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BACKGROUND: The undersupply of health professionals in rural areas impacts healthcare access for those living in rural Australia. A strategy to increase the rural health workforce is to recruit and educate rural people. However, long-standing inequities for rural Australians in accessing tertiary education persist. The aim of this study was to audit the 2023 offerings of Australian allied health, nursing, dental and medical university courses to identify geographical availability and those delivered online. METHODS: A desktop audit of Australian allied health, nursing, dental and medical courses offered in 2023 was undertaken to identify the courses and delivery modes of those courses offered in regional, rural and remote locations. The audit involved searching lists of professionally accredited courses and university websites, which is publicly available information about health courses. Data were tabulated and descriptive statistics used for data analysis. RESULTS: There were marked differences in online and rural course offerings across health professions in Modified Monash (MM) Model category 2-7 locations. Nursing/midwifery had the most courses while pharmacy, podiatry, dental and medicine had few offerings and optometry had none. Social work, nursing/midwifery and psychology also had the most online course offerings. Most courses were offered in MM2 and MM3 locations with few offerings in rural or remote areas. The availability of studying part-time was very limited and often this was only for the early years of the course. Inconsistencies relating to the course information on university websites existed relating to course delivery mode descriptions. CONCLUSIONS: There is a lack of rural on-campus or online course offerings for some allied health disciplines, dentistry and medicine. Provision of end-to-end, flexible courses in rural areas or online is needed to reduce access barriers for rural students and to enable sustainable rural health workforce development.
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Servicios de Salud Rural , Humanos , Australia , Población Rural , Accesibilidad a los Servicios de Salud , Educación a DistanciaRESUMEN
Introduction: Telehealth is used by allied health professionals to deliver health care remotely. This umbrella review addressed the following questions: (1) What telehealth interventions have been implemented to deliver allied health care? (2) What are the reported clinical benefits, and challenges of the implementation of telehealth delivered allied health interventions? (3) What are the reported experiences of patients and clinicians? Methods: A rapid umbrella systematic review method was utilized. Following a search of five electronic databases, only systematic reviews reporting on telehealth-delivery allied health interventions published in the past 10 years were included. Reported outcomes included clinical effectiveness, implementation factors, and patient/clinician experiences. Methodological quality was established using the A MeaSurement Tool to Assess systematic Reviews 2. Results: After applying eligibility criteria to 571 studies, 26 studies were included. Findings indicate that telehealth-delivered allied health interventions may obtain similar clinical outcomes as compared with face-to-face appointments. Patients reported less stress and valued the reduced need to travel when telehealth was used. Patient satisfaction with telehealth delivered care was equal to face-to-face care, and no differences were noted in the capacity to build therapeutic alliance when using telehealth. Difficulties with technology use were reported by clinicians and patients. Clinicians were identified as needing increased time management skills. Cautious interpretation of findings is recommended due to the quality rating of low to critical low for the majority of individual reviews. Conclusions: Telehealth-delivered care might obtain similar clinical outcomes to face-to-face care; however, difficulties may arise during broad implementation. It is recommended that health services be strategic to overcome implementation barriers and provide targeted support to enable effective, equitable, and sustained allied health service delivery via telehealth.
