Wednesday, 27 July 2016

Soccer connects student to community

Champion links: Rachael Shirlow (right) found it easy to immerse herself in the local community, especially once she joined the local soccer team.
Monash medical student and soccer enthusiast Rachael Shirlow had established herself in Melbourne after moving from NSW to complete her first three years of study when she found out she was headed for year-long rural placement in Gippsland.

While she was not opposed to the news Rachael said she hadn't opted for a rural placement so the ‘random allocation’ was somewhat unexpected.

"This will work for me"

Despite some trepidation, it took just a few short weeks for the young student to realise “this was going to work for me”. While she had spent her initial years studying medicine in Melbourne, Rachael is a country girl and she found herself quickly immersed in the Leongatha community, both in and out of the workplace.

“What really contributed to the ease of the transition for me was the Monash Rural Health group in South Gippsland,” she said. “It is so organised, the tutors were so friendly and the orientation was very welcoming and relaxed so the nine of us students who were placed in South Gippsland, between Leongatha, Foster and Wonthaggi, were able to quickly get to know one another.”

Rachael shared a Leongatha house with some of her fellow students and between them they rotated through a series of GP placements across the region as well as shorter ‘intensives’ in the areas of community psychiatry, women's health and paediatrics.

Sporting links

She soon found herself connected in more ways than one after she joined the local soccer team, Leongatha Knights, which went on to win the South Gippsland League grand-final. “I found that I made friends so easily in this environment, I have even attended the wedding of one of my friends from the club since then,” she said.

Rachael relished the opportunity to return to the sport she loves. “I had played soccer right through my schooling years but in the first years of medical studies in Melbourne I found I had to take a break,” she said.

The simplicity of country life lent itself to a better balance. “It's so much easier to get around than in the city, so that leaves more time for sleep, study and leisure – a lot of students can get quite anxious by the fourth year of this course but being in a rural area gives you an opportunity to escape city stressors,” Rachael said.

More opportunities

The advantages were so many that Rachael opted to return to South Gippsland this year for her six-week surgical rotation as a fifth year student. Much of the appeal lay in the level of support she said students experience in a smaller environment, and the extra opportunities for practical experience.

“We absolutely had more opportunities that our metro-based counterparts,” Rachael said. “The ratio of students to teachers is less so it is actually a lot more engaged and interactive than sitting in a lecture with say 100 people; there is a general feeling of being valued.”

“When I was doing my women’s health round, for example, I could be called at 2am (by the staff) because they knew I wanted to attend and be part of what was happening,” she added.

Returning to a familiar area for her surgical rotation was “a fantastic experience,” Rachael said. “I had gotten to know the GP anaesthetists really well so they would get me to do drips and airways and assist wherever practical; I also gained valuable experience in suturing and they really helped to talk me through things.”

Her experiences in South Gippsland have cemented Rachael’s intention to return to a country area to practice medicine upon graduation. “My main interests lie in general practice and paediatrics but either way I can take either of those specialties to the country and that’s what I intend to do,” she said.

Friday, 22 July 2016

The poetics of illness stories

As a lone qualitative sociologist in a mostly hard science-based, quantitative field of teachers and researchers, the opportunity for Dr Marg Simmons to present her work at a recent conference in Italy was a welcome one.

Based at Monash Rural Health Churchill, Dr Simmons’s current project is focused on collecting stories of illness from survey participants. Her conference presentation offered a voice to these participants through ‘poetic representation’, where she chose to explore some of the responses on illness narratives, in poetic form. “This conference took an interdisciplinary approach to the ‘broken narrative’ which occurs when people become ill and the narrative structure and stability of their life stories are disrupted.”

Transformative: poetry can convey ideas and emotions more powerfully than prose text. (Image Deviant Art.)

Dr Simmons’s presentation also referenced authors whose research on illness refers to the loss of a ‘roadmap’ for a person’s life when illness strikes, the non-discriminatory nature of illness such as cancer, the shock and acceptance around diagnoses, the use of military metaphors to describe illness, the perpetual interruption to life which comes with illness and the gratitude expressed by some people with illness.

A series of poems were constructed and presented by Dr Simmons, each of which sought to capture the stories of her participants. One collective poem, ‘No particular words’ - in response to a survey question about language or words used to describe a participant’s illness – explored the irony of there being many words to describe illness yet often no words for the suffering.

Dr Simmons said the act of constructing poetic-like representations of her data was “careful and thoughtful transformative work” with the analysis process demanding that she ask herself constantly ‘what is this poem trying to tell me?’ “I think poetry can sometimes convey an idea or emotion more powerfully than text and is certainly very evocative and moving,” she said.

