Reflective practice in postgraduate midwifery education

The literature is abundant with the benefits of reflective practice in midwifery education and other disciplines. At Deakin University, Victoria, Australia,  students enrolled in the Graduate Diploma of Midwifery have embraced reflective practices by means of computer mediated learning applications. Students enrolled in this course reside in metropolitan, regional and rural areas of Victoria and had previously experienced issues of ‘distance’ and ‘isolation’ from peers  and academics. Since 2007 two computer modalities, Elluminate Live and  Deakin Studies Online have been incorporated into the lecture timetables for the  Graduate Diploma of Midwifery to allow students to participate in online  discourse and maintain an online reflective journal space. This innovation for the  promotion of reflective practices supports and upholds the oral tradition midwives are renowned for by increasing cohesion of each student course cohort,  collaboration between peers and access to midwifery academics.

Engaging students in authentic science through school - community links : learning from the rural experience

There is an increase in school-community linked initiatives in school science. A substantial proportion of these involve rural schools. This article asks the question: In what ways do these initiatives offer possibilities for better engaging rural students with school science? The paper draws on information from a number of school-community linked science initiatives in rural areas, including exemplars from the recent Australian School Innovation in Science, Technology and Mathematics (ASISTM) project, which were obtained primarily through interviews with participants. The initiatives are analysed in terms of an 'innovation framework', concerning the ideas and purposes underlying them, the knowledge and pedagogies used, and the experiences of the participants in the initiative. The paper concludes that these initiatives differ in significant respects from traditional school science, and offer the possibility of productive future directions. The authors discuss the challenges and policy directions that need to be pursued to represent these practices in mainstream curricula.

Why do medical graduates choose rural careers?

Introduction: This study is based on the metaphor of the ‘rural pipeline’ into medical practice. The four stages of the rural
pipeline are: (1) contact between rural secondary schools and the medical profession; (2) selection of rural students into medical
programs; (3) rural exposure during medical training; and (4) measures to address retention of the rural medical workforce.
Methods: Using the rural pipeline template we conducted a literature review, analysed the selection methods of Australian
graduate entry medical schools and interviewed 17 interns about their medical career aspirations.
Results: Literature review: The literature was reviewed to assess the effectiveness of selection practices to predict successful
gradation and the impact of rural pipeline components on eventual rural practice. Undergraduate academic performance is the
strongest predictor of medical course academic performance. The predictive power of interviews is modest. There are limited data
on the predictive power of other measures of non-cognitive performance or the content of the undergraduate degree. Prior rural
residence is the strongest predictor of choice of a rural career but extended rural exposure during medical training also has a
significant impact. The most significant influencing factors are: professional support at national, state and local levels; career
pathway opportunities; contentedness of the practitioner’s spouse in rural communities; preparedness to adopt a rural lifestyle;
educational opportunities for children; and proximity to extended family and social circle. Analysis of selection methods: Staff
involved in student selection into 9 Australian graduate entry medical schools were interviewed. Four themes were identified:
(1) rurality as a factor in student selection; (2) rurality as a factor in student selection interviews; (3) rural representation on student
selection interview panels; (4) rural experience during the medical course. Interns’ career intentions: Three themes were identified:
(1) the efficacy of the rural pipeline; (2) community connectedness through the rural pipeline; (3) impediments to the effect of the
rural pipeline, the most significant being a partner who was not committed to rural life
Conclusion: Based on the literature review and interviews, 11 strategies are suggested to increase the number of graduates
choosing a career in rural medicine, and one strategy for maintaining practitioners in rural health settings after graduation.

Leadership and learning across small rural schools

Educational leadership in Australia has undergone dramatic change over the past two decades, becoming increasingly complex as globalisation has profoundly affected and influenced schools and schooling.

