The Dementia Experience: Immersive Simulated Learning

Mrs Kathryn Fitzgerald1, Ms Jodi Ullrich1

1WA Centre For Rural Health, Geraldton, Australia

Abstract:

All rural health professionals work with clients with dementia at some time, and it is one of the key areas where interprofessional practice is critical for client-centred care. While as Allied Health professionals we can bring our expertise to the interprofessional team, how much do we really understand about the dementia experience of our clients?
At the WA Centre for Rural Health, our simulation educators have devised authentic rural interprofessional experiences through a simulation education program suitable for all health and care staff in hospital, community and residential care facilities. Scenarios are developed to match the work backgrounds of the participants and include experiencing some of the sensory and environmental impacts of dementia in the simulations. Types of scenarios include using the GERontologic Test (GERT) suit and MaskEd high fidelity simulation. Debrief after the simulations has confirmed that these experiences have a significant impact on the participants’ understanding and practice. Further workshops will be offered throughout 2018 and 2019 with planned evaluation on the impact on long term practice.
The workshop will not include any background or theory on dementia however the outcomes for conference delegates who attend this workshop are;
1. experience sensory and environmental impacts of dementia
2. self reflection about how to modify their own practice as a result of immersion experiences
3. develop ideas about using simulation principles in their own workplace to increase understanding of dementia
We will present an overview of our simulation approaches, and facilitate modified scenarios for participation.


Biography:

Kathryn Fitzgerald has worked in rural and remote areas as an Allied Health professional in clinical practice, in policy and program development and in health professions’ education for over 30 years, and has been involved with SARRAH since the organisation’s early days. She currently works as the Clinical Education Manager for the WA Centre for Rural Health based in the Midwest of Western Australia.
Jodi Ullrich has in worked rural and remote areas as a Registered Nurse for 15 years. She has passion for working with children and providing health professional education mainly in the area of simulation based training programs. She currently works as the Simulation Educator for the WA Centre for Rural health based in the Midwest region of Western Australia

“Working in a bubble”: the experiences and meaning of professional isolation from the perspective of health professionals working in rural and remote Western Australia.

Ms Jodi Smith1, Professor  Sonya Girdler1, Doctor Petra Wagman1

1Curtin University, Bentley, Australia

Abstract:

Objective:To understand the experience and meaning of professional isolation (PI) from the perspective of health professionals working in rural and remote Western Australia.

Design: A qualitative, grounded theory approach was used. Semi‐structured interviews were completed with 32 theoretically selected health professionals. Data were analysed using a constant comparative method to provide detailed descriptions of the experience of PI.

Results:Three core themes emerged from the data. The first theme “Professional isolation means working in a bubble” described the feeling of working alone without outside influence or connection. The second core theme was “it could be worse if you were way out Woopwoop” describing the variations in opinions on if geographical isolation was directly linked to PI. The third core theme was “I choose not to feel professional isolation”, described how some participants recognised the need to avoid PI and had put strategies in place to counteract it. Participants saw PI as leading to negative outcomes for the client, the health professional and the community. Whilst participants universally viewed PI as negative, some participants acknowledged that there could be positive gains including personal and professional creativity, learning new skills and networking opportunities.

Conclusions:Participants were interviewed described diverse, complex situations and clinical issues that led to them feeling PI. Health professionals viewed PI as involving multiple features, being potentially present in all workplaces and leading to poor work performance stress and burnout. Participants also described PI as something they felt they could manage with experience, knowledge and networks.


Biography:

Jodi Smith is an Occupational Therapist of far too many years experience, with decades of this experience working in rural and remote settings in WA, SA and NT. Jodi is currently studying for a PhD and this research is part of a larger study looking at defining the term professional isolation.

Bottom-Up Schools: Using technology in rural and remote schools to support child regulation for improved learning and social outcomes

Ms Dagney Hopp1, MS Rebecca Hammond1, Ms  Kim  Casburn1

1Royal Far West, Manly, Australia

Abstract:

Every year, hundreds of country children with limited access to local allied health services benefit from Royal Far West (RFW)’s multi-disciplinary model of care for behavioural, learning and mental health disorders.

