Are recent health, welfare and care graduates part of a rural and remote workforce solution? Evidence from Tasmania, Australia.

BACKGROUND: Strong growth in graduate supply from health, welfare and care courses across Australia may bode well for easing rural workforce shortages. However, little is known about the employment opportunities available for recent graduates in non-metropolitan areas. This study aimed to quantify and describe advertised job vacancies for health, welfare and care professions in Tasmania, a largely rural and geographically isolated island state of Australia. Further, it aimed to examine those job vacancies specifying that recent graduates were suitable to apply. METHODS: Job advertisements for health, welfare and care professionals were collected weekly throughout 2018 from six online job vacancy websites. Data were extracted on 25 variables pertaining to type of profession, number of positions, location, and graduate suitability. Location of positions were recoded into a Modified Monash Model (MM) category, the Australian geographic standard used to classify rurality. Positions advertised in MM2 areas were considered regional and MM3-7 areas rural to very remote. Data were analysed using descriptive and inferential statistics. RESULTS: Over the twelve-month period, 3967 advertisements were identified, recruiting for more than 4700 positions across 49 different health, welfare and care professions in Tasmania. Most vacancies were in the non-government sector (58.5%) and located in regional areas (71.7%) of the state. Professions most frequently advertised were registered nurse (24.4%) and welfare worker (11.4%). Eleven professions, including physiotherapist and occupational therapist, recorded a disproportionate number of advertisements relative to workforce size, suggesting discipline specific workforce shortages. Only 4.6% of collected advertisements specified that a recent graduate would be suitable to apply. Of these, most were for the non-government sector (70.1%) and located in regional areas (73.4%). The professions of physiotherapist (26.6%) and occupational therapist (11.4%) were most frequently represented in advertised graduate suitable positions. CONCLUSIONS: Despite a range of advertised employment opportunities for health, welfare and care professionals across Tasmania, few specified vacancies as suitable for recent graduates and most were located in regional areas of the state. Health, welfare and care services in non-metropolitan locations may need to develop more employment opportunities for recent graduates and explicitly advertise these to job-seeking graduates to help grow and sustain the rural and remote health workforce into the future.

EPINEST, an agent-based model to simulate epidemic dynamics in large-scale poultry production and distribution networks.

The rapid intensification of poultry production raises important concerns about the associated risks of zoonotic infections. Here, we introduce EPINEST (EPIdemic NEtwork Simulation in poultry Transportation systems): an agent-based modelling framework designed to simulate pathogen transmission within realistic poultry production and distribution networks. We provide example applications to broiler production in Bangladesh, but the modular structure of the model allows for easy parameterization to suit specific countries and system configurations. Moreover, the framework enables the replication of a wide range of eco-epidemiological scenarios by incorporating diverse pathogen life-history traits, modes of transmission and interactions between multiple strains and/or pathogens. EPINEST was developed in the context of an interdisciplinary multi-centre study conducted in Bangladesh, India, Vietnam and Sri Lanka, and will facilitate the investigation of the spreading patterns of various health hazards such as avian influenza, Campylobacter, Salmonella and antimicrobial resistance in these countries. Furthermore, this modelling framework holds potential for broader application in veterinary epidemiology and One Health research, extending its relevance beyond poultry to encompass other livestock species and disease systems.

Preparing for success in final summative medical specialist examinations: The case for RACE.

