Karin Fisher

Survey of the rural allied health workforce in New South Wales to inform recruitment and retention

OBJECTIVE To investigate the demographics, employment, education and factors affecting recruitment and retention of New South Wales (NSW) rural allied health professionals. DESIGN Descriptive study, cross-sectional survey. SETTING Regional, rural and remote areas of NSW, Australia. PARTICIPANTS The sample includes 1879 respondents from more than 21 different allied health occupations. MAIN OUTCOMES MEASURES Variables included gender, age, marital status, employment sector, hours worked, community size, highest qualification, rural origin and continuing education, as well as others. Certain variables were compared for profession and gender. RESULTS Women made up 70% of respondents, with a mean age of 42 years. Men were older, with more experience. Sixty per cent were of rural origin and 74% partnered, most with their partner also working. Eighty-four per cent worked in centres of 10,000 or more people. The public sector accounted for 46% of positions and the private sector 40%. Eleven per cent worked across multiple sectors and 18% were self-employed. Two-thirds worked 35 hours or more per week, although only 49% were employed full-time. Job satisfaction was high but 56% intended leaving within 10 years, 28% to retire. Over 90% of respondents qualified in Australia and more than 80% held a degree or higher qualification. Almost half were dissatisfied with access to continuing education. CONCLUSIONS The NSW rural allied health workforce is strongly feminised, mature and experienced. Recruitment should target rural high school students and promote positive aspects of rural practice, such as diversity and autonomy. Retention strategies should include flexible employment options and career development opportunities.

Syphilis and disadvantage in rural communities

Sir: Although research recognizes the association between socioeconomic gradients and sexually transmitted infections (STIs), the role of social capital, social cohesion and social networks in the spread of STIs, there is very little information of the association between socioeconomic status and STIs. In a study in an area health service in Northern New South Wales, Australia a sample of 254 syphilis notifications over an 11 year period from 1994 to 2004 was used to examine if there was a relationship between socioeconomic status and syphilis notifications. An area-based measure, aggregated from census information was used as a proxy to assess the socioeconomic position of people and small areas. Data was divided into three equal groupings called tertiles and were identified as low, medium and high disadvantage. Analysis of the data showed that the majority of notifications were from women (66.5%) with an overall median age of 24.7 and an age range of between 15 to 91 years. Nearly, three quarters (75.2%) of syphilis notifications were in people who identified as aboriginal. The analysis showed that the majority of syphilis notifications (55%) occurred in women (74%), who identified as Aboriginal in one statistical local area (SLA). The remaining SLAs each had ,10% of all syphilis notifications. While the analysis for all syphilis notifications showed that 70% occurred in a tertile of high disadvantage, syphilis notifications reported for younger males were more likely be from a tertile of low disadvantage. The study highlights that geographical location and socioeconomic disadvantage underpins the differences identified in the syphilis notification data. Some of these trends are indicative of the disadvantages experienced by rural communities. In developing policy and practice, this study serves to highlight that location should be an important consideration in the allocation of resources and in the subsequent delivery of health services to continue to address all aspects of health inequality. Further research into the importance of inequities and evidence of effective interventions would be an important contribution and beneficial for the public health agenda. There is also an urgent need to better understand how social location in rural communities influence experiences of STIs and access to health services for sexual health. In small communities, the regulation of STI related information is particularly significant because of the higher likelihood of both professional and private relationships being more interrelated and connected.