Because of the challenges in accessing consistent allied health services in some country areas, strengthening capacity of rural and remote communities to support child development is a key strategic pillar of RFW’s work. Schools, and in particular teachers, are increasingly playing a role in this day-to-day support. Technology is an invaluable modality for ensuring equity of access to professional development opportunities for rural and remote schools.

RFW’s specialist multi-disciplinary paediatric team have developed a NSW Education Standards Authority (NESA) accredited, technology delivered Capacity Building Program. The modules are based on latest evidence and include live feedback sessions with senior Allied Health Professionals to build learning and practice in key areas of child development, behaviour and mental health. One of the most successful Capacity Building packages are Occupational Therapist-led Regulation modules. These modules focus on regulation including sensory, emotional, environmental and relationship mechanisms that impact and underpin child behaviours and outcomes in school. RFW’s Senior OTs work with school staff to identify what they are doing well, as well as thinking through new strategies and techniques to apply across the whole school. These strategies can support schools to build safe and supportive school environments with a bottom-up approach to supporting children at all developmental stages.

Presenters will share about the development and success of the Occupational Therapy Regulation modules.


Biography:

Dagney Hopp is a Senior Occupational Therapist and Team Leader of Occupational Therapy, Dietetics and Orthoptics at Royal Far West. She works as a clinical lead in the multi-disciplinary paediatric team, providing both in-person and telehealth assessment, therapy and capacity building services for children, families, schools and communities in rural and remote Australia. Dagney’s paediatric specialisation has been developed through her previous roles as Senior Occupational Therapist at a number of mutli-disciplinary paediatric health and education practices. Dagney’s skills as a collaborative, multi-disciplinary team provider have a strong focus on addressing childhood trauma and regulation issues.

Where Am I, What’s My Login? Building a survival toolkit in changing space and time.

Mr Lenny Aronsten1

1Rural Locum Assistance Program, Canberra, Australia

Abstract:

Presenting my experience as a locum physiotherapist for Rural Locum Assistance Program over the last six years I hope will provide a discussion springboard for participants to make practical contributions in building a survival toolkit for locum health professionals.

The brief of Rural LAP is ‘a component of the Australian Government’s rural workforce capacity agenda and aims to provide targeted rural support services to general practitioners, specialists, nurses and allied health professionals in rural and remote Australia’. But rather than wax lyrical about adventures in far away lands (or country towns), my preference is to highlight something of the challenges that have changed my life as I’ve changed landscapes. Locum stints are by definition short posts where you need to hit the ground running. One can often feel like a roadie bumping in and out of a gig, living out of a suitcase. However, there are great benefits to be had with the choice to be a locum physio – a journey of discovery across an array of work and geography. The challenges from these years as a roving locum are encapsulated in my title ‘Where Am I, What’s My Login?’. This is actually a question I’ve not infrequently asked myself, an example of losing one’s frame of reference, an occupational hazard of being on the road. I have in my own way gathered a few survival tools to maintain some sense of community and belonging, and I would enjoy the opportunity to workshop these strategies here at this conference


Biography:

Lenny Aronsten has twenty-three years experience as a physiotherapist across a broad range of applications and environments around Australia including hospital, private practice, defence force, industrial, and remote area service delivery. Following a good decade in remote and indigenous practice, Lenny decided on a sea change, which lead to joining Rural Locum Assistance Program in 2012. The last six years as a physio with Rural LAP has been a great journey of practice in rural towns across the country. Time off between locum stints has allowed the presenter to combine travel to Europe and a slight obsession with physical sciences, music and photography, in chasing the crossroads of art and science.

Taking Tracheostomy Care across the Territory

Dr Carole Maddison1, Mrs Jaya Thomas1

1Clinical Learning Education and Research Services (CLEaRS), Top End Health Services, Darwin, Australia

Abstract:

Background and Aim/s:In 2014 the education program resulted from an identified need to enhance clinical skill and knowledge of tracheostomy care for all health care staff at Royal Darwin Hospital. This was driven by high staff turnover and the need to ensure an Interprofessional approach to learning and care delivery.
The seven hour program was collaboratively designed with medical, allied health and nursing input and a strong focus on the patient experience to inform practice.

