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Rural General Practice (rural + general_practice)
Selected AbstractsEmpirical evidence for symbiotic medical education: a comparative analysis of community and tertiary-based programmesMEDICAL EDUCATION, Issue 2 2006Paul Worley Background, Flinders University has developed the Parallel Rural Community Curriculum (PRCC), a full year clinical curriculum based in rural general practice in South Australia. The examination performance of students on this course has been shown to be higher than that of their tertiary hospital-based peers. Aim, To compare the learning experiences of students in the community-based programme with those of students in the tertiary hospital in order to explain these improved academic outcomes. Method, A case study was undertaken, using an interpretivist perspective, with 3 structured interviews carried out over 2 academic years with each of 6 students from the community-based programme and 16 students from the tertiary hospital. The taped interviews were transcribed and analysed thematically using nud*ist software. Results, The community-based programme was successful in immersing the students in the clinical environment in a meaningful way. Four key themes were found in the data. These represented clear differences between the experiences of the community-based and hospital-based students. These differences involved: the value that students perceived they were given by supervising doctors and their patients; the extent to which the student's presence realised a synergy between the work of the university and the health service; opportunities for students to meet the aspirations of both the community and government policy, and opportunities for students to learn how professional expectations can mesh with their own personal values. Conclusion, This study has provided empirical evidence for the importance of the concept of symbiosis in understanding quality in medical education. [source] Community participation in organising rural general practice: Is it sustainable?AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 4 2006Judy Taylor Abstract Objective:,We analysed community participation in organising rural general medical practice in order to suggest ways to extend and sustain it. Design:,A multisite, embedded case-study design collecting data through semistructured interviews, non-participation observation and a document analysis. Setting:,One remote and two rural communities in Australia. Participants:,Community members, GPs, health professionals, government officers and rural medical workforce consultants. Results:,High levels of community participation in recruiting and retaining GPs, organising the business model, and contributing to practice infrastructure were evident. Community participation in designing health care was uncommon. Participation was primarily to ensure viable general practice services necessary to strengthen the social and economic fabric of the community. There were factors about the decision-making and partnership processes in each of the communities that threatened the viability of community participation. Conclusions:,We recommend that a concept of community development and explicit facilitation of the processes involved is necessary to strengthen participation, create effective partnerships and ensure inclusive decision-making. [source] Do the learning needs of rural and urban general practitioners differ?AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 6 2005James A. Allan Abstract Introduction:,The challenges of rural general practice have given rise to a separate rural training stream and a separate rural professional body. The differences are characterised by the nature of the work undertaken by rural GPs and reflected in the continuing medical education topic choices made when surveyed. Methods:,In 2001 a survey was designed and distributed by the Royal Australian College of General Practitioners and Divisions of General Practice in South Australia and Northern Territory. The survey utilised a list of 104 topics. The topic choices of rural and urban GPs were compared. Results:,The survey was distributed to approximately 1762 GPs and yielded 578 responses (33%). Rural GPs were more likely to select the following topics: Anaesthetics, Aboriginal Torres Strait Islander health, Population Health, Renal medicine, Cardiology, Teaching skills, Obstetrics, Neonates, Arrhythmias, Fracture management, Tropical medicine and Therapeutics. Urban GPs were more likely to select Menopause, Travel medicine and Palliative care (P < 0.05). Discussion:,Many of the areas of difference reflected aspects of rural general practice. There were also many similarities in topic choices between these two groups. [source] Cognitive Behavioural Therapy: A Study of Rural General Practitioners' Understanding and ExpectationsAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 5 2003David Pierce ABSTRACT Introduction:,Cognitive behavioural therapy (CBT) has been extensively used to manage depression and anxiety. It has been offered to general practitioners (GPs) as a technique suited to primary care. Methods and results:,Forty-two GPs, who had participated in workshops on CBT, in rural Victoria, were