Tuesday, 22 November 2016

Simulation-based research projects, with a focus on teaching medical students, were showcased by Monash Rural Health Bendigo lecturers at the recent Australasian Simulation Congress. The work of senior lecturers Dr Cameron Knott, Pam Harvey and Adele Callaghan was presented at the inaugural congress. The event bought together three simulation conferences for the first time - SimHealth, SimTech and the International Simulation and Gaming Association (ISAGA).

Monash Rural Health (MRH) has long researched, developed and practised the use of simulation as a teaching modality for medical students and other healthcare workers and students. It is delivered across the school’s numerous regional sites, often within dedicated simulated suites.

“Simulation, as a teaching method, involves students practising skills relevant to their profession while being in a safe and supportive simulated learning environment,” Ms Harvey said.

Patient safety and the deteriorating patient

At the congress, staff members discussed research projects which look at the impacts of simulation on students. Ms Callaghan’s research focused on final year medical students and their experiences participating in a ‘Patient Safety’ module consisting of team-based clinical scenarios based around a patient with worsening symptoms.

Her subsequent report was co-authored by Dr Knott, an intensive care physician at Austin Health and Bendigo Health who is also an academic lead at MRH Bendigo’s Clinical Skills and Simulation Centre.

“Recognising the deteriorating patient is a crucial skill for junior doctors,” Ms Callaghan said, “so we focus on the communication and procedural skills that need to be applied in the time before the response team arrives.”

Initial findings showed students had applied the skills learned through simulation, in clinical practice – a result Ms Callaghan said would help to inform curriculum for future students.

Breaking bad news

Ms Harvey’s research studied the effect of a series of simulated workshops teaching communication skills associated with breaking bad news. Students practised breaking bad news before being videoed performing this in a mock exam situation where they were assessed by doctors.

She said the research showed the effectiveness of this teaching approach. “Gaining a perception of what the patient understands about their situation is very important when the news you need to deliver is not good,” Ms Harvey said. “Unless you know where the patient is at, you can’t empathetically and appropriately communicate at a time when we know communication influences patient outcomes.”

Laparoscopic surgical model

Monash medical student Sam Alexander, who has completed numerous placements with Monash Rural Health across Gippsland, also gave a presentation on a new laparoscopic surgical model he is developing with Monash Children’s Hospital paediatric surgeon Mr Ram Nataraja.

The congress was also attended by Marnie Connolly, senior lecturer at MRH East and South Gippsland and winner of the 2015 Achievement Award presented by Simulation Australasia, which recognised her “significant contribution to the advancement of modelling and simulation within Australasia.”  She was accompanied by fellow East & South Gippsland researcher Casey Stubbs.


Friday, 18 November 2016

Local researchers take out top British book prize

Local Monash researchers have taken out a prestigious British Medical Association (BMA) book prize as they prepare to expand their ‘recovery model’ project, for parents with a mental health illness, across Gippsland next year.

Prof. Darryl Maybery & Assoc. Prof. Andrea Reupert.
Professor Darryl Maybery, director of Monash University Department of Rural Health in Moe, and colleague Associate Professor Andrea Reupert, director of Professional Psychology Programs at Monash’s Krongold Clinic, were barely aware they had been nominated for the major, medical book prize when word came recently that, together with three international co-editors, they had won the BMA President’s Award.

Their book, Parental Psychiatric Disorder: Distressed Parents and their Families, was commended for its “innovative approach to thinking about and working with families where a parent has a mental illness”.

“With the soaring impact of adult mental and emotional ill health on clinical services and on society generally this outstanding book is timely in addressing a neglected area in a comprehensive way,” said BMA President Professor Sir Al Aynsley-Green Kt. in his commendation.

The recognition has been welcomed by Professor Maybery, who – together with fellow researchers Associate Professor Reupert and Dr Melinda Goodyear – plan to expand their four-year research project known as Let’s Talk About Children, across Gippsland from early next year.

The project, funded through the Victorian government Mental Illness Research Fund, is trialling specific interventions to engage with families and children within specialist mental health and family services. It aims to implement a recovery model for parents.