BACKGROUND: Failure rates on medical specialist final summative examinations in Australia are high, regardless of speciality. Examination failure can have detrimental psycho-social, financial and job security effects on the trainee, while delays in completion of training adversely impacts workforce growth and health outcomes for the community. The study aimed to explore the preparation factors that contribute to ophthalmology trainee success in their final summative examination. METHODS: Semi-structured in-depth interviews were conducted with 29 participants via telephone or Zoom with ophthalmology trainees and Fellows. To be eligible, interviewees had to have sat the Royal Australian and New Zealand College of Ophthalmologists Advanced Clinical Examination (RACE) within the past five years or were providing supervision to trainees preparing for RACE. Interviews were audio-recorded, transcribed and thematically analysed. RESULTS: Examination success was underpinned by six themes relating to preparation: (i) 'Those who fail to plan, plan to fail', which related to development and adherence to a study plan; (ii) 'It takes a village' encompassed trainees establishing and activating personal and professional supports; (iii) 'Get to know your opponent', which encompassed developing an understanding of the examination construct, format and requirements; (iv) 'There is no substitute for hard work', which related to intensive study over a period of 12-18 months; (v) 'Keep pace with the herd', which referred to benchmarking preparation efforts and progress against peers; and (vi) 'Don't jump the gun', which related to ensuring readiness to sit. CONCLUSIONS: Maximising medical specialist examination pass rates is in the best interest of trainees, training Colleges, health care systems and communities. Recognising and facilitating preparation approaches that foster success in final summative examinations are the collective responsibility of trainees, specialist training Colleges, training networks and health systems. Trainees need to plan for examination success, be self-determined to commit to intensive study over an extended time period and be realistic about their readiness to sit.

Method in limbo? Theoretical and empirical considerations in using thematic analysis by veterinary and One Health researchers.

This article spans a number of theoretical, empirical and practice junctures at the intersection of human and animal medicine and the social sciences. We discuss the way thematic analysis, a qualitative method borrowed from the social sciences, is being increasingly used by veterinary and One Health researchers to investigate a range of complex issues. By considering theoretical aspects of thematic analysis, we expand our discussion to question whether this tool, as well as other social science methods, is currently being used appropriately by veterinary and human health researchers. We suggest that additional engagement with social science theory would enrich research practices and improve findings. We argue that considerations of 'big theory' - ontological and epistemological positionings of the researcher - and 'small(er)' theory, the specific social theory in which research is situated, are both necessary. Our point of departure is that scientific discourse is not merely construction or ideology but a unique and continuing arena of debate, in part at least because of the elevation of self-criticism to a central tenet of its practice. We argue for further engagement with the core ideas and concepts outlined above and discuss them in what follows. In particular, and by way of focusing the point, we suggest that for veterinary, One Health, and human medical researchers to use thematic analysis to its maximum potential they should be encouraged to engage with both broader socio-economic theories and with questions of ontology and epistemology.

Usability of Augmented Reality Technology in Situational Telementorship for Managing Clinical Scenarios: Quasi-Experimental Study.

BACKGROUND: Telementorship provides a way to maintain the professional skills of isolated rural health care workers. The incorporation of augmented reality (AR) technology into telementoring systems could be used to mentor health care professionals remotely under different clinical situations. OBJECTIVE: This study aims to evaluate the usability of AR technology in telementorship for managing clinical scenarios in a simulation laboratory. METHODS: This study used a quasi-experimental design. Experienced health professionals and novice health practitioners were recruited for the roles of mentors and mentees, respectively, and then trained in the use of the AR setup. In the experiment, each mentee wearing an AR headset was asked to respond to 4 different clinical scenarios: acute coronary syndrome (ACS), acute myocardial infarction (AMI), pneumonia severe reaction to antibiotics (PSRA), and hypoglycemic emergency (HE). Their mentor used a laptop to provide remote guidance, following the treatment protocols developed for each scenario. Rating scales were used to measure the AR's usability, mentorship effectiveness, and mentees' self-confidence and skill performance. RESULTS: A total of 4 mentors and 15 mentees participated in this study. Mentors and mentees were positive about using the AR technology, despite some technical issues and the time required to become familiar with the technology. The positive experience of telementorship was highlighted (mean 4.8, SD 0.414 for mentees and mean of 4.25, SD 0.5 for mentors on the 5-point Likert scale). Mentees' confidence in managing each of the 4 scenarios improved after telementoring (P=.001 for the ACS, AMI, and PSRA scenarios and P=.002 for the HE scenario). Mentees' individual skill performance rates ranged from 98% in the ACS scenario to 97% in the AMI, PSRA, and HE scenarios. CONCLUSIONS: This study provides evidence about the usability of AR technology in telementorship for managing clinical scenarios. The findings suggest the potential for this technology to be used to support health workers in real-world clinical environments and point to new directions of research.

Rural origin student representation in health courses at the University of Tasmania: 2011-2020.