“I hope my research will add to the body of knowledge which can help to translate illness experiences into important stories that highlight the connections and similarities in those stories as well as the challenges and disruptions that illness brings to people’s lived experience, to hopefully make a difference for patients,” she said.

The local researcher also hopes her work will help to better inform health professionals about the use of language around illness.

Dr Simmons’s study is ongoing, with her survey still open to anyone who has an experience of illness, whether they are a patient, carer or professional.

The survey, which takes about 30 minutes to complete, is available online. For more information, contact Dr Marg Simmons by phone  (03) 5122 7527 or email margaret.simmons@monash.edu.

Wednesday, 20 July 2016

Learning to talk with seriously ill patients

A partnership between Monash Rural Health and Gippsland Region Palliative Care Consortium is teaching local medical students critical communication skills for dealing with palliative care patients. The two local organisations have come together in recent years to share the facilitation of annual workshops for Monash University year 4C medical students on GP placement in West and South Gippsland and the Latrobe Valley.

Communication skills: the joint workshops teach students how to communication with patients in palliative care.
Dr Cathy Haigh, Deputy Director and Year 4C Academic Coordinator at MRH Latrobe Valley and West Gippsland, said the partnership between MRH and the GRPCC had been fostered through sharing space alongside one another in cottages on the West Gippsland Hospital grounds. “Then, when funds became available several years ago, the consortium was proactive in initiating the idea of a communication skills workshop for our students and we were very open to the idea,” she said.

The workshops include talks by palliative care experts from Melbourne who inform students about appropriate ways to manage the impacts of palliative care drugs, for example. Another key part of the learning is centred on teaching students to effectively and empathetically manage and respond to patients across a range of scenarios involving the personal and psychological impacts of their situations. Led by local psychologist Dr John Reeves, West Gippsland Palliative Care Consortium nurse Anny Byrne and professional actress Veronica Pocaro, who plays the role of a patient, this component of the workshop is particularly welcomed by students.

Dr Paul Brougham, Head of General Practice with Monash Rural Health Latrobe Valley & West Gippsland, said the workshops were “as much about communication skills as they are about palliative care”.  He said they had been instrumental in helping students to develop critical communication skills in a safe environment. “Within this environment, it doesn’t matter if the students make mistakes because if they don’t do something well they have an opportunity to try again, without causing any offence, and learn from their mistakes. The small group sessions are also an advantage, allowing everyone to participate and to critique and learn from one another,” he said.

Dr Brougham said that patients would be the ultimate beneficiaries of teaching students to convey empathy, speak to them without jargon and consult in a way that encourages them to express themselves. “Although this teaching is done in a palliative care context, it really has the potential to benefit patients and students across all areas of clinical practice - these social and communication skills are so important and yet they are not always taught,” he added.

Student feedback on the program is invariably positive with one student from a recent workshop saying the opportunity had provided “one of the best sessions of the year thus far for me.” Another praised the “underlying principles of hypothesis testing, self-critique and self-improvement” as being “important life and career skills.”  Dr Haigh said the success of consecutive workshops, which cater for a total of around 25 students across three sessions each year, has seen both parties commit to continuing with the arrangement into the future.

Tuesday, 19 July 2016

Reluctant student becomes enthusiastic rural ambassador

When Monash medical student Ben Amberg was allocated a rural placement in Gippsland as part of his studies last year he assumed a mistake had been made.

The Adelaide native who had spent the first two years of his course at Monash University’s Clayton campus, was a city boy who planned on a city placement and was less than enthused to find he was being sent to Traralgon – a town he knew nothing of – for the third year of his medical degree.

Just one year down the track and Ben is back, this time of his own accord, for another year in the Latrobe Valley after discovering the benefits of living and studying in a rural area. And it is not only patients at Latrobe Regional Hospital and local GP clinics who will benefit from having the keen student return.

Winner: Ben Amberg found a niche with the Traralgon football team. (Photo: Latrobe Valley Express)

The talented footballer also made his mark in the local sporting community during 2015, playing in a grand-final winning Traralgon senior football side. He will return to the side this year.

For Ben though, a key benefit to undertaking his local placement, facilitated by Monash Rural Health, emerged to be the learning opportunities offered through being part of a smaller team in a non-metropolitan based hospital.

Describing his initial reluctance to move to a rural area, Ben said “I probably didn’t know too much about it; I had talked to lots of students above me who told me about the great teaching at the Alfred, for example…so I requested a metropolitan placement. Later, when I opened my email to find I’d been allocated a rural placement I thought maybe there had been a mistake,” he said.

