publisher: AMPCo
Date: 03-2018
DOI: 10.5694/MJA17.01169
Publisher: Wiley
Date: 08-2000
DOI: 10.1046/J.1440-1584.2000.00305.X
Abstract: The National Rural General Practice Study (NRGPS) was the first comprehensive national study covering rural and remote general practitioners throughout Australia. It was undertaken in 1996-1997 and drew on data from existing sources such as the Australian Bureau of Statistics and the Australian Institute of Health and Welfare, together with a postal survey of general practitioners in rural and remote areas. There was a 75% response rate to the survey, which covered professional issues, personal and social issues, personal background, patient issues, recruitment and retention programs and changing health services. Overall, the study findings confirmed those of previous in idual State-based studies in the early 1990s and showed that there had been some changes since those previous studies. In particular, access to continuing medical education has improved, the rural medical workforce appears to be ageing, the proportion of women rural doctors is increasing and the projected length of stay in rural practice is decreasing. Whereas in the early 1990s the projection for rural doctor numbers was continuing decline, the NRGPS projected overall numbers in rural practice as staying approximately the same over the next 5 years. In the light of these trends, the challenge is to implement targeted initiatives that improve the recruitment and retention of rural and remote general practitioners.
Publisher: Springer Science and Business Media LLC
Date: 15-08-2016
Publisher: Wiley
Date: 26-08-2016
DOI: 10.1111/MEDU.13084
Abstract: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relationships over time and across disciplines and venues. The evidence base for LICs reveals transformational professional and workforce outcomes derived from a number of small institution-specific studies. This study is the first from an international collaborative formed to study the processes and outcomes of LICs across multiple institutions in different countries. It aims to establish a baseline reference typology to inform further research in this field. Data on all LIC and LIC-like programmes known to the members of the international Consortium of Longitudinal Integrated Clerkships were collected using a survey tool developed through a Delphi process and subsequently analysed. Data were collected from 54 programmes, 44 medical schools, seven countries and over 15 000 student-years of LIC-like curricula. Wide variation in programme length, student numbers, health care settings and principal supervision was found. Three distinct typological programme clusters were identified and named according to programme length and discipline coverage: Comprehensive LICs Blended LICs, and LIC-like Amalgamative Clerkships. Two major approaches emerged in terms of the sizes of communities and types of clinical supervision. These referred to programmes based in smaller communities with mainly family physicians or general practitioners as clinical supervisors, and those in more urban settings in which subspecialists were more prevalent. Three distinct LIC clusters are classified. These provide a foundational reference point for future studies on the processes and outcomes of LICs. The study also exemplifies a collaborative approach to medical education research that focuses on typology rather than on in idual programme or context.
Publisher: Wiley
Date: 10-05-2022
DOI: 10.5694/MJA2.51525
Publisher: Wiley
Date: 04-2002
Publisher: Wiley
Date: 18-09-2015
DOI: 10.1111/MEDU.12797
Abstract: This paper describes the transition processes experienced by Year 3 medical students during their longitudinal integrated clerkship (LIC). The authors conceptualise the stages that encompass the transition through a LIC. The purpose of this study was to understand the perspectives of 12 Northern Ontario School of Medicine (NOSM) Year 3 medical students about their transition process. Data were collected longitudinally through three conversational interviews with each of these students, occurring before, during and after the clerkship. The authors used a guided walk methodology to explore students' everyday lives and elicit insights about the transition process, prompted by the locations and clinical settings in which the clerkship occurred. Participants identified three interconnected stages in the transition process: (i) shifting from classroom to clinical learning (ii) dealing with disorientation and restoring balance, and (iii) seeing oneself as a physician. Interview data provided evidence for the adaptive strategies the participants developed in response to these stages. Based on these findings, the transition process during a LIC can be characterised as one of entering the unfamiliar, with few forewarnings about the changes, of experiencing moments of confusion and burnout, and of eventual gains in confidence and competence in the clinical roles of a physician. Recommendations are made regarding future research opportunities to further scholarship on transitions.