OBJECTIVE: To describe longitudinal trends in the admission and completion of domestic Tasmanian rural origin students in health courses at the University of Tasmania (UTAS). METHODS: A retrospective audit of records for all domestic Tasmanian students admitted to, or who completed a health course offered by UTAS between 2011 and 2020 was conducted. Data extracted from student records included gender, age, Indigenous background, rural origin (based on residential address outside of Launceston or Hobart at the time of application), health discipline, year of admission and/or completion. Data were analysed in STATA. RESULTS: Between 2011 and 2020, 7516 domestic Tasmanian students were admitted to health courses at UTAS, of which 22.6% were rural origin (vs. a rural population of 36.7%). Students admitted were mostly female (77.0%) and studying nursing (51.1%). Rural origin students were more likely to study at the regional campus in Launceston than in Hobart, the capital city (OR, 3.79 [3.4-4.3, p < 0.00]). Over this same period, 5086 students completed a health course. There was little difference in completion rates among regional vs. rural origin students (OR, 1.04 [1.0-1.1, p < 0.00]); however, completion rates decreased with increasing remoteness. Indigenous and male students were less likely to complete than non-Indigenous (OR, 0.73 [0.7-0.8, p < 0.05]) and female students (OR, 0.97 [1.0-1.0, p < 0.05]) respectively. CONCLUSIONS: Tasmanian rural origin students are admitted to a range of health courses at UTAS and many complete. However, additional measures are needed to attract a greater number of local rural origin students to study health courses and to support them through to course completion.

'Growing your own' a case study of a collaborative training program in medical radiation science.

INTRODUCTION: Two universities run a collaborative Medical Radiation Science program where students undertake study in Tasmania before transferring to a partner university in another state to complete their program. This study assessed rates and predictors of graduate radiographers, radiation therapists and nuclear medicine technologists (collectively classified as medical radiation practitioners according to AHPRA [https://www.medicalradiationpracticeboard.gov.au/About.aspx; ahpra.gov.au/registration/registers] contemporary classification) returning to Tasmania and rural locations to practice. METHODS: A cross-sectional 22-item online survey including open-ended questions was administered via Facebook. Rates of graduates working in Tasmania and rural locations, work satisfaction, and program efficacy were assessed. Logistic regression was used to assess predictors of working in Tasmania and rural locations. RESULTS: 58 Facebook members from a total of 87 program graduates were invited to participate. Of these, 21 responded. Thirteen (62.0%) were currently working in Tasmania, of which the majority practised in regional (MMM2) areas. Most (90.5%) reported that they were happy at work, with all participants reporting the course prepared them well or very well for their first professional jobs. 71.4% stated that the provision of the first 2 years of the course in their home state influenced their decision to study medical radiation science. Being born in a rural region (MMM > 2) was a predictor for working in Tasmania (OR = 3.5) and rural locations (OR = 1.77). Males were twice as likely to work in Tasmania (OR = 2.3) and more rural locations (OR = 2.0). CONCLUSIONS: Collaboration is beneficial in producing professionals in regions with smaller enrolments limit the ability to grow their own graduates independently. Interuniversity collaborative models are recommended for other rural regions to meet local health workforce needs.

Psychometric Evaluation of the Grit Psychological Resources Scale (GPRS).

Background: Psychological resources have been shown to play a prominent role in buffering against stress and are associated with various positive constructs, including grit, defined as having the disposition to pursue long-term goals with both passion and perseverance. Objective: The objective of this study was to validate a new scale developed to measure the psychological resources of grit. Methods: A quantitative research study was conducted online with an international sample of 277 adults from a range of professional backgrounds. The psychometric properties of the 20-item Grit Psychological Resources Scale (GPRS) were evaluated by performing tests of reliability and validity. Results: Reliability tests provided evidence of high internal consistency (α = 0.91) and test-retest reliability (r = 0.75). Demographic variables did not significantly predict scores or influence survey completion. Face, content and convergent validity provided additional psychometric support for the GPRS with this sample. Confirmatory factor analysis results supported a second-order model with four sub-scales. The first-order factors loaded highly onto the second-order factor, with correlations ranging from 0.80 to 0.97. Conclusion: The GPRS showed satisfactory psychometric properties, indicating that the scale is a reliable and valid instrument for measuring the psychological resources of grit. This scale can be used to identify more targeted developmental approaches for personal and professional growth. Further, the tool enables information to be gathered on changes pre- and post-improvement initiatives to assess their effectiveness in training and continuing education.