'Girls talking about girls' issues' : the importance of girls-only health and physical education in promoting well-being

Recognition of the important role schools play in the promotion of student well-being can be seen in the growing number of policies and programs being implemented in schools across Australia. This paper reports on some initial data from focus group interviews with Year 9 and 10 girls involved in the pilot of a health and physical activity intervention designed to connect them to their local community and reconnect them with their school and their peers. The aim of the program was to build connectedness and resilience by engaging young women in non-traditional physical activities whilst providing them with a sound understanding of health issues relevant to adolescent girls. Situated in a relatively isolated rural community 200 kilometres south-east of Melbourne the program was overwhelmingly delivered by regional and local agencies in conjunction with the local secondary school. The intervention was built on a partnerships model designed with the purpose of increasing participation and access for young women whilst building a sustainable program run in partnership between the school and local agencies and services. The initial data from this pilot indicates the program is having a positive impact on the young women's sense of self and their bodies, their relationships with their peers and in reducing bullying behaviour amongst the girls. However, the data raises some important questions around the adequacy of school-based health education, and the sustainability of approaches designed to be delivered by outside agencies rather than classroom teachers.

Building capacity for rural health : the role of boundary crossers in coalition maturity for partnerships with external agents

The concept of partnership has entered policy rhetoric and is urged as good practice in a variety of domains including health. Rural communities tend to have fewer resources available for the provision of services such as health than their metropolitan counterparts, and so could be expected to benefit from partnerships with external agencies. Indicators of coalition maturity for working in partnership with external agents in order to build stronger communities are distilled from the group development and partnership research literature and considered in the light of the experiences of the University Department of Rural Health in community engagement. The chapter draws on experiences of two rural community coalitions working to plan and negotiate health service provision. The coalitions were analysed against the indicators. A key indicator of maturity and readiness for working in partnership with external agents is related to the behaviour of ‘boundary crossers’. Boundary crossers are defined as people who move freely between two or more domains and who understand the values, cultures and language, and have the trust, of both. Domains can be within a community or be the community and an external sector. Community health professionals, especially those in senior positions, often act as boundary crossers between the community and broader domains such as regional/state health services or policy, although other community members can fill the role. Other key indicators of coalition maturity for working in partnership with external agents include local leadership that empowers the community, a willingness of community coalitions to take risks and mould opportunities to meet their vision, and a culture of critical reflection and evaluation of past actions.

This chapter analyses the impact of boundary crossing behaviour on community readiness and partnerships with external agents that are intended to build rural community capacity to plan and negotiate health service provision. It is argued that the characteristics and modus operandi of boundary crossers who are members of rural community coalitions affect the level of maturity of the coalitions and community readiness to work with external agents. An understanding of the characteristics and modus operandi of boundary crossers provides valuable insights for external agents in designing their approach to partnerships that build rural community capacity for health.

Pathways from rural schools : does school VET make a difference?

This paper reports results from an NREC funded study of the medium term outcomes for youth and their communities of VET programs delivered by rural schools. The key findings relate to the outcomes of school VET programs in terms of education and training, employment, and community outcomes such as rural youth retention, and to the features that contribute to successful outcomes. Rural school VET students are less likely to continue with post school education and training in general, but more likely to go onto further vocational education and training than school non-VET students. The study reports strong links between industry area of school VET course, and further education and training, or employment, in the same industry area. It also indicates that school VET students are more likely to live in a rural area at some time during their working life. The features of rural school VET programs that influence outcomes include the purpose of the school VET program and work placements. Student motivation and gender also influence outcomes for individual students. Rural school VET courses represent pathways to related education and training for students who intend to live in a rural area during their working life, and for those who do not.

Education and training institutions : building social capital for regional development

Education and training institutions from schools through to universities have a vital role in supporting development in regional Australia. The interaction between these institutions and their rural communities influences the social capital of the community and the extent to which the community is a learning community, willing and able to manage change to the community’s advantage.

There are benefits to be had from a collaborative approach to planning and delivering training. This approach is consistent with theories of social capital that emphasise the crucial part played by networks, values and trust in generating superior outcomes for individuals, communities and regions. Research has found that education and training is most effective in building social capital and learning communities were there is attention to customising or targeting education and training provision to local needs. The key to matching provision with local needs, particularly in the more rural and remote areas, is collaboration and partnerships. Partners can be regional organisations, other educational institutions, businesses and government. The factors that enhance the effectiveness of the collaborations and partnerships are the elements of social capital: networks, shared values and trust, and enabling leadership.

