DISCIPLINE OF GENERAL PRACTICE - UNIVERSITY OF TASMANIA
Emily Hansen
RCBI Coordinator
Ph: 03 62264769
E: Emily.Hansen@utas.edu.au
Tasmanian PHCRED RCBI Conference Bursary Holder
Dr Jon Lane attended the 29th American National Rural Health Association Conference in the United States. The University of Tasmania PHCRED RCBI Program offers conference bursaries to early career primary health care researchers who have been accepted as presenters in a conference. This allows them to meet other researchers with similar interests, gain skills in conference presenting and to disseminate results from their research. In May 2006 the Discipline of General Practice and the University Department of Rural Health jointly awarded GP Registrar Dr Jon Lane a bursary to assist with travel costs associated with attending The 29 th American National Rural Health Association. This conference was held in Reno, Nevada, from 16-19 May 2006. While under the auspices of the National Rural Health Network (NRHN) Dr Lane conducted research into disparities between the resources available to medical students in comparison with those of other disciplines such as nursing. He presented results from his research in a paper entitled Barriers to Undergraduate Rural Health Placements.
 His research findings demonstrate significant barriers to rural placements for Australian students from Nursing, and other Allied Health disciplines (especially psychology, dietetics, podiatry) in terms of their access to funded and supported undergraduate rural placements. Most noticeably, whilst Medical students have access to free accommodation, students from other disciplines were having to find their own accommodation and pay up to $180 per week. They also had significantly more trouble accessing rural placements because their Universities either did not offer rural placements, or would not allow them to go on rural placements.
Dr Lane found attending the conference to be a "a very educational experience". It provided an opportunity for him to disseminate his research to an international audience and to learn from the rural workforce retention programs running in other countries. He was particularly impressed by the long term mentoring and support available to American medical students with an interest in rural health. In the USA students are followed from their entrance into Medicine through to their subsequent completion of specialist training. This has led to a retention rate in excess of 80% of residents trained in a particular area who then choose to practice in the same area.
DEPARTMENT OF GENERAL PRACTICE - FLINDERS UNIVERSITY
Professor Richard Reed
Director, Flinders University PHCRED
E: richard.reed@flinders.edu.au
The Flinders University Department of General Practice, located at Flinders Medical Centre, commenced a journal club and a combined seminar program in 2006. Seminars and journal club meetings are held on alternate Wednesdays with promotion of these events going to several list serves and newsletters.
To date, attendees have come from within the department, from other university departments and from the medical centre thus ensuring robust discussion on the issues presented.
Seminar topics have included: Equity of GP prescribing , Respiratory research in primary care , and Can lean thinking save health care? Journal club topics have included: Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care, the ADGP CEO (Kate Carnell)'s speech at the National Press Club in March, and Why Most Published Research Findings are False.
Details of upcoming topics can be found at http://som.flinders.edu.au/FUSA/GP-Evidence/PHCRED/seminar2006.htm
We have also been building research capacity through the allocation of bursaries and mentoring to the following:
- Janet Kelly, a community health nurse, is working on a project titled Gilles Plains Aboriginal women's health
- Lindsay McWha, an occupational therapist, has been funded to work on her project The impact of coping and functional independence in older people with mild cognitive impairment
- Jo Nolan, a physiotherapist, is being supported to work on Consumer perspective on fall prevention strategies - what is acceptable
DEPARTMENT OF RURAL HEALTH - UNIVERSITY OF MELBOURNE
Lisa Bourke
PHCRED Team
Ph: 03 5823 4519
E: bourke@unimelb.edu.ua
Update from Shepparton
The Department of Rural Health, University of Melbourne in Shepparton (Victoria) is continuing its PHCRED program. We had two of our PHCRED fellows complete their 2005 fellowship. One of these fellows is pursuing her research on gestational diabetes further and has enrolled in a Masters degree with us. The other completed a project on 'community readiness' for youth health services and is planning on publishing her work. We continue to run a range of workshops for primary health professionals to teach research and evidence-based practice skills. These are usually attended by 15-20 participants and provide training and an opportunity for networking; evaluations have been very positive. In addition, we have seven new research fellows starting in July 2006 and will begin with a four-day intensive research methods workshop. These fellows are primary health care professionals from a range of disciplines, organisations and geographic locations, pursuing a diversity of interests from palliative care, breast feeding in CALD communities to environmental health, aged care and diabetes.