Methods:Presenters include nursing, medical, speech pathology disciplines with an enthusiastic patient / consumer.
Delivery design comprises pre-session assessment, theory and practical skills undertaken in a simulated clinical setting.
The program has been extended to Alice Springs staff with theoretical sessions delivered via Videoconference and skills stations completed in the simulated clinical setting at each venue.

Results:In 2016-2017 six sessions were delivered with three videoconference-linked to Alice Springs.
There were 137 attendees from Nursing and Allied Health disciplines.
The program received commendation from the ACHS accreditation surveyors in August 2017 for innovation and the inclusion of the patient perspective.
Future inclusion of Katherine and Gove hospitals is planned.

Conclusion:The success of the program highlights the importance of engaging patients in the planning and delivery of education for clinicians. This program includes
• Patient centred care
• Interprofessional collaboration
• Simulation and practical skills
• Use of technology to reach geographically dispersed audiences

References: Available on request


Biography:

Jaya Thomas has worked in the CLEaRS (Clinical Learning Education and Research Service) team as Nurse Educator with the Graduate Nurse Program and Nurse Education Consultant delivering a range of programs across the Top End Health Service. She has experience in acute clinical nursing as well as an in-depth understanding of chronic disease management. She has completed a Master of Nursing and holds a Graduate Certificate in Education. Jaya has been integral to the development of the Tracheostomy Care program that has been delivered across the Northern Territory.

The Allied Health and Nursing Education Outreach Program – Reaching Out Across the State

Dr Ruth Nicholls1, Ms Helen  Codman1, Ms Melody Trueman1, Mrs Chrissy Temperley1

1Royal Children’s Hospital, Melbourne, Parkville, Australia

Abstract:

The Allied Health and Nursing Education Outreach Program (AHNEOP) based at the Royal Children’s Hospital, Melbourne commenced in mid-2017 with the aim of delivering tailored paediatric education and training to Nurses and Allied Health Professionals (AHPs) across the state of Victoria. This new and innovative program takes professional development out to communities state-wide thereby providing AHPs in regional and rural locations with the opportunity to receive inter-professional training and education within their workplace. Designed according to the learning needs identified by teams, the programs provide a unique opportunity for colleagues to learn and train together.
In 2017, a full day inter-professional education program was developed by expert AHPs from RCH that addressed common themes identified in the education requests received from across the state. The themes related to many of the common challenges faced by AHPs who provide care during the early years of life, including environmental, social and family factors, early detection, red flags and developmental surveillance. This program was attended predominantly by Speech Pathologists, Occupational Therapists, Physiotherapists, Social Workers, Dieticians, Maternal and Child Health Nurses and Allied Health Assistants. Within the first few months of launching the AHNEOP, the Allied Health inter-professional education program was delivered to 5 sites and 145 AHPs across Victoria.
Evaluation has been overwhelmingly positive leading to the program being repeated in various locations to maximise availability to regional and rural AHP’s. This outreach model has been a significant change to previous models of education delivery and recommendations for the future will be discussed.


Biography:

Ruth Nicholls is the Allied Health Clinical Education Lead at The Royal Children’s Hospital in Melbourne. In this role, Ruth leads and oversees the strategic direction of clinical education for Allied Health staff and students, and collaborates closely with Nursing Education, Medical Education and Workforce Development across the RCH Campus. A Speech Pathologist by background, Ruth has worked across a range of clinical, research and academic settings including public health services, early intervention, education, private practice, research, project management and academia.

Helen Codman is the Manager of the Allied Health and Nursing Education Outreach Program. A paediatric nurse by background, Helen has worked extensively in the Nursing Education team at the Royal Children’s Hospital across a range of settings, predominantly in the clinical area supporting Undergraduate, Graduate and Post Graduate students along with staff new to the area of paediatrics. Helen was a contributing author for the RCH Nursing Competency Framework and is involved in the writing and reviewing of the nursing Clinical Practice Guidelines.

