Barriers and enablers to clinical fieldwork education in rural public and private allied health practice

There is a need to maximise rural clinical fieldwork placement to build health workforce capacity. This study investigated allied health professionals' (AHPs) experience of supervising students as part of work-integrated learning in public and private rural health settings. An anonymous postal questionnaire with 30 questions was used to collect quantitative and qualitative data about the barriers and enablers that AHPs encounter when supervising students in their clinical setting. A total of 113 public and private AHPs from Southwest Victoria, Australia, returned the questionnaire. The AHPs were trained in the disciplines of occupational therapy, physiotherapy, speech pathology, dietetics, podiatry or psychology. The majority of respondents (75%) had previously supervised students. Most respondents had only provided fieldwork education in the public sector. Allied health professionals working in public and private sectors had positive experiences with clinical fieldwork education and often had increased job satisfaction while supervising students. They experienced similar enablers to involvement in clinical fieldwork education programs, however the barriers they encountered were different. The findings highlight the differing issues between rural public and private settings that need to be addressed for successful clinical fieldwork education and work-integrated learning. Strategies to address the identified barriers need to be specific to the work conditions of each setting.

Retention of allied health professionals in the south-west of Victoria

The article reports on the research studies about the role of the allied health professionals in primary and preventive health care in Victoria. The studies shows that allied health practice in rural areas provide information on the strategies to maintain the health workforce. The results of the final report regarding the allied workforce issues in south-west Victoria was discussed. The details about the participants, methods and results of the survey regarding the retention of allied health professionals in south-west Victoria.

A conceptual model for recruitment and retention : allied health workforce enhancement in Western Victoria, Australia

Attracting and retaining allied health professionals in rural areas is a recognised problem in both Australia and overseas. Predicted increases in health needs will require strategic actions to enhance the rural workforce and its ability to deliver the required services. A range of factors in different domains has been associated with recruitment and retention in the allied health workforce. For example, factors can be related to the nature of the work, the personal needs, or the way an organisation is led. Some factors cannot be changed (eg geographical location of extended family) whereas others can be influenced (eg education, support, management styles). Recruitment and retention of allied health professionals is a challenging problem that deserves attention in all domains and preparedness to actively change established work practices, both individually as well as collectively, in order to cater for current and predicted health needs. Changes to enhance workforce outcomes can be implemented and evaluated using a cyclic model. The Allied Health Workforce Enhancement Project of the Greater Green Triangle University Department of Rural Health (GGT UDRH) is working towards increasing the number of allied health professionals in the south west of Victoria. Based on themes identified in the literature, an interactive model is being developed that addresses recruitment and retention factors in three domains: (1) personal or individual; (2) organisation; and (3) community.

Access and attitude of rural allied health professionals to CPD and training

Continuing professional development (CPD) activities for allied health professionals are becoming mandatory as a means for professionals to maintain accreditation or skills. To access CPD activities, rural allied health professionals have the added costs of travel, accommodation and information technology access. It is assumed that health professionals in rural areas want access to training and CPD. In 2003, a survey of allied health professionals was carried out in Southwest Victoria, Australia, with the aim of identifying access and attitudes to CPD. Results showed that allied health professionals in Southwest Victoria were highly qualified, wished to access CPD more than four times a year and were prepared to spend a mean rate of $1000 (1300) per annum on CPD activities.

An exploration of issues of management and intention to stay : allied health professionals in south west Victoria, Australia

Management of allied health staff and services often has implications for staff stability and retention. A survey of allied health staff in South West Victoria was conducted in 2003 to explore issues relating to recruitment and retention. Findings relating to management and retention of staff in their current job are addressed in this report. A total of 138 staff returned their questionnaires. Results were related to Maslow's hierarchy of needs, level of belonging, with professional needs identified as feeling supported, orientation to the position, clear job description, and able to recommend the position to others. Qualitative data showed that recommending the position was associated with job satisfaction, autonomy, flexibility, and variety of work. The immediate management structure was significantly related to retention. Reasons given for intending to leave were related to management categories. These were management structure, lack of career structure, and lack of professional support. Reasons given by respondents for not recommending their current position were as follows: not for long-term career, risk of deskilling if staying too long, and financially unrewarding. These reasons were also related to management. Positive reasons for staying, which were related to management, included flexible work conditions, variety of clinical and management experience, good working environment, good support, and autonomy. Recommendations are given for organizational development and training for managers.

