Paul Worley

• Flinders University

Background: There is an urgent need to scale up global action on rural workforce development. This World Health Organization-sponsored research aimed to develop a Rural Pathways Checklist. Its purpose was to guide the practical implementation of rural workforce training, development, and support strategies in low and middle-income countries (LMICs)...

Unfortunately information regarding the disclaimer of Paul Worley’s affiliation is missing from the original article. Please find the information here: Paul Worley is affiliated to the Prideaux Centre for Research in Health Professions Education, Flinders University, Adelaide, Australia. He is the …

Introduction The longitudinal integrated clerkship is a model of clinical medical education that is increasingly employed by medical schools around the world. These guidelines are a result of a narrative review of the literature which considered the question of how to maximize the sustainability of a new longitudinal integrated clerkship program....

Objectives: The Deakin University School of Medicine commenced in 2008 as a rurally focused medical school in south-eastern Australia. This research was designed to examine the effectiveness of the school's adoption of small regional clinical school settings. Methods: A retrospective cohort study of the first two cohorts of students was employed...

Context: Longitudinal integrated clerkships (LICs) represent a model of the structural redesign of clinical education that is growing in the USA, Canada, Australia and South Africa. By contrast with time-limited traditional block rotations, medical students in LICs provide comprehensive care of patients and populations in continuing learning relat...

Across the globe, a “fit for purpose” health professional workforce is needed to meet health needs and challenges while capitalizing on existing resources and strengths of communities. However, the socio-economic impact of educating and deploying a fit for purpose health workforce can be challenging to evaluate. In this paper, we provide a brief ov...

Background: Many internal and external obstacles, must be overcome when establishing a new medical school, or when radically revising an existing medical curriculum. Aims: Twenty-five years after the Flinders University curriculum was introduced as the first graduate-entry medical programme (GEMP) in Australia, we aim at describing how it has be...

WHO Technical Officers and Technical Work Group members listed in Author section. The key objective of this report is to highlight the progress on the strategies and activities of WHO and its partners to transform health workforce education. It documents the activities undertaken in support of World Health Assembly resolution WHA66.23 on transform...

Basic and Advanced Life Support have improved survival in people who experience cardiac arrest. In clinical education, performance is assessed as an indicator of future skill performance, but the assumption that this relates to patient outcomes has not been widely tested. This study examines the relationship between two common skill teaching method...

Title How do two common skill teaching methods compare in terms of cost effectiveness? Background: Clinical educators have many competing demands for their time and skills. In this setting, Peyton’s four-step approach (4SA) to teaching clinical skills has gained favour in courses such as Advanced Life Support (ALS). However, evidence comparing the...

"Community" has featured in the discourse about medical education for over half a century. This discourse has explored relationships between medical education programs and communities in community-oriented medical education and community-based medical education and, in recent years, has extended to community-engaged medical education (CEME). This P...

Technical Working Group and WHO Technical Officers listed in Author section. The rationale for the evaluation toolkit: the World Health Assembly resolution and technical working group. The urgent need to ensure that the health workforce has a broad training which accurately reflects their existing and developing working practices prompted the 2013...

Aims Walker and Peyton’s Four Stage Approach (4SA) for teaching clinical skills has been growing in popularity since its initial description in 1998 but it is not routinely used in clinical skill instruction. This study aims to compare the effectiveness of 4SA with the more traditional approach of ”See one, Do one” (SODO). The primary outcome measu...

There is now a broad evidence-base that demonstrates the health of rural populations is different from populations in urban areas 1-4. These differences may be due to various environmental, geographic, economic and cultural factors that have been termed recently the 'rural determinants of health', but are also likely to be due to peculiarities of t...

Longitudinal integrated clerkships (LIC) in the first major clinical year in medical student training have been demonstrated to be at least equivalent to and in some areas superior to the "traditional block rotation" (TBR). Flinders University School of Medicine is starting a pilot changing the traditional teaching at the major Academic Medical Cen...

WHO Technical Officers and members present of the Technical Working Group are listed in the Author section. The purpose of this two day meeting was to review the work done by the sub-groups to date and suggest further modifications or refinements where necessary. The outcomes of the discussions during this meeting will be used as the basis for fu...

To estimate the proportion of students in Australian medical schools who undertake international medical electives (IMEs), particularly in developing countries, and to ascertain which medical schools provide predeparture training and postelective debriefing. Extraction of data on the number of students undertaking electives from the Medical Schools...

This study examined the hypothesis that a medical school in a low-resource setting, based on volunteer faculty, can be sustainable and associated with improvement in medical workforce and population health outcomes. Using a retrospective case study approach, this study described the formation of the Ateneo de Zamboanga University School of Medicine...

Australia's medical education system is undergoing a socially motivated transformation focused on improving access to medical care for rural and remote communities. A rural and remote backbone of Rural Clinical Schools (RCS), University Departments of Rural Health, regional medical schools, and the postgraduate college, ACRRM, have enabled communit...