In addition to our usual PHCRED program, we are developing the Rural Health Academic Network (RHAN) by initiating a network of researchers and research organisations across northern Victoria. We are formally establishing relationships with seven rural health centres to be 'spokes' in this network. These spokes will be provided with research training and support as the university and health centres together develop joint research projects from a regional approach. One of the main goals of RHAN is to increase the analysis of health data that these services already have in order to improve the quality and continuity of health care. This new but exciting prospect is being undertaken by all staff at the Department of Rural Health.
VicPHCRED
Dr Phyllis Lau
Lecturer/State Coordinator of Victorian Primary Health Care Research, Evaluation & Development Partnership (VicPHCRED)
Department of General Practice
University of Melbourne
Ph: 03 8344 9042
E: plau@unimelb.edu.au
What do we do at VicPHCRED Monthly Education Meetings?
To promote networking and, indeed, fellowship amongst the RDP fellows in Victoria, VicPHCRED has initiated a structured approach in 2006 with monthly education meetings that gather fellows from all its three institute partners: Departments of General Practice at Monash University and the University of Melbourne and the School of Rural Health in Shepparton. VicPHCRED see these monthly meetings, which commenced in May this year, as conducive to maximising available teaching resources as well as improving effectiveness and efficiency of the program. These meetings are opportunities for fellows to participate in small-group learning with their peers, and to exchange ideas and solutions about their research projects.
Three former RDP fellows contributed to the May meeting by sharing their learning experiences. They talked about what motivated them to participate in the program, what they got out of it, and where are they now in terms of research and/or career. They gave tips on how to 'get the most out of your fellowship' and 'your supervisors', how to 'develop your research questions' and 'plan your projects', how to juggle between 'time, money, life and effort'. They stressed the importance of networking and sharing ideas. They also caution the current fellows about the potential pitfalls and misconceptions to avoid. Current fellows reflected that it was very beneficial and encouraging to hear what former fellows have to say about the program.
Critical appraisal and data management were the topics covered in the June meeting. Basic critical appraisal tools like questions and checklists on how to make sense of a research paper, how to assess methodological quality and statistical analysis of a research, what do some of the terminology in research papers mean, etc. were discussed. Principles of research development, data management, basic statistics, data analysis, data presentation were all discussed. Fellows found such presentations and discussions stimulating and beneficial since, for most of them, they are novices embarking on a hitherto unfamiliar research experience.
For more information about the VicPHCRED Fellowship and the Monthly Education Meetings contact:
Dr Phyllis Lau
Ph: 03 8344 9042
E: plau@unimelb.edu.au
SOUTH-EAST QUEENSLAND RESEARCH NETWORK (SEQRN) - THE UNIVERSITY OF QUEENSLAND, GRIFFITH UNIVERSITY, BOND UNIVERSITY
Assoc Professor Geoff Mitchell
PHCRED Program Manager
Ph: 07 3365 5504
E: g.mitchell@uq.edu.au
GPs and other primary care clinicians find the challenge of learning about research methods difficult. The numbers of clinicians attending workshops aimed at getting started in research have been disappointing, so we have adopted a different means of teaching about research - the concept of learning by doing. We have established SEQRN as a means of practitioners working with established researchers to conduct small practice based research projects, the group debates what the focus of the research will be and a final subject is chosen. Participants can either join the team doing the research or identify patient participants.
Now that Griffith University and Bond University have established PHCRED programs, we are in the process of expanding the program to be a true South-East Queensland network. We are jointly sharing the cost of a network coordinator, which will improve the efficiency and output of the group significantly.
One project is near completion, one is in the data collection phase and a third project is being developed. When the program is fully mature, we expect that four projects, each at different parts of the research continuum, will run simultaneously. At this stage, three non-academic GPs have been involved in planning and running the studies, and 50 GPs have enrolled patients to the studies.
This project highlights the value of hands-on experience as a learning tool, as well as the value of cooperation between university departments.
