Archive | Research

What matters in remote & rural practice? Your input requested…

RuralGP.com has just received this request from Elizabeth, who is seeking contributions to research that she is carrying out into the needs of remote & rural practice in Scotland.  If you are able to assist, please contact Elizabeth directly…

My name is Elizabeth Lemmon, I am a PhD student based at the University of Stirling and currently undertaking an internship at the Scottish Government within the Health and Social Care Analysis Team. The aim of the internship is to carry out some research into remote and rural general practice in Scotland in an attempt to better characterise them in terms of their activities and the challenges they face. I’m currently pulling together data which are publicly available on general practices to improve the evidence base and identify where further data analysis are needed.

I am contacting you to ask if anyone would be interested in sharing their experiences within remote and rural general practice and highlight any areas which you feel are priorities or which need further research?

I understand that there is currently work taking place within the Scottish Government on the Primary Care Evidence Collaborative which is developing a 10-year evaluation framework for primary care transformation. The work I will be doing during my internship on remote and rural practices will help to identify priorities for data, research and analysis and ensure that rural issues are included.

Any feedback is much appreciated!

Elizabeth Lemmon
Scottish Graduate School of Social Science Intern
Health and Social Care Analysis
Scottish Government
Email: Elizabeth.Lemmon@gov.scot
T: 0131 244 3469

 

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RRH Guide to Getting your work Published

One of the sessions at #ruralwonca was delivered by some of the team at the Journal for Remote & Rural Health.  I was really sorry to miss it, due to presenting in another session, but my tweeted request to make the advice available online was answered quickly and the presentation is now available – see below.

The journal team are keen to encourage and motivate rural healthcare professionals to share their research, and seem genuinely interested in helping budding writers to put pen-to-paper or finger-to-keyboard.

There is a lot of great innovation and problem-solving going on in rural practice.  Rural healthcare professionals tend to know their communities well, are used to dealing with limited resources, and some of the best examples of teamwork are to be found in rural settings.  However ‘being academic does not come easy to everyone, and the process of writing up evaluation and research can sometimes feel tedious and time-consuming.

However, it is now easier than ever to find interested journals, and there seems to be a drive to make the steps to getting work published more accessible.

Watch the presentation below for the RRH team’s top tips on getting your research out to a wider audience.  You can find the guidelines for authors available here.

Also, on the theme of research, here’s a great project that aims to enable rural doctors to develop their research activity through pragmatic and direct support.  Delivered by the Faculty of Medicine at Memorial University in Newfoundland, it’s called the ‘6 for 6’ programme.  Click here for more details or watch the video below.

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Protective personality traits for LICs

Assoc Professor Diann Eley

Today I attended a session at #ruralwonca which was delivered by Associate Professor Diann Eley from the University of Queensland on the role of personality traits on student experience of Longitudinal Integrated Clerkships.

Diann has gained considerable experience in this area, and specifically on how best to support and mentor students effectively whilst encouraging them to reflect on their own personalities – and how that impacts on their clinical decision-making.

I was delighted that Diann gave me a few minutes of her time after her presentation to discuss this in more detail, particularly as this work is highly relevant to the development of LICs in Scotland.

You can listen to our discussion here:

 

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Clinical courage: an evolving concept crucial to rural practice

I was introduced to the concept of clinical courage when attending an International Rural Research Symposium last year at Tromso University in Norway.  Dr Lucie Walters, of Flinders University in Australia, ran an enthralling workshop about some work that she and her team are doing to quantify and understand what we mean and can learn from clinical courage, particularly in the context of professional isolation and delivery of rural health services.

It’s a concept that seems to resonate easily with rural health practitioners, particularly rural GPs.  Despite this, there is relatively little that I have found to expand on the concept.  Two very helpful resources are a “President’s Message. Clinical Courage” by Dr John Wooton (found in Can J Rural Med 2011; 16(2)) and two comments from Peter Dunlop and Keith MacLellan in the followup issue (found in Can J Rural Med 2011; 16(3)).  The latter comment introduces another concept of ‘learned helplessness’, and I suspect that this will be of increasing importance as debate evolves regarding the fragmentation of undergraduate curriculums and the need to consider generalist undifferentiated training versus teaching in more specialist settings.