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Telemedicina , Humanos , Telemedicina/organización & administración , Satisfacción del Paciente , Revisiones Sistemáticas como Asunto , Técnicos Medios en SaludRESUMEN
BACKGROUND: Volar plate injuries of the proximal interphalangeal (PIP) finger joint are common. Conservative treatment involves orthoses to limit hyperextension at the PIP joint yet allow movement of the joints to prevent joint stiffness and deformity. Custom-made dorsal blocking orthoses are recommended treatments. Previous research also supports the use of a figure-of-8 orthosis, although the comparative effectiveness of these orthoses is not currently known. PURPOSE: This study aimed to compare the figure-of-8 orthosis and dorsal blocking orthosis for changes in the range of movement, pain, and function following stable volar plate PIP joint injuries and to compare the number of hand therapy appointments required. STUDY DESIGN: A parallel-group pilot randomized controlled trial. This trial was registered with the Australian and New Zealand Clinical Trials Registry (Trial ID: CTRN12619000449134). METHODS: Participants aged 13-65 years were recruited from an outpatient hand therapy service and randomly assigned to experimental or control groups. The experimental group of 20 participants received a custom-made thermoplastic figure-of-8 orthosis limiting the extension to 15-20 degrees. The control group of 22 participants had a dorsal blocking orthosis, which was serially extended by 10 degrees weekly starting at 30 degrees flexion. Participants were blinded to their group allocation. Outcome measures included range of movement, edema, pain, function, and number of hand therapy appointments. Data collection was completed by the treating therapist who was not blinded to group assignment. Data analysis included a series of mixed-model analyses of variance to examine changes over time. RESULTS: Forty-two participants were recruited and had their data analyzed. No significant between-group differences were observed for DIP flexion, PIP flexion, pain, and function from baseline to follow-up. Both groups exhibited significant improvements in these outcomes over time (p < 0.001); effect sizes ranged from small to large (0.28-0.79). On average, the intervention group required 4 (±1.5) appointments compared to 6 (±1.5) in the control group over the same period representing a significant difference (p < 0.001). CONCLUSIONS: Both dorsal blocking and figure-of-8 orthoses provide similar outcomes. The use of a figure-of-8 orthosis, or a dorsal block orthosis fabricated in maximal comfortable extension depending on severity, could reduce the number of appointments and increase convenience for patients.
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BACKGROUND: The participation and success of university health students in rural areas is critical in addressing the maldistribution of the rural health workforces internationally. Particular attention to the experiences of mature-aged health students is needed to build a sustainable rural health workforce, given the higher proportions of mature-aged university students in rural, regional and remote areas compared with metropolitan areas and rural mature-aged students wanting to stay in their communities. However, little is known about the kinds of supports rural mature-aged students require to succeed with their studies. METHODS: Drawing on rural standpoint theory and using structural inequality as a retention lens, we explored the current and potential supports that rural mature-aged nursing and allied health students require to successfully participate and complete their pre-professional university course. A Stakian multicase study was undertaken with cases at three rural university campuses in Australia. The data collection was primarily qualitative, with semi-structured interviews, campus surveys and focus groups involving 36 participants (including students, academic and professional staff, and placement supervisors). RESULTS: This study found supports were provided formally and informally by the university, by the community and manifested by students. Several support gaps as well as potential supports to alleviate them were identified. These include formally acknowledging the mature-aged cohort and their diverse experiences and non-university commitments; fostering connections between mature-aged students; making university affordable; preparing mature-aged students for university; adapting course content and delivery; and restructuring placements for mature-aged students. CONCLUSIONS: We argue that rural mature-aged nursing and allied health students require supports that are age-specific, appropriate to the community context, and harness existing relational processes of rural university campus activity. Rural university campuses need to involve rural mature-aged students and other stakeholders relevant to each context in the process of identifying and implementing student supports for this cohort.
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Servicios de Salud Rural , Salud Rural , Humanos , Anciano , Universidades , Encuestas y Cuestionarios , EstudiantesRESUMEN
INTRODUCTION: Almost half a million Australians have served with the Australian Defence Force. Given the high prevalence of physical and mental health conditions and complexity of civilian life adjustment after military service, high-quality occupational therapy services are critical. However, there is limited description of occupational therapy service provision to individuals funded by the Australian Department of Veterans' Affairs to inform government policy. The aim of this study was to describe the practice of Australian occupational therapists working with former service members and identify opportunities to enhance practice and policy. METHODS: A cross-sectional study using an online survey was conducted to collect information from occupational therapists providing services to Department of Veterans' Affairs clients. Frequency analyses were performed to describe quantitative data. Qualitative data were analysed using thematic analysis. No consumer or community involvement occurred. RESULTS: Participants included 123 Australian occupational therapists residing in metropolitan (47%), regional (28%) and rural/remote (23%) areas. Most occupational therapists (69%) had over 15 years of clinical experience and worked in private practice (87%). Common interventions included home modifications, equipment prescription and assistive technology (77%), goal-oriented rehabilitation (16%) and activities of daily living or function assessments and education (13%). Three themes describing practice issues were identified: (1) Service provision as rewarding yet underfunded, (2) Administrative complexity and lack of understanding of the occupational therapy role and (3) Need for specialist professional development opportunities. CONCLUSION: Australian occupational therapists are providing a range of services to Department of Veterans' Affairs clients although mostly relating to physical conditions. Occupational therapy practice with former Australian Defence Force members should be expanded to meet their diverse and complex needs. Further research and education are needed to support use of specialist knowledge and interventions. Advocacy by peak associations and policy reform are urgently required to ensure sustainable services, particularly in rural areas.
