Wednesday, 16 December 2015

Summer scholarships give a taste of career in research

Engaging in research during your university break might sound arduous but four enthusiastic recipients of Monash University Summer Research Scholarships have declared the experience inspiring. The scholarships aim to encourage high quality students interested in a career in research or academia.

The four students, who have just completed a three-week scholarship stint based at Moe with Monash Rural Health, found working as part of the Schools Study component of the Hazelwood Health Study was time well spent.

Working holiday: four Monash students took on a Summer Research Scholarship with the Hazelwood Health Study at the end of 2015 (l-r) Stephanie Van Boxtel, Josephine Slifirski, Cathy Saleta, Sally Robinson

The Schools Study is part of the ‘psychological impacts research stream’ of the Hazelwood Health Study. It is working closely with local schools, comparing Morwell schools which were most impacted by the Hazelwood mine fire smoke event with other schools in the Latrobe Valley. The Monash students assisted with interviewing Latrobe Valley students across years three and five in primary school and seven and nine at secondary school.

For Cathy Saleta, Josephine Slifirski, Stephanie Van Boxtel and Sally Robinson – four students from diverse study backgrounds - an opportunity to work with the Rural Health research team was what motivated them to apply for the Summer Scholarship.

Plans for further study confirmed

As she neared the end of her Bachelor of Community Welfare & Counselling, Cathy reflected on her growing interest in research which she attributed to the encouragement of a lecturer. The scholarship experience has convinced the Churchill student and mother of three to pursue her plan to do honours and a PhD with a focus on wellbeing and mental health.

Cathy commended Monash Rural Health on its approach to scholarship students, describing the induction and the training provided around qualitative interviewing as “fantastic”. As a local who experienced first-hand the impact of the Hazelwood Mine Fire, Cathy said she was particularly attracted to the Schools Study. “This is a real life project that we really hope will inform future events,” said Cathy, adding that navigating some of the complexities of data gathering had been a useful learning experience.


Exploring new ground: the research process

Next year, Josephine embarks on her honours year studying population health following her completion of the Bachelor of Biomedical Science. A self-described city girl, she had minimal understanding of the Hazelwood Mine Fire before participating in the Schools Study. “This field of rural health really interested me as it is something unfamiliar to me,” she said. “I wasn’t aware of how significant the mine fire impact was or how significant mines are as a part of the community.”

Steph, who has a dual interest in research and clinical work, next year embarks on her final year of the Bachelor of Heath Science and Bachelor of Social Work. The Longwarry-based student was aware of the impact of the mine fire on people she knew and was keen to work on the Schools Study.

For Sally Robinson, who has just completed her first year in Monash’s graduate-medical degree with Monash Rural Health in Churchill, the research scholarship satisfied her interest in exploring mental health and psychology qualitative research work after working on previous research projects with Monash and the Royal Children’s Hospital.

Give it a go

Asked what advice she would offer to other students who might consider applying for a summer or winter research scholarship, Sally said “If you are thinking about it, don’t be scared about what you do or don’t know beforehand…there is scope for you to speak up and the staff are very approachable so I would recommend anyone giving it a go.”

Sally’s fellow students agreed. As a student whose pathway has taken twists and turns while she has juggled family responsibilities, Cathy said “I think there are probably single parents like myself who might think this is not possible for them…I would say just do it, you would not regret it.”

Friday, 11 December 2015

Gippsland health workforce benefits from PERU

A student placement collaboration between Monash  Rural Health and Latrobe Community Health Service (LCHS) is seeing numerous students go on to become staff at LCHS, adding quality to the local health workforce.

A Memorandum of Understanding signed between the organisations has helped to grow student placement numbers at LCHS exponentially since it was signed in 2009.

In the past few years around 12 new employees have joined LCHS after having completed their placements through the innovative program known as PERU (Placements Education and Research Unit), including four in more recent months.

Workforce development: A collaboration between Latrobe Community Health Service and Monash Rural Health is helping recruit new health professionals. (Left-right) LCHS People, Learning & Culture Senior Manager Jacqueline Eddy, new LCHS employee (and Monash student) Venus Brammall and Monash Monash Rural Health Senior Lecturer Dr Susan Waller.
Monash Rural Health Senior Lecturer Dr Susan Waller said students, who come from multiple educational institutions, including Monash, undertook placements across a wide range of primary intervention allied health settings at LCHS, with their learning supported by Monash Rural Health during that time.

The success of PERU involves a team effort from Monash Rural Health and LCHS, is supported by the directors of both organisations and includes on-the-ground administration provided by LCHS.

Last year the program was moved to the People, Learning & Culture department of LCHS and Dr Waller said the move had strengthened links between staff and students. She said ongoing evaluation of the program had shown the program was effective and well regarded by students.

“We get good feedback from students who say their supervision was appropriate and helpful and they felt welcome at LCHS,” she said.

As part of its commitment to PERU, Monash Rural Health is involved in the student planning process, provides educational leadership, trains LCHS in the supervision of students, runs simulated clinics for students and, with the support of Monash Rural Health Research Fellow Dr Anske Robinson, increases and enhances research at LCHS.

LCHS Acting Senior Manger People, Learning & Culture Jacqueline Eddy said LCHS regarded PERU as a valuable recruitment stream, with large numbers of high quality students participating.

“As supervisors of these students we also experience a personal level of satisfaction,” Ms Eddy said. “We get to watch and support them in building their skills and applying those skills in a practical way in the workplace.”

New employee Venus Brammall said she had first-hand experience of the benefits provided by PERU to students at LCHS.

The Monash Bachelor of Business and Commerce student, who lives locally, spent six months in placement at LCHS this year and this month has taken on a role within People, Learning and Culture at the organisation.

“I felt really well supported and it helped to grow my skills in Human Resources,” she said, adding that LCHS had been flexible in accommodating her ongoing study commitments within her new position.

“PERU can certainly support students who come through the corporate area of LCHS,” Dr Waller said.

Students hosted by LCHS have more recently gone to become staff working across drug and alcohol treatment services, podiatry, counselling, human resources and occupational therapy.

Wednesday, 9 December 2015

Developing the "self-improving healthcare system"

Dr Cameron Knott
While he was an intensive care trainee, Dr Cameron Knott was a member of a team whose patient died as the result of a medical intervention. The experience led him to reflect* on the need for, not only self-improvement, but also developing skills around teams behaviour.

An intensive care and organ donation specialist with Austin Health and intensive care specialist at Bendigo Health, Dr Knott is also now the academic lead for the SRH Bendigo Clinical Skills and Simulation Centre. Clinical simulation-based education is an important aspect of his ongoing work on developing the “self-improving healthcare system”.

“I didn’t like the way medicine was being taught effectively by humiliation,” he said. “By contrast, the simulation-based approach is supportive. Rather than being classroom based, it’s learning by doing. It is also a safe place that gives learners the space to reflect on what they do and how to do it better.”

As well as fostering a personal culture of self-improvement, the experiential approach of simulation-based education enables the teaching of team behaviour. “I want to reduce the silo effect of education,” Dr Knott said. “We teach medical students using simulation-based education, but we have the students play the role of nursing staff or pharmacist. We need to allow them to be coached by those specialist practitioners.”

Such real world coaching would contribute to the work readiness of graduates, another of Dr Knott’s concerns. “There can be a gap between what graduates think they’ll be doing and what they actually end up doing,” he said. Dr Knott is working to reduce that gap through simulation-based education.

* C Knott, A personal experience on staff experiences after critical incidents, MJA, 2014; 201(9), 550-551. doi: 10.5694/mja14.00681

Monday, 7 December 2015

New staff bring years of experience to Sale

Two new staff have been appointed academic coordinators for medical students based in Sale.

Prue Berry is the new Year 4C coordinator and Casey Stubbs the Year 3B coordinator. Prue, from Marra, and Casey, from Sale, have long careers in nursing and education.

Prue Berry (left) and Casey Stubbs (right) bring many years' experience to their new roles.