Rethinking policies for the retention of allied health professionals in rural areas : a social relations approach

Objective: Retaining allied health professionals in rural areas is a recognised problem. Generally the literature has concentrated on three elements: practitioner needs, community needs and organisational needs. There has been little attempt to focus other types of social relations in which health practitioner retention and recruitment takes place. The aim of this paper is to question the present dominant hierarchical approach taken in relation to the retention of allied health professionals in rural localities.

Methods: The data derives from a survey in Southwest Victoria, Australia. The sample was purposive rather than representative as it was intended to be exploratory in nature rather than definitive.

Results: The data indicates that there is a greater tendency for allied health professionals in private practice to be retained in rural areas than those in the public sector.

Conclusion: The paper concludes by raising some questions about the pertinence of present models for regional health initiatives since they are locked into a bureuacratic model where relationships are hierarchical and asymmetrically controlled.

The evolution of a state-wide continuing education programme for allied health professionals

Allied health professionals require continuing education (CE) to maintain and improve competencies and standards of care. Research suggests that professional access to CE in rural areas can be difficult.

This article uses an action research framework to describe the development and implementation of a CE programme for allied health professionals in a rural area in Australia, and its subsequent evolution into a state-wide programme. To evaluate programme relevance, attendance and perceived clinical relevance, physiotherapists (n = 75) in southwest Victoria were surveyed 1year after commencement of a CE programme. A secondary outcome was the perceived effect on clinical practice.

More than two-thirds (68.6%) of physiotherapists attended at least one workshop, 57.2% attended four or more sessions and 22.9% attended at least one of the two conducted courses over the period. In addition, 20% of the physiotherapists perceived that attending the programme had a large positive effect on their therapeutic skills, whereas 68.6% reported some effect. From a regional CE programme for physiotherapists the programme evolved into a state-wide programme for 22 allied health professions.

Workload capacity measures for estimating allied health staffing requirements

Workforce planning methodologies for the allied health professions are acknowledged as rudimentary despite the increasing importance of these professions to health care across the spectrum of health services settings. The objectives of this study were to (i) identify workload capacity measures and methods for profiling allied health workforce requirements from a systematic review of the international literature; (ii) explore the use of these methods in planning workforce requirements; (iii) identify barriers to applying such methods; and (iv) recommend further action. Future approaches to workforce planning were explored through a systematic review of the literature, interviews with key stakeholders and focus group discussions with representatives from the different professional bodies and health agencies in Victoria. Results identified a range of methods used to calculate workload requirements or capacity. In order of increasing data demands and costliness to implement, workload capacity methods can be broadly classified into four groups: ratio-based, procedure-based, categories of care-based and diagnostic or casemix-based. Despite inherent limitations, the procedure-based measurement approach appears to be most widely accepted. Barriers to more rigorous workforce planning methods are discussed and future directions explored through an examination of the potential of casemix and mixed-method approaches.

The work conditions of allied health professionals : the impact on satisfaction, commitment and psychological distress

The present study investigated the extent to which the Demand-Control-Support (DCS) model, in combination with organizational justice variables, predicts the employee-level outcomes of allied health professionals'. Allied health professionals from an Australian healthcare organization were surveyed, with 113 participating (52,6%). Multiple regression analyses revealed that the DCS model predicted all the outcome variables of job satisfaction, organizational commitment and psychological distress. Conversely, significant contributions of the organizational justice variables were limited to organizational commitment and psychological distress. The results of the study provide practical implications for the job conditions of allied health professionals, in particular, the delivery of support and maintaining high levels of justice.