Beyond the 'big smoke': Enabling supervision of ophthalmology trainees in regional, rural and remote Australia.

OBJECTIVE: Expansion of opportunities for ophthalmology training beyond the 'big smoke' is anticipated to support the future distribution of ophthalmologists in regional, rural and remote areas of Australia. However, little is known about what enables supervision outside of metropolitan tertiary hospital settings that would contribute to positive training experiences for specialist medical trainees and encourage them to leave the 'big smoke' once qualified. The aim of this study was therefore to explore the perceived enablers of ophthalmology trainee supervision in regional, rural and remote health settings across Australia. SETTING: Australia. PARTICIPANTS: Ophthalmologists working in regional, rural or remote health settings with experience and/or interest in supervising ophthalmology trainees (n = 16). DESIGN: Qualitative design involving semistructured interviews. RESULTS: Seven key enablers of ophthalmology trainee supervision in regional, rural and remote health settings were identified: adequate physical infrastructure, resources and funding to host a trainee; availability of online curriculum and teaching resources so as to ensure equity of training opportunities; pre-established training posts, driven by supervision 'champions'; a critical mass of ophthalmologists to help share the supervisory load; relationships and support between training posts, the training network and the Specialist Medical College; alignment of trainee competence and attitude with the needs of the training setting; and the recognition of reciprocal benefits for supervisors through supporting trainees, including workforce support and renewal. CONCLUSION: With training experiences beyond the 'big smoke' anticipated to influence future ophthalmology workforce distribution, implementation of enablers of trainee supervision should occur in regional, rural and remote health settings wherever possible.

Education support services for improving school engagement and academic performance of children and adolescents with a chronic health condition.