Prue has worked for Central Gippsland Health Service in Sale for the last 16 years, initially as a critical care nurse and during the last seven years as a clinical educator. She is keen to expose medical students to the advantages of working in rural general practice and rural hospitals.

Both Prue and Casey believe their careers as nurses will bring valuable knowledge to their roles.

“One of the major strengths of nurses is their communication skills, and an enormous part of nursing and medicine centres around good communication,” Prue added.

Casey spent some years as an intensive care nurse at the Monash Medical Centre in Melbourne before taking up a position over three years ago as a nurse educator at Latrobe Regional Hospital in Traralgon. “After working in education, I realised that was what I really wanted to do in my career,” Casey said. “I have found my place in education.” Casey’s aim is to help medical students feel confident and comfortable before actually entering the workplace. She believes her nursing background will enhance her role.

Prue will oversee eight Year 4C students who will spend the academic year in Sale and surrounding towns. This rotation includes general practice, children’s health (paediatrics), women’s health (obstetrics and gynaecology) and mental health.

Casey will have eight Year 3B students next year, who will spend most of their time in the medical and surgical wards at Central Gippsland Health Service with specialty sessions in the emergency department and operating theatres. Students will also rotate to Bairnsdale Regional Health Service on a roster basis for medical and surgical experience.

Tuesday, 3 November 2015

Gippsland presentations: we need to focus on fathers with mental illness

Need for a re-focus: Rhys Price-Robertson will talk about the particular challenges for fathers with a mental illness at two presentations in Gippsland in November.
With almost all of the existing research on parenting and mental illness stigma focused on mothers, it’s important to focus separately on fathers’ experience of stigma a Monash researcher will explain at two presentations in Gippsland this month.

Rhys Price-Robertson - a ‘knowledge broker’ for the Children of Parents with a Mental Illness (COPMI) national initiative and PhD candidate at Monash University - will talk about his research during the presentations aimed at both professionals and the general community.

‘Stigma’ has been a prominent theme in research and reviews on fatherhood and mental illness, with a recent report by the Australian Institute of Family Studies showing fathers with mental illness can face unique hardships. (Mr Price-Robertson has also published on this theme.)

Mr Price-Robertson found that for many of the fathers who participated in his research, fatherhood was central to their self-image; however mental health practitioners and researchers frequently overlooked the significance of that role. His research has revealed the need for system-wide reform to ensure Australian health and welfare services are capable of effectively engaging with fathers with mental ill-health. He will outline recent attempts to develop models and practices of recovery that incorporate the parenting role.

The upcoming presentations offer the local community a valuable opportunity to understand the challenges facing fathers with a mental illness. During both presentations there will be time for discussion, and for audience members to share their personal or professional experiences. There will also be time to informally speak with Mr Price-Robertson after the presentations while light refreshments are served.

Presentation dates

Bairnsdale: Wednesday 25 November 2015, 6.30-8.30pm
Rooms 4 & 5, Monash University School of Rural Health, Day Street

Traralgon: Thursday 26 November 2015, 6.30-8.30pm
Conference Room 2, Quality Inn Latrobe Convention Centre, 5501 Princes Highway

Registration

Places are limited, so please register to attend

For further information or if you have any trouble registering online, please contact:
Keith Sutton (School of Rural Health MUDRIH)
Phone: (03) 5128 1031
Email: keith.sutton@monash.edu

Friday, 23 October 2015

Rural towns agree: distance not the main decider in whether to visit the doctor


Research in five rural towns about the factors that influence a decision to visit a doctor for non-urgent care could have major implications for planning primary health care services.

Lead researcher, Dr Bernadette Ward of the School of Rural Health at Monash University, said that, when planning health services, planners and policy makers generally assume that distance to a clinic is the main or only factor in rural people’s decision to see a doctor.

“This study shows that is not the case,” said Dr Ward.



“Data provided by the residents of Stanhope, Birchip and Heyfield in Victoria, and Grenfell and Jerilderie in New South Wales quite clearly demonstrate that people will travel relatively long distances to see a doctor they prefer.

“The distance they have to travel to see a doctor ranks only third in importance – a long way behind preference for a doctor and availability of a doctor.”

Although many published studies highlight the importance of doctor-patient relationships in use of doctors’ services, this is the first empirical study to show how people trade off the different factors that influence their decision to visit a GP.

The results varied slightly between relatively closely settled rural areas and more sparsely settled areas.

In sparsely settled areas, the availability of a GP is ranked slightly above preference for a GP, and well above distance to the service and cost.

“The fact that distance is consistently ranked as less important than availability of, or preference for, a GP suggests that most rural residents accept the need to travel some ‘reasonable’ distance in order to access health care,” said Dr Ward.

What constitutes a ‘reasonable distance’ varied with geographic location: the more sparsely populated the region, the further residents were prepared to travel.

“What it the study does demonstrate that planners need to incorporate other dimensions of access to services besides their availability,” said Dr Ward.

“Optimum use of doctors and other primary health care services relies on providing appropriate care in line with the needs and preferences of individual communities."

The paper – ‘Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care’ – was published in Australian Health Review. For more information contact Dr Bernadette Ward: bernadette.ward@monash.edu or 0427 059 205.

Friday, 16 October 2015

Act sick to help train a doctor

Volunteer sim patients, Andrew Hood and Alison Sinnott help train future doctors
The School of Rural Health Churchill needs volunteers to play an important role in training future doctors. The site needs up to 50 people, especially men aged 30 to 40, to take on a simulated patient role for part of the students’ end-of-year clinical skills exams in November.

"Sim patients" are trained to portray conditions such as a heart attack, high blood pressure, chest pains or even a broken arm. A clinician then observes how the student records the patient history and treats the “patient”.

Sim patient coordinator, Susan Smith said she contacts volunteers in the demographic needed by the exam scenarios who are then trained in their “illness”.  Some volunteers, like Andrew Hood, have been doing it for years because they enjoy the experience so much.

Andrew, who initially studied computing with Monash University and has now returned to study for a science degree, is from Yallourn North and has volunteered since 2007. A friend from Latrobe Regional Hospital who was involved with Andrew in community theatre suggested he would be ideal.

“I enjoy acting, it’s a great challenge,” he said. “It is also great to help with these students’ education in becoming good doctors.”

He not only volunteers for clinical skills examinations but also on a regular basis throughout the year as part of the students’ training. Andrew says it’s not like learning a script. It is more a question and answer scenario. “You are given initial training to explain the procedure,” he said. “You get used to it fairly quickly and it all becomes familiar. I like it when I am given a more complicated role to give them a challenge,” he said.

Sometimes the volunteers are required to change into hospital gowns and lie on a hospital bed in the simulated ward or may have to present in shorts and a t-shirt to make the scenario more realistic.
Ms Smith said the more volunteers recruited the better. “We need such a broad demographic range and we don’t always need everyone,” she said. “But all volunteers get paid for their time and training.”

If you are interested in being a sim patient volunteer, contact Ms Smith at the School of Rural Health Churchill by phone 5122 7445 or email: susan.smith@monash.edu

Tuesday, 29 September 2015

Traralgon boy returns to practice as local doctor

Though he was once a promising Traralgon College student with a penchant for biology and chemistry, Mitchell Kraan – now a doctor at Latrobe Regional Hospital – knew from early on that he didn’t want to spend his days mixing test tubes in a lab.

When teachers encouraged Mitchell and his peers to start thinking about career options, the long-time local knew he wanted a job with a science base but, importantly, one where he was working with – and helping – people. Reflecting back on his initial ambitions, Mitchell admits “it has all turned out fairly well in that regard.”

As a high school graduate, Mitchell entered the five year undergraduate medical degree at Monash University’s Clayton campus and progressed through, studying hard and undertaking a series of clinical rotations both rurally – including his fourth year at the School of Rural Health’s Traralgon site - and in Melbourne.