The project evolved after Professor Maybery, a practising psychologist for 15 years, completed his PhD and decided to focus on the impact of a parent’s mental health on their children. “I had worked in prisons and with drug and alcohol support services for many years so I understood the significance of parental mental illness in the lives of children,” he said.

The project will enter its third and final phase from next year and Professor Maybery said data collected from 28 agencies across Victoria so far indicated that the new approach “really improves relationships between clinicians and parents”.

“By talking about ‘real issues’ such as parenting and children and not just confined to the parent’s illness, connections are enriched and conversations can become positive and empowering.

“The project also aims to create positive change in workplaces to improve clinicians’ skills and, in turn, support the longer-term recovery of people with severe mental illness by addressing their parenting role as a core part of the treatment,” he said.

Let’s Talk About Children has benefited from international research collaborations, the input of Monash PhD students and the support of partner agencies. In Gippsland, it has secured the support of Latrobe Regional Hospital’s Adult Mental Health Service, which Professor Maybery said would be critical to implementing a randomised control study with hundreds of parents in Gippsland in the first half of next year. Other key local agencies will also come on board.

The partnership approach will ensure Let’s Talk About Children can be embedded in a variety of settings, with clinicians supported to trial its implementation.

“We know that almost one quarter of all children will, at some stage, have a parent with a mental health problem and that a proportion of these children are at risk of developing similar problems of their own,” Professor Maybery said. “So the critical priority, and the goal that drives us all, is the wellbeing of these kids and we look forward to expanding this project locally.”

Tom wins 2016 Rural Engagement Award

Monash University medical student Tom Ponsonby has taken out Monash Rural Health (MRH) East & South Gippsland’s prestigious Rural Engagement Award for his many and varied contributions to the local community.

Dr David Iser presents Tom Ponsonby with the 2016 Rural Engagement Award

The 28-year-old South Gippsland-based student, who is part of Monash’s graduate entry medicine course, has spent his second year of clinical training with Monash Rural Health in Leongatha.
He was recently announced the recipient of the school’s 2016 Rural Engagement Award (REA) after being nominated by academic coordinators and professional staff.

“This is a great way to publicly recognise and celebrate a student who has made an extraordinary contribution to rural engagement in the community,” said MRH East & South Gippsland academic coordinator Jennie Casey.

Tom was awarded a medallion, certificate and $200 as part of the initiative which commenced last year for MRH East & South Gippsland students.

The keen student, who grew up in Tasmania, has made his mark in South Gippsland across diverse settings. He has visited the local secondary college to talk with year nine to 12 students about careers in health and pathways into medicine and participated in health promotion activities run by the Leongatha hospital including a women’s health night run by the community health centre.

As a trainer for the Foster Football Club, Tom has also immersed himself in the South Gippsland sporting community, attending weekly training sessions and games at the club where he said he was made “very welcome”.

“Tom has also become part of the Foster Medical Centre team,” said Ms Casey. “He has readily integrated into all aspects of the practice, not only in the clinical setting but he has often been seen on study days helping out at the front desk.”

“Winning the award means a lot to me,” said Tom, “especially knowing the genuine commitment and enthusiasm the Monash Rural Health South Gippsland team has for rural health and educating future doctors in this region.”

“I've had a fantastic year in Foster, been taught by doctors who I really admire and been given many opportunities to develop and apply my medical skills.”

Tom said staff at MRH South Gippsland, the Foster Medical Clinic and the South Gippsland Hospital had all taken him under their wing and patients had been “kind enough to see the student doctor.”
“The real prize I've received for rural engagement this year has been getting to know the people and get involved in the community, and I hope to be back in the future,” he added.

Tuesday, 8 November 2016

John Flynn Placement Program and international students

As part of my work as a committee member of the Australian Medical Students’ Association (AMSA) Rural Health team, I had the privilege to speak to representatives from the Department of Health and the Australian College of Rural and Remote Medicine (ACRRM). Together with Skye Kinder, Co-Chair of AMSA Rural Health, we discussed the benefits of including international students in the John Flynn Placement Program (JFPP).