BACKGROUND: Chronic health conditions in children and adolescents can have profound impacts on education, well-being and health. They are described as non-communicable illnesses that are prolonged in duration, do not resolve spontaneously, and rarely cured completely. Due to variations in the definition of chronic health conditions and how they are measured prevalence estimates vary considerably and have been reported to be as high as 44% in children and adolescents. Of young people with a chronic health condition, an estimated 5% are affected by severe conditions characterised by limitations to daily activities impacting their ability to attend school. School attendance is important for academic and social skill development as well as well-being. When children and adolescents are absent from school due to a chronic health condition, school engagement can be affected. Disengagement from school is associated with poorer academic achievement, social-emotional functioning and career choices. Education support services for children and adolescents with chronic health conditions aim to prevent disengagement from school, education and learning during periods where their illness caused them to miss school. However, there is limited evidence on the effectiveness of educational support interventions at improving school engagement and educational/learning outcomes for children and adolescents with chronic health conditions. OBJECTIVES: To describe the nature of educational support interventions for children and adolescents with a chronic health condition, and to examine the effectiveness of these interventions on school engagement and academic achievement. SEARCH METHODS: We searched eight electronic databases which span the health/medical, social sciences and education disciplines between 18 and 25 January 2021: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid). CINAHL (EBSCO), PsycINFO (EBSCO), ERIC (Education Resources Information Center), Applied Social Sciences Index and Abstracts: ASSIA (ProQuest), and PubMed (from 2019). We also searched five grey literature trials registers and databases between 8 and 12 February 2021 to identify additional published and unpublished studies, theses and conference abstracts, as well as snowballing reference lists of included studies. SELECTION CRITERIA: Randomised controlled trials (RCTs), controlled before-and-after studies and interrupted time series studies that met the inclusion criteria were selected. Other inclusion criteria were: participants - must include children or adolescents (aged four to 18 years) with a chronic health condition, intervention - must include educational support, outcomes - must report the primary outcomes (i.e. school engagement or academic achievement) or secondary outcomes (i.e. quality of life, transition to school/school re-entry, mental health or adverse outcomes). DATA COLLECTION AND ANALYSIS: Two people independently screened titles and abstracts, and full-text articles, to identify included studies. Where disagreements arose between reviewers, the two reviewers discussed the discrepancy. If resolution was unable to be achieved, the issues were discussed with a senior reviewer to resolve the matter. We extracted study characteristic data and risk of bias data from the full texts of included studies using a data extraction form before entering the information into Review Manager 5.4.1. Two people independently extracted data, assessed risk of bias of individual studies and undertook GRADE assessments of the quality of the evidence. Meta-analysis was not possible due to the small number of studies for each outcome. Our synthesis, therefore, used vote-counting based on the direction of the effect/impact of the intervention. MAIN RESULTS: The database searches identified 14,202 titles and abstracts. Grey literature and reference list searches did not identify any additional studies that met the inclusion criteria. One hundred and twelve full-text studies were assessed for eligibility, of which four studies met the eligibility criteria for inclusion in the review. All studies were randomised controlled studies with a combined total of 359 participants. All included studies were disease-specific; three studies focused on children with cancer, and one study focused on children with Attention Deficit Hyperactivity Disorder (ADHD). There was evidence that education support improved school engagement with three of four studies favouring the intervention. Three studies measured academic achievement but only two studies provided effect estimates. Based on the vote-counting method, we found contradictory results from the studies: one study showed a positive direction of effect and the other study showed a negative direction of effect. One study measured transition back to school and found a positive impact of education support favouring the intervention (SMD 0.18, 95% CI -0.46 to 0.96, no P value reported). The result came from a single study with a small sample size (n = 30), and produced a confidence interval that indicated the possibility of a very small or no effect. The overall certainty of evidence for these three outcomes was judged to be 'very low'. Two of four studies measured mental health (measured as self-esteem). Both studies reported a positive impact of education support interventions on mental health; this was the only outcome for which the overall certainty of evidence was judged to be 'low' rather than 'very low'. No studies measured or reported quality of life or adverse effects. Risk of bias (selection, performance, detection, attrition, reporting and other bias) was assessed using the Cochrane risk of bias tool for randomised trials (version 1). Overall risk of bias for all studies was assessed as 'high risk' because all studies had at least one domain at high risk of bias. AUTHORS' CONCLUSIONS: This review has demonstrated the infancy of quality research on the effectiveness of education support interventions for children and adolescents with chronic health conditions. At best, we can say that we are uncertain whether education support interventions improve either academic achievement or school engagement. Of the secondary outcomes, we are also uncertain whether education support interventions improve transition back to school, or school re-entry. However, we suggest there is some evidence that education support may slightly improve mental health, measured as self-esteem. Given the current state of the evidence of the effectiveness of education support interventions for children and adolescents with chronic health conditions, we highlight some important implications for future research in this field to strengthen the evidence that can inform effective practice and policy.

A systematic review of the preferences of rural and remote youth for mental health service access: Telehealth versus face-to-face consultation.

INTRODUCTION: Telehealth has become an increasingly popular method to deliver mental health services to rural and remote youth who are challenged by distance and service availability. However, it remains unclear whether rural and remote youth would prefer to access mental health services via telehealth or by attending services in person. OBJECTIVE: To systematically review the preferences of rural and remote youth for mental health service access via telehealth versus face-to-face consultation. DESIGN: Systematic review of published research papers cited in databases CINAHL, MEDLINE and PubMed databases between 2000 and 2021. FINDINGS: From a total of 225 articles identified, four were found to meet inclusion criteria. Three studies reported rural and remote youth preferred to access mental health services face-to-face over telehealth. However, three studies also reported youth viewed telehealth as an important adjunct to in person attendance, especially in situations of large travel times. DISCUSSION: Although telehealth can facilitate mental health service access, rural and remote youth may prefer to see a mental health professional in person, with telehealth regarded as an adjunct to, not a replacement for, face-to-face consultation. CONCLUSION: Whilst rural and remote youth may prefer to access mental health services in person rather than via telehealth, further well designed research is needed to better understand under what circumstances this preference holds true and why. Caution should be exercised in generalising this finding because of the few studies that met the inclusion criteria and different conditions under which youth made their choice to access mental health services.

Development of a framework to support situational tele-mentorship of rural and remote practice.

