Remote Placements Research Articles

Living and working with the people of ‘the bush’: A foundation for rural and remote clinical placements in undergraduate medical education

Background: The Australian Government's policies and programmes to redress the medical workforce shortage in rural and remote areas focus on recruitment of rural students and provision of rural clinical placements. The University of Notre Dame's Rural and Remote Health Placement Programme (RRHPP) uses an additional approach to address this issue.Aim: This article describes the RRHPP undertaken by all medical students in the first 2-years of their course and examines the educational worth of this approach.Method: Data were obtained from curricular documents, publications about the RRHPP and evaluation questionnaires administered to students and supervisors.Results: The RRHPP provides students with opportunities to develop a patient- and community-centred perspective on the health issues of rural and remote populations by having them live and work with people in these areas prior to clinical placements. It is based on sound educational principles and underpinned by participation of rural/remote communities as experts and equal teaching partners. The RRHPP is valued and perceived by a majority of students and placement hosts as a useful strategy to develop medical students’ understanding of the rural/remote community context and its impact on health.Conclusion: This community participatory approach benefits medical students and rural/remote communities.

A taste of rural Highlands and Islands general practice: evaluation of remote placements in GP specialty training

Despite being home to the most remote GP practices in the UK, the Highlands and Islands GPST programme offers its trainees limited opportunity to gain experience in remote general practice. In an attempt to remedy this situation, a pilot of short remote placements was carried out in spring/summer 2010. The aims of the pilot were to assess the placements' feasibility including level of interest from GPSTs and remote GPs; evaluate the perceived benefits to GPSTs and their hosts; and consider the impact such placements might have on recruitment to remote and rural general practice. Following the placements, semi-structured interviews were conducted with participating GPSTs and host GPs. In addition, written statements were collated from interested GPSTs prior to their placement indicating why they wished to take part. Parties who had expressed an interest but for whom a placement did not take place were asked to complete a follow-up questionnaire. Placements were highly valued by both GPSTs and their host GPs. In particular, the GPSTs valued being able to 'put themselves in the shoes of a remote GP' and being able to discuss potential career pathways with a remote practitioner. The participating GPSTs all had pre-existing interests in a career in remote and rural general practice, but found this was reinforced by their remote placement experience. Sufficient host GPs were identified to accommodate all of the interested GPSTs and placements were successfully organised despite a limited budget. Difficulties obtaining study leave did hinder some GPSTs, and this consideration along with resource limitations are potential barriers to the scheme being continued in the future. Remote placements are valued by GPSTs considering a career in remote and rural general practice and tend to reinforce their interest in this area. However, it is unknown whether this will impact on recruitment. Inviting GPSTs from outwith the North of Scotland to experience a remote placement might allow them an insight into remote and rural general practice that is not possible from their host deanery. The benefits of a remote placement to GPSTs without a pre-existing interest in remote and rural general practice have not been assessed.

Remote maintenance and fault analysis system for custom-made machine

AbstractIn the special machines and custom made machine industry, machine manufacturers have to deal with maintenance services in spread market, while individualization of customer demands increases complexity to maintenance services. That is the case in stone cutting machines manufacturing business, where maintenance is a critical factor because of the high customization of each machine and because of the variety and difference of the working conditions for similar machines. Stone mechanic characteristics or saw blade tool behaviour affect the process performance, which sometimes becomes a maintenance issue. Other factors as machines remote placements as well as user technology skills have to be taken into account. Remote maintenance based on remote monitoring and analysis and on realistic simulation helps in avoiding cost and frequent “local” maintenance services in this industry. However, both have to be as much realistic as possible to be able of getting useful information. The paper presents a control-monitoring-simulation architecture built around the use of “custom-made” machines models working with the actual “custom-made” control system. The paper describes how, with this architecture, efficient analysis and machine intervention may be achieved for stone cutting saw blade machines.