Mitchell Kraan (far right) with colleagues Ken and Sandra at Latrobe Regional Hospital. Happy to be back in the Valley
Now aged 25, Mitchell is in his second year out of university and working as a resident at Latrobe Regional Hospital.

Six minutes to get to work

He says while he always harboured a “vague intention” to return and work in the Latrobe Valley, years spent negotiating traffic and living in a “shoe-box apartment” in Melbourne cemented the appeal of living in a region.

“In my first year at uni I lived six kilometres from the campus but it could still take up to 40 minutes to do that trip and eventually I thought ‘I can’t keep doing this’…now I live in Traralgon and it is six minutes door to door for me to get work,” he said.

“I really like the culture at LRH. You get to know the nurses and support personnel, and because I am from this area, I already knew some of the staff – it has a real community feel and it feels different to Monash Medical Centre or the Alfred, for example, where there are so many graduates.”

Continuity with patients

This year Mitchell is gaining experience in paediatrics, psychiatric care, obstetrics and gynaecology to add value to the GP training he will commence next year.

Spending the fourth year of his studies at the School of Rural Healtnh and participating in the integrated GP program – through a placement at Moe Newborough Health - proved critical to Mitchell’s decision to pursue GP training.

“I had a great experience as part of this program, there was so much variety and we had a chance to have continuity with patients; we could see them over multiple episodes and really get to know them and track them,” he said.

“I did my paediatric work as a student locally and you have your tutorials run directly by consultants like [Director of Paediatrics] Dr Joseph Tam who then takes you on rounds, you have such good access…when I was in the Cabrini Hospital [in Melbourne] I could be tenth in line to see a patient.”

Time for life outside work

Despite the well-known rigours of life as a junior doctor, Mitchell says living locally has helped him strike a balance between work and leisure.

Part of the Scouting community since he was a young boy, Mitchell is now with the Victorian Rover Scouts in Churchill and has held positions on the Region and State leadership teams. He is a keen participant in the Scouts’ musical theatre production, Strzelecki Showtime, and also plays indoor soccer.

“These pursuits are so different from what I do during the day and I like that,” Mitchell said. “I have friends I went to uni with who are being shuffled between city hospitals and they can forget that sort of thing, it’s too hard for them.”

A career in medicine is achievable

Asked whether he would encourage other young students to consider a career in medicine, Mitchell doesn’t hesitate.

“I didn’t have a private school education and my parents weren’t doctors but I just decided that this is what will suit me and I knew I wanted to help people,” he said. “And I think you really do – especially by second year, you have a lot of patient contact and interaction and there is that real capacity to impact on people in such a positive way.”

“I am not shying away from the reality; there is a lot of paper work along the way – especially as an intern – but if you persevere, you don’t have to wait too long to really have that feeling that you are helping,” he added.

Monday, 28 September 2015

Dean's award recognises online teaching excellence

Professor Ross Coppel presents Dr Eleanor Mitchell with the Dean's Award for Excellence in Education (Quality of Teaching) in August 2015.

A love of online teaching and a passion to create change in that space has underpinned the significant achievements of School of Rural Health lecturer Dr Eleanor Mitchell.

Dr Mitchell, who teaches at the school’s Bairnsdale site, was a recent recipient of the Dean’s Award for Excellence in Education (Quality of Teaching).

A former research manager at the Royal Victorian Eye and Ear Hospital, Dr Mitchell moved to East Gippsland to work with SRH about five years ago, to develop research in the region. Her role involves assisting academics and health professionals to establish their own research and program evaluations.

The Dean’s Award is in recognition of the successful delivery of a research methods unit to distance education Master’s degree students. Students who are enrolled in this unit come from all over the world and often are from a diverse range of health-related fields. “This provides for interesting and diverse online discussion,” Dr Mitchell said.

Dr Mitchell’s enthusiasm for the unit is infectious. “I teach the students about the background of research and they go through working on a topic of their choice, they undertake a literature review, prepare an ethics application, develop their own proposal and they often choose topics that they are working on.”

When Dr Mitchell took over the unit in 2012 it was being taught in a traditional distance education mode but, with a clear idea of how she wanted to engage off-campus students, Dr Mitchell moved the unit online into Moodle, to enable rich interaction between students and regular communication between Dr Mitchell and the students.

Student feedback indicates the success of these changes, received as part of the Student Evaluation of Teaching and Units process.

Inspired by her own less-than-ideal experiences studying by distance education, Dr Mitchell has also joined forces with Dr Angelo D’Amore, Senior Lecturer and Education Leader at MUDRIH, to conduct research into online learning. The pair are looking at what makes a good online educator and what can be done better.

“Eventually we would love to be able to develop a toolkit for those embarking on online teaching,” she said.

Dr Mitchell is also preparing to present the preliminary research findings at the 12th annual conference of the International Society for the Scholarship of Teaching and Learning in October this year.

Friday, 18 September 2015

Medical student aims for Australian Olympic team

Alex Rowe has his sights set on the 2016 Olympics - and a career in medicine
The rigours of training for international athletic success might not be everyone’s idea of respite but for Monash medical student Alex Rowe, currently studying at the School of Rural Health in Churchill, his many hours of local running are providing just that.

The high achieving yet humble track star is the fastest man in Australia over 800 metres. Just over 12 months ago Alex ran 1 minute 44.4 seconds to equal the record of Olympic champion Ralph Doubell, which stood for 46 years.

The 23-year-old Melburnian, a gold and silver Australian National Track and Field Championships medallist, is no stranger to hard work – on or off the track.

In order to maintain his form with up to two hours of daily training – and keep up with his studies - Alex has mastered time management; rising earlier, running during lunch breaks and using afternoon time as efficiently as possible. Sometimes he runs in the company of his flat-mate, a VFL umpire, but often alone.

“I try to use the training as a release and a chance to take my mind off the study; it helps to clear my mind so I can go back to the study fresh,” said Alex.

Despite his best efforts, the study load coupled with training and racing demands, on home soil and overseas - made harder by the geographic separation from his coach Justin Rinaldi  - have taken an inevitable toll.

Alex recently announced he was withdrawing from the IAAF World Championships in Beijing as he felt the study load was affecting his training.

“I wouldn’t have had it any other way this year though,” said Alex. “I am enjoying this course so much…but I have decided to defer next year so I can dedicate myself to training and competition.”
“It was a tough decision because I do love both, but when you think about the window of time available when it comes to elite sport, the decision becomes clearer.”

“I absolutely love it here and after running I would definitely consider coming back to a rural position because of the great lifestyle and how much I have enjoyed my time here,” said Alex. “But whilst I am running I need to have the support of the home environment and regular access to my coach.”
With youth on his side, Alex is optimistic his best performances are ahead of him.

“I just want to continue to push myself and see where I end up,” he said. “For me it is all based on the effort and the process, rather than the outcome…but if I keep doing the right things then there are things I would like to achieve, which would hopefully be an Olympic and World Championships final and getting that 800 metre record on my own.”

Wednesday, 16 September 2015

Disabled tutors train medical students

Eleven people living with a disability helped as tutors when a group of 50 medical students from School of Rural Health sites at Bairnsdale, Sale, Leongatha, Traralgon and Warragul took part in an annual disability education forum.

The tutors participate in services run by Cooinda Hill in Traralgon. Cooinda Hill Chief Executive Officer, Chris Trotman, said her clients were pleased their opinions were valued which was why the centre had taken part in the program for a number of years.

Gippsland-based Monash medical students learn from clients of Cooinda Hill in Traralgon.

Director of the Centre for Developmental Disability Health Victoria, Dr Jane Tracy, told the fourth year Gippsland-based medical students that people with disabilities encountered many barriers to healthcare, and these included the attitudes and communication skills of doctors and other health professionals.

“Many of these medical students haven't spent time with someone with a disability in a personal interaction,” Dr Tracy said.

“In medical environments, people with disabilities are usually in passive and vulnerable roles, and often feel dependent and disempowered ,” she said. “We want medical students to engage as equals with all patients, and we want people with disability to know they have the right to good healthcare, and the right to complain if this does not occur.