Situational tele-mentorship refers to the use of technology to provide interactive, two-way communication between an advisor (the mentor) and a novice (mentee) to enhance the management of a dynamic clinical scenario in real-time.This article develops a conceptual framework to support situational tele-mentorship of healthcare professionals working in rural and remote practices by critically exploring the concept of mentorship within medical education literature and applied to healthcare professionals working in more isolated settings.The situational tele-mentorship framework consists of synchronous telecommunication technologies and the problem-solving process. The end-users of the framework are the mentor located centrally and the mentee dealing with a challenging situation at a remote location using communication technology. The problem-solving process' stages are preparation, identification, action, and evaluation. The mentor and mentee use the 5W1H model, which is a summary of the questions of who, what, where, when, why, and how, applied in two-way communication.This framework provides medical teachers and clinicians with a detailed, yet concise exposition of critical elements required to implement situational tele-mentorship. Healthcare providers can also use this framework to help coordinate resources and manage stakeholders in tele-mentoring situations.

Is hope associated with HIV-acquisition risk and intimate partner violence amongst young women and men? A cross-sectional study in urban informal settlements in South Africa.

Hope is a concept that may mediate between the structural constraints people live under and their HIV-acquisition risk behaviours/experiences. Drawing on data collected as the baseline for an intervention trial between September 2015 and September 2016, among young (18-30-year-old), out-of-school women and men in urban informal settlements in Durban, South Africa, we assess whether hope, assessed by the Snyder Hope Scale, is associated with HIV-risk behaviours/experiences. 677 women (35.5%; 33.7%; 30.9%; low, medium, and high hope scores respectively) and 668 men (40.6%; 32.8%; 26.7%; low, medium, and high hope scores respectively) were included. Among women, adjusted analyses showed high levels of hope, compared to low levels, were associated with greater modern contraceptive use (aOR1.57, 1.04-2.37). For men, medium or high levels of hope, compared to low levels, were associated with reduced physical and/or sexual IPV perpetration (med: aOR0.55, 0.38-0.81, high: 0.38, 0.25-0.57), emotional IPV perpetration (med: aOR0.54, 0.36-0.80, high: aOR0.62, 0.41-0.94) and transactional sex (med: 0.57, 0.38-0.84, high: aOR0.57, 0.39-0.86) respectively. For men, hope potentially captured a pathway between an individual's structural context and their HIV-risk behaviour. Yet this was not the case for women. It may be the Snyder Hope Scale does not adequately capture localised meanings of hope.

Benefits and challenges to ophthalmology training via the Specialist Training Program.

INTRODUCTION: The Specialist Training Program (STP) is a commonwealth funding initiative to support specialist medical training positions in regional, rural and remote areas, and in private settings. The program helps to improve the skills and distribution of the specialist medical workforce by providing trainees experience of a broader range of healthcare settings. OBJECTIVE: To examine the benefits and challenges of ophthalmology training delivered by the STP in regional, rural, remote, and/or private settings across Australia. DESIGN: Qualitative design involving semi-structured in-depth interviews with thirty-two participants experienced in the delivery of ophthalmology training at STP posts including ophthalmology trainees (n = 8), STP supervisors and clinical tutors (n = 16), and other stakeholders (n = 8). FINDINGS: Training delivered at STP posts was reportedly beneficial for ophthalmology trainees, their supervisors and the broader community given it enabled exposure to regional, rural, remote and private settings, access to unique learning opportunities, provided workforce support and renewal, and affordable ophthalmic care. However, all participants also reported challenges including difficulties achieving work/life balance, unmet training expectations, a lack of professional support, and financial and administrative burden. Malalignment between trainee preferences for STP posts, low STP literacy and limited regional, rural and remote training experiences were also seen as missed opportunities to foster future rural ophthalmic workforce development. DISCUSSION: The STP improves access to ophthalmic care in underserved populations while enabling valuable rural and/or private practice exposure for medical specialist trainees and workforce support for supervising ophthalmologists. CONCLUSION: Efforts are needed to improve the quality of training experiences provided at STP posts and post sustainability. Although research is needed to investigate the longer-term benefits of the STP to rural and/or private workforce recruitment and retention, RANZCO should develop further regional, rural and remote STP posts to help realise future rural practice intention amongst ophthalmology trainees.

