Not So Natural Selection: Community-Engaged LIC Selection · Community-Engaged LIC Selection...

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