After confirmation that he would indeed be heading to the Latrobe Valley for the year, Ben set up house with a friend who had also been placed locally. His first few weeks signalled an “exciting transition” from “two years with our heads in books to suddenly being in a hospital and getting used to ward rotations.”

At the same time Ben, who had been playing football for Monash in Melbourne, was recruited to – and embraced by - the Traralgon Football Club.

“I know it sounds cliché but I really did quickly become part of the community then,” the young student said. “Suddenly I had 25 mates who were helping me out, a whole network of friends and a different social circle.”

This year Ben is relishing the familiarity of his new home town. “It is good to be back at the club, seeing all the familiar faces, and it is good to be back at LRH, with a big year coming up – year four – and different ward experiences to look forward to as well as a GP rotation in Moe.”

Ben’s year at LRH convinced him that, contrary to his earlier assumptions, the opportunities in a smaller setting are diverse and valuable.

“I think being able to do rotations for up to a month with the same team meant we developed good relationships with clinicians, who also gave us tutorials throughout the year…they get to know you and vice versa, then if there is anything they know you are interested in they will offer you opportunities.

“As year three and four students I think our job is to become really familiar with the fundamental type cases such as heart disease, asthma and diabetes – the most common cases we need to become really competent at managing – and I feel the more exposure we can get to those cases the better our skills are going to be and, from my experience, being in a rural experience is the best way to increase that exposure,” he added.

Friday, 15 July 2016

Gippsland health sciences students win bursaries

Two Monash University students from Gippsland are this year’s recipients of the Tim McArdle Memorial Bursary. The bursary is made available each year to students studying health-science degrees at Monash University. It is named in memory of local doctor, Tim McArdle, who was killed while riding his bike in Warragul in 2002.

Haiden Webb from The Gurdies in South Gippsland, a radiography and medical imaging student and Jessica Earl from Drouin in West Gippsland, an emergency health and paramedic student, each received $4000.

The funds for the bursary were raised in community following Dr McArdle’s death and are administered by Monash University while are overseen by a local committee. Committee chair, Cleo Sahhar, said the bursary was an example of something positive coming from a tragedy and praised both young recipients for their commitment to study.

Deputy Director of Monash Rural Health Latrobe Valley & West Gippsland, Dr Cathy Haig, said a photograph of Dr McArdle in the midwifery ward at West Gippsland Hospital was a lasting reminder to young students of his commitment to medicine and the high regard in which he was held in the local community. She said medical students in years two, three and four were placed at the hospital and in local practices to gain clinical learning experiences. “This is a wonderful process which provides them with the education necessary to make them safe and efficient doctors,” Dr Haigh said.

Dr McArdle’s mother, Patricia Wilson, presented the bursaries, congratulating both on their achievements. Haiden told the audience he had gained inspiration from the speeches delivered which had highlighted Dr McArdle’s life and work. “I hope I can better myself as a result of this award,” he said. Jessica was unable to attend because of study commitments however her father, a charge nurse at West Gippsland Hospital, said she was very proud to receive it.

Wednesday, 6 July 2016

Online help for young diabetics

An online system to help prevent young diabetics from “falling through the cracks” has been developed with the help of a Gippsland researcher from Monash Rural Health. The system is designed to encourage better interaction between diabetes educators and Type 1 diabetics aged between 18 and 35.

Avoiding the cracks: co-developer, Bill Haigh, and Monash Rural Health staff member, Cathy Haigh, test the new online tool to help young people manage their diabetes.


According to Simulation Coordinator, Blended Learning and Research at Monash Rural Health, Bill Haigh, young people in this age group are at risk of moving into “denial” about their diabetes. “Many are just coming out of a situation where parents have had control of their health and there is often a great deal of peer pressure,” Mr Haigh said. “This system is designed as a way of helping them understand their illness and recognising the pitfalls.”

Mr Haigh was approached by Deakin University to participate in the joint research project. It basically digitised an existing paper-based theory by Danish researcher Vibeka Hoffman who developed a decision-making and problem solving method called guided self-determination or GSD.

The online system helped the educator and client have a more meaningful dialogue about diabetes, they were both happy and it allowed the educator to engage with an increased number of clients. Diabetes Australia is now seeking funding to have the researchers develop a “train the trainer” online program for Type 1 diabetes.

Mr Haigh presented a poster on the system (PDF 1.6 MB) at this year's ANZAHPE (Australia and New Zealand Association for Health Professional Educators) conference in Perth where it was well received.

For more information, contact Mr Haigh 5122 7231 or bill.haigh@monash.edu