When students from different professions are co-located: the importance of interprofessional rapport for learning to work together

Abstract With increasing interest and research into interprofessional learning, there is scope to more deeply understand what happens when students from different professions live and study in the same location. This study aimed to explore the issue of co-location and its effects on how students learn to work with other professions. The setting for this study was a rural health education facility in Australia with close links to local health care and community services. Philosophical hermeneutics informed the research method. Interviews were undertaken with 29 participants, including students, academic educators and clinical supervisors in diagnostic radiography, medicine, nursing, nutrition and dietetics, pharmacy, physiotherapy, occupational therapy, and speech pathology. Photo-elicitation was used to facilitate participant engagement with the topic. The findings foreground the value of interprofessional rapport building opportunities for students learning to work together. Enabled by the proximity of different professions in shared educational, clinical and social spaces, interprofessional rapport building was contingent on contextual conditions (balance of professions, shared spaces and adequate time) and individuals interpersonal capabilities (being interested, being inclusive, developing interpersonal bonds, giving and receiving respect, bringing a sense of own profession and being patient-centred). In the absence of these conditions and capabilities, negative professional stereotypes may be inadvertently re-enforced. From these findings suggestions are made for nurturing interprofessional rapport building opportunities to enable students of different professions to learn to work together.

Comparison of the results of two rural allied health workforce surveys in the Hunter New England region of New South Wales: 2005 versus 2008.

OBJECTIVE To compare the results of the 2005 and 2008 surveys of the rural allied health workforce in the study region. DESIGN Comparative analysis of two cross-sectional surveys. SETTING The rural, northern sector of the Hunter New England region of NSW, Australia. PARTICIPANTS Both surveys targeted 12 different allied health professions. There were 225 respondents in 2005 and 205 in 2008. MAIN OUTCOME MEASURES Comparison is made for 15 dependent variables. RESULTS There was no significant difference for most variables between 2005 and 2008. Mean age and mean years qualified decreased slightly, from 43 to 41 years and from 20 to 17 years, respectively. The proportion of respondents of rural origin was about two-thirds in both studies and about half had a rural placement during training. While more than half supervised students, only about one-third had received training for that role. In both 2005 and 2008, the proportion working 35 or more hours each week was about 66% but the proportion working more than 40 hours had doubled to about 36%. In both surveys about half intended leaving their job within 10 years, while the proportion satisfied with continuing professional development access had halved, from 70% to 35%. CONCLUSIONS Most results of the 2005 Hunter New England survey were verified. It was confirmed that a large proportion of the allied health workforce in the region intend leaving their job in the next 5 to 10 years. This is a concern for the development of new service delivery models.

Educators’ Interprofessional Collaborative Relationships: Helping Pharmacy Students Learn to Work with Other Professions

Similar to other professions, pharmacy educators use workplace learning opportunities to prepare students for collaborative practice. Thus, collaborative relationships between educators of different professions are important for planning, implementing and evaluating interprofessional learning strategies and role modelling interprofessional collaboration within and across university and workplace settings. However, there is a paucity of research exploring educators’ interprofessional relationships. Using collaborative dialogical inquiry we explored the nature of educators’ interprofessional relationships in a co-located setting. Data from interprofessional focus groups and semi-structured interviews were interpreted to identify themes that transcended the participants’ professional affiliations. Educators’ interprofessional collaborative relationships involved the development and interweaving of five interpersonal behaviours: being inclusive of other professions; developing interpersonal connections with colleagues from other professions; bringing a sense of own profession in relation to other professions; giving and receiving respect to other professions; and being learner-centred for students’ collaborative practice. Pharmacy educators, like other educators, need to ensure that interprofessional relationships are founded on positive experiences rather than vested in professional interests.

Community Collaboration Beyond the Red Tape

Dealing with “red tape” is a daily occurrence for those involved in the community engagement program at the University of Newcastle Department of Rural Health (UONDRH). For the purpose of this chapter, the community engagement program refers to activities that have been specifically designed, fostered, organised and monitored by the UONDRH to enable health professional students to engage with people from the local community for mutually beneficial outcomes.

Caring for Patients Who Have Sexually Transmitted Infections

Caring for patients with sexually transmitted infections commonly requires a team approach while simultaneously invoking a range of moral responses. Understanding these responses is integral to recognising how, who and why someone might get on board the team. In this chapter we reflect on real-life situations from patient and health professional perspectives.