Promoting rural practice: Zee Lim (centre) and Skye Kinder (third from right) are advocating for John Flynn Placements to be opened to more international medical students.

The JFPP, funded by the Department of Health, aims to act as a catalyst to promote regional and rural health to all medical students, including those who do not come from a rural background. By providing such placement opportunities, the JFPP hopes to encourage future medical practitioners to work in rural Australia.

Personally, I am grateful that the School of Rural Health has allowed me to undertake a year-long clinical placement in Latrobe Regional Hospital, where I have thoroughly enjoyed my first clinical year. Furthermore, I appreciate the financial assistance given to us in the form of rural elective bursaries.

However, many universities do not provide such opportunities to international medical students, often excluding them not only from rural clinical allocations, but from elective bursaries as well. These students end up missing out on experiencing rural medicine, which is an integral portion of an Australian medical degree.

AMSA Rural Health conducted a nationwide online survey in 2016, where international medical students shared their opinions about rural health in Australia. The results were overwhelmingly positive. Out of 287 responses, 83% were interested in working in regional and rural Australia, while 88.8% were interested in the JFPP. This underscores the high level of interest international medical students have for rural and regional health.

Many positives came out of the discussion, with ACRRM acknowledging the benefits of international student involvement in the JFPP, and the Department of Health agreeing to continue discussions with the respective policy makers. I hope that the JFPP will be made available to future batches of international medical students in Australia.

Zee Lim, Year 3B student 2016

Monday, 7 November 2016

Teaching medical students with simulation

Simulation-based research projects, with a focus on teaching medical students, were showcased by Monash Rural Health Bendigo lecturers at the recent Australasian Simulation Congress.

The work of senior lecturers’ Dr Cameron Knott, Pam Harvey and Adele Callaghan was presented at the inaugural congress. The event bought together three simulation conferences for the first time - SimHealth, SimTech and the International Simulation and Gaming Association (ISAGA).

Monash Rural Health has long researched, developed and practised the use of simulation as a teaching modality for medical students and other healthcare workers and students. It is delivered across the school’s numerous regional sites, often within dedicated simulated suites. “Simulation, as a teaching method, involves students practising skills relevant to their profession while being in a safe and supportive simulated learning environment,” Ms Harvey said.

Deteriorating patients and junior doctors

At the congress, staff members discussed research projects which look at the impacts of simulation on students. Ms Callaghan’s research focused on final year medical students and their experiences participating in a ‘Patient Safety’ module consisting of team-based clinical scenarios based around a patient with worsening symptoms.

Her subsequent report was co-authored by Dr Knott, an intensive care physician at Austin Health and Bendigo Health who is also an academic lead at Monash Rural Health Bendigo’s Clinical Skills and Simulation Centre.

“Recognising the deteriorating patient is a crucial skill for junior doctors,” Ms Callaghan said, “so we focus on the communication and procedural skills that need to be applied in the time before the response team arrives.” Initial findings showed students had applied the skills learned through simulation, in clinical practice – a result Ms Callaghan said would help to inform curriculum for future students.

Breaking bad news

Ms Harvey’s research studied the effect of a series of simulated workshops teaching communication skills associated with breaking bad news. Students practised breaking bad news before being videoed performing this in a mock exam situation where they were assessed by doctors.

She said the research showed the effectiveness of this teaching approach. “Gaining a perception of what the patient understands about their situation is very important when the news you need to deliver is not good,” Ms Harvey said. “Unless you know where the patient is at, you can’t empathetically and appropriately communicate at a time when we know communication influences patient outcomes.”


Laparoscopic surgical model

Monash medical student Sam Alexander, who has completed numerous placements with Monash Rural Health across Gippsland, also gave a presentation on a new laparoscopic surgical model he is developing with Monash Children’s Hospital paediatric surgeon Mr Ram Nataraja.

Awards

The congress was also attended by Marnie Connolly, senior lecturer at MRH East and South Gippsland and winner of the 2015 Achievement Award presented by Simulation Australasia, which recognised her “significant contribution to the advancement of modelling and simulation within Australasia.”  She was accompanied by fellow East & South Gippsland researcher Casey Stubbs.