Publisher: The Association of Faculties of Medicine of Canada
Date: 21-07-2019
DOI: 10.36834/CMEJ.43460
Abstract: Background:Social support may be beneficial for medical students who must develop adaptive strategies to respond to the demands and challenges during third-year clerkship.We provide a detailed description of the supportive behaviours experienced by third-year students during a longitudinal integrated clerkship (LIC) in the context of rural family medicine. Methods:Informed by a social constructivist research paradigm, we undertook a qualitative study to understand from the students’ perspectives the presence and characteristics of social support available during a LIC.Data were collected from conversational interviews at three points during the eight-month clerkship year, pre-, during, and post-clerkship, to explore how 12 medical students experienced social support. We employed an innovative methodological approach, the guided walk method, to gain the students’ stories in the contexts where they were taking place. Results: The participants described the relationships they developed with various sources of social support such as (a) preceptors, (b) peers, (c) family, (d) health professionals, and (e) community members. Conclusion:Various in iduals representing communities of practice such as the medical profession and community members were intimately related to the longitudinal aspects of the students’ experiences. The findings lend credence to the view that it really does take a community to train a future physician.
Publisher: Informa UK Limited
Date: 27-04-2019
Publisher: Wiley
Date: 18-10-2012
DOI: 10.1111/MEDU.12006
Publisher: Wiley
Date: 09-09-2005
Publisher: Wiley
Date: 10-2000
Publisher: Emerald Group Publishing Limited
Date: 10-12-2016
Publisher: Springer Science and Business Media LLC
Date: 03-09-2020
DOI: 10.1186/S12960-020-00502-X
Abstract: Recruiting and retaining a skilled health workforce is a common challenge for remote and rural communities worldwide, negatively impacting access to services, and in turn peoples’ health. The research literature highlights different factors facilitating or hindering recruitment and retention of healthcare workers to remote and rural areas however, there are few practical tools to guide local healthcare organizations in their recruitment and retention struggles. The purpose of this paper is to describe the development process, the contents, and the suggested use of The Framework for Remote Rural Workforce Stability . The Framework is a strategy designed for rural and remote healthcare organizations to ensure the recruitment and retention of vital healthcare personnel. The Framework is the result of a 7-year, five-country (Sweden, Norway, Canada, Iceland, and Scotland) international collaboration combining literature reviews, practical experience, and national case studies in two different projects. The Framework consists of nine key strategic elements, grouped into three main tasks (plan, recruit, retain). Plan: activities to ensure that the population’s needs are periodically assessed, that the right service model is in place, and that the right recruits are targeted. Recruit: activities to ensure that the right recruits and their families have the information and support needed to relocate and integrate in the local community. Retain: activities to support team cohesion, train current and future professionals for rural and remote health careers, and assure the attractiveness of these careers. Five conditions for success are recognition of unique issues targeted investment a regular cycle of activities involving key agencies monitoring, evaluating, and adjusting and active community participation. The Framework can be implemented in any local context as a holistic, integrated set of interventions. It is also possible to implement selected components among the nine strategic elements in order to gain recruitment and/or retention improvements.
Publisher: Wiley
Date: 25-03-2011
DOI: 10.1111/J.1440-1584.2011.01187.X
Abstract: The World Health Organization has drawn up a set of strategies to encourage health workers to live and work in remote and rural areas. A comprehensive instrument designed to evaluate the effectiveness of such programs has not yet been tested. Factors such as Stated rural intention, Optional rural training, Medical sub-specialization, Ease (or self-efficacy) and Rural Status have been used in idually or in limited combinations. This paper examines the development, validity, structure and reliability of the easily-administered SOMERS Index. Limited literature review and cross-sectional cohort study. Australian medical school. A total of 345 Australian undergraduate-entry medical students in years 1 to 4 of the 5-year course. Validity of the factors as predictors of rural career choice was sought in the international literature. Structure of the index was investigated through Principal Components Analysis and regression modelling. Cronbach's alpha was the test for reliability. The international literature strongly supported the validity of the components of the index. Factor analysis revealed a single, strong factor (eigenvalue: 2.78) explaining 56% of the variance. Multiple regression modelling revealed that each of the other variables contributed independently and strongly to Stated Rural Intent (semi-partial correlation coefficients range: 0.20-0.25). Cronbach's alpha was high at 0.78. This paper presents the reliability and validity of an index, which seeks to estimate the likelihood of rural career choice. The index might be useful in student selection, the allocation of rural undergraduate and postgraduate resources and the evaluation of programs designed to increase rural career choice.