So, I was delighted to be asked to participate in an interview run by two of the Flinders University students Ella and Laura who are assisting with the project, whilst here in Cairns at the WONCA World Rural Health Conference.  They interviewed me, and they kindly agreed to me interviewing them!

You can hear about their experiences of medical teaching so far, and also more about the concept of clinical courage in the audio clip below:

 

Ella and Laura, 2nd year medical students at Flinders University

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RuralGP.com at #ruralwonca

Today marks the start of the 14th WONCA World Rural Health Conference, being held in Cairns, Australia.

The programme is set to contain a fantastically diverse range of research and workshops covering everything from improvements in patient care, to developing new and effective ways to collaborate across boundaries in rural health.  You can follow the events on twitter using the #RuralWonca hashtag, and already there has been a huge number of comment and links

View the WONCA Rural Conference programme

So far, the vibe at #RuralWonca has been great… benefitting from Cairns hospitality (boosted by a dynamic and helpful team from ACRRM) and a stimulating range of input from stalwart experts in rural medicine, to young, enthusiastic students and young doctors.

Thursday saw a full day of proceedings for the WONCA World Working Party for Rural Health – with the annual Council meeting held in spectacular surroundings of a seminar room looking directly onto rainforest.  As well as hearing about events from the last year, and sorting out logistics for yet another busy year ahead, there was debate about how best to support member organisations and do everything possible to support the growing number of student and young doctor organisations.  The highlight of 2018 is set to be the 15th World Rural Health Conference.  Crumbs, we haven’t even started the 14th conference yet, but for a taster of what’s in store – in New Delhi – see the video below!

Friday brought the World Summit on Rural Generalist Medicine.  The concept and importance of rural generalism in health ecosystems is reaching high levels of resonance now within Australia (where political support for recognising this is higher than ever), and much further afield in both ‘developed’ and ‘developing’ nations.  It is clear that empowering rural generalism within healthcare systems has never been more important, with absolute needs to train future doctors in medical complexity, meet the demands of an ageing population and achieve the levels of health service efficiency that are often more easy to find in the generalist setting.

The Summit also saw the launch of the Japanese Rural Generalist Programme: a major achievement and indicative of the direction that other countries are likely to go too, not least through the inspiration that these developments bring.

You can follow tweets from the Summit meeting using the hashtag #RuralGeneralist

And now for the main event.  This looks set to be a stimulating and busy few days ahead, bringing together an enthusiastic and dedicated group of international confreres giving the opportunity to recognise and drive forward international innovation and collaboration in rural health.  We hope to feature a number of interviews and reports on RuralGP.com over the next few days, like we did with the last conference in Dubrovnik, between a very packed and interesting programme of events.

Follow the WONCA World Rural Health Conference on Twitter:

#ruralwonca

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WONCA World Rural Health conference all set for April

This year will see the WONCA World Rural Health Conference take place in Cairns, Australia from 29th April.  It will be preceded by the National Rural Health Conference of Australia, which will promise to bring even more research, innovation and collaboration to the wider event.

Registration is now available from the conference website.  The organisers have also put together this film to whet the appetite of potential delegates.  It looks set to be a fantastic event.  RuralGP.com will be there, and we hope to run a similar range of interviews and podcasts like we did from Dubrovnik in 2015.  This reflective commentary from the 2015 conference demonstrates that the conference offers a unique chance to get together with like-minded confreres and share great practice from across the world.

We hope to see you there!

Early bird registration fees available until the end of January.

… and if that’s not enough (!), here’s Ian Couper of South Africa, being interviewed in Dubrovnik in 2015 giving some encouragement for others – particularly students and new doctors – to attend WONCA in Cairns…

ianIan Couper, South Africa

Ian is a rural family doctor, and a stalwart of Rural WONCA.  You can read more about his background here.


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New research: rural recruitment & retention

rural-4In January this year, I was contacted by Pauline von Zabeltitz, a final year student at the University of Aberdeen, who was studying for an MA (Hons) in Economics and International Relations.

For her dissertation, she was keen to explore the various projects and initiatives being used to improve recruitment and retention to rural GP practice in Scotland.