Local connections sponsor Solomons nurses

Nurses at the Solomon Islands’ largest hospital will soon be provided with much-needed kits to help them perform their work thanks to a partnership between the Bendigo Strathdale Rotary Club and Monash Rural Health.

A series of coincidental connections and a shared commitment to assisting the under-resourced hospital has seen the local service club raise funds for 11 ‘nurse starter’ kits, worth around $1000, which will soon be delivered to the National Referral Hospital (NRH) in the country’s capital, Honiara.

Sponsorship partners: Mary Preston (Rotary), Pam Harvey (Monash Rural Health), Ken Longford (Rotary) and Liz Longford (Rotary)
While members of the Bendigo Strathdale Rotary Club travelled to Solomon Islands several years ago to provide financial support for a number of programs, club secretary Mary Preston said their efforts were complicated by ‘not really having contacts on the ground over there.’

Nevertheless, the club remained open to finding ways to ease health challenges in the Islands, which include a rise in non-communicable diseases and premature deaths. In recent months, a practical opportunity emerged through Bendigo clinical specialist nurse Lynne Wanafalea who has travelled to the Islands to spend 12 months as an emergency nurse advisor at the NRH as part of an Australian federal government project.

Mary said the local Rotary club already knew of Lynne, who worked in Bendigo Health’s emergency department and at Monash Rural Health Bendigo, teaching clinical skills to medical students.
Lynne has her own connection to the islands, being married to a chief of an area of Malaita, one of the main islands. She and her husband have six children and have lived in Bendigo for the past 23 years.

Within her first month at the NRH Lynne was struck by the urgent need for basic nursing tools including stethoscopes, blood pressure monitors, thermometers, scissors and penlights.  She contacted her Monash colleague, senior lecturer Pam Harvey praising the hard working NRH emergency nurses but raising concerns about the poorly resourced facility which was contending with cases including dysentery, malaria and tuberculosis.

Monash Rural Health staff and medical students pledged their commitment to helping, via a ‘Sponsor a Solomon Island Nurse’ project and as part of this effort Pam contacted the local Rotary club which quickly supported the cause. “We saw this as a really practical way to help out - we know the nurses will be able to use these kits for a long time to enhance their work - and also a safe option, knowing that someone will be travelling to the islands and delivering the kits,” Mary said. With the support of Bendigo-Waverley South, the local club ran a raffle with the proceeds subsequently donated to purchasing the nursing kits.

This month, a friend of Lynne’s will hand deliver the kits to NRH nurses including Florence Aluta, who shared her story as part of the ‘Sponsor a Solomon Island nurse project.’

“My favourite role in the emergency department is triage…this can become very frustrating at times though, when we have no equipment to do patient assessment,” she said. “Nearly half of our patients are babies and children who can deteriorate very quickly – any equipment to help us would be fantastic.”

Thursday, 3 November 2016

Rural placement introduces metro students to Helimed

Monash University medical students learned about the significance of an air ambulance service to rural and remote areas during a recent visit to Helimed as part of a two-week rural placement.


Ambulance Victoria paramedic Ben Meadley spent time with the Clayton-based year two students at the Helimed air ambulance base at Latrobe Regional Airport in Traralgon. He shared stories about the work of Helimed in Gippsland, which includes hospital transfers, airlifting critical patients from remote locations and search and rescue missions on both land and water.

The rural placements are facilitated by Deborah Hewetson, Year 2 program coordinator at Monash Rural Health Latrobe Valley & West Gippsland.

Clinical skills educator Lane Johnson said the local visits are designed to introduce the students to rural communities and rural health practice. She said the placements focused on clinical practice and involvement in community activities and included visits to local pharmacies, hospitals and Indigenous sites.

The students, based in Warragul and Traralgon for their two-week placement, also participated in a clinical skills education session which saw Monash Rural Health Traralgon-based staff and years three and four medical students teach them skills including basic life support, plastering, wound dressings and the use of a laparoscopic simulator.