In the fall of 2008, MEDICC Review published a roundtable discussion with six of eight deans representing schools of health sciences with a strong social accountability mandate, who had just founded a new collaborative: the Training for Health Equity Network (THEnet). The topic was the changing paradigm of medical education. MEDICC Review returns t...

This paper aims to consider why general practitioners (GPs) teach, in particular by defining the longitudinal supervisory relationships between rural clinician-preceptors and students. A total of 41 individual semi-structured interviews were conducted with GPs, practice managers and students. All interviews were audiotaped, transcribed and analysed...

Flinders University in Australia has had a rural longitudinal integrated clerkship for selected medical students, the Parallel Rural Community Curriculum, since 1997. The Northern Ontario School of Medicine (NOSM) in Canada introduced a similar clerkship for all NOSM students in 2007. An external evaluation of both programs was conducted in 2006 an...

To report the development of the first Rural Medical Immersion Programme (RMIP) of the University of Otago in New Zealand. We review medical education trends and challenges for educating New Zealand's doctors and recruiting them to careers in rural practice. We describe key features of the RMIP developed in response to these challenges. Medical edu...

To use data from an evaluation of the Flinders University Parallel Rural Community Curriculum (PRCC) to inform four immediate challenges facing medical education in Australia as medical student numbers increase. Thematic analysis of data obtained from focus groups with medical students undertaking the PRCC, a year-long undergraduate clinical curric...

Investigate agreement between lipid pathology results from point-of-care testing (PoCT) devices and laboratories. Agreement was assessed using the Bland-Altman method. : Mean difference (limits of agreement) were: -0.28 mmol/L (-1.04, 0.48) for total cholesterol, -0.09 mmol/L, (-0.55, 0.36) for HDL-C. Median difference (nonparametric limits of agre...

The goal of global equity in health care requires that the training of health-care professionals be better tuned to meet the needs of the communities they serve. In fact medical education is being driven into isolated communities by factors including workforce undersupply, education pedagogy, medical practice and research needs. Rural and remote me...

Australian medical education is increasingly influenced by rural workforce policy. Therefore, understanding the influences on medical graduates' practice location and specialty choice is crucial for medical educators and medical workforce planners. The South Australian Flinders University Parallel Rural Community Curriculum (PRCC) was funded by the...

From 2005 to 2007 the Australian Government funded a multicentre, clustered randomized controlled trial to determine the clinical effectiveness, cost-effectiveness, satisfaction and safety of point of care testing (PoCT) in general practice (GP). PoC tests measured (and devices used) in the trial were haemoglobin A1c and urine albumin:creatinine ra...

There is ample evidence to show that rural community-based learning encourages students to consider a career in rural practice, but there is far less evidence in regard to the clinical educational value of such experiences in comparison with traditional hospital-based teaching. In 1997, eight volunteer medical students undertook their entire fifth-...

To compare the clinical effectiveness of point-of-care testing (PoCT) and that of pathology laboratory testing, as measured by therapeutic control in chronic conditions. Multicentre, cluster randomised controlled trial using non-inferiority analysis. 53 Australian general practices in urban, rural and remote areas across three Australian states, Se...

The practice of having medical students see patients in a general practice setting, in their own consulting rooms, prior to the GP preceptor joining the consultation does not increase general practitioner (GP) consultation time. How do GPs meet the needs of both patient and student without extending consultation time? This study sought to quantify...

Introduction Medical schools today are being challenged to educate doctors who are willing and able to practice in areas of poverty and workforce need. In many countries, there is a shortage of doctors practicing in rural and remote communities. There is evidence that locating undergraduate medical education in rural areas increases the likelihood...

To provide data on the career trajectories of medical students from rural and remote workforce programs at Flinders University (the Parallel Rural Community Curriculum [PRCC] and the Northern Territory Clinical School [NTCS]), comparing them with students at the urban Flinders Medical Centre (FMC). Retrospective postal survey of all 150 graduates w...

At Flinders University, Adelaide, a subset of students on the 4-year, graduate-entry medical course chooses to spend Year 3 based in rural general practice as part of the Parallel Rural Community Curriculum (PRCC). This programme is equivalent to the tertiary teaching hospital option in terms of student educational outcomes. However, there is conce...

Australian Government initiatives to address medical workforce shortages in rural Australia include increasing the intake of students of rural background and increasing exposure to rural medicine during training. Rural-orientated medical training programs in the USA that selectively admit students from rural backgrounds and who intend to practise a...

Accreditation of the Australian College of Rural and Remote Medicine (ACRRM) as a standards and training provider, by the Australian Medical Council (AMC) in 2007, is the first time in the world that a peak professional organisation for rural and remote medical education has been formally recognised. As a consequence, the Australian Government prov...

Introduction: Increasing numbers of graduating medical students in Australia will provide opportunities to expand intern places into more rural locations. This commentary documents the curriculum design process undertaken to translate intern training to a rural hospital. Context: Following the SA Department of Health review of rural general practic...

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. To compare the learning experiences of students in...