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Terapia Ocupacional , Veteranos , Humanos , Terapia Ocupacional/organización & administración , Terapia Ocupacional/normas , Estudios Transversales , Australia , Masculino , Femenino , Persona de Mediana Edad , Adulto , Política de SaludRESUMEN
BACKGROUND: Across the care economy there are major shortages in the health and care workforce, as well as high rates of attrition and ill-defined career pathways. The aim of this study was to evaluate current evidence regarding methods to improve care worker recruitment, retention, safety, and education, for the professional care workforce. METHODS: A rapid review of comparative interventions designed to recruit, retain, educate and care for the professional workforce in the following sectors: disability, aged care, health, mental health, family and youth services, and early childhood education and care was conducted. Embase and MEDLINE databases were searched, and studies published between January 2015 and November 2022 were included. We used the Quality Assessment tool for Quantitative Studies and the PEDro tools to evaluate study quality. RESULTS: 5594 articles were initially screened and after applying the inclusion and exclusion criteria, 30 studies were included in the rapid review. Studies most frequently reported on the professional nursing, medical and allied health workforces. Some studies focused on the single domain of care worker education (n = 11) while most focused on multiple domains that combined education with recruitment strategies, retention strategies or a focus on worker safety. Study quality was comparatively low with a median PEDro score of 5/10, and 77% received a weak rating on the Quality Assessment tool for Quantitative Studies. Four new workforce strategies emerged; early career rural recruitment supports rural retention; workload management is essential for workforce well-being; learning must be contextually relevant; and there is a need to differentiate recruitment, retention, and education strategies for different professional health and care workforce categories as needs vary. CONCLUSIONS: Given the critical importance of recruiting and retaining a strong health and care workforce, there is an immediate need to develop a cohesive strategy to address workforce shortfalls. This paper presents initial evidence on different interventions to address this need, and to inform care workforce recruitment and retention. Rapid Review registration PROSPERO 2022 CRD42022371721 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022371721.
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Aprendizaje , Servicios de Salud Rural , Humanos , Preescolar , Adolescente , Anciano , Recursos Humanos , Técnicos Medios en Salud , Carga de Trabajo , Salud MentalRESUMEN
INTRODUCTION: Telehealth has become one of the main methods of delivering allied health professional services world-wide, yet many professionals do not have sufficient training to deliver high-quality telehealth services. This review aims to identify what competencies allied health professionals require for effective telehealth service delivery. METHODS: This scoping review used the Population Concept Context framework and searched the following databases: MEDLINE, CINAHL, PsychInfo, Cochrane, EMBASE, Web of Science, PEDro, United Kingdom Health Forum, WHO, Health Education England, and all UK and Australian AHP professional bodies. RESULTS: A total of 37 articles were included out of 92,525 identified by the literature search. Competencies were related to two areas: (1) delivery of the telehealth consultation and (2) service management of telehealth consultations. The first area included the following competency themes: clinical reasoning, communication, effectively using technology, person-centred care, practice-based assessment and intervention knowledge/behaviour/skills, privacy, security, and patient safety, professionalism, and setting up the technical environment. The second area included the following competency themes: digital infrastructure, informing practice, and management. Although findings emphasised the importance of telehealth competencies, none have been implemented within education. One-third of the articles were from the discipline of psychology. CONCLUSION: This is the first scoping review to combine telehealth competencies reported across allied health disciplines. Although there were a vast range of competencies, they need implementation into teaching and learning to be practically useful. Most competencies were from psychology, but potentially applicable for other allied health professionals. A shared and adaptable standard for telehealth competencies would be useful to ensure high-quality practice across all allied health professionals.