Publisher: Wiley
Date: 02-2006
DOI: 10.1111/J.1365-2929.2005.02366.X
Abstract: Flinders University has developed the Parallel Rural Community Curriculum (PRCC), a full year clinical curriculum based in rural general practice in South Australia. The examination performance of students on this course has been shown to be higher than that of their tertiary hospital-based peers. To compare the learning experiences of students in the community-based programme with those of students in the tertiary hospital in order to explain these improved academic outcomes. A case study was undertaken, using an interpretivist perspective, with 3 structured interviews carried out over 2 academic years with each of 6 students from the community-based programme and 16 students from the tertiary hospital. The taped interviews were transcribed and analysed thematically using NUD*IST software. The community-based programme was successful in immersing the students in the clinical environment in a meaningful way. Four key themes were found in the data. These represented clear differences between the experiences of the community-based and hospital-based students. These differences involved: the value that students perceived they were given by supervising doctors and their patients the extent to which the student's presence realised a synergy between the work of the university and the health service opportunities for students to meet the aspirations of both the community and government policy, and opportunities for students to learn how professional expectations can mesh with their own personal values. This study has provided empirical evidence for the importance of the concept of symbiosis in understanding quality in medical education.
Publisher: Informa UK Limited
Date: 10-2000
DOI: 10.5172/JFS.6.2.231
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2009
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/HC18092
Abstract: ABSTRACT BACKGROUNDCommunity engagement is believed to be an important component of quality primary health care. We aimed to capture specific ex les of community engagement by general practices, and to understand the barriers that prevent engagement. METHODSWe conducted 20 distinct interviews with 31 key informants from general practice and the wider community. The interviews were semi-structured around key relevant topics and were analysed thematically. RESULTSKey themes identified from the interview transcripts included an understanding of ‘community’, ex les of community engagement and the perceived benefits and barriers to community-engaged general practice. We particularly explored aspects of community engagement with Māori. CONCLUSIONSGeneral practices in the study do not think in terms of communities, and they do not have a systematic framework for engagement. Although local ch ions have generated some great initiatives, most practices seemed to lack a conceptual framework for engagement: who to engage with, how to engage with them, and how to evaluate the results of the engagement.
Publisher: Rural and Remote Health
Date: 31-08-2020
DOI: 10.22605/RRH5835
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2015
Publisher: Journal of Nepal Medical Association (JNMA)
Date: 07-2003
DOI: 10.31729/JNMA.850
Abstract: As we move into the third millennium, it is clear that the World Health Organisation(WHO) goal of “Health for All” is yet to be achieved. Nowhere is this more evidentthan in developing countries like Nepal where the majority of people live in ruralareas, many of them caught in the poverty-ill health-low productivity downward spiral.In recent decades, most programs aimed at improving population health outcomeshave been designed and delivered with little or no involvement of medical practitionersother than specialists in specific diseases or population ublic health.General practice is the medical discipline which involves the provision of continuing,comprehensive, community-based patient-centred prevention-oriented primary care.General practitioners are at the interface between: low technology/low cost and hightechnology/high cost care medical and non-medical health and welfare services andin idual care for illness, injury or disability and community opulation healthapproaches to improving health status. This places general practice and generalpractitioners in a pivotal position to provide in iduals and families with timely cost-effective care, and to provide leadership in the development and implementation ofhealth care systems which are responsive to community and societal needs.Since 1994, the WHO and WONCA, the World Organisation of Family Doctors, havebeen working together first through a landmark Invitational Conference and Reporton “Making Medical Practice and Education More Relevant to People’s Needs: TheContribution of the Family Doctor”, and more recently through a Memorandum ofAgreement and the Towards Unity for Health (TUFH) Project. TUFH promotes effortsworldwide to create unity in health service organisations particularly throughsustainable integration of medicine and public health, in idual health and communityhealth related activities. Achievement of “Health for All” will require development ofbalanced, affordable and sustainable health care systems which build on the broadexpertise of general practitioners and general practice.
