not so natural selection: community-engaged lic selection · community-engaged lic selection...
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Professor Jennene Greenhill
NotSoNaturalSelection:Community-EngagedLIC
Selection
FlindersUniversityRuralHealthSA2016
Disclosure
Ihavenoconflictofinterest.
ThePRCCprogramisfundedbytheAustralianGovernmentthroughtheDepartmentofHealth
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Ø 31.3% of Australians live in rural and remote areas
Ø Rural people have poor access to health & education = socioeconomic disadvantage.
Ø “The further people live away from major cities, the less healthy they are likely to be” (Australia's health 2012 AIHW)
Ø Mal-distribution of the medical workforce results in < 23% living in rural, remote and outer metropolitan regions
WhatkindofdoctorsdoesAustralianeed?
DrFredMcConnellandDrDellaYarnoldinKatherine
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RemoteAreaClassification
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Parameter 3
1. Identifyruraloriginstudentsinmedicine,nursingandalliedhealththroughuniversityadmissions.
2. Promoteruralprogramsviastudentnetworks,YouTubechannel,CPR4Kids,careerexpos
3. Deliverruralsub-quotaselectionprocessandevaluation4. EstablishruralstreamfromselectiontoruralinternshipsandvocationaltrainingTargets:• 34MDstudents40weeks+1800additionalclinicalplacementweeksinruralhospitals
andclinics minimum5weeks• MD28%Ruralorigin,AlliedHealth&Nursingstudents15%ruralorigin
Studentselectionandruralstudentrecruitment
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ResearchQuestionsHowdoestheMDruralselectionprocessinfluencemedicalstudent’scareerchoice?(NB:notonlyintentiontoworkrurally)
Howdoescommunity-basedselectionidentifystudentswhowillthriveinthePRCC?Dostudentsreturntoworkrurally?
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Methods• Trackingdataforalumniwhograduatedbefore2013• Onestudentwhohaddiedwasexcluded,• CurrentlocationofpracticeasofSept2014was
documented,APHRAdatausedandinsomecasespersonalcontactifavailable.
Associate Professor Rebecca Adams
• NBriskofunderestimatingruralpracticelocation
• TherearefewjobsfordoctorsinruralSouthAustraliasoourgraduateswhobecomespecialistsfindawaytocontributeviavisitingruralareasandteachingourPRCCstudents.
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ParallelRuralCommunityCurriculumPRCCmodel
• 34students- 40weekLIC• 5towns(popn 5-10,000)x2studentseachpractice• BasedinGeneralPractice,Hospitals&communityPRCCTeam• AdminTeam– studentsupport&accommodation
• ClinicalEducator– alocalGP
• SimulationEducator– localRNorAHP• GPSupervisorsineachclinic• AboriginalHealthLecturer• VisitingSpecialists
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FlindersUniversityRuralClinicalSchool2016
• PRCC (Parallel Rural Community Curriculum) – RuralSubQuotaSelection - ruralorigin24places– 25-30%ofallstudentsin3rd year– 1st yearstudentsdoCREW(communityruralengagementweek)– 2nd yeardoAdvancedStudiesvisitingruralcommunity– 3rd yeartheydothePRCC– 4th yeartheydoa8weekplacementormore– Ruralinternships5only(butplanningformore)
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SelectionCommitteeCommunityLiaisonCommittee(CLC)
• CLCconsistsof3communitymembers,aclinician,studentandaprofessionalstaffmember
• CLCselectsupto24studentswithruralbackgroundannually• ApplicantsscreenedbythefacultyforaminimumGPAandrural
origin(mustliverurallyfor5yr consecutiveor10yrcumulative)
• CLCcreatedtheirowncriteria
Selectionprocess1. Autobiographicalstatement2. Interview- 45minutes3. Groupscenariosreethicalorsocialissues4. Socialinteraction
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Advancedstudiesprojects– NewIntegratedMentalHealthservices– SchoolBasedMentalHealthServices– Socialimpactinruralcommunities– TeachingCPR4Kids– Obstetricretrievals– Epidemiologyofstroke
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SelectionCriteriaThe selection process is based on Transformational Learning – critical reflection and constructive discourse.
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Dr Cherie PricePartner Victor Medical
Centre 2014
Dr Cherie Price2006
Cherie PricePRCC 1998
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LocationofPracticeSubquotacomparedwithallPRCC
N= 260, Pearson Chi Square = 13.136, p=0.002**
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LocationofPracticeDifferencebetweenPRCCsites
N= 260, Pearson Chi Square = 21.41, p=0.024*
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Questions?WhatwillyourLICprogram
belikein2036?
IPE