“This training helps breaks down barriers – medical students and doctors feel more comfortable and confident – and people with disability feel they can speak up for themselves. Part of the social change that has happened over the last few decades has been in relation to the recognition of rights and values of people with disabilities.

“For their part, the people from Cooinda Hill clients have told us they love the opportunity to contribute to teaching the doctors of the future, they love meeting new people … and they love being paid for their contribution!”

Dr Tracy provides a theoretical framework for students to use to understand the causes and impacts of developmental disabilities. She outlines examples of the health problems that typically accompany syndromes such as Down syndrome, and where to get more information so students can provide optimal healthcare for their patients with disability.

“It is important for our future doctors to understand that they must always engage with the primary patient. It may seem easier and quicker to talk to an accompanying family member or paid staff member, but the patient is entitled to the courtesy of being spoken to directly; the support person can provide further information and clarification as required,” said Dr Tracy.

Tuesday, 8 September 2015

Mildura rotations leave students keen for rural practice

Four final year students who have undertaken final year rotations at the School of Rural Health Mildura say they'll definitely be back.

Ben Bambery, Eleanor Bulford, Jacob Jewson and Kenneth de Jong have spent their time in Mildura working across a number of areas including the hospital’s Emergency Department. The benefits of studying in a regional area are many they say.

Final year students (from left) Jacob Jewson, Kenneth de Jong, Ben Bambery and Eleanor Bulford,
say they'll be back.

“We have been exposed to more hands-on training than would have been possible in a metropolitan hospital,” Ben said. “We never felt we were at the end of a long line of doctors.”

Jacob added: “At the big emergency departments in Melbourne, there is a long line of junior doctors. We are fortunate to be exposed to many aspects of medicine and can practise our skills.”

Kenneth and Eleanor both said it was “easy to integrate into the Mildura Hospital”.

“There is a sense of community,” Kenneth said. “You know the other doctors and nurses who are always willing to help,” he added.

Next year, Ben will be at the Austin Hospital, Eleanor at St Vincent’s, Jacob at the Alfred and Kenneth at Eastern Health in Box Hill.

However because of these hospitals’ affiliation with Victorian regional hospitals they will spend parts of their year in the country.

“It would be great to return to Mildura,” they said.

Three of the four students didn’t decide to study medicine until late in secondary school.

Even though both Ben’s parents are doctors, he had no pressure to follow them into the medical field. “My two brothers are engineers,” he said. “I was initially looking at some sort of biological science course.”

Eleanor confessed to always having an interest in medicine however didn’t make her mind up until the last minute. “I was thinking of doing an arts degree,” she said.

Jacob grew up on a farm at Swan Hill, where his father was a farmer and his mother a nurse. “I knew from a young age that farming wasn’t for me,” he said. “I enjoyed science subjects and chose medicine at the end of year 12.”

Kenneth is the only one of the group who always wanted to be a doctor. “My grandparents were doctors and my mum is a nurse,” he said. “It is what I always wanted to do.”

Monday, 7 September 2015

Skills weekend gives students a Bendigo taster

First and second year Monash University medical students had a taste of what’s to come in their course, thanks to fellow students at Bendigo.

A clinical skills weekend at the School of Rural Health Bendigo exposed them to a range of practical procedures.

It was organised by WILDFIRE, the university’s rural and indigenous health club for medical, nursing and allied health students across the university’s campuses and rural clinical schools. A group of interns and resident doctors from Bendigo Health also volunteered for the weekend.

Practice: first and second year medical students got a taste of studying in Bendigo
at a clinical skills weekend.

Interim Director of the School of Rural Health Bendigo, Associate Professor Chris Holmes, said the WILDFIRE clinical skills weekend was a welcome student-led initiative.

“Many of the attendees have had no previous contact with rural centres and the program showcases the student experience in Bendigo, which we hope leads some to consider study and a future in rural areas,” Associate Professor Holmes said.

Bendigo WILDFIRE sub-branch president and third year medical student, Dan Hogarty, helped organise the event. He attended the skills weekend last year as a second year student and found it “a great experience”.

“These 42 students from Clayton get a country experience with a chance for some hands-on learning,” Dan said. “It helps give them a taste for what is to come next year.”

Most of the students are part of the Extended Rural Cohort program, a stream within the Monash medical course.

These students undertake the majority of their clinical education within hospitals and community-based practices in northern rural and regional Victoria. This extended rural training option is provided for students interested in practising medicine in a rural or regional location.

Interns and resident doctors from Bendigo Health ran six stations throughout the weekend.

Stations included looking at a chest x-ray, practising eye examinations, performing a nasograstric tubing procedure, suturing, oxygen therapy, cannulation and performing an electrocardiogram (ECG).

“One of the most interesting parts of the weekend for the students was spending time in the school’s simulation laboratory,” Dan said. “The lab in Bendigo is amazing.

“We find the students get a lot out of the weekend. The first two years of medicine are highly theoretical so it is great for them to come here and see what it is like.”

Associate Professor Holmes complimented the students on a successful event.

“The WILDFIRE students in Bendigo have done an outstanding job pulling together colleagues, junior doctors and clinical skills staff to provide an entertaining and informative experience in Bendigo, and the weekend helps to reinforce the very strong medical education program here,” he said.


Tuesday, 25 August 2015

Clinical skills showcases in Latrobe Valley

Efforts to showcase rural living and learning to a group of Monash medical students over a recent weekend in Traralgon were well rewarded.

Monash University’s Rural and Indigenous Health Club, WILDFIRE, initiated a clinical skills weekend at the Monash School of Rural Health's Latrobe Valley site at Latrobe Regional Hospital, for 30 medical students.

The student group included those enrolled in the metropolitan based Bachelor of Medicine, Bachelor of Surgery (MBBS) and graduate entry students based at the School of Rural Health in Churchill.

Students learning aseptic technique
and cannulation
WILDFIRE’s Gippsland President, third year medical student Lisa Guion, said this was the first time the student-led cub had initiated a clinical skills weekend in the Latrobe Valley, with previous events being run by the School of Rural Health East Gippsland and Bendigo.

Held over two days, the event showcased the benefits of living and studying medicine in a regional or rural setting, while exposing metropolitan students to local Monash School of Rural Health facilities and clinical settings.

The recent WILDFIRE South East Clinical Skills Weekend included a trip to the Tyers lookout, where Ms Guion said the students had an opportunity to observe the impact of industry and natural disaster in the Latrobe Valley.

Social activities were also incorporated into the weekend but, critically, students participated in skills-based learning across five stations of rotating activities, covering laparoscopic simulation, cannulation, obstetrics scenarios, trauma cases and airway management on Saturday.

Monash medical students learn to suture,
using donated pigs trotters,
Ms Guion said a comprehensive two-hour suturing workshop, using pigs’ trotters donated by a local butcher, was facilitated by local GP Dr Michael Kunze and assisted by students based at Traralgon and Warragul.

“It was so important for these students to see how our clinical settings operate and to understand the benefits of the near-peer teaching that happens here, where the student to consultant ratios are often so much better than in metropolitan areas,” she said.

Ms Guion said a dinner held at Century Inn on the Saturday night surpassed her own expectations, with high levels of interaction between students and guest speakers, including Breed Street GP and obstetrician Dr Brougham, LRH intern and former Monash medical student Dr Mitchell Kraan, fifth year student Ms Kym Clemence and Dr Matthew Carroll who is a researcher with the Monash-led Hazelwood Mine Fire Health Study.

School of Rural Health Latrobe Valley & West Gippsland Director Associate Professor Joseph Tam said it was pleasing to have so many local professionals dedicate their time to contribute to the clinical skills weekend.

“These sorts of initiatives are underpinned by the goal of encouraging the long term commitment of medical practitioners to living and working in rural and regional areas.

“Ultimately, developing a sustainable rural health workforce is in the best interests of all of us and WILDFIRE is to be commended on the work it does to contribute to this outcome,” said Associate Professor Tam.

