Search

Objective: The aim of this review is to explore the multifaceted roles of registered nursing practice in rural and remote areas of Australia. Background: People in rural and remote Australia have less access to healthcare than their metropolitan counterparts. They are also burdened with higher rates of chronic disease and premature mortality. These areas also have less doctors and allied health professionals than metropolitan areas, with the core workforce being registered nurses. One strategy to address the health workforce disparities, is to promote registered nurses to work to their full scope and in advanced generalist roles. An understanding of the current roles of the registered nurse is therefore required to assist in determining how their scope could be extended, and to inform appropriate educational planning. Study design and methods: An integrative review of literature was used to obtain articles from online databases relevant to nursing from 1995 to 2017. Data was quality appraised, extracted, and thematically analysed. Results: Registered nurses in rural and remote Australia work in diverse contexts that have a major influence on the roles they undertake. They are already required to be multi-skilled and to practice at an advanced level, including undertaking some aspects of the health professional role traditionally the domain of medical practitioners. These registered nurses often feel unprepared for the breadth and complexity of this role. Discussion: To enable registered nurses to be adequately prepared for rural and remote practice, educational programs need to be flexible, accessible and affordable. The registered nurse's existing experience and expertise should be recognised, and educational pathways structured to enable the nurse to expand their practice according to the context in which they work and the needs of the community. Conclusion: Registered nurses in rural and remote areas function as advanced generalists. Greater understanding these roles is necessary to inform the development of 'fit for purpose' educational models. Implications for research, policy and practice: Future research is needed to focus on evaluation of existing models of rural and remote nursing practice and in particular the role of the nurse as doctor substitute. The findings of this study highlight the potential expanded contribution of registered nurses in these areas, which is an important factor for consideration by policy makers. In practice, supportive frameworks are required to ensure registered nurses are able to function to their full capacity in their unique context. [ABSTRACT FROM AUTHOR]

Objective: To explore the influence of nonmetropolitan clinical immersion placements (CIPs) on undergraduate chiropractic student experience, professional attributes, and practice destination. Methods: Students enrolled in an Australian undergraduate chiropractic program were invited to complete a service experience questionnaire and an open-ended reflective feedback form following a nonmetropolitan CIP (Part A). Online searches were performed to gather data on graduate practice location (Part B). Results: Sixty-four students participated in Part A. All agreed that the placement was educational and should be retained in the program. Students agreed that the placement enhanced respect for individuals and awareness of others in need, highlighted the importance of respect for all people, improved empathy for the disadvantaged, and provided an opportunity to improve communication skills. Most indicated that they were more likely to practice in a country setting as a result of their placement, with those participating in a country placement more likely to practice in nonmetropolitan regions after graduation. Conclusion: Many chiropractic programs around the world are adopting CIPs. This study is the 1st to investigate the possible influence of nonmetropolitan CIPs on the development of desirable attributes in Australian chiropractic students. It also discusses the potential influence of nonmetropolitan CIPs on future practice location decisions. These results support the utility of CIPs to help meet the educational objectives of chiropractic programs and possibly address the maldistribution of the chiropractic workforce in Australia. [ABSTRACT FROM AUTHOR]

OBJECTIVES∙To evaluate the benefit of a skills laboratory based training programme to urology resident training by end-user assessment. SUBJECTS AND METHODS∙All participants in a urological skills workshop programme conducted at the Royal Australasian College of Surgeons in Melbourne, Australia, between 2004 and 2009 were included.∙This was a retrospective review using a structured questionnaire.∙Topics regarding course organization, content, delivery and relevance to clinical practice were examined.∙Free-text entry responses allowed participants to elaborate on specific points as appropriate. RESULTS∙During the study period, 35 individual workshops were conducted.∙In all, 41 of 43 eligible participants completed the survey for a response rate of 95%.∙Overall, 26 (63%) found the experience valuable, interesting and useful.∙Of the remainder (37%), four (10%) found it interesting but not useful to training, five (12%) found it useful and a good idea but not well conducted, and two (5%) found it neither interesting nor useful for training.∙Workshop success was intimately related to the quality of the simulator or model used: highly rated workshops consistently used models that were 'realistic' and 'lifelike', while poorly rated workshops were associated with models considered 'impossible' and 'not tested'. CONCLUSIONS∙The use of skills laboratory based workshops can enhance the surgical training of urology residents, at least as assessed by the end-users themselves.∙However, closer attention to the selection and use of properly tested and validated models may maximize the educational opportunity.∙Translational research prospectively examining the impact of workshops on live patient surgery and outcomes is still required. [ABSTRACT FROM AUTHOR]