Short‐stay rural and remote placements in dental education, an effective model for rural exposure: A review of eight‐year experience in Western Australia

The increase in demand for dental care over the next 10 years is expected to outstrip the supply of dental visits in Australia, resulting in an ongoing shortage of dental practitioners. As trends in medicine have shown, the greatest effect will be felt in rural and remote regions, where an undersupply of dentists already exists. It is clearly evident that it is important to provide strategies that will increase the recruitment and retention of practitioners in rural and remote areas. Previous research suggested an increased likelihood for health graduates to choose rural practice if they have a rural background, or were exposed to rural practice during their education. Short-stay (three to four weeks) placements for final-year dental students has been part of dental education in Western Australia for near on a decade. This paper reflects on the experiences gained from managing this placement program. Short-stay placements are a quality learning initiative but need a high level of planning and a clear vision to be effective. The key factors in ensuring sustainable, student centred learning is driven through a small core group of staff who have strong direct links with rural and remote communities, students and support providers. The integration of service, education and research goals have played a critical role in sustaining placements. The philosophy underpinning the rural placements needs to be clearly articulated and applied effectively in each step of their implementation and a highly focused customer-service driven implementation is required to make short-stay rural and remote placements effective.

International Nursing Student Exchange: Rural and Remote Clinical Experiences in Australia

ABSTRACT A rural and remote international clinical exchange permits the senior nursing student to experience another culture and to develop a feel for daily life and nursing practice abroad. In a student exchange between Australia and Canada, similarities exist with regard to life and work for nurses who live in these developed countries. Similarities extend to a growing population base of original inhabitants or indigenous peoples with complex health challenges. Differences, however, are also apparent in rural and remote health care delivery due to the uniqueness of each country's demographics, nursing programs, nursing culture, and health care systems. In the rural hospitals of the Riverland region, South Australia, the Australian public and private health care systems are witnessed working side by side. Aboriginal health care with its unique cultural care practices was experienced in the remote Aboriginal community of Hermannsburg in the Northern Territory, and in the district hospital in Alice Springs. The international exchange provided the opportunity to reflect on the impact of the social determinants of health, and the similarities and differences between developed countries in nursing practice and nursing culture. The sense of community and autonomy gained in rural and remote placements in Australia provided incentive for nursing students to consider this area of practice on their return to Canada.

Machine model-based remote maintenance and fault analysis system for custom-made CNC machines

In stone cutting machines manufacturing business, maintenance is a critical factor because of the high customisation of each machine and because of the variety and difference of the working conditions for similar machines. Stone mechanic characteristics or saw blade tool behaviour affect the process performance. Machines remote placements and user technology skills have to be also taken into account. Remote maintenance based on remote monitoring and analysis with realistic simulation helps in avoiding cost and frequent 'local' maintenance services. The paper presents a control-monitoring-simulation architecture built around the use of 'custom-made' machines models working with the actual 'custom-made' control system. [Received 18 March 2009; Revised 22 July 2009; Accepted 1 August 2009]

Factors That Influence Asynchronous Discourse with Preservice Teachers on a Public, Web-based Forum

This study investigated asynchronous communication factors that influence the discourse of preservice science teachers on a non-restrictive, public Web-based forum. Salient elements that promoted discourse among the participants included the level of interest in a topic, the immediate relevancy of a topic to a participant at a particular time, and interpersonal factors among participants. Limitations using asynchronous communication perceived by preservice teachers included receiving feedback too late to be of use and issues pertaining to the absence of visual cues during discourse exchanges. The linear, temporal interface of the Web-based forum appeared to be a factor that limited the depth of the discussion.Telecommunication networks are transforming higher education. Recent developments in computer telecommunications technology have emerged as a means for providing support to beginning teachers. University teacher educators can continue to provide preservice teacher training with electronic networks when students are at remote student teaching placements. A fundamental advantage of computer networking is the flexibility it offers. Geographical and time constraints are overcome because messages can be sent at any time of the day and from any place. Electronic communication can provide a communication bridge that increases the frequency of interactions among student teachers and university personnel (Thomas, Clift, & Sugimoto, 1996). The fact that the network is available 24 hours a day is a strength only this technology can offer. In addition, combining the network with good on-site support greatly improves the quality of supervision in teacher training (Casey & Vogt, 1994).As Web-based learning tools proliferate in higher education settings, there is a need for focused research on how such technology augments and redefines academic learning environments (Koschmann, Myers, Feltovitch, & Barrows, 1994). Because the Web is accessible to preservice teachers at home, at the university, and in their student teaching placements, it is important that research be conducted to evaluate the impact of preservice teachers’ use of Web-based forums, as well as their perceptions of dialoguing with the aid of this new technology tool.