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BACKGROUND: Research capacity and capability of rural health professionals is essential to the delivery of evidence-based care and for informing strategies to address rural health inequities. Effective implementation of research education and training is fundamental to building rural health professional research capacity and capability. A lack of overarching guidance to inform the delivery of research education and training in rural health services can contribute to gaps in capacity-building approaches. The aim of this study was to identify characteristics of the design and implementation of current research training for rural health professionals in Victoria, Australia, to inform a future model for rural health professional research capacity and capability building. METHODS: A qualitative descriptive study was undertaken. Key informants, with extensive knowledge of research education and training in rural health services in Victoria, were invited to participate in semi-structured telephone interviews via snowballing recruitment methods. Interview transcripts were analysed inductively, with themes and codes mapped to the domains of the Consolidated Framework for Implementation Research. RESULTS: Of the 40 key informants approached, 20 agreed to participate including 11 regional health service managers, five rural health academics and four university managers. Participants suggested that research training varied in quality and relevance to rural health professionals. Training costs and lack of tailoring to the rural context were key barriers, whereas experiential learning and flexible modes of delivery enabled training uptake. Health service and government policies, structures, and processes both enabled or stifled implementation opportunities, with rural health professional networks from different regions offering capacity for research training development, and government departmental structures hampering training coordination. Tension between research activities and clinical practice, and health professional knowledge and beliefs, shaped the delivery of training programs. Strategically planned and evaluated research training programs and education via co-design with rural health professionals and use of research champions were strongly recommended by participants. CONCLUSIONS: To optimise research training for rural health professionals and increase the quality and quantity of relevant rural health research, a systematically planned, implemented, and resourced region-wide research training model is required.
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Servicios de Salud Rural , Salud Rural , Humanos , Personal de Salud , Australia , Escolaridad , Investigación CualitativaRESUMEN
BACKGROUND: The quality of the academic workforce is influenced by multi-level interactionist factors yet there is limited research into these influencing factors. AIM: To investigate relationships between individual characteristics of Australian occupational therapy academics and work-related variables. METHOD: An exploratory cross-sectional online survey collected demographic data and used standardized scales including the Turnover Intention Scale, 9-item Utrecht Work Engagement Scale, Work-Life Balance Scale, Role Overload Scale and Self-Defined Burnout Scale. Data were analysed using descriptive and inferential statistics. RESULTS: Academics who were more than five years in their current academic level were: significantly more likely to consider leaving their job; more often frustrated when not given opportunity to achieve their work-related goals; and less engaged. Those who had worked in higher education for longer than ten years were more likely to report role overload while participants working in higher education for less than five years were less likely to report burnout. CONCLUSIONS AND SIGNIFICANCE: To meet current and future demand for Australian occupational therapists, an engaged and supported academic workforce is needed. These findings suggest the need for attention to mentoring and career development particularly for those in academic levels longer than five years to increase work engagement and retention.
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Agotamiento Profesional , Terapia Ocupacional , Humanos , Australia , Compromiso Laboral , Estudios Transversales , Satisfacción en el Trabajo , Recursos Humanos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To explore and describe strategies to enhance the implementation of an organisational clinical supervision framework and subsequently inform the development of a model of implementation of clinical supervision for allied health professionals in a regional health care setting. SETTING: A large regional health service in Victoria, providing hospital, rehabilitation, community, mental health and aged care services. PARTICIPANTS: Allied health managers employed at the health service were members of an action research group. DESIGN: This longitudinal study used an action research approach. The action research group informed the repeated cycles of planning, action and reflection. Data from recorded action research meetings were analysed using content analysis. RESULTS: The action research group met 11 times over a 5-year period informing four action research cycles. Six main themes relating to factors that enhanced the quality of clinical supervision emerged from the analysis of the action research group data: purpose and value of clinical supervision; clinical supervision characteristics; differences between disciplines; framework development; training and support and implementation of clinical supervision. CONCLUSION: The findings from this comprehensive longitudinal study provide evidence-based approaches to the implementation of allied health clinical supervision. The action research approach used ensures that the strategies described are realistic and sustainable. A model has been developed to inform the implementation of clinical supervision for allied health.