Networks are most effective where there were opportunities and structures for interaction, which can be termed interactional infrastructure, that foster networks within the region, and networks that extended outside the region. Interactional infrastructure includes regional forums, committee structures, consultative processes and opportunities for informal discussion addressing the issues of education, training and employment in a community or region. Better outcomes are evident when there is an interactional infrastructure that is resourced with financial, physical and human resources of sufficient quantity and quality. Collaborations provide access to a greater range of external resources through extended external networks. Effective networks and shared visions, values and trust among the partners in a collaboration, are fostered by enabling leaders. Educational institutions are well placed to supply the ‘human infrastructure’ that makes collaborations and partnerships work, including enabling leadership.

Attention to factors associated with the quality of social capital, especially interactional infrastructure including leadership, shared vision and values and networks within and external to the community, can be expected to improve the effectiveness of education and training outcomes. More importantly, a collaborative approach to planning for education and training in rural regions will build the capacity of regions and their constituent communities to develop and change by building social capital resources. Leadership is an important driver of processes that build community and regional capacity and ultimately produce social and economic benefits through regional development. Educational providers in rural regions are well placed to act as enabling leaders.

Developing effective learning programs : what extension can learn from the fields of adult education and learning communities

Learning is an investment in capacity building that has and will continue to reap rewards for primary producers and government in terms of increased sustainable production, profitability, exports, jobs and sustainable rural communities. Primary production operates in a context of continual change and requires up to date, complex and varied skills of primary producers and land managers.

A recent national research project funded by the Department of Agriculture, Forestry and Fisheries Australia confirmed that application of best practice from the theory of adult education in designing and developing learning programs in primary industry results in learning activities that provide information that is relevant to farmers’ needs, delivered in an entertaining way, and that draws on examples directly relevant to the participants. As a result, the training often exceeds the expectations of the participants.

The project produced a self-assessment checklist to identify ways of improving the development and delivery of training for extension practitioners and training providers. The key issues include continuous monitoring of client’s needs, and actively seeking opportunities to meet and work with industry organisations, other training providers and funding bodies.

There appear to be two drivers for the development of learning programs. One is problems or opportunities identified by people and organisations that could be termed ‘scanners’ and who tend not to be potential participants, the other is learning needs expressed by individuals or enterprises who want to participate in learning activities (participants). Scanners are typically industry organisations, government agencies and researchers, but may include providers and participants. Extension practitioners are well-placed to act as scanners.

It is very important that farmers and farmer organisations contribute to the development of new learning programs. Without industry input and support, extension practitioners and training providers cannot be expected to ensure they meet client needs. In other words, to develop effective learning programs, there must an industry learning community of producers, industry organisations, extension practitioners and training providers and other stakeholders such as supply chain enterprises, government and researchers.

Maturing school-community partnerships : developing learning communities in rural Australia

This paper reports findings from a project that examined the extent and nature of the contribution of rural schools to their communities’ development beyond traditional forms of education of young people. Case study communities in five Australian States participated in the project, funded by the Rural Industries Research and Development Corporation. Communities and schools that share the belief that education is the responsibility of the whole community and work together, drawing on skills and knowledge of the community as a whole, experience benefits that extend far beyond producing a well-educated group of young people. The level of maturity of the school– community partnership dictates how schools and communities go about developing and sustaining new linkages, or joint projects. Twelve characteristics central to the success of school–community partnerships were identified. The characteristics are largely sequential in that later characteristics build on earlier ones. Underscoring these characteristics is the importance of collective learning activities including teamwork and network building, which have been identified elsewhere as key social capital building activities. A generic model of the relationship between the indicators of effective school–community partnerships and the level of maturity of those partnerships is forwarded.

Pathways from rural schools : does VET make a difference?