Ms Guion said feedback from students who participated in the recent weekend had been positive, with some students already indicating their interest in studying in Gippsland.

The event was partially sponsored by Medical Indemnity Protection Society (MIPS) and Southern GP Training.

Monash medical students gathered in the Latrobe Valley for a recent clinical skills weekend.


Tuesday, 18 August 2015

Medical students orchestra plays Churchill

The Monash Medical Students Orchestra plays outside Melbourne for the first time on 22 August. Photo: FreeImages.com/John Siebert.
Members of the Monash Medical Students Orchestra have their final rehearsal this week in preparation for a concert of classical and contemporary music at Churchill this Saturday 22 August.

This will be the first time the orchestra has performed in regional Victoria with the concert at Federation University Churchill’s auditorium a collaboration between Federation University and Monash University School of Rural Health.

According to orchestra co-chair, Charlotte O’Leary, the orchestra members are “excited” about the visit.

“We have two major concerts a year and start rehearsing weekly for two months prior to the event,” Charlotte said.

The concert will be of special significance to fellow chair and student Tim Harkins, whose grandmother from Sale, unable to travel to Melbourne, will see him perform for the first time in some years.

Tim plays the viola and Charlotte the cello.

Charlotte said many university students found having outside interests, such as music or sport, helped balance their life.

She was performing in a string quartet at the recent Monash University Open Day and was approached by a prospective student trying to decide between studying medicine and music.

“We told her you can study medicine and play music part-time but you can’t study music and do medicine part-time,” she added. “We all felt we have the best of both worlds.”

The orchestra’s conductor is music graduate Robert Dora. “It is a full symphonic orchestra,” Charlotte said. “Robert puts the program together with input from the students.”

The program will feature a mixture of classical and contemporary orchestral music. The classical repertoire will be selected from the romantic Third Movement of Rimsky-Korsakov's Scheherazade, Bartok's Romanian Dances and Berlioz's dramatic Hungarian March

Some of the lighter and more well known music will include the theme song from Angry Birds, Les Miserables and Batman: The Dark Knight Rises. There may even be some extra percussion in the form of a typewriter!

There will also be performances from the orchestra's smaller ensembles, including a traditional Chinese stringed instrument.

The orchestra numbers 75, however between 45 and 50 medical students will perform at the Churchill concert from 5-7pm on Saturday, August 22. Earlier in the day, the orchestra will welcome residents from Hazelwood House in Churchill to rehearsal.

Entry is a gold coin donation however bookings are necessary through sarah.j.russell@monash.edu or 5122 7445.

Monday, 10 August 2015

Laptop donations make a difference

The clients of numerous community based organisations across wider Gippsland have benefited from the donation of laptops from the Monash University School of Rural Health.

The agencies form a vital part of the school's Community Based Practice  program, run from its Churchill site. Each year agencies who provide care for disadvantaged people in the Gippsland community host medical students as part of a four day rural-based Community Based Practice placement.

Monash School of Rural Health students Megan and Andrew  present
Moe Lifeskills Community Centre students Justin and John with donated laptops.

School of Rural Health Churchill Director, Associate Professor Shane Bullock, said the school greatly valued the contribution of Gippsland agencies, including specialist development schools and other disability support services, to the educational experience of Monash medical students.

“When the students undertake these placements they have a valuable opportunity to observe the outstanding skills of multi-disciplinary teams in a community setting and they are able to contribute to the work of the agency,” Associate Professor Bullock said.

“Understanding the nature of this work, and empathising with it, stands students in good stead on their path to becoming effective healthcare professionals. They come to recognise that these agencies offer valuable services to which they can refer their patients.”

So when an opportunity arose to help these agencies, which all too often deliver their services on tight budgets, the School of Rural Health Churchill was eager to take advantage of it.

Upon the conclusion of a former laptop loan scheme for students, more than 100 laptops have been returned to the School of Rural Health since 2013. Keen to see the HP Elitebook devices put to good use, School of Rural Health Churchill re-imaged them and donated them to multiple Community Based Practice agencies.

The laptops, the final 45 of which were distributed in recent weeks, have been welcomed by agencies including Moe Lifeskills, the George Gray Centre in Maffra, Headway, Quantum, the Heyfield Resource Centre, Baringa School, Cooinda Hill, the Latrobe Special Development School, the South Gippsland Specialist School and some of Gippsland’s councils.

Moe Lifeskills Community Centre Chief Executive Officer Dr Carole Broxham said it was well documented that computer technology and the internet had a “tremendous potential to broaden the lives and increase the independence of people with disabilities.”

Dr Boxham said it was unfortunate that those benefits were “a long way off being realised for some people”, with statistics showing access to a computer at home, and to the internet, was lower for people with disabilities that for the general population.

“The donation of laptops from the School of the Rural Health helps us to address this issue,” she said. “We provide computer training to learners with disabilities and this has meant we are now in a position to loan laptops to students to use at home…this supports them to achieve their learning outcomes and increase their skills and confidence.”

Baringa School Whole School Coordinator Ann-Marie Ernst said the three laptops her school had received were being used to support students’ learning in the classroom and made it easier for staff to support students with fine motor skills to complete tasks.

Cooinda Hill Manager, Support Services Rebecca Massaro said the donation to her service, which provides support to adults living with a disability, had provided clients with “greater access to technology on the move”.

Sale Specialist School Principal Shelagh Donegan said the donated laptops were a “welcome and valuable asset” to the students at her school.

“Some students are experienced users while others are just learning how to access and use computers but these laptops are in good condition, run well and are able to run software specifically for special needs students,” she said.

Ms Doneghan said the extra had also simplified access for students in wheelchairs as they could now use a computer at any desk in the class room.

Headway Gippsland Inc General Manager Jenelle Henry said the laptops were being used to help Headway’s client group develop their social media and internet skills, with the assistance of a program co-ordinator, as part of its social and recreational programs.

Monday, 13 July 2015

Rural nursing students receive study bursary

Study help: nursing students (left to right at front) Rhianan Bale, Gabrielle Miller and Mieke Polman-Short with members of the McArdle family and staff of the School of Rural Health

Three Monash University nursing students from West Gippsland have received the Tim McArdle memorial bursary to support their studies.

The bursary was set up after Dr McArdle, a highly respected local GP in the West Gippsland region, was killed in a cycling accident near Warragul in 2002. A graduate of Monash, Dr McArdle also taught and mentored local medical students over many years.

Following Dr McArdle’s tragic death, a bursary fund was established in an effort to honour the GP’s outstanding contribution to the Gippsland community. It is administered by a local committee, including School of Rural Health (SRH) Latrobe Valley & West Gippsland Director, Associate Professor Dr Joseph Tam, in conjunction with the Monash University Medical Fund.

The 2015 bursary recipients, Gabrielle Miller of Crossover, Mieke Polman-Short of Mountain View and Rhiannan Bale of Warragul, received $3000 each. Mieke and Gabrielle are studying Bachelor of Nursing, while Rhiannon is studying Bachelor of Nursing and Midwifery.

The bursaries were presented at a recent ceremony attended by members of the McArdle family and representatives of the Monash SRH Latrobe Valley & West Gippsland.

Dr Cathy Haig, Deputy Director of the SRH Latrobe Valley & West Gippsland, told the audience that the bursary was “a tremendous legacy to a doctor who was held in such high esteem”.

Commenting on the strong relationship the university has with Gippsland, Dr Haigh outlined the work of the SRH clinical schools at Latrobe Regional Hospital in Traralgon and West Gippsland Hospital in Warragul. She said students trained at the hospitals as well as being placed at local medical practices including the West Gippsland Medical Centre, where Dr McArdle practised.

“It is hoped some of these Undergraduate students will continue to return to Gippsland after graduating,” she said.