Enhancing the Pathway to Allied Health – Make the change early in your career

Miss Hilary Byrth1

1Podiatry Department, Country Health Connect, Mount Gambier, Mount Gambier, Australia

Abstract:

Background: ‘Achieving attitudinal and practice change is one of the greatest challenges in health care.’ Historically there is a lack of awareness amongst early career professionals in nursing and medicine of the scope, impact and value of Allied Health professions (AHP) on patient care.

Objective: Does the introduction of AH colleagues and scope of practice materially change the referral practices of early career Nurses and Doctors?

Method: Country Health SA Transition to Professional Practice (TPPP), ‘is a broad program covering theoretical and clinical aspects of the nurse/midwife and medical roles‘. TPPP is run annually in Mount Gambier. An additional presentation by and about AHPs will be included in the 2018. Each AHP will have 10 minutes to provide information on scope of practise, clinical priority tool and referral criteria with supporting written information.
A baseline perception survey will be completed prior to the presentation. This survey will be repeated at 3 and 6 month intervals and the data analysed.
AHP referrals will be audited 1 month prior to the presentation and at 3 and 6 month intervals using a predetermined set of ‘value’ criteria (eg appropriate use of priority tool, timeliness of referral, increase in referrals).

Results:It is hoped that it will demonstrate that the introduction of information regarding the scope and impact of AHP delivered in person as part of a structured learning program has a long-term effect on the referring and interprofessional attitudes of early career Doctors and Nurses.


Biography:

Hilary is a Podiatrist that has been based in the Mount Gambier, South Australia since graduating from a Bachelor of Podiatry in 2016.
Due to experiences in her studies, Hilary was drawn to providing care in rural and remote settings and moved to the Mount Gambier as a new graduate. Now as a clinical Podiatrist with 2 years experience she is providing care in outreach communities, has a passion for interprofessional management of country living clients and involved in the introduction multi disciplinary high risk foot management clinics.

Developing intentional interprofessional practice on the West Coast

Miss Jane George1,3, Ms Brittany Jenkins1, Dr Cameron Lacey1,2

1West Coast District Health Board, Greymouth, New Zealand, 2University of Otago, Christchurch, New Zealand, 3Auckland University of Technology, Auckland, New Zealand

Abstract:

Aim/Objectives: To develop workforce and stakeholder awareness, organisational policy, pathways, and strategy for the West Coast rural health workforce in terms of interprofessional practice which supports workforce sustainability and high quality care.

Background: An initial group of WCDHB Clinical Leaders and Educators met in November2017 to start exploring Interprofessional Practice (IPP) and Education (IPE) on the Coast, including creating a shared understanding of what IPP/IPE is and what it is not.

The kaupapa of this roopu is to develop a West Coast wide strategy for promoting and implementing interprofessional concepts regarding ways of working and learning.

Methods and emerging findings: Following the formation of this Interprofessional Education Roopu, surveys were undertaken to gauge the level of understanding across the workforce about Interprofessional practice, to gain a benchmark for our programme of work. Information was gathered on the range of interprofessional activities being undertaken, and education sessions were held to introduce the concept of interprofessional practice.

Conclusions: It is recognised that in rural settings, interprofessional practice is common, if unrecognised as such. Developing a visible programme of interprofessional education, working in partnership with professional bodies and education providers will allow the WCDHB to strengthen and formalise this fundamental aspect of care.


Biography:

Jane George is a Registered Clinical Social Worker and Associate Director of Allied Health, Scientific and Technical Workforces at the West Coast DHB.  Her Master of Social Welfare examined effective supports for those who frequently attend Emergency Departments and her Doctor of Health Science research will explore the challenges and opportunities for the recruitment and retention of Allied Health staff in rural and remote areas.  Jane is a Fellow of the Australasian College of Health Service Management, and a contributor and reviewer for the Aotearoa New Zealand Social Work journal.