Publisher: Wiley
Date: 12-2001
DOI: 10.1046/J.1440-1584.9.S1.5.X
Abstract: Governments have recently instituted several programmes designed to attract medical students to rural practice. Questions may be raised as to whether interventions based around issues identified as important to practising rural general practitioners (GPs) are equally applicable to undergraduate medical students. The results of two studies on the importance of personal and practice issues as ascribed by Australian rural GPs and Victorian medical students are analysed. The effect of the students' gender, place of origin and intended location of practice is assessed. Findings suggest that practising GPs may have resolved many of the student issues and may be well placed to advise students on perceived hurdles to rural practice. Furthermore, students may be seeking a practice style similar to that sought by female GPs. The present paper concludes that while there are similarities between the groups, the differences identified support caution when basing student programmes on research performed on rural GPs.
Publisher: Informa UK Limited
Date: 11-2005
DOI: 10.1080/13576280500289728
Abstract: This article documents a number of rural medical education initiatives in Australia, Canada and the United States. A typology is created reflecting the centrality the rural mandate and characterizing different features of each school's program. Interviews with school officials are drawn on to reflect the challenges these schools face. Seven schools noted for their rural programs were selected from the three countries and interviews were conducted with senior officials. The interview data was supplemented by published material on the schools. The Typology: Three kinds of school are distinguished: Mixed Urban/Rural Schools (University of Washington, US, the University of British Columbia, Canada and Flinders University, Australia) DeFacto Rural Schools (University of New Mexico, US and Memorial University, Canada) and Stand Alone Rural Schools (James Cook University, Australia and the Northern Ontario School of Medicine, Canada). The Pipeline Approach: All of the schools adopted in varying degrees a pipeline approach to meeting the need for rural doctors focusing on: (a) early recruitment (b) admissions (c) locating clinical education in rural settings (d) rural health focus to curriculum and (e) support for rural practice. The analysis does not strongly favor one model over others, although the Stand-Alone Rural schools had more opportunities to adopt innovative curricula reflecting rural health issues and to foster positive views of rural practice. Government funding targeting rural health needs will remain critical in the development of all these programs.
Publisher: AMPCo
Date: 07-2017
DOI: 10.5694/MJA17.00216
Publisher: Wiley
Date: 02-2001
DOI: 10.1046/J.1440-1584.2001.00322.X
Abstract: The 'Rural Pharmacist Training and Support Program' was a pilot project that was conducted by the Monash University Centre for Rural Health. It examined the implementation of Pharmacy Board of Victoria Guidelines to Residential Care Facilities in the Loddon Mallee region of Victoria. Through a series of workshops, pharmacists were encouraged to discuss and address difficulties that were impeding implementation of the guidelines. These included upskilling in clinical pharmacy and ways to overcome the shortage of pharmacists in rural areas. Furthermore, the project was a catalyst for eight additional outcomes. This project highlighted the challenges facing rural pharmacists as they seek to implement the guidelines and resulted in a number of recommendations that addressed workforce issues, training and continuing education, Pharmacy Board requirements, improved communication with other health professionals and undergraduate training.