Tuesday, 7 July 2015

Mental Health Vacation School offers “light bulb” moments

If past experiences are any guide, there will be plenty of ‘light bulb’ moments for nursing and allied health students next week as a group of twelve, from outside this region, take part in Monash University’s Gippsland Mental Health Vacation School (13-17 July).

The unique program, which evolved from the Monash School of Rural Health’s Department of Rural and Indigenous Health, is underpinned by a commitment to increasing the numbers of mental health professionals in Gippsland. Over the period of a week it introduces third and fourth year students – from nursing, psychology, social work, occupational therapy and speech pathology – to employment opportunities and professional work being undertaken in the region, and promotes the benefits of living and working locally.



The vacation school – which commenced in 2010 - is the product of a fruitful partnership between the SRH Department of Rural and Indigenous Health and Gippsland’s mental health service providers.

SRH Lecturer Keith Sutton said students from a range of institutions including Monash, the Universities of Melbourne and New England, Deakin and Swinburne, would spend the week visiting numerous Gippsland services which “all fall under the umbrella of behavioural health services” but vary in their nature.

“Services the students will visit include clinical and non-clinical organisations, alcohol and drug services and organisations such as Headspace and the Gippsland Centre Against Sexual Assault,” Mr Sutton said.

“We enjoy fantastic support from over 18 Gippsland organisations and when we approached them to be involved again this year, they all said yes.”

The program is the only one of its kind in Australia and, at its core, seeks to redress the imbalance in the proportion of mental health professionals working in rural and remote areas compared with metropolitan areas.

“The approach which has generally been relied upon is having students undertake placements in rural and regional areas but we know that there are low numbers of allied health workers taking up these opportunities so we developed a clear strategy around focusing on a short period of time and minimising the costs for students to participate, while also building in some social events and local outings,” Mr Sutton said.

The program aims to add an extra dimension to students’ existing courses and is careful to avoid duplication.

The testimonies of past participants, coupled with early indications from a longitudinal research program tracking students after their time in the program, suggest SRH Department of Rural and Indigenous Health is on the right track.
Former participant Matthew Jackman said his vacation school experience had been “inspiring” and shown him “there are great opportunities for innovation and creativity within a rural context”.

Firdous said she appreciated “exposure to the cross-cultural aspect” of the program, particularly the opportunity to visit Indigenous organisations and “watch them working on the ground.”

Rachael Humphries found her time in Gippsland “really helpful to experience how it would be to adjust to rural life.”

A critical component of the Gippsland Mental Health Vacation School is the continued connections SRH maintains with participants, usually through social media processes.

“We continue to feed these students information about employment opportunities in the region and other things that are happening in the field,” Mr Sutton said.

Research on the program’s longer-term impact is in its early stages but Mr Sutton said “we do know that exposure to the program, regardless of the student’s background – whether it is rural or metropolitan – has a positive effect on their perceptions of working rurally and of rural mental health work.”

The program has been inundated with applications this year and, in response, SRH will offer another intake over the summer months.

Wednesday, 1 July 2015

Study to identify what helps rural mothers manage mental health difficulties

A Monash University study is looking for participants to find out what factors contribute to helping rural women with children manage mental health difficulties and get better.

Warrnambool-based researcher and social worker, Rochelle Hine, said that the study aims to contribute to changes in support services so they harness successful factors.

“Parenting is a tough job for anyone, especially if you’ve experienced mental health difficulties as well,” said Ms Hine.

“Nearly one in four Victorian children live with a parent who has experienced mental health difficulties.

“And, while women in rural areas can face particular challenges, they may also have strong social connections that help them manage.

“We’d like to hear from mothers in the Warrnambool and Ballarat districts about what has helped them manage mental health difficulties whether that’s personal strategies or social networks and connections.”

Ms Hine hopes that the outcome of the study will be changes in mental health and community services to support factors shown to be effective.

“If we can identify the strategies and social support mechanisms that women use to manage mental health difficulties and their parenting role, community and family services can promote those factors to support women to get better,” said Ms Hines.

A social worker with many years’ experience in the mental health field, and a mother of four herself, Ms Hines has a keen interest in research that will have practical outcomes for women, especially those in rural areas.

“I have lived and worked in the Warrnambool region for the past 15 years, so I’m aware of the challenges facing both women and support services in that setting.

“I hope women with children will share their experiences so other women in similar situations will benefit from what we learn,” said Ms Hines.

The confidentiality of participants is guaranteed and no identifiable information will be published. A small thanks in the form of a shopping voucher will be given to all participants.

Women interested in participating can contact Rochelle Hine on 5565 8043 or rhhin1@student.monash.edu

Tuesday, 23 June 2015

Gippsland Aboriginal students check out health careers

Two students learning about careers in the health sector at Just Looking@Careers in Health
A group of eleven local Aboriginal secondary school students recently spent time learning about possible careers in the health sector as part of a long and established relationship between the Monash School of Rural Health (SRH) East & South Gippsland and the Centre of Excellence for Aboriginal Health in East Gippsland (CEAHEG).

SRH East & South Gippsland Director Dr David Campbell said the program, known as Just Looking@Careers in Health, mostly involves local year eight and nine students and aims to encourage young Aboriginal students to consider jobs in the health profession.

The sessions, which have now run on three occasions through a partnership with CEAHEG and Monash SRH, will be held eight times every year. They see CEAHEG and Monash SRH work with schools in local towns and involve Bairnsdale Regional Health Service staffers, who talk about their roles and help to ‘demystify’ their professions.

School of Rural Health staff and Monash medical and nursing students also show the school students around the School of Rural Health's skills laboratory, which is the site of a range of simulation activities for students, health educators and service providers across the region.

The Smith Family has also been actively involved in the sessions.

 Dr Campbell said the student events, which offer an important opportunity for connection between local Aboriginal students and health professionals, also form a critical part of SRH East & South Gippsland’s support for the CEAHEG.

SRH East & South Gippsland has been working with the local Aboriginal community over past years, to help expand the Aboriginal health professional workforce through CEAHEG. Dr Campbell and Dr Jane Greacen have contributed to research to understand the barriers and issues faced by local Aboriginal families and students in completing school, attending university and pursuing health careers.

Research outcomes were discussed at a major CEAHEG conference held in Bairnsdale last year. The conference was attended by local Elders and other members of the East Gippsland Aboriginal community, health service representatives, local health practitioners, university academics, secondary school representatives and members of local, state and federal government.

Dr Campbell said SRH East & South Gippsland’s work with CEAHEG had enjoyed some local successes with two local Aboriginal students commencing paramedic training, supported by Ambulance Victoria, and other allied health personnel recruited to Bairnsdale Regional Health Service from the Aboriginal community.

Drs Campbell and Greacen have also worked to improve the educational experience of Monash medical students on clinical placements by establishing tutorials on local Aboriginal culture and health.

Elder Doris Paton, who is Chairperson of CEAHEG, Bonnie O’Shanassy who is the Koorie Hospital Liaison Officer, and Dr Jane Greacen who works as a GP at GEGAC, deliver these tutorials at the SRH Bairnsdale site.

“The SRH East & South Gippsland footprint covers many Aboriginal communities,” Dr Campbell said. “We understand the importance of engaging with these communities in a local and meaningful way; designing and delivering Aboriginal curriculum and working in partnership with local health professionals to increase employment prospects for Aboriginal people in this sector – that is the most effective way to improve the health of the East Gippsland Aboriginal community.”

Friday, 5 June 2015

Culturally-sensitive model identifies health issues early

A health model to identify and treat mental illness in Aboriginal men will be the focus of an Australia-wide webinar on 18 June 2-3 pm as part of national Men’s Health Week. (Register for details on how to join the webinar.)

Mental disorders are the second leading cause of disease burden in Indigenous communities after cardiovascular disease.

 Monash University School of Rural Health researcher and lecturer, Dr Anton Isaacs, hopes the webinar presentation will lead to other regional and rural communities trialling, and eventually implementing, the model.