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Técnicos Medios en Salud , Preceptoría , Servicios de Salud Rural , Anciano , Humanos , Investigación sobre Servicios de Salud , Estudios Longitudinales , Grupos de Población , LiderazgoRESUMEN
OBJECTIVE: This study aimed to investigate the perceptions and beliefs of rural high school teachers about student suicide completion in their school and their perceived self-efficacy in identification of suicidality in students (suicidal ideation, plans and behaviours). DESIGN: A cross-sectional survey methodology. SETTING: Gippsland and the Loddon Mallee regions of Victoria, Australia. PARTICIPANTS: Rural high school teachers. OUTCOME MEASURE: A survey that aimed to obtain participants' perceptions and self-reports about students who had died by suicide in their school within the last 5 years, their perceived self-efficacy in identifying suicidal students and barriers to helping students at risk. RESULTS: Two hundred and seventy-seven rural high school teachers participated and 86% reported that a student from their school had died by suicide within the last 5 years. Sixty-five per cent believed that more than one student had died by suicide and 70% perceived they were currently aware of students experiencing suicidality in their class. Receiving professional development about suicide and obtaining help from mental health clinicians predicted perceived self-efficacy in identification of suicidality in students. Participants perceived the barriers to help students at risk included insufficient numbers of school-based mental health professionals and community mental health services. CONCLUSIONS: Many rural high school teachers perceive they are at the front line of the youth suicide crisis due to unmet service need in youth mental ill health. Increased access to effective services immediately after teachers become aware of suicidality may assist in reducing youth suicide in rural areas.
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Maestros , Suicidio , Adolescente , Estudios Transversales , Humanos , Ideación Suicida , VictoriaRESUMEN
BACKGROUND: Collaborative consultation involving educational staff, allied health professionals and parents working towards goals for children with disability is considered best practice in inclusive education. However, challenges can hinder effective collaboration, thereby potentially limiting child outcomes. AIMS: The study aims were to (a) explore the experiences of teachers, teacher assistants, allied health professionals, and parents engaging in collaborative teamwork to support inclusion of children with disability in mainstream primary schools, and (b) identify key factors influencing effective teamwork and the design of support strategies. METHODS AND PROCEDURES: A co-design research method emulated collaborative consultation and authentic stakeholder teamwork. Data were from a series of six co-design workshops (15 h); discussions were audio-recorded and transcribed verbatim. An interpretive descriptive method of thematic analysis resulted in four key themes. OUTCOMES AND RESULTS: Critical factors that influenced collaborative teamwork were access to diagnosis and funding, mechanisms for team communications, practical ways of working together, and shared understandings of inclusion. CONCLUSIONS AND IMPLICATIONS: Stakeholder teams require effective communication mechanisms and practical ways of working together within and outside of classrooms. Shared understandings of inclusion provide a foundation for collaboration, requiring access to professional development to ensure teamwork is informed by best inclusive education practice.
