How health professionals conceive and construct interprofessional practice in rural settings: a qualitative study

Parker, Vicki; McNeil, Karen; Higgins, Isabel; Mitchell, Rebecca; Paliadelis, Penny; Giles, Michelle; Parmenter, Glenda

doi:10.1186/1472-6963-13-500

Cited by 29 publications

(37 citation statements)

References 30 publications

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“…8 In rural Australia with its relative workforce shortage, sustainable, practice-based IPL can be particularly challenging. 9 In this paper, we describe a model of IPL -the Health 'Hubs and Spokes' (HHS) Project -which was based in rural towns and organised around locally-relevant priorities. HHS involved small teams of students from different disciplines, working together on a project identified by the host organisation.…”

Section: Introductionmentioning

confidence: 99%

Building social capital with interprofessional student teams in rural settings: A service-learning model

Craig

Phillips

Hall

2015

Aust J Rural Health

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INTRODUCTIONInterprofessional learning (IPL) in health professional education is based on the notion that learning together will support more effective ways of working together. 1 IPL has the potential to improve interprofessional collaboration and the effectiveness and quality of patient care. Practice-based, rather than classroom-based, collaborative learning has been commended as an effective application of IPL. [2][3][4][5][6][7] However, it can be cumbersome to arrange and supervise. 8 In rural Australia with its relative workforce shortage, sustainable, practice-based IPL can be particularly challenging. 9In this paper, we describe a model of IPL -the Health 'Hubs and Spokes' (HHS) Project -which was based in rural towns and organised around locally-relevant priorities. HHS involved small teams of students from different disciplines, working together on a project identified by the host organisation. It was designed to be a sustainable model of interprofessional education using service learning -a type of practice-based learning where students engage with a community partner to collaborate, reflect and develop outcomes of real world benefit. 10 Although service learning is relatively new to Australian higher education settings, it is increasingly being adopted and is particularly well suited to students in the health professions. 11-12In theory service learning can lead to mutual benefits and outcomes for community organisations, universities and students, as a result of engaged scholarship and partnerships focused on clearlyarticulated local needs and service gaps. 13 A risk of university-community partnerships is that university needs may be prioritised over those of the community. 14 To avoid this, HHS focused on aspects of social capital that are particularly relevant for rural communities: the Project worked within networks of trusted agents in the community (community-based facilitators, and clinical supervisors) 15 and through its projects attempted to support the service-capacity of essential health institutions in the community. 16 Thus social capital was both an integral factor in the working of HHS and in the outcome of the individual team projects. Students' reactions, change in perceptions, and the impact of HHS on their behaviour have been described elsewhere. 17,18 In this paper, we describe the outcomes of the HHS at the level of the rural health service or community, and discuss potential programmatic tensions between focusing on service level outcomes, and outcomes that relate to individual attitudinal and behavioural characteristics. METHODSThe Health 'Hubs and Spokes' Project is described in Box 1.Study type. This was a qualitative study using semi-structured interviews with 43 local facilitators, academic staff and health professionals (ascertainment, 80% of those involved in delivering the project), and 14 representatives of local health or community services (Table 1).Setting. Six rural towns in South East NSW, the location for 37 IPL teams of 89 students (82% of the 108 students who ...

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Section: Introductionmentioning

confidence: 99%

Building social capital with interprofessional student teams in rural settings: A service-learning model

Craig

Phillips

Hall

2015

Aust J Rural Health

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“…As may have been expected, CPs talked at length and in detail about how they wished to promote rural medicine to students with the hope that they would base their future practice in such locations. They also wished to educate students about the distinctive features of rural medicine(Theme 4) such as the importance of generalism and interprofessionalism, topics which align well with studies about rural practice (Hogenbirk et al, 2004;Pashen et al, 2007;Mariolis et al, 2008;Parker et al, 2013;Donato, 2015). Our major finding, however, was the rather divergent views of the participant groups regarding a range of topics falling under broad thematic areas such as social accountability (Theme 1) and living in place (Theme 5).…”

Section: Discussionmentioning

confidence: 99%

Remote and rural placements occurring during early medical training as a multidimensional place-based medical education experience

Ross¹,

Cameron²,

Greenwood³

2020

Educ. Res. Rev.

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The Northern Ontario School of Medicine delivers medical education aiming to improve the health outcomes for persons living in Northern Ontario, including those in underserviced rural and geographically remote communities. Second year students experience rural medicine and living during two four-week long placements set in remote and rural communities (RRCP) supervised by local physicians. This place-based approach to medical education aims to equip learners with the skills and dispositions needed to work there successfully. The goal of the study was to develop a better understanding of RRCPs from different perspectives: Institutional, community-preceptors and students. Data was collected by review of institutional documents, semi-structured interviews, and questionnaires to obtain information about the aims of each group. A place-based educational framework informed the analysis which developed themes and sub-themes using a constructivist approach. The aims of each group were in five themes, social accountability, community engagement, integrated learning, forming the rural clinician, and living in place as a rural clinician. Differences were, however, apparent in terms of emphasis and perceived relevance, with these being related to the perceptual, political, ideological and social dimensions. For example, the finding that students did not value extra-clinical learning about or within the wider community can be viewed as students having a different place-relationship with the community than their teachers in terms of the social dimension. The data suggests that curricula should include consideration of the various ways students and teachers interact with placement communities with the aim of gaining understanding of, and bridging the gap between, their different expectations.

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“…27 It is important to tackle some organizational barriers, including the burden of daily practice, the isolated practice of each health professional, and a hierarchical culture that limits communication within the healthcare team and with other levels, as has been reported in similar environments. 28 Breaking these barriers requires the incorporation of actions to foster an atmosphere of respect and collaboration, build the commitment of all participants, and strengthen shared experiences for the benefit of the population they serve, as well as to achieve job satisfaction. In this regard, the pertinence of incentives to acknowledge the performance of the healthcare staff in order to promote dignified, professional working conditions is still under debate and deserves further exploration.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a multifaceted educational strategy for strengthening rural primary health care

Reyes-Morales

Gómez-Bernal²,

Gutiérrez-Alba

et al. 2017

Salud Publica Mex

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Objective. To evaluate the feasibility and acceptability of a comprehensive educational strategy designed to improve care quality in rural areas of Mexico. Materials and methods. A demonstration study was performed in 18 public rural health centers in Mexico, including an educational intervention that consists of the following steps: Development of the strategy; Selection and training of instructors (specialist physicians from the referral hospital and multidisciplinary field teams); Implementation of the strategy among health care teams for six priority causes of visit, through workshops, individual tutorials, and round-table case-review sessions. Feasibility and acceptability were evaluated using checklists, direct observation, questionnaires and in-depth interviews with key players. Results. Despite some organizational barriers, the strategy was perceived as worthy by the participants because of the personalized tutorials and the improved integration of health teams within their usual professional practice. Conclusion. The educational strategy proved to be acceptable; its feasibility for usual care conditions will depend on the improvement of organizational processes at rural facilities.

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How health professionals conceive and construct interprofessional practice in rural settings: a qualitative study

Cited by 29 publications

References 30 publications

Building social capital with interprofessional student teams in rural settings: A service-learning model

Building social capital with interprofessional student teams in rural settings: A service-learning model

Remote and rural placements occurring during early medical training as a multidimensional place-based medical education experience

Feasibility of a multifaceted educational strategy for strengthening rural primary health care

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