This paper reports findings from a survey of former students from six Australian rural school clusters. It compares the experiences and outcomes of students who had participated in a school vocational education and training (VET) program with those who had not. School VET courses intended to provide a pathway to local employment appear to be successful in retaining students who otherwise may have left school before completing Year 12, and in assisting their transition from school to work. For all school VET students, the work placement component of the program aids the transition to local jobs and apprenticeships, and increases youth retention in the community. As the findings indicate that school VET students are predisposed to live in a rural area at some time during their working life, the paper concludes that VET programs in rural areas have special potential to develop skills and pathways for the future workforce of rural Australia.

Landscapes of learning : lifelong learning in rural communities

Reviews the non-fiction book 'Landscapes of Learning: Lifelong Learning in Rural Communities,' edited by Fred Gray.

Skill shortages in health : innovative solutions using vocational education and training

Introduction: This article reports findings of a project funded by the Australian National Council for Vocational Education Research. The project explores solutions to current and projected skills shortages within the health and community services sector, from a vocational education and training perspective. Its purpose is to locate, analyse and disseminate information about innovative models of health training and service delivery that have been developed in response to skill shortages.

Methods: The article begins with a brief overview of Australian statistics and literature on the structure of the national health workforce and perceived skill shortages. The impact of location (state and rurality), demographics of the workforce, and other relevant factors, on health skill shortages is examined. Drawing on a synthesis of the Australian and international literature on innovative and effective models for addressing health skill shortages and nominations by key stakeholders within the health sector, over 70 models were identified. The models represent a mixture of innovative service delivery models and training solutions from Australia, as well as international examples that could be transposed to the Australian context. They include the skill ecosystem approach facilitated by the Australian National Training Authority Skill Ecosystem Project. Models were selected to represent diversity in terms of the nature of skill shortage addressed, barriers overcome in development of the model, healthcare specialisations, and different customer groups.

Results: Key barriers to the development of innovative solutions to skills shortages identified were: policy that is not sufficiently flexible to accommodate changing workplace needs; unwillingness to risk take in order to develop new models; delays in gaining endorsement/accreditation; current vocational education and training (VET) monitoring and reporting systems; issues related to working in partnership, including different cultures, ways of operating, priorities and timelines; workplace culture that is resistant to change; and organisational boundaries. For training-only models, additional barriers were: technology; low educational levels of trainees; lack of health professionals to provide training and/or supervision; and cost of training. Key enhancers for the development of models were identified as: commitment by all partners and co-location of partners; or effective communication channels. Key enhancers for model effectiveness were: first considering work tasks, competencies and job (re)design; high profile of the model within the community; community-based models; cultural fit; and evidence of direct link between skills development and employment, for example VET trained aged care workers upskilling for other health jobs. For training only models, additional enhancers were flexibility of partners in accommodating needs of trainees; low training costs; experienced clinical supervisors; and the provision of professional development to trainers.

Conclusions: There needs to be a balance between short-term solutions to current skill shortages (training only), and medium to longer term solutions (job redesign, holistic approaches) that also address projected skills shortages. Models that focus on addressing skills shortages in aged care can provide a broad pathway to careers in health. Characteristics of models likely to be effective in addressing skill shortages are: responsibility for addressing skills shortage is shared between the health sector, education and training organisations and government, with employers taking a proactive role; the training component is complemented by a focus on retention of workers; models are either targeted at existing employees or identify a target group(s) who may not otherwise have considered a career in health.

Interactional infrastructure in rural communities : matching training needs and provision

This paper reports some of the main lessons learnt from a collaborative project titled Generating jobs in regional Tasmania: a social capital approach investigating how two small rural Tasmanian communities could better match local training needs with training provision. The project was conducted within the context of the wider social, economic and demographic changes affecting the two rural communities and their ongoing efforts to manage such change. The paper provides a profile of the two communities with particular attention to their local education, training and employment infrastructure. Three research questions in terms of improving the contributions of leadership, partnerships and social capital are addressed. Development and utilisation of social capital, particularly in the form of interactional infrastructure (defined as opportunities and structures for interaction in a community) that brought together the range of stakeholders, appeared the key to successfully matching needs with provision.