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Niños con Discapacidad , Técnicos Medios en Salud , Niño , Comunicación , Humanos , Integración Escolar , Instituciones AcadémicasRESUMEN
BACKGROUND: The COVID-19 pandemic has required widespread and rapid adoption of information and communications technology (ICT) platforms by health professionals. Transitioning health programs from face-to-face to remote delivery using ICT platforms has introduced new challenges. OBJECTIVE: The objective of this review is to scope for ICT-delivered health programs implemented within the community health setting in high-income countries and rapidly disseminate findings to health professionals. METHODS: The Joanna Briggs Institute's scoping review methodology guided the review of the literature. RESULTS: The search retrieved 7110 unique citations. Each title and abstract was screened by at least two reviewers, resulting in 399 citations for full-text review. Of these 399 citations, 72 (18%) were included. An additional 27 citations were identified through reviewing the reference lists of the included studies, resulting in 99 citations. Citations examined 83 ICT-delivered programs from 19 high-income countries. Variations in program design, ICT platforms, research design, and outcomes were evident. CONCLUSIONS: Included programs and research were heterogeneous, addressing prevalent chronic diseases. Evidence was retrieved for the effectiveness of nurse and allied health ICT-delivered programs. Findings indicated that outcomes for participants receiving ICT-delivered programs, when compared with participants receiving in-person programs, were either equivalent or better. Gaps included a paucity of co-designed programs, qualitative research around group programs, programs for patients and carers, and evaluation of cost-effectiveness. During COVID-19 and beyond, health professionals in the community health setting are encouraged to build on existing knowledge and address evidence gaps by developing and evaluating innovative ICT-delivered programs in collaboration with consumers and carers.
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COVID-19 , Salud Pública , Tecnología Biomédica , COVID-19/epidemiología , COVID-19/prevención & control , Países Desarrollados , Humanos , Pandemias/prevención & control , SARS-CoV-2RESUMEN
OBJECTIVE: To determine the contextual factors influencing research and research capacity building in rural health settings. DESIGN: Qualitative study using semi-structured telephone interviews to collect data regarding health professionals' research education and capacity building. Analysis involved inductive coding using Braun and Clark's thematic analysis; and deductive mapping to the Consolidated Framework for Implementation Research (CFIR). SETTING: Victorian rural health services and university campuses. PARTICIPANTS: Twenty senior rural health managers, academics and/or research coordinators. Participants had at least three years' experience in rural public health, health-related research or health education settings. MAIN OUTCOME MEASURES: Contextual factors influencing the operationalisation and prioritisation of research capacity building in rural health services. RESULTS: Findings reflected the CFIR domains and constructs: intervention characteristics (relative advantage); outer setting (cosmopolitanism, external policies and incentives); inner setting (implementation climate, readiness for implementation); characteristics of individuals (self-efficacy); and process (planning, engaging). Findings illustrated the implementation context and the complex contextual tensions, which either prevent or enhance research capacity building in rural health services. CONCLUSIONS: Realising the Australian Government's vision for improved health service provision and health outcomes in rural areas requires a strong culture of research and research capacity building in rural health services. Low levels of rural research funding, chronic workforce shortages and the tension between undertaking research and delivering health care, all significantly impact the operationalisation and prioritisation of research capacity building in rural health services. Effective policy and investment addressing these contextual factors is crucial for the success of research capacity building in rural health services.
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Creación de Capacidad , Servicios de Salud Rural , Australia , Atención a la Salud , Investigación sobre Servicios de Salud , Humanos , Investigación CualitativaRESUMEN
BACKGROUND: Clinical supervision makes an important contribution to high quality patient care and professional wellbeing for the allied health workforce. However, there is limited research examining the longitudinal implementation of clinical supervision for allied health. The aim of this study was to determine the effectiveness of clinical supervision for allied health at a regional health service and clinicians' perceptions of the implementation of an organisational clinical supervision framework. METHODS: A cross-sectional study was conducted as a phase of an overarching participatory action research study. The Manchester Clinical Supervision Scale (MCSS-26) tool was used to measure clinical supervision effectiveness with additional open-ended questions included to explore the implementation of the clinical supervision framework. MCSS-26 findings were compared with an initial administration of the MCSS-26 5 years earlier. MCSS-26 data (total scores, summed domain and sub-scale scores) were analysed descriptively and reported as mean and standard deviation values. Differences between groups were analysed with independent-samples t-test (t) and one-way between groups ANOVA. RESULTS: There were 125 responses to the survey (response rate 50%). The total MCSS-26 score was 78.5 (S.D. 14.5). The total MCSS-26 score was unchanged compared with the initial administration. There was a statistically significant difference in clinical supervision effectiveness between speech pathology and physiotherapy (F = 2.9, p = 0.03) and higher MCSS-26 scores for participants whose clinical supervisor was a senior clinician and those who chose their clinical supervisor. Seventy percent of participants perceived that the organisation's clinical supervision framework was useful and provided structure and consistent expectations for clinical supervision. CONCLUSIONS: Clinical supervision was effective for allied health in this regional setting and clinical supervision effectiveness was maintained over a 5 year period. The implementation of an organisational clinical supervision framework may have a positive effect on clinical supervision for some professions.