Community-led health check

Mental health services and local Aboriginal Elders, who support the health model, will participate in the webinar. These include local Elder and police liaison officer Laurie Marks; local Elder Rex Solomon who works with the Victorian Department of Education; local Elder Cliff Wandin, who is highly regarded in his community; Berwyn Lampitt, a senior mental health nurse at Latrobe Regional Hospital; and Dr Isaacs.

 Dr Isaacs, who is based at Monash University Department of Rural and Indigenous Health (MUDRIH) in Moe, has been instrumental in the design and set up of mental health services for rural and regional people who are medically under-served. Aboriginal people form a large part of this cohort.

Alarming health statistics

It is the alarming mental health statistics in his area of Gippsland, Victoria - and across Australia more broadly – which have inspired Dr Isaacs’ work.

 “Many indigenous people don’t know they have a mental health problem and if they do, they find it difficult to talk about it,” he said.

 “This may lead them to attempt suicide or become involved in crime.

 “Very few Aboriginal men go directly to a mental health service for help; it’s usually via the judicial system.”

 Dr Isaacs spent several years working within his local Aboriginal community until he became a “trusted friend”.

The vital role of Elders

He soon observed that Indigenous men find a closed, sterile environment unsettling; they prefer to sit outside to have “a yarn”; they experience significant gender issues discussing sensitive problems with women; and any meeting place must be culturally appropriate.

 Dr Isaacs put a proposal to the local Elders to host a Koori Men’s Health Day which sought to overcome some of these barriers. He knew the model needed to be sustainable and acceptable to the Aboriginal community and, critically, men needed to come.

Most importantly, the model provided a way for the Aboriginal community to take ownership of it.

According to Dr Isaacs, that’s where the Elders played a vital role, suggesting a local community hall as the setting for the day. Aboriginal men were invited along for a “yarn” and a barbecue, and in the process, would undergo health checks. He said attendance was beyond his expectations.

“The health check was constructed in such a way that there was no mention of the word ‘mental’ so the whole issue of stigma was removed as a barrier to seeking help,” Dr Isaacs said.

Assembly line technique

The model adopted an assembly line technique. A medical examination was undertaken at the first station, a blood test at the second and finally, a mental health screening at the third.

The mental health screening was undertaken by the mental health triage team from the local mental health services whose members were all culturally competent.

“Having the Elders there made it much easier,” Dr Isaacs added. “While some men had the health check, others were chatting together and listening to several health-based presentations.

“If anyone was picked up at any of these stations as needing further medical treatment, they were referred to their general practitioner.

 “If there was a mental health problem evident, the triage team offered further follow-up in the mainstream service, where someone would be waiting to help them when they arrived, so they were meeting with people they already knew.”

A model that can be replicated

Dr Isaacs is confident if these health days can be repeated regularly, they offer an effective opportunity to identify not only psychological but also medical problems among Aboriginal men at a much higher rate than what is currently being achieved.

To date, two Koorie Men’s Health Days have been held with the second day being run by the Aboriginal community and supported by Dr Isaacs. “The Aboriginal community is very happy with this model and is currently exploring ways and means to run it on a regular basis.”

Friday, 22 May 2015

Gippsland simulation training open for viewing

Simulation learning facilities are opening their doors to the Gippsland community in May.

Simulated learning facilities for health professionals and students in the Gippsland region will open their doors in May.

Simulation facilities at the Monash University Department of Rural and Indigneous Health (MUDRIH), Latrobe Community Health Service and Latrobe Regional Hospital will conduct open days on 25 and 26 May. The Gippsland Simulation Showcase will welcome service clubs, secondary schools, training providers, Ambulance Victoria and local councils and businesses to demonstrate the advantages ‘simulation’ has to offer more broadly in the community.

“We want to continue the expansion of simulation learning,” Dr Waller said. “These sorts of activities can be adapted for any organisation, whether it is in human resources, occupational health and safety, aged care….the method can be applied widely.”

The powerful learning tool is finding favour with students and health professionals across Gippsland and has recently had its Commonwealth Government funding extended.

Pioneered by Monash School of Rural Health, Extended Gippsland Regional Interprofessional Partnership in Simulation (EGRIPS) has expanded across the region in recent years, seeing a range of services and organisations partner to deliver multiple facilitated clinics for the benefit of students and existing health professionals.

School of Rural Health Senior Lecturer, Dr Susan Waller, who is based at Monash University Department of Rural and Indigenous Health (MUDRIH) in Moe, currently works as project manager on EGRIPS project.

Dr Waller welcomed a recent announcement that EGRIPS would continue to receive funding support until the end of the year and will be collaborating with partners, Ramahyuck, Bass Coast Health, Central Gippsland Health Service, West Gippsland Health Group and Gippsland Lakes Community Health to ensure the sustainability of simulation resources into the future.

The benefits of simulated learning environments are now well documented and Dr Waller said ongoing support from Gippsland’s communities would be critical to seeing the model adopted widely.

“EGRIPS provides a great example of health sector interprofessional collaboration,” she said. “Clinical experiences are created in simulated scenarios to enable students to learn in a ‘safer’ environment, with the benefit of feedback from other students and clinicians who observe the activity.”

Dr Waller explained that EGIPS was an extended version of GRIPS, a program developed by Monash School of Rural Health and delivered for students on placement at Latrobe Community Health Service locations.

Simulated actors play the role of a ‘patient’ portraying presentations based on real-life cases and students or professionals then use a structured, holistic tool to interview those patients and develop collaborative plans for their care, according to Dr Waller.

At the conclusion of the assessment, the actors ‘de-role’ and provide feedback about how they felt during the activity. “The simulated actor is respected as a teacher,” she added. “Some of the most powerful learnings come from the ‘patients’ and they support the development of a reflective health practitioner.”

Other professionals and students are able to observe the interview ‘live’ – as it is conducted in a ‘sim-ready’ consulting room - then provide feedback

Interprofessional workshops are also held regularly at Latrobe Community Health Service, supported by the School of Rural Health. The workshops aim to broaden each student’s understanding of the role of their colleagues and explore ways to how work together within the ‘social model of health’.

 “The value of the community health experience to a person’s quality of life is better understood as students work on case studies together and share their experiences in collaborative activities,” Dr Waller said.

Open day details

Gippsland Simulation Showcase
Latrobe Regional Hospital, Monday 25 May 2015, 9.00am-10.00am and 10.30am-11.30am
Latrobe Community Health Service Moe, Tuesday 26 May 2015, 2.00pm-4:30 pm

For further information contact Dr Susan Waller 0410 505 299

Wednesday, 13 May 2015

Latrobe Valley team supports global health project

Helen Chambers (left) and Dr Hanan Khalil (right) based in Mode, operate one of 72 global research nodes. (Image courtesy Latrobe Valley Express)

Medical professionals across the world searching for answers about the management of chronic diseases are being supported by a research project in the Latrobe Valley.

The Centre for Chronic Disease Management is a collaboration between Monash University’s School of Rural health, School of Nursing and Midwifery, Latrobe Regional Hospital and Latrobe Community Health Service.

The centre scours the globe for the best available research and makes it available to clinicians who subscribe to the Joanna Briggs Institute, an international research and development facility through the University of Adelaide.

JBI has about 100,000 health care subscribers globally and the Moe-based centre is one of 72 JBI research nodes across the world.

The centre’s director, Dr Hanan Khalis, said the project’s objective was to improve patient care by educating clinicians.

Its efforts so far have been recognised by three international awards.

“It’s about bringing together all the research on a topic so clinicians have a better understand of how to help a patient. We take the best evidence that’s out there, critically appraise it and summarise the information. It then goes through a peer review process and is uploaded to the internet as an evidence summary resource for clinicians worldwide,” Dr Khalil said.

“If a clinician is presented with a question from a patient, such as whether vitamin B12 will help a diabetic with nerve pain, they can access this resource tool and find the answer.”

“If a clinician is presented with a question from a patient, such as whether vitamin B12 will help a diabetic with nerve pain, they can access this resource tool and find the answer.”