Pauline has very kindly agreed to having her dissertation published on RuralGP.com in order to share the analysis that she has undertaken over the last six months.  Her report provides yet more substance behind some of the core issues that we know affects rural recruitment & retention, whilst providing another perspective and some new ideas to add to the present work on this area.

Coming from a family with a strong medical background, healthcare related issues have always been of great interest to me and throughout my degree, I got the chance to explore this topic further through a Health Economics course. Discussing Health Economic issues and policies led me eventually to my final Dissertation topic, writing about the recruitment and retention issues in rural Scotland regarding healthcare providers such as GPs.

Specific issues highlighted include rural connectivity, access to undergraduate placements and the GP Rural Fellowship scheme.  She manages to cover a wide spectrum of other considerations, and some evaluation of present approaches to this problem.

You can download her report by clicking on the button below.

An analysis of current initiatives targeting the recruitment and retention of GPs to remote and rural Scotland [1.4 MB]

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Abstracts Invited for Rethinking Remote 2016

remoteconf

Abstracts are invited for the Rethinking Remote conference, to be held on 23-24 May 2016 in Inverness.

Programme themes:

  • PROFESSIONAL SUPPORT
  • COMMUNITY ENGAGEMENT
  • EDUCATION
  • TECHNOLOGY

Specific themes

Submissions are invited in areas broadly related to the main conference themes above.

These are likely to cover topics such as:

  • pre-hospital care
  • extreme remote care
  • management of time-critical emergencies
  • patient safety
  • rural health care
  • models for remote supervision and support
  • new kinds of healthcare workers
  • health care competencies; educating remote workers
  • recruitment and retention
  • psychosocial care of citizens and staff in remote areas
  • digital technology and innovations in remote health care
  • self care
  • point-of-care
  • decision  support

Deadline for abstract submissions is 29th January 2016.

More information available at the conference website.

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How do GPs diagnose infection in the elderly?

bugsDiagnosis of serious infection in elderly patients and the decision to admit: a qualitative interview study with UK GPs

Diagnosis of serious infection in the growing elderly primary care population is important, because it carries high mortality, but challenging, because the signs, symptoms and tests which we use in younger patients can be less accurate in the elderly.

Dr Abi Moore is a GP trainee and clinical researcher based at the University of Oxford.  She is involved in a project that aims to find out how GPs diagnose serious infection in the elderly in the community and how they decide whether a patient needs admission.  In order to get a useful answer to this question she is keen to explore the views and experiences of currently practising GPs working in a variety of different settings.

Abi is keen to find GPs who would be willing to take part in this study, which involves a recorded telephone or face-to-face interview lasting 30-45 minutes.  She realises how pressured time can be and would therefore be happy to conduct the interview to fit around schedules, including early morning, evenings or weekends.  She can offer a certificate of participation in research that may be useful for appraisal or revalidation purposes and will reimburse you #60 for your time.  The information sheets below give further details about what participation in the study will involve.

You can contact Abi at the email address below if you are willing to participate in an interview.  She will then contact you by email or by telephone if you prefer, to arrange a convenient time.

Recruiting Letter    Information Sheet

Email Abi: abigail.moore@phc.ox.ac.uk

Ethics approval number: MS-IDREC-C1-2015-054

Photo (Creative Commons) by Bobjgalindo

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Reporting soon from WONCA Rural Conference in Dubrovnik

dubrovnik banner 492x170This week sees the 13th WONCA World Rural Health conference take place in Dubrovnik, Croatia.  It looks set to bring together rural health professionals from across the world, and just looking at the programme, it is clear that there is a lot of experience being gathered in one place.

I’m delighted and grateful that RCGP Scotland has supported me in attending the conference, and we will be presenting our ‘Being Rural‘ report on the Saturday, during Scientific Session 14.  In addition, this will be a huge opportunity to share ideas and meet similarly-challenged confreres in the world of rural health – and I hope to come back with useful, relevant ideas that have worked in other areas… to bring this back to the work we’re doing at the RCGP Scotland Rural Strategy Group and wider, and to see implementation of the things we know need to be better.

As part of this, I hope to run a daily blog report of sessions attended, and lessons learned.  Depending on wifi, I’ll be participating in the twitter coverage using the hashtag #woncarural2015.

 

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