Publisher: Yong Loo Lin School of Medicine
Date: 06-2016
Publisher: Elsevier BV
Date: 11-2011
DOI: 10.1016/J.PUHE.2011.08.006
Abstract: Aboriginal people are under-represented in epidemiological research, largely due to past failures to engage and recruit Aboriginal communities, research fatigue and the use of culturally inappropriate methods. A qualitative study was undertaken in rural and urban Aboriginal communities in north-eastern and south-western Ontario to identify culturally congruent public health research methodologies. A qualitative participatory research study using focus group discussions. This study employed a participatory research framework to elicit methodological suggestions for conducting public health research with Aboriginal communities during focus groups with healthcare providers from six erse Aboriginal health organizations in Ontario, Canada. Continuing requests for participation in health research studies have led to community exhaustion. Discussions explored appropriate methods to obtain community approval and support for a study, the need for cultural sensitivity training for researchers, the value of conducting studies of interest and benefit to the community, advantages and disadvantages of qualitative and quantitative studies, the benefit of both Aboriginal and non-Aboriginal ethics reviews, the importance of safeguarding trusted information, types of incentives that may enhance study participation, suggestions to improve the collection of questionnaire information and biological specimens, how to resolve contentious issues and dissemination of study results. In order to successfully engage Aboriginal people in health studies, researchers need to build rapport with communities, have a community presence, be respectful and collaborative, utilize incentives, and employ flexible and adaptive methodologies of reasonable length. Oral interviews are preferred to self-completed information. The use of more mixed methods methodologies was suggested when quantitative data collection is necessary. Communities expect presentations about research findings.
Publisher: Oxford University Press (OUP)
Date: 08-2003
Abstract: Despite the huge differences between developing and developed countries, access is the major issue in rural health around the world. Even in the countries where the majority of the population lives in rural areas, the resources are concentrated in the cities. All countries have difficulties with transport and communication, and they all face the challenge of shortages of doctors and other health professionals in rural and remote areas. Many rural people are caught in the poverty- ill health-low productivity downward spiral, particularly in developing countries. Since 1992, WONCA, the World Organization of Family Doctors, has developed a specific focus on rural health through the WONCA Working Party on Rural Practice. This Working Party has drawn national and international attention to major rural health issues through World Rural Health Conferences and WONCA Rural Policies. The World Health Organization (WHO) has broadened its focus beyond public health to partnership with family practice, initially through a landmark WHO-WONCA Invitational Conference in Canada. From this has developed the Memorandum of Agreement between WONCA and WHO which emphasizes the important role of family practitioners in primary health care and also includes the Rural Health Initiative. In April 2002, WHO and WONCA held a major WHO-WONCA Invitational Conference on Rural Health. This conference addressed the immense challenges for improving the health of people of rural and remote areas of the world and initiated a specific action plan: The Global Initiative on Rural Health. The "Health for All" vision for rural people is more likely to be achieved through joint concerted efforts of international and national bodies working together with doctors, nurses and other health workers in rural areas around the world.
Publisher: Informa UK Limited
Date: 02-01-2016
DOI: 10.1080/14739879.2015.1128684
Abstract: Despite the substantial differences between developing and developed countries, access is the major rural health issue. Studies in many countries have shown that the three factors most strongly associated with entering rural practice are: (1) a rural upbringing (2) positive clinical and educational experiences in rural settings as part of undergraduate medical education (3) targeted training for rural practice at the postgraduate level. This paper presents ex les of successful rural primary care-based education in different parts of the world, then introduces the Wonca Rural Medical Education Guidebook which was launched at the 2014 Wonca Rural Health World Conference and concludes with a brief report of the 2015 conference held in Dubrovnik Croatia.
Publisher: Informa UK Limited
Date: 26-10-2022
Publisher: Longwoods Publishing
Date: 31-01-2018
DOI: 10.12927/HCPAP.2018.25505
Abstract: To achieve sustainability, remote and rural communities require health service models that are designed in and for these settings and are responsive to local population health needs. This paper draws on a panel discussion at the Rural and Indigenous Health Symposium held in Toronto, ON, on September 21, 2017. Active community participation is an important contributor to success in rural health system transformation, as well as health workforce recruitment and retention. Increasingly, communication technology is contributing to the quality and effectiveness of healthcare in remote rural community settings, particularly by ensuring that specialist expertise is accessible to and supportive of the local providers of care. Recent medical graduates bring life experiences and work expectations to rural primary care that are different from their senior colleagues. Successful recruitment and retention of the rural primary care workforce depend increasingly on offering a "turnkey" clinic work supported by a functioning electronic medical record. Rural health system sustainability occurs most frequently through ongoing collaboration and partnerships, partnerships, partnerships. It is through partnerships with communities, health services and healthcare providers that the Northern Ontario School of Medicine (NOSM) has been successful in producing medical graduates who provide care responsive to population health needs in previously underserved communities of northern Ontario. Sustainable healthcare in remote and rural communities is enhanced by active community participation and clustering these communities in local networks. An important key to success is shifting from hospital-centric to community-centric care.