For further information contact:
Geoff Mitchell
University of Queensland
E: g.mitchell@uq.edu.au
Michael Yelland
Griffith University
E: m.yelland@griffith.edu.au
Shirley McIlvenny
Bond University
E: s.mcilven@staff.bond.au
SCHOOL OF MEDICINE & SCHOOL OF NURSING SCIENCES - JAMES COOK UNIVERSITY
Jane Mills
Primary Health Care Research, Evaluation and Development Fellow
Ph: 07 4038 2255
E: jane.e.mills@bigpond.com
Nursing in general practice is poised to be key to the delivery of primary health care in the future. This has been influenced by the Australian Government introducing a variety of Medicare item numbers for procedures performed by nurses. I am working with a group of seven nurses in general practice during my time as a PHCRED Fellow with the School of Medicine/School of Nursing Sciences at James Cook University. Together we are using action research to explore the factors that impact on nurses in general practice implementing a change in their practice - in this case, cervical screening.
Action research is a useful and pragmatic methodology in studies such as this because it stimulates incremental change throughout the process, as opposed to implementation being a separate project resulting from research. Action research cycles involve participants observing their practice, reflecting on this both individually and as a group, proposing potential changes that might make a difference and then implementing and evaluating these changes. This cycle is repeated as participants work to refine actions based on their evaluations and other evidence for best practice.
 So far our action research group has met twice, initially to introduce the study and then to undertake a reconnaissance of the factors influencing their implementation of cervical screening. Together we ranked the factors listed and have formulated the first action for the group to implement. One of the ways that we are planning on evaluating these actions is through the use of creative journaling, underpinned by a set of reflective questions.
Potential benefits from the research arise from identifying barriers and issues that are faced by nurses in general practice who are changing their practice and the strategies that they have used to successfully overcome these. As a mid-career researcher the opportunity to develop skills in a new research methodology is invaluable, and creates a platform for further research in the future.
DISCIPLINE OF GENERAL PRACTICE - THE UNIVERSITY OF QUEENSLAND
Denise Schultz
PHCRED Qld Coordinator
Ph: 07 3346 4905
E: d.schultz@uq.edu.au
PHCRED Queensland Roadshows
During 2005 the Primary Health Care Research, Evaluation and Development (PHCRED) Queensland program offered workshops and information sessions to general practitioners and other primary health care workers in south western and central Queensland. This culminated into two 'roadshows' which presented workshop sessions to participants in Toowoomba, Roma, Charleville, Biloela, Emerald and Rockhampton.
Workshop evaluations completed by the participants indicated that the workshops (although introductory) were extremely beneficial. The flexible and interactive delivery enabled individual needs to be addressed with one on one discussions following most of the workshops to address particular project issues. In some instances this continued via phone, email and in person. Most attendees were very keen to attend any future workshops on offer.
Further 'roadshows' are planned during 2006 with a one week trip being planned for Longreach, Barcaldine, Blackall, Charleville and Roma during the last week in August. A second roadshow visiting Biloela, Gladstone, Bundaberg, Hervey Bay, Maryborough and Kingaroy is earmarked for mid October. Previously visited towns, Biloela, Roma and Charleville will be offered an advanced workshop for previous participants as well as an introductory workshop.
 The duration of each workshop is approximately three hours and PHCRED provide for catering with the venue usually supplied by the participants' organisations.
Workshops are available on Getting Started in Research, Reviewing the Literature, Introduction to Evidence Based Practice, Program Evaluation, Integrating Quantitative and Qualitative Evaluation, Questionnaire Design and Data Management, Grant Writing, Tips for presentations, Writing for publication, SPSS and Endnote.
Day time workshops are offered to mainly allied health staff from Queensland Health and other primary health care organisations, with the most popular topics being Program Planning and Evaluation and Questionnaire Design using local projects as examples. Our evening sessions are aimed towards GPs, with GPs from the PHCRED program facilitating these presentations usually on Getting Started in Research or Reviewing the Literature.
PHCRED Queensland is a collaboration between Bond University, Griffith University, James Cook University, Mt Isa Centre for Rural and Remote Health and The University of Queensland.
For further information on PHCRED Qld roadshows please contact:
Denise Schultz
E: d.schultz@uq.edu.au
MOUNT ISA CENTRE FOR RURAL AND REMOTE HEALTH
Kristin E McBain
Research Officer
Research Unit
Ph: 07 4744 7912
E: kris.mcbain@jcu.edu.au
The focus of my RDP fellowship project is accessibility of mainstream health care for Indigenous Australians in Mount Isa. A literature review revealed the commonly described barriers to utilising mainstream health care services experienced by members of 'minority populations' both internationally and within Australia.
These include:
- transportation issues and distances to health care practices;
- lack of private health insurance and the cost of medical care; and,
- language and cultural barriers including misdiagnosis or inappropriate care.