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Técnicos Medios en Salud , Preceptoría , Estudios Transversales , Humanos , Calidad de la Atención de Salud , Encuestas y CuestionariosRESUMEN
INTRODUCTION: There is a long-standing undersupply of nursing and allied health professionals in rural Australia. Rural, mature-aged people form an untapped section of rural communities that could help to address these workforce needs. There is little understanding of the supports required to assist rural, mature-aged nursing and allied health students to complete their studies and enter the rural health workforce. OBJECTIVE: To scope factors influencing rural, mature-aged nursing and allied health students' ability to access, participate, and succeed in higher education. DESIGN: A scoping review of the international rural nursing and allied health and education literature was undertaken. Five databases (CINAHL Complete, MEDLINE, Education Resources Information Center [ERIC], Embase, and Education Research Complete), key peer-reviewed journals, and Australian grey literature were searched. FINDINGS: Fourteen articles were included in the review. Ten studies described rural, mature-aged nursing and allied health student characteristics, 6 described barriers to students participating and succeeding in higher education, and 4 described student supports. DISCUSSION: This review found limited evidence to guide higher education providers in attracting, supporting and retaining rural, mature-aged nursing and allied health students. In particular, evidence of student supports is required beyond those manifested by students themselves or their family, to include offerings from university and government sources. CONCLUSION: Substantially more research attention is needed to understand the experiences of rural, mature-aged nursing and allied health students, and supports required for this cohort to access, participate and successfully complete higher education.
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Servicios de Salud Rural , Enfermería Rural , Estudiantes de Enfermería , Anciano , Técnicos Medios en Salud , Australia , Humanos , Población Rural , Estudiantes , Recursos HumanosRESUMEN
OBJECTIVE: To evaluate a group clinical supervision program for allied health professionals in a regional health service. DESIGN: This study used a mixed-methods design including a cross-sectional, quantitative survey of group clinical supervision participants and a focus group of facilitators. SETTING: A large regional health service in Victoria, providing hospital, community and mental health services. PARTICIPANTS: Allied health professionals and managers employed at the health service. INTERVENTIONS: Group clinical supervision, based on a critical reflection model, was implemented in 3 settings. MAIN OUTCOME MEASURE: The Clinical Supervision Evaluation Questionnaire was administered to group clinical supervision participants, with additional open-ended questions included. The Clinical Supervision Evaluation Questionnaire tool consists of 3 subscales relating to the purpose, process and impact of group clinical supervision. A focus group was used to capture the perspectives of group clinical supervision facilitators. RESULTS: Fifteen survey responses were received. The overall Clinical Supervision Evaluation Questionnaire score was 56.53 (standard deviation 7.66). Scores for the Process Subscale were higher than the Purpose and Impact subscales. Themes from the open-ended survey questions included the following: value of multiple perspectives, opportunities for reflection, peer support and group process and structure. Themes from group facilitators' focus group included the following: need for group clinical supervision, value of facilitator training and support, and sustainability. CONCLUSION: Group clinical supervision was perceived to be effective, enhancing reflection, learning and peer support. Organisational support, facilitator training, group structure and planning for sustainability were identified as critical factors for success. Interprofessional and cross-organisational models of group clinical supervision are strategies that could help address issues relating to access to quality clinical supervision for rural allied health professionals.