Co-designing Community Out-of-hours Palliative Care Services: A systematic literature search and review.

BACKGROUND: In order to provide responsive, individualised and personalised care, there is now greater engagement with patients, families and carers in designing health services. Out-of-hours care is an essential component of community palliative care. However, little is known about how patients, families and carers have been involved in the planning and design of these services. AIM: To systematically search and review the research literature that reports on how out-of-hours palliative care services are provided in the community and to identify the extent to which the principles of co-design have been used to inform the planning and design of these services. DESIGN: Systematic literature search and review. DATA SOURCES: A systematic search for published research papers from seven databases was conducted in MEDLINE, PsycINFO, Embase, Emcare, PubMed, CINAHL and Web of Science, from January 2010 and December 2021. Reference list searches of included papers were undertaken to source additional relevant literature. A manifest content analysis was used to analyse the data. RESULTS: A total of 77 papers were included. The majority of out-of-hours services in the community were provided by primary care services. The review found little evidence that patients, families or carers were involved in the planning or development of out-of-hours services. CONCLUSION: Incorporating patients, families and carers priorities and preferences in the planning and designing of out-of-hours palliative care service is needed for service providers to deliver care that is more patient-centred. Adopting the principles of co-design may improve how out-of-hours care scan be delivered.

The use of telehealth in the provision of after-hours palliative care services in rural and remote Australia: A scoping review.

BACKGROUND: Accessing quality palliative care, especially at the end of life is vital in reducing physical and emotional distress and optimising quality of life. For people living in rural and remote Australia, telehealth services can be effective in providing access to after-hours palliative care. OBJECTIVE: To review and map the available evidence on the use of telehealth in providing after-hours palliative care services in rural and remote Australia. METHOD: Scoping review using Arksey and O'Malley methodological framework. Findings are reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Scopus, Web of Science, CINAHL Complete, Embase via Ovid, Emcare via Ovid, and Medline via Ovid databases were searched. Peer-reviewed studies and grey literature published in English from 2000 to May 2021 were included. RESULTS: Twelve studies were included in the review. Four main themes were identified: 1) Stakeholder perceptions of service; 2) benefits to services and users; 3) service challenges; and 4) recommendations for service improvement. CONCLUSION: Telehealth can connect patients and families with healthcare professionals and enable patients to continue receiving care at home. However, challenges relating to patients, service, staff skills, and experience need to be overcome to ensure the success and sustainability of this service. Improved communication and care coordination, better access to patient records, and ongoing healthcare professional education are required. IMPLICATIONS: Protocols, comprehensive policy documents and standardized operating procedures to guide healthcare professionals to provide after-hours palliative care is needed. Ongoing education and training for staff is crucial in managing patients' symptoms. Existing service gaps need to be explored and alternative models of after-hours palliative care need to be tested.

Considerations for Training and Workforce Development to Enhance Rural and Remote Ophthalmology Practise in Australia: A Scoping Review.

Australia has one of the lowest per capita numbers of ophthalmologists among OECD countries, and they predominantly practise in metropolitan centres of the country. Increasing the size and distribution of the ophthalmology workforce is of critical importance. The objective of this review was to investigate the context of rural ophthalmology training and practise in Australia and how they relate to future ophthalmology workforce development. This scoping review was informed by Arksey and O'Malley's framework and the methodology described by Coloqhuon et al. The search yielded 428 articles, of which 261 were screened for eligibility. Following the screening, a total of 75 articles were included in the study. Themes identified relating to rural ophthalmology training and practise included: Indigenous eye health; access and utilisation of ophthalmology-related services; service delivery models for ophthalmic care; ophthalmology workforce demographics; and ophthalmology workforce education and training for rural and remote practise. With an anticipated undersupply and maldistribution of ophthalmologists in the coming decade, efforts to improve training must focus on how to build a sizeable, fit-for-purpose workforce to address eye health needs across Australia. More research focusing on ophthalmology workforce distribution is needed to help identify evidence-based solutions for workforce maldistribution. Several strategies to better prepare the future ophthalmology workforce for rural practise were identified, including incorporating telehealth into ophthalmology training settings; collaborating with other health workers, especially optometrists and specialist nurses in eyecare delivery; and exposing trainees to more patients of Indigenous background.