These issues are relevant to varying degrees in Mount Isa and while they affect the health prospects of all remote citizens, they are most likely to impact negatively on the health of those populations that are already disadvantaged.
Further research will examine the relative impact of reported barriers in order to assess the gravity of each in a local context. This will include a review of the health services available in Mount Isa and an examination of the ways that Indigenous Australians overcome these barriers by utilising their own social support networks in times of illness, healing and need. This will provide a more complete understanding of the ways that local Aboriginal and Torres Strait Islanders understand, express and pursue their health care needs. The outcomes of this project will inform decision making processes to improve the accessibility of mainstream health services to minority populations.
The RDP fellowship has allowed protected time to develop these ideas, explore appropriate methodologies, perform research, and create and maintain networks. The research completed in this project will be integrated into a future PhD study. The RDP program has allowed me as a novice researcher in Primary Health Care to develop the necessary skills to perform research at a higher level.
THE RESEARCH CAPACITY MATRIX
Dr David Whyatt
Primary Health Care Research Fellow
Department of Rural Health
Combined Universities Centre for Rural Health, Geraldton
Ph: 08 9956 0200
E: davidw@cucrh.uwa.edu.au
Dr Tracy Reibel
WA PHCRED Statewide Coordinator
Department of General Practice
University of Western Australia
Ph: 08 9449 5131
E: tracy.reibel@uwa.edu.au
Dr Phyllis Lau
Lecturer/ VicPHCRED Statewide Coordinator
University of Melbourne
General Practice
Ph: 03 8344 9042
E: plau@unimelb.edu.au
A research skills assessment tool - the RESEARCH CAPACITY MATRIX for individuals - has been developed and refined at the Combined Universities Centre for Rural Health in Geraldton. It has been applied to five fellows who completed RDP in Geraldton as well as preliminarily applied to eight current RDP fellows in Victoria. Evaluation of these assessments and the process of validating the matrix is currently underway. It is hoped that the application of such skills assessment will guide and monitor the capacity development activities at these two sites.
The matrix consists of defined milestones (based on experience and demonstrated peer acknowledgement of capacity) in nine proficiency domains (originally delineated in the Research Spider; Smith et al., 2002, Primary Health Care Research and Development):
- Generating a research idea
- Writing a research protocol
- Finding relevant literature
- Critically reviewing literature
- Using quantitative research methods
- Using qualitative research methods
- Writing and presenting a research report
- Applying for research funding
- Publishing research
Level of proficiency in each domain will determine the experience and therefore the level of supervision and assistance required by an individual.
Level 1: Novice
no previous experience
- training required
Level 2: Initiate
some experience
- mentoring or guidance required
Level 3: Proficient
experienced
- peer review required
Level 4: Expert
acknowledged by peers as such
- career development required
Level 5: Leader
acknowledged within field as such
Systematic evaluation and monitoring of the levels of research capacity training required to achieve improved research skills outcomes is in line with the Phase II goal of PHCRED being 'recognized as an essential mechanism through which Australian primary health care researchers receive the training, support and experience necessary to undertake purposeful, high quality research'. For more information about the Research Capacity Matrix and how your institute or state could be involved in the evaluation and validation process, please contact the authors.
WA PHCRED
Dr Tracy Reibel
WA PHCRED Statewide Coordinator
University of Western Australia
General Practice, School of Primary, Aboriginal and Rural Health Care
Ph: 08 9449 5131
E: tracy.reibel@uwa.edu.au
With the appointment in May of a Statewide Coordinator for the PHCRED program in Western Australia, PHCRED units at the Combined Universities Centre for Rural Health, and the Universities of Western Australia and Notre Dame Australia are working towards a greater degree of coordinated research activity and capacity building.
During 2006, ten new research projects are underway via fellowships and bursaries with more to follow. These cover a broad range of primary health care issues and will be undertaken by general practitioners, midwives, nurses, allied health practitioners, and others working in the area of primary health care.
The University of Notre Dame Australia PHCRED unit is hosting a seminar series and this will continue in August, September and October. The seminars are open to all those interested in primary health care, including students, and attract CPD points for participating general practitioners. Topics have included cardiovascular diagnosis, stroke prevention in primary care, and qualitative research methods, among others. Information regarding the forthcoming series will be posted to the ResNet email network. For inclusion on this network, email tracy.reibel@uwa.edu.au
The annual one day PHCRED state conference will be held again on 11 November and provides the opportunity for presentation of research projects as well as participation in research oriented workshops. Under the working title of Primary Health Care Now! Current Research and Evaluation Development in WA the three PHCRED units are collaborating with the Royal Australian College of General Practitioners to create an interesting and interactive forum for participants.
