Around 500 delegates converged in Hobart for the National Australian & New Zealand Association for Health Professional Educators (ANZAHPE) during July.
The four-day conference focused on ‘Sustainability in Health’. Members of the Rural Clinical School (RCS) joined health educators from across Australia and New Zealand to explore this important topic.
RCS academics presented posters and delivered workshops on a number of topics which included the role of academic registrars in medical education, health advocacy and what makes a positive general practice placement.
Dr Lizzi Shires, Director of the RCS, said it was important that so many staff could contribute to the future of medical education.
“The Rural Clinical School has developed many innovative ways of teaching in rural areas, and it is good to be able to share these ideas on a national stage,” Dr Shires said.
“Staff learnt from other universities how to tackle issues that affect us all and new teaching innovations.
“Some of the key things we took away from the conference is how we as individuals and organisations can contribute to sustainability on a global scale.
“We also looked at how we can be more sustainable. Medical teachers are a scarce, and ageing, resource - how do we sustain ourselves and develop the next generation of medical teachers.
“We look forward to implementing new ideas and research to help us to continue to be a sustainable Rural Clinical School.”
Rural Clinical School presentations at ANZAHPE:
What makes a positive general practice placement? Motivating medical students to learn in general practice
Dr Lizzi Shires
RCS Director Dr Lizzi Shires shared results of a study which found that a positive experience in general practice can increase the motivation of medical students to learn. There are some simple features that general practices can employ to support teaching and learning for their medical students; enhancing motivation to learn and engendering a positive general practice placement.
Evaluation of intern training in rural primary care settings in Tasmania
Dr Lynn Hemmings
In January 2018, newly-graduated Tasmanian medical interns began undertaking three-month terms in five rural and remote general practices across the State (King Island, Queenstown, St Helens, Huonville and Flinders Island). This presentation examined how the program is tracking so far while sharing feedback and experiences of the interns who are completing the rotation. It also unpacked the broader aims of the initiative in boosting Tasmania’s rural and remote health workforce.
General Practice Academic Registrar Post – Why are these important in medical education?
Dr Sarvin Randhawa, Dr Elisabeth Robin and Dr Lizzi Shires
In 2016, the University’s Rural Clinical School appointed its very first academic GP registrar to support medical student teaching programs. It now employs two. GP registrars are practising doctors, who are undergoing further specialty training to become fully-qualified GPs. Medical students consider GP registrars as good educators, who often a better understanding of the challenges faced at medical school and are approachable as professional mentors. Research shows many registrars are interested in taking on this educator role but do not feel they have the skills. This presentation provided feedback into this teaching approach from the perspective of the RCS’s academic registrars (Sarvin and Elisabeth) while exploring how these positions could be developed and supported to ensure a sustainable primary care and medical education workforce into the future.
Can Australian and New Zealand medical and health professional institutions equip graduates to become effective health advocates in the 21stcentury?
Dr Nick Towle
Dr Towle led a workshop exploring how health advocacy curriculum at Australian and New Zealand medical schools can be strengthened. Amid rising inequalities within nations and looming ecological crises, such as climate change, there are calls for a reorientation of the purpose of health professional education institutions to become more socially accountable. Dr Towle highlighted that the response of medical and health education institutions must come in the form of training future graduates with the capacity to reach beyond the clinic and advocate for measures that address these wider threats to health.
Health Advocacy, finding a home within undergraduate medical education
Dr Nick Towle
In a second workshop, Dr Nick Towle shared study findings which investigated the attitudes and experiences of Australian medical academics around health advocacy curriculum. Health advocacy is mandated as a core competency for medical graduates nationally and internationally and aligned to the growing expectation of medical schools to become more socially accountable. However, curriculum development in this domain has been slow, definitions of health advocacy remain contested, with divergence in approaches to teaching and assessment. The majority of participants rated the development of health advocacy skills in medical graduates as important (38%) or very important (54%). Half were personally engaged in health advocacy, though many perceived it to be a difficult area to teach (40%) and difficult or very difficult to assess (70%). The study also identified considerable divergence in the ways academics conceptualised health advocacy and what they considered to be important curriculum content.
Rural Generalist workforce development model: Palliative Care
Dr Rosemary Ramsay, Rural Clinical School and Palliative Care North-West Tasmania
Dr Ramsay shared details of a Rural General Medical Specialist Model which has resulted in a permanent GP Registrar Palliative Care post within the Tasmanian Health Service (THS) North-West. The post is funded by a unique partnership between the THS with the RCS and sees a registrar (currently Dr Tim Andrewartha) working in community palliative care while teaching into the University medical program. Dr Ramsay explained how the GP Registrar position shows a way to develop a sustainable rural palliative care workforce in Tasmania, which could be applied to other rural areas in Australia.
Teaching Mental Health in a rural setting
Miranda Stephens
Miranda’s presentation provided insight into the challenges of teaching a mental health curriculum to students in rural areas. She then shared details of how the RCS is addressing this through an innovative community-based teaching model. The model helps provide an enhanced learning experience for students and also services which host them, allowing them to spend time in an acute hospital setting, community mental health services, state and federal services and private practices. Students learn and utilise skills by contributing to triage services and by providing psycho-education to patients. Simulated multi-disciplinary learning and small group teaching is embedded within the rotation to enhance direct experience, share varied learning and for consistency in assessment.
The Prevalence of Sexual Harassment and Bullying amongst General Practice Registrars at a Regional Training Centre
Dr Lizzi Shires, Colleen Cheek, Dr Penny Allen and Dr Sarvin Randhawa
Dr Randhawa shared the findings of a research project which aimed to identify the prevalence of sexual harassment and bullying of GP registrars at a regional training centre. There was a 45% response rate to an online survey which found 44% of participating GP registrars had been sexually harassed or bullied during their medical journey. The study identified patients or relatives as the most common perpetrators of sexual harassment, while doctors at hospital were the main perpetrators of bullying. The research also highlighted an opportunity for increased training in sexual harassment and bullying. Increased awareness and management of these behaviours may curb incidence and promote a sustainable professional environment.
What should a final year OSCE mark sheet look like?
Dr Lizzi Shires
Dr Shires co-presented with other medical schools looking at shared assessment processes in both OSCEs and for exit exams. Australia has 19 medical schools with graduating students, 15 of which are members of ACCLAiM, a national collaboration to develop and compare standards for OSCE’s across Australia. Medical schools meet twice yearly to develop OSCEs and compare and contrast current standards in assessment. This paper was developed from a workshop where marking was discussed.
Prescribing Skills Assessment – initial results from an Australian cross-institutional pilot
Dr Lizzi Shires
Dr Shires co-presented a second topic with other universities. The presentation looked at the results of a national collaboration on assessing prescribing skills. In the United Kingdom medical students have a mandatory assessment to ensure that they can prescribe safely on graduation. This assessment was modified for the Australian context and delivered formatively across several medical schools. The results of this collaboration and the lessons learnt were shared during the presentation. Prescribing is a core skill for doctors, and many medical students don’t feel confident upon graduation. This exam and the resources supporting it is a practical way to develop and assess these skills.