The centre has completed 150 evidence summaries with another 30 in the pipeline.  Some look at the impact of alcohol on conditions like asthma or depression, or how smoking affects respiratory conditions and mental illnesses.

Thirty one ‘recommended practices’, which instruct clinicians on how to treat a patient with a particular condition, are also available.

“We know there is a huge burden of chronic disease in Gippsland, especially in rural areas where people may not have access to specialist health professionals.  We believe that by targeting chronic disease, we may be able to help clinicians provide a greater level of care in this region and elsewhere,” Dr Khalil said.

Statistics from the National Heart, Lung and Blood Institute in the United States show chronic diseases such as diabetes, stroke, cancer and heart disease account for about 60 per cent of all deaths globally, with more than three quarters of these deaths occurring in low and middle-income countries.

One of the growth areas in the management of chronic diseases is in the use of over-the-counter complementary medicines or vitamins by patients looking for relief or an alternative to the side effects of traditional medicines.

Clinicians have been left to grapple with issues like whether the vitamin is safe or whether it has done anything at all to improve the patient’s health.

However, there are challenges in ensuring the evidence that has been gathered is of interest and relevant to clinicians across the world.

Helen Chambers who is a project officer for JBI and a research officer with the Monash University Department of Rural and Indigenous Health, said the evidence summaries and the recommended practices had to take into account the limitations faced by clinicians in other countries.

“We need to be aware that we may have been looking at studies from Western countries and the evidence summaries are being read by people from third-world countries where they may not have the resources to try a particular medical intervention,” she said.

“So we acknowledge in the summary that we have presented the best available evidence but it might not be suitable if there is a lack of resources.”

The evidence summaries are updated each year as further information is sourced and research uncovers new findings.

The Centre for Chronic Disease Management has recently had a paper accepted for publication in the prestigious international journal, ‘Worldviews on Evidence-Based Nursing’.

Dr Khalil is also the editor-in-chief and Helen Chambers the managing editor of another highly regarded publication, the International Journal of Evidence-Based Healthcare.

Originally published in the Latrobe Valley Express 11 May 2015

Student raises funds for new Swan Hill hospice



Laura Nield is a Monash Year 4 ERC student who is currently placed in Swan Hill.

Laura is running a half marathon this year – she has signed up for the Run Melbourne half marathon in July, with the intention of running to help raise funds for the Swan Hill hospice fund.

As Swan Hill District Health currently does not offer any hospice options for its patients, the money raised from fundraising will go towards the development of a hospice in the town. Currently $30,000 has been raised, with a target of $100,000.

If you are interested in donating to this worthwhile cause, please visit Laura’s fundraising page.

Tuesday, 28 April 2015

Career switch proves positive for local doctor

Career change: Michael Abbott moved from pharmacy to a career in medicine .
As a young pharmacist Michael Abbott moved from Melbourne in 2008 to take up a position with Latrobe Regional Hospital (LRH) in Traralgon. At the time, a career switch was not on his agenda.
Fast forward seven years however and Michael has recently returned to LRH but, following four years of study through Monash University, including at the School of Rural Health’s clinical training sites in Gippsland, he is now a medical intern with plans to practice as a rural GP.

Monash SRH operates multiple sites across rural and regional Victoria, including Churchill and Latrobe Valley & West Gippsland, and focuses on providing a high quality education experience for Monash medical students in order to develop a sustainable rural health workforce.

While working locally as a pharmacist Dr Abbott became aware of the possibility of entering Year A of the Monash graduate entry Bachelor of Medicine/Bachelor of Surgery (MBBS) program, based at Churchill. The prospect of training to become a doctor while continuing to live in Traralgon, and the opportunity for multiple rural placements, appealed to the former Melbournian.

Soon Dr Abbott found himself among a cohort of fellow graduate students from a diversity of backgrounds embarking on a pathway to medical practice.

“I had decided I wanted a change and I saw medicine as a way of becoming more involved in patient care in a different way and with slightly different responsibilities,” he said.

Dr Abbott’s four years with Monash offered various study and clinical practice experiences across Gippsland, from general medicine and surgery at LRH to women’s health, psychiatry and GP practice in Traralgon and Moe followed by placements in Warragul and Heyfield as well as stints in anesthetics and emergency in Melbourne during his final year.

“Throughout this time I felt well supported and I enjoyed the many opportunities for practical, hands-on experience that are possible through a rural school, in a smaller environment and where you are working with many of the same staff and teachers who you get to know,” Dr Abbott said. “I think when you are training in Melbourne you are a lot more in the background.”

As a trainee intern Dr Abbott has joined a number of other Monash medical graduates (who had undertaken rural clinical placements) choosing to stay local.

Dr Abbott’s intern year is structured as a series of ten week clinical rotations in surgery, general medicine, emergency and anaesthetics, all at LRH, as well as another rotation in general medicine in Sale.

Next year he hopes to start rural generalist GP training with a view to staying in the Latrobe Valley, working as a rural GP and potentially specialising in hospital anesthetics.

Although his professional hours are long, demanding and often hectic, Dr Abbott said he was embracing the work.

“I just really enjoy working in rural communities,” he said. “I think the work is more diverse and I like small communities, working with smaller teams and getting to know people.”

Monday, 23 February 2015

Flying start to a final year

Monash medical student, Julia Buras discovered remote health first-hand during her placement
with the Royal Flying Doctor Service

NOT so long ago Julia Buras was a Trafalgar High School student hoping to secure a university place after year 12.  Now a fifth year medical student with the Monash School of Rural Health, the Gippslander is close to becoming a doctor and she has recently spent a fortnight with the Royal Flying Doctor Service (RFDS) Western Operations.

From the Jandakot base south of Perth in Western Australia, Julia accompanied medical teams flying to airports servicing remote areas. The teams provided levels of care from stable patient transfer to critical care in the aircraft.

This year Julia, in her final year with Monash SRH, will be largely based at Latrobe Regional Hospital in Victoria, but will rotate through Melbourne and other rural Victorian areas. Julia organised the RFDS placement herself, seizing an opportunity to broaden her experience and learning opportunities.

Among the many highlights of her time in WA was the “privilege of working with some really amazing doctors, nursing staff and pilots”.

“The end result of the actual flight is the combination of effort from many people including medical officers, nurses, pilots and administrative and co-ordination centre workers,” she said.

“Together they ensure there is an aircraft available, it is equipped with everything that may be needed, it is staffed appropriately, they consider the crew’s flying hours and the weather and ensure the altitudes being travelled are appropriate for the patient’s condition.

“There are so many factors to consider because the crew needs to be completely self-sufficient when caring for the patient.  It was fantastic to watch these teams in action.”

Julia’s experience was often supplemented with geography ‘tutorials’ to provide a context for the flight logistics planning and journey.

 “I had firsthand experience of seeing not only how finite resources impact upon remote health outcomes, but also of how vast Australia is,” she said.

 “For me it was important to have a visual concept of the distances between locations, so I had a close look at the maps of WA, which helped me to appreciate the time and effort that goes into providing this service.

“The RFDS provides services to one third of Australia and the system differs depending on the state they are operating in.  There are so many sparsely populated communities in WA, many without medical care and some without good road access. The RFDS is critical to reducing the time taken for a patient to receive urgent medical attention.”

It was a steep learning curve for the Gippsland student in the first days of her placement. “During one handover a doctor was telling me about a patient who had presented at the Hollywood Hospital and who had come in from Denmark, so I thought the patient had been in three countries,” she laughed. “But Hollywood and Denmark are actually two locations within about a 400 kilometre radius of Perth...so that was truly a ‘local’ geography lesson for me.”

Reflecting on her placement, Julia said “I was made to feel part of the team, there was a lot to learn and the clinicians were always happy to provide in-flight tutorials on a topic.”

Julia encouraged other students to pursue their interests through placements a little out of the ordinary.

“I found my placement to be absolutely amazing.  I know a placement with RFDS may not be for everyone, but it is great to follow what you enjoy and explore it further.”