The conference aims to engage Fellowship recipients in the presentation of their research projects in a semi-formal environment. This provides the opportunity for early career researchers to gain valuable experience in this important area of research dissemination.
FREMANTLE SCHOOL OF MEDICINE - UNIVERSITY OF NOTRE DAME AUSTRALIA
Tom Brett
Director, Notre Dame PHCRED
Ph: 08 9433 0258
E: tbrett@nd.edu.au
The first six months of the Notre Dame PHCRED program has concentrated on the development of a number of key areas.
Research staff appointments
Dr Robert Moorhead
- Research advisor
Dr Diane Arnold-Reed
- Program coordinator
Associate Professor Tom Brett
- Director
Researcher Development Program
Dr Michael Eaton has been awarded a RDP fellowship on the five-practice knowledge and attitudes to prostate cancer study.
Dr William Walker has been awarded a RDP fellowship on a primary prevention study on cardiovascular disease in general practice.
Primary Care Research fellowship appointees
Dr Alan Wright, Dr Walter Kaczmarczak, Dr Frank Jones and Dr Andrew Marangou received primary care research fellowships to support their involvement with the five-practice prostate study.
Semester One meetings and seminars
Three structured educational meetings were held during the first semester. Meetings focussed on key national priority research areas and were held in conjunction with Fremantle Regional Division of General Practice, Western Australia General Practice Education and Training (WAGPET) and University of Western Australia PHCRED.
The April meeting was on sexually transmitted infections with Associate Professor Donna Mak. Jan Harmsden, librarian, Notre Dame School Medical Library, also presented on literature searches and evidence based medicine.
Presenter Gerry O'Driscoll presented to the May meeting on risk factor modification for cardiovascular disease. Caroline Bulsara, UWA PHCRED, presented to both the May and June meetings on the topic of Qualitative Research methods.
Professor Graeme Hankey was guest presenter for the June meeting on stroke prevention in primary care.
Collaborations with other Notre Dame schools
Notre Dame PHCRED is currently exploring a number of possible collaborative research projects involving the schools of Nursing, Health and Physical Sciences, Physiotherapy and Counselling on primary care related areas.
Writing bursaries
A number of writing bursaries are currently on offer to encourage involvement of early career researchers in the development of their own research ideas. These range from supporting involvement of indigenous high school students in health related projects to support for primary care researchers with literature searches and refinement of research proposals.
CAPRE PROGRAM, DISCIPLINE OF GENERAL PRACTICE - THE UNIVERSITY OF NEWCASTLE
Ms Susan Goode
Program Coordinator
Ph: 02 4968 6737
E: susan.goode@newcastle.edu.au
2006 RDP: New Approaches
Continuing with the success of our 2005 Research and Development Program (RDP), CAPRE has recently appointed four new RDP participants for 2006. I would like to take this opportunity to introduce the participants: Dr Erica Rowley (GP), Dr Graeme Horton (GP), Mr Anthony Critchley (a Psychologist and Project Coordinator) and Ms Karen Barrett (a Social Worker).
It has been a difficult process to advertise and fill these positions within a 12 month timeframe. However, each RDP participant has now been appointed on a 0.2FTE fractional appointment. Fortunately, they will be in time to attend the New South Wales Primary Health Care (PHC) Short Course on Research Methods hosted by the NSW PHC Consortium at the University of New South Wales (UNSW) from 19-22 June 2006. Following this intensive methods course we are flying our RDPs to Perth for the national GP & PHC Research Conference, which they are all very excited about. Other planned activities for our RDPs include: individual mentoring and structured supervision, RDP peer-support meetings, critical appraisal journal club and a six-month program of research skills clinics.
This year, the focus of our RDP has been different to the previous Programs due to the very short-timeframe. Our 2006 RDP participants will have appointments of approximately six months rather than the planned 12 months. Therefore, our RDPs are in the early stages of developing their research question, conducting a literature review, writing a project protocol and submitting ethics applications.
We are planning a RDP Research Forum in late November which will provide our RDP participants with an opportunity to present their RDP research as a work-in-progress and provide them with the opportunity to network with other early career researchers.
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