surveyed about their use, expectations and understanding of CBT. Most of the GPs either occasionally or regularly used CBT. Respondents expressed concern that CBT would lengthen their consultations, while recognising its usefulness in their practice and capacity to enhance doctor,patient communication. Conclusions:,The GPs in this study, while regarding CBT as an appropriate technique in general practice, expressed both broad outcome expectations from its use and concerns about its time management impact. This study indicates the need for further research on the role of CBT in rural general practice. [source] COGNITIVE BEHAVIOURAL THERAPY: A STUDY OF RURAL GENERAL PRACTIONERS, UNDERSTANDING AND EXPECTATIONSAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 5 2003David Pierce ABSTRACT Introduction: Cognitive behavioural therapy (CBT) has been extensively used to manage depression and anxiety. It has been offered to general practitioners (GPs) as a technique suited to primary care. Methods and results: Forty-two GPs, who had participated in workshops on CBT, in rural Victoria, were surveyed about their use, expectations and understanding of CBT. Most of the GPs either occasionally or regularly used CBT. Respondents expressed concern that CBT would lengthen their consultations, while recognising its usefulness in their practice and capacity to enhance doctor,patient communication. Conclusions: The GPs in this study, while regarding CBT as an appropriate technique in general practice, expressed both broad outcome expectations from its use and concerns about its time management impact. This study indicates the need for further research on the role of CBT in rural general practice. [source] ALTERNATIVE CURRICULAR OPTIONS IN RURAL NETWORKS (ACORNS): IMPACT OF EARLY RURAL CLINICAL EXPOSURE IN THE UNIVERSITY OF WEST AUSTRALIA MEDICAL COURSEAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2000June Talbot The aim of this study was to assess the impact of a 4-day rural placement in Western Australia on the interest of fourth year medical students in a career in rural general practice. Students undertaking their Alternative Curricular Options in Rural Networks attachment (ACORNS) completed pre- and post-questionnaires examining their expectations, experiences of, and attitudes to rural general practice. Of the 103 students who participated, 81% expressed an interest in a rural career after the placement, whereas prior to this experience only 48% had been interested. The students also recorded a wide range of learning experiences, both clinical and procedural, and expressed positive attitudes to the variety of experiences and the role of the rural GP. The study concluded that early exposure to rural general practice enhances students' interest in a potential rural practice career and provides them with a broad range of experiences. The role of rural practitioners as role models for students needs to be acknowledged and reinforced. [source] Antenatal home blood pressure monitoring: a pilot randomised controlled trialBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2000H. Ross-McGill Research Midwife Objective To measure recruitment to, compliance with, and the acceptability of a trial designed to test whether a reduced schedule of antenatal visits combined with training in self-measurement of blood pressure at home may improve hypertension screening and save money. To test the specific hypothesis that even after taking into account extra unscheduled visits, the reduced schedule with ambulatory monitoring reduces total visits. Design A pilot randomised controlled trial. Setting Four urban and four rural general practices in Yorkshire and Lancashire. Population One hundred and five low risk women in the third trimester of pregnancy. Eighty women participated. Intervention Women were invited to participate at 24,28 weeks. Those who accepted were allocated either to a standard nine subsequent visit schedule (30, 32, 34, 36, 37, 38, 39, 40, 41 weeks) or to a reduced schedule (34, 38, 41 weeks). Those in the latter group measured their blood pressure weekly using a portable sphygmomanometer at home. Main outcome measures Recruitment, total number of clinic visits, frequency of blood pressure measurement, schedule preference, and anxiety. Results Although there were more unscheduled visits in the home monitoring group, this did not outweigh the reduction in scheduled visits, (total visits reduced from 7.4 to 4.5, P < 0.001), and blood pressure was measured during more weeks (9 vs 7 weeks, P < 0.001) in the experimental group. Most women expressed a preference for the reduced schedule both when the idea was first suggested, and after they had experienced it, and there were no significant differences in anxiety. Conclusion Replacement of antenatal screening visits with home blood pressure monitoring is acceptable to women. The reduction in clinic visits is not compensated by an increase in visits for other reasons and overall blood pressure measurement is omitted less often. Whether it reduces adverse outcomes or has any rare side effects will require a larger trial, but this pilot study indicates that it is likely to be safe, and that such a large trial would be feasible. [source] | ||||||||||