As universities rely more heavily on rural GPs to precept medical students, the formation of symbiotic partnerships benefiting students, universities and GPs, becomes imperative. In order to develop and consolidate these partnerships universities must understand who their rural GP preceptors are and how precepting impacts on them. A review of the l...

As universities rely more heavily on rural GPs to precept medical students, the formation of symbiotic partnerships benefiting students, universities and GPs, becomes imperative. In order to develop and consolidate these partnerships Universities must understand who their rural GP preceptors are and how precepting impacts on them. A review of the l...

As medical schools make use of an increasing variety of clinical teaching settings, it is of interest to find that that there is very little published research that explores the actual learning activities undertaken by students in different environments. This study was designed to describe and analyse a typical week for students learning the same c...

Medical schools in Australia are being funded by the Commonwealth Government Department of Health and Aging to move a considerable amount of undergraduate clinical education into rural and remote settings. There are concerns that these students may be disadvantaged in terms of exposure to appropriate clinical learning opportunities. This study comp...

The Rural and Remote Area Placement Program (RRAPP) began in April 2000 to provide a rural community practice training term for junior doctors and to increase the opportunities for junior doctors to experience training outside the hospital setting. Recent research into the community-based training and experience for junior doctors in Australia sugg...

To determine whether moving clinical medical education out of the tertiary hospital into a community setting compromises academic standards. Cohort study. Flinders University four year graduate entry medical course. In their third year, students are able to choose to study at the tertiary teaching hospital in Adelaide, in rural general practices, o...

Vertical integration of medical education is currently a prominent international topic, resulting from recent strategic initiatives to improve medical education and service delivery in areas of poorly met medical need. In this article, vertical integration of medical education is defined as 'a grouping of curricular content and delivery mechanisms,...

Covers several topics, including: preparaing for rural practice; the importance of personal and professional networks; practice styles, professional and family life challenges.

This chapter provides a comprehensive overview of training for general practice in Australia.

The chronic shortage of doctors in rural Australia has been well documented. Enabling medical students to undertake positive rural experiences during their undergraduate course is a well-supported long-term strategy to provide a sustainable solution to this problem. The Parallel Rural Community Curriculum (PRCC) was developed by Flinders University...

Relationships do matter! In fact, medicine cannot be learned without them, and community-based medical education (CBME) curricula that ignore them or take them for granted do so at their students' peril. As CBME is becoming more popular, there is a need to develop appropriate frameworks for describing quality in CBME to ensure that it remains a pri...

Relationships do matter! In fact, medicine cannot be learned without them, and community-based medical education (CBME) curricula that ignore them or take them for granted do so at their students peril! Could these assertions provide a key to quality in CBME curricula? In a previous paper, I provided evidence for a simple model of four key relation...

IntroductionThe last 10 years has been an interesting time for Australian medical education despite reduced funding.WorkforceThere are five main workforce trends: a rural/urban maldistribution, a need for more specialists, public hospital staffing difficulties, increasing female practitioners and under-representation of indigenous practitioners.Iss...

Increasing interest in general practice research, especially postal surveys, has been met with decreasing response rates. Prospective, longitudinal surveys pose additional concerns for general practice researchers, one of the major problems being sample attrition after project commencement. This article draws on the authors' experiences from seven...

In recent times, legislative initiatives in Australia have changed the method by which doctors enter general practice. One result of this tightening has been to restrict the access of junior doctors to medical experiences outside the hospital environment, and force a closer examination of the 'generalist training' provided to junior doctors. The Au...

Is teaching a medical student always a financial burden on rural general practice? If so, is the current trend towards increasing placement of students in rural practice sustainable? Retrospective studies of short-term attachments to rural general practice have repeatedly shown a financial cost to the practice. Might the results be different for ex...

In the eyes of many, the critical shortage of doctors in rural areas is the only reason for providing rural experiences for medical students. This article reviews the body of evidence supporting rural placements as a long-term medical workforce strategy and additional evidence regarding the apparent educational benefits of such placements. By enabl...

IntroductionIn an attempt to address the rural medical workforce maldistribution and the concurrent inappropriate caseload at the urban tertiary teaching hospitals, Flinders University and the Riverland Division of General Practice decided to pilot, in 1997, an entire year of undergraduate clinical curriculum in Australian rural general practice. T...

There is ample evidence to show that rural community-based learning encourages students to consider a career in rural practice, but there is far less evidence in regard to the clinical educational value of such experiences in comparison with traditional hospital-based teaching. In 1997, eight volunteer medical students undertook their entire fifth-...

Undergraduate teaching of anaesthesia occurs in about two-thirds of Australian departments of anaesthesia: however, student contact hours are limited compared with those of other disciplines. Seventy-five directors of anaesthesia were surveyed by written questionnaire concerning the time devoted in their department to undergraduate study and teachi...

Increasing exposure of undergraduate medical students to rural practice is a key component of the national effort in Australia to redress the rural workforce shortage. For this exposure to be successful, willing cooperation of current rural general practitioners is essential. To date there has been no formal assessment of rural general practitioner...