Publisher: Informa UK Limited
Date: 02-09-2004
Publisher: Wiley
Date: 11-1999
DOI: 10.1046/J.1440-1584.1999.00259.X
Abstract: The Rural Health Support Education and Training (RHSET) Program is a Commonwealth Government grants program established in 1990 to enhance the access to rural communities to effective health services. The emphasis has been on professional workforce issues. Up until December 1997, 431 applications for funding had been approved and close to $37 million allocated. This article considers the grants awarded in that period according to their main topic of interest within three broad groupings: policy and tertiary service provision health discipline-specific groups and special interest groups such as Aboriginal and Torres Strait Islanders and community organisations. Each subgroup is introduced and its contents outlined. It also suggests that despite heightened government interest in rural and remote health, a niche can still be found for RHSET. It further argues that the time has come for a major evaluation of project activity to ensure non-duplication and to develop performance indicators for evaluating projects addressing rural and remote area workforce issues.
Publisher: AMPCo
Date: 06-2000
DOI: 10.5694/J.1326-5377.2000.TB124131.X
Abstract: In the eyes of many, the critical shortage of doctors in rural areas is the only reason for providing rural experiences for medical students. This article reviews the body of evidence supporting rural placements as a long-term medical workforce strategy and additional evidence regarding the apparent educational benefits of such placements. By enabling medical students to learn for significant periods of time in rural communities, it is now possible for universities to address the medical workforce imperatives of the communities they serve at the same time as providing intrinsic educational advantages to their students.
Publisher: Wiley
Date: 12-10-2014
DOI: 10.1111/MEDU.12532
Abstract: The purpose of this paper is to provide a critical analysis of a mobile research method, the guided walk, and its potential suitability in medical education research. The Northern Ontario School of Medicine's (NOSM) longitudinal integrated clerkship served as the research context in which the guided walk method was used to explore the lived experiences of 12 Year 3 medical students undertaking their clerkship in one of eight different communities across Northern Ontario, Canada. Informed by the social constructivist research paradigm, the guided walk method was employed to answer the research question: how do Year 3 medical students at NOSM describe their clerkship experiences as encountered in their placement and living contexts? Through an inductive thematic analysis of the data, the findings provided a rich description of the guided walk from the participants' and the researcher's perspectives. There were significant advantages to using the guided walk rather than other types of qualitative research approaches. The guided walk made it easier for participants to take part in the study, provided context-rich research interactions, and led to serendipitous encounters for both participants and the first author. There were also challenges and limitations associated with the guided walk method. For ex le, this method carries inherent challenges with reference to the safeguarding of confidentiality and anonymity for both participants and those encountered during the walk. The guided walk method is promising within medical education, particularly for researchers seeking to gain participants' stories in the contexts to which they refer. This method may be appropriate for use in medical education research in areas such as the evaluation and assessment of a student's clinical decision-making skills and competency development, as well as the consolidation of strategies to manage ethical and professional dilemmas.
Location: Australia
Location: No location found
Location: No location found
Start Date: 2004
End Date: 2019
Funder: Ontario Ministry of Health and Long-Term Care
View Funded ActivityStart Date: 2018
End Date: 2021
Funder: Northern Ontario Academic Medicine Association
View Funded ActivityStart Date: 2002
End Date: 2004
Funder: Canadian Institutes of Health Research
View Funded ActivityStart Date: 1999
End Date: 2000
Funder: Department of Health, Australian Government
View Funded ActivityStart Date: 2007
End Date: 2008
Funder: Cancer Care Ontario
View Funded ActivityStart Date: 1997
End Date: 1998
Funder: Department of Health, Australian Government
View Funded Activity