Development of a scale to measure the psychological resources of grit in adults.

Grit, a personality trait characterized by  having passion and perseverance for long-term goals, has been linked to increased performance, retention, and well-being in various fields. In the 15 years since the original grit scale was published, many studies have investigated factors that promote grit. However, a scale has not yet been developed measuring characteristics that can contribute to higher levels of grit. This study aimed to develop a novel scale to measure the psychological resources of grit. The Delphi technique was used to obtain consensus from a national and international panel of academics and practitioners who are experts in grit and related constructs. A total of 30 participants rated 100 scale items over three rounds of online surveys. Experts agreed that items selected for the final scale (n = 20) were essential, with 85% rating them as important or very important. The scale, called the Grit Psychological Resources Scale, has promise as a helpful tool for practitioners involved in staff development and building capabilities that contribute to goal achievement.

The Australian pharmacist workforce: distribution and predictors of practising outside of metropolitan and regional areas in 2019.

OBJECTIVE: This study describes the distribution of the Australian pharmacists' workforce using a range of indicators and identifies predictors of practising outside of metropolitan and regional areas. METHODS: A cross-sectional description of the 2019 pharmacy workforce. Pharmacists who completed the 2019 workforce survey as reported in the Australian National Health Workforce Dataset (NHWDS). The main outcome measures were the number of pharmacists per 100 000, the proportion working less than 35 h a week, the proportion with primary qualification from overseas (outside of Australia and New Zealand) and the proportion aged 65 years or older. Additionally, predictors of practising outside of metropolitan and regional areas were also identified. KEY FINDINGS: Nationally, there were 102 pharmacists/100 000 with one-third working less than 35 h a week. About 10% of pharmacists obtained their primary qualification from overseas and 4% were 65 years old or older. Males were more likely to practise outside of metropolitan and regional areas [OR, 1.40 (1.30-1.50); P < 0.001], while younger people were less likely to practise outside of these locations [OR, 0.71 (0.66-0.76); P < 0.001]. Those who had obtained their primary qualification overseas were also more likely to practise outside of metropolitan and regional areas. CONCLUSIONS: Analysis of the 2019 NHWDS suggests an uneven distribution of the pharmacist workforce. Also, three predictors of practising outside of major cities and regional centres were identified.

Usability of augmented reality technology in tele-mentorship for managing clinical scenarios-A study protocol.

BACKGROUND: Tele-mentorship is considered to offer a solution to training and providing professional assistance at a distance. Tele-mentoring is a method in which a mentor interactively guides a mentee at a different geographic location in real time using a technological communication device. During a healthcare procedure, tele-mentoring can support a medical expert, remote from the treatment site, to guide a less-experienced practitioner at a different geographic location. Augmented Reality (AR) technology has been incorporated in tele-mentoring systems in healthcare environments globally. However, evidence is absent about the usability of AR technology in tele-mentoring clinical healthcare professionals in managing clinical scenarios. AIM: This study aims to evaluate the usability of Augmented Reality (AR) technology in tele-mentorship for managing clinical scenarios. METHODS: This study uses a quasi-experimental design. Four experienced health professionals and a minimum of twelve novice health practitioners will be recruited for the roles of mentors and mentees, respectively. In the experiment, each mentee wearing the AR headset performs a maximum of four different clinical scenarios in a simulated learning environment. A mentor who stays in a separate room and uses a laptop will provide the mentee remote instruction and guidance following the standard protocols for the treatment proposed for each scenario. The scenarios of Acute Coronary Syndrome, Acute Myocardial Infarction, Pneumonia Severe Reaction to Antibiotics, and Hypoglycaemic Emergency are selected, and the corresponding clinical management protocols developed. Outcome measures include the mentors and mentees' perception of the AR's usability, mentorship effectiveness, and the mentees' self-confidence and skill performance. ETHICS: The protocol was approved by the Tasmania Health and Medical Human Research Ethics Committee (Project ID: 23343). The complete pre-registration of our study can be found at https://osf.io/q8c3u/.