Mind the gap: is it time to invest in embedded researchers in regional, rural and remote health services to address health outcome discrepancies for those living in rural, remote and regional areas?

Moran, Anna; Haines, Helen; Raschke, Nicole; Schmidt, Diana; Koschel, Alison; Stephens, Alexandre; Opie, Cynthia; Nancarrow, Susan

doi:10.1071/py18201

Cited by 30 publications

(52 citation statements)

References 14 publications

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“…Finally, the overall quality of evidence is low, limiting the impact of the study's findings. Whilst data were extracted and synthesised using program logic to overcome the lack of quality, there remains a critical need to invest in producing high quality research in rural contexts [7,56].…”

Section: Study Limitationsmentioning

confidence: 99%

What works, why and how? A scoping review and logic model of rural clinical placements for allied health students

Moran

Nancarrow

Cosgrave

et al. 2020

BMC Health Serv Res

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Background Allied health services are core to the improvement in health outcomes for remote and rural residents. Substantial infrastructure has been put into place to facilitate rural work-ready allied health practitioners, yet it is difficult to understand or measure how successful this is and how it is facilitated. Methods A scoping review and thematic synthesis of the literature using program logic was undertaken to identify and describe the contexts, mechanisms and outcomes of successful models of rural clinical placements for allied health students. This involved all empirical literature examining models of regional, rural and remote clinical placements for allied health students between 1995 and 2019. Results A total of 292 articles were identified; however, after removal of duplicates and article screening, 18 were included in the final synthesis. Australian papers dominated the evidence base (n = 11). Drivers for rural allied health clinical placements include: attracting allied health students to the rural workforce; increasing the number of allied health clinical placements available; exposing students to and providing skills in rural and interprofessional practice; and improving access to allied health services in rural areas. Depending on the placement model, a number of key mechanisms were identified that facilitated realisation of these drivers and therefore the success of the model. These included: support for students; engagement, consultation and partnership with key stakeholders and organisations; and regional coordination, infrastructure and support. Placement success was measured in terms of student, rural, community and/or program outcomes. Although the strength and quality of the evidence was found to be low, there is a trend for placements to be more successful when the driver for the placement is specifically reflected in the structure of the placement model and outcomes measured. This was seen most effectively in placement models that were driven by the need to meet rural community needs and upskill students in interprofessional rural practice. Conclusion This study identifies the factors that can be manipulated to ensure more successful models of allied health rural clinical placements and provides an evidence based framework for improved planning and evaluation.

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Section: Study Limitationsmentioning

confidence: 99%

What works, why and how? A scoping review and logic model of rural clinical placements for allied health students

Moran

Nancarrow

Cosgrave

et al. 2020

BMC Health Serv Res

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“…The need to build health research capacity in rural and remote Australia is well recognised 1,2 . The beneficial impacts of increased research capacity include helping to create new career pathways, improving staff satisfaction, retention and organisational performance 3 . Building health research capacity requires a planned multifaceted strategy 4 which could include, for example, partnering with experienced researchers or the provision of research training through non‐award or coursework study 1 .…”

Section: Introductionmentioning

confidence: 99%

Importance of research higher degree training availability in rural and remote regions

Campbell

Kumar

2021

Australian J Rural Health

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Aims This commentary contends that research by higher degree research training is a sustainable strategy for capacity building the rural and remote health research workforce, provided they have equitable opportunity for access, participation and attainment. Context The path for health professionals into academic roles, particularly in rural and remote areas, can be fraught. A strong research skill set might not form a significant component of a clinician's prior experience. Concurrently, university academic positions usually include the PhD as an essential qualification which is misaligned with the experience and skills of rural and remote applicants who are otherwise well‐qualified. Approach Higher degree researches are one mechanism for extending the research expertise and capabilities. However, non‐traditional and remotely located cohorts such as the rural and remote health research workforce can face barriers to accessing, participating in and successfully completing formal research training. Barriers include the prevalence of the apprenticeship model of research training grounded in assumptions of colocation and face‐to‐face learning and supervision and a focus on the binary relationship between supervisors and students. In this commentary, the authors call for greater flexibility and equity in the higher degree research training system to cater for health professionals located in rural and remote practice contexts. Conclusion Institutional investment in, and commitment to, a truly distributed higher degree research model would ensure a stronger rural and remote workforce who can aspire to a range of career options and thereby positively impacting on the health and research outcomes for rural and remote Australia.

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“…Research capacity-building is an avenue for these organisations to have the capability to produce research that leads to better understanding of locally relevant issues and consider improvements and enhancements [1]. Research in rural areas presents its own set of challenges and the solutions proposed have included specific rural training [2] and embedded health service researchers [3]. The challenges of providing training on research skills in rural areas include a limited pool of experts in rural research, a similarly limited pool of research experts based in rural areas, structural barriers requiring thoughtful educational design [4] and maintaining support to sometimes isolated learners [5].…”

Section: Introductionmentioning

confidence: 99%

Workplace-based health research training: a qualitative study of perceived needs in a rural setting

Schmidt

Reyment²,

Webster

et al. 2020

Health Res Policy Sys

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Background: The calls for increased numbers of researchers in rural health are growing. To meet this demand, training is needed. If training is to be effective, the value placed on research, the organisational need for research training and key targets for research skill development within a rural health organisation must be understood. Methods: This qualitative study was underpinned by a critical realist perspective that allowed exploration of the organisational, cultural and structural contexts of research training and of the ability of individuals to act within these contexts. Individual interviews with purposively selected key informants from the organisation's board, executive and facility management (n = 7) and two focus groups with a convenience sample of frontline health workers with interests in research (total n = 11) were held. Data were analysed using NVivo software and thematic analysis. Results: The themes emerging from this study were the fragmentation of research activity, a need for systems that support research and collaboration for expertise. Conclusions: This study has identified an overreliance on individual activity leading to a fragmented approach to research. There is a need for supportive structures, coordination and workplace leadership to overcome a longstanding culture that views research as out of the rural scope of practice. Identifying research training targets, partnering for educational expertise and planning for long-term sustainability are necessary steps toward increasing research activity in the longer term.

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Mind the gap: is it time to invest in embedded researchers in regional, rural and remote health services to address health outcome discrepancies for those living in rural, remote and regional areas?

Cited by 30 publications

References 14 publications

What works, why and how? A scoping review and logic model of rural clinical placements for allied health students

What works, why and how? A scoping review and logic model of rural clinical placements for allied health students

Importance of research higher degree training availability in rural and remote regions

Workplace-based health research training: a qualitative study of perceived needs in a rural setting

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