The allied health rural generalist pathway: a cost consequence analysis.

INTRODUCTION: Rural and remote health workforces face longstanding challenges in Australia. Little is known about the economic effectiveness of workforce initiatives to increase recruitment and retention. A two-level allied health rural generalist pathway was introduced as a workforce strategy in regional local health networks (LHNs) in South Australia in 2019. This research measured the resources and outcomes of the pathway following its introduction. METHODS: A multi-phase, mixed-methods study was conducted with a 3-year follow-up period (2019-2022). A cost-consequence analysis was conducted as part of this study. Resources measured included tuition, time for quarantined study, supervision and support, and program manager salary. Outcomes measured included length of tenure, turnover data, career progression, service development time, confidence and competence. RESULTS: Fifteen allied health professional trainees participated in the pathway between 2019 and 2022 and seven completed during this time. Trainees participated for between 3 and 42 months. The average total cost of supporting a level 1 trainee was $34,875 and level 2 was $70,469. The total return on investment within the evaluation period was $317,610 for the level 1 program and $58,680 for the level 2 program. All seven completing trainees continued to work in regional LHNs at the 6-month follow-up phase and confidence and competence to work as a rural generalist increased. CONCLUSION: This research found that the allied health rural generalist pathway has the potential to generate multiple positive outcomes for a relatively small investment and is therefore likely to be a cost-effective workforce initiative.

Title-blended supervision models for post-graduate rural generalist medical training in Australia: an interview study.

BACKGROUND: Expanding rural training is a priority for growing the rural medical workforce, but this relies on building supervision capacity in small towns where workforce shortages are common. This study explored factors which support the use of blended supervision models (consisting of on- and offsite components) for postgraduate rural generalist medical training (broad scope of work) in small rural communities. METHODS: Data were collected between June and August 2021 through semi-structured, in-depth interviews with medical training stakeholders experienced in blended supervision models for rural generalist training. Interviews were audio-recorded, transcribed verbatim and analysed using an inductive thematic analysis process. RESULTS: Fifteen participant interviews provided almost 13 h of audio-recorded data. Four themes were developed: governance, setting, the right supervisor and the right supervisee. Blended supervision models may be effective if selectively applied including where the model is well-planned, the setting has local team supports and supervisor and supervisee characteristics are appropriate. CONCLUSIONS: Understanding factors involved in the application of blended supervision models can help with expanding rural generalist training places in distributed communities. Blended supervision models can be effective for rural generalist training if the model is planned, and the context is suitable.