Rural Clinical School, University of Queensland, Toowoomba, QLD.
School of Rural Health, Monash University, Bendigo, VIC.
Med J Aust. 2024 Oct 7;221 Suppl 7:S29-S34. doi: 10.5694/mja2.52446.
Explore stakeholder perspectives of the benefits of continuously training general practitioners in the same rural or remote practice in distributed locations via the Remote Vocational Training Scheme (RVTS).
DESIGN, SETTING, PARTICIPANTS: Online one-hour semi-structured interviews were conducted with 27 RVTS staff, participants and supervisors from all states and territories between 16 October and 24 November 2023. Data were deductively and inductively coded by stakeholder type and the range of benefits, and the findings were informed by insights from a project reference group and a stakeholder advisory group. Questions explored the benefits of the RVTS - a program which supports doctors already working in rural, remote and First Nations communities to train towards general practice or rural generalist fellowship while remaining in the same practice.
Perspectives on the nature and spread of benefits.
Broad benefits were perceived to flow to four system-level stakeholders: communities, health services, participants and policy makers. Perceived participant and community benefits were doctors staying longer in distributed locations with tailored place-based supports and training, doctors building relationships with patients, and doctors learning through longitudinal care. Health service benefits included reduced reliance on locums, improved continuity of accessible and appropriate services in areas otherwise facing major recruitment and retention issues, and the doctors having more time to contribute to improving service quality and upskilling local staff. Policy-maker benefits were sustaining safe and high quality services for distributed populations with high needs.
The RVTS model was perceived to offer diverse benefits for different system stakeholders which could improve quality of learning, service delivery and community care. It also aligned with key policy directions for a distributed and sustainable generalist workforce under the goals of the National Medical Workforce Strategy 2021-2031 and the directions set by the independent review of overseas health practitioner regulatory settings led by Robyn Kruk. However, models like the RVTS largely rely on distribution levers to recruit more doctors to the locations it supports.
通过远程职业培训计划（RVTS）探索利益相关者对在偏远地区相同农村或偏远实践中持续培训全科医生的看法。
设计、地点和参与者：2023 年 10 月 16 日至 11 月 24 日期间，通过在线进行了 1 小时的半结构化访谈，采访了来自所有州和地区的 27 名 RVTS 工作人员、参与者和主管。根据项目参考小组和利益相关者咨询小组的意见，按利益相关者类型和利益范围对数据进行了演绎和归纳编码。问题探讨了 RVTS 的好处——该计划支持已经在农村、偏远和第一民族社区工作的医生在同一实践中接受培训，以成为全科医生或农村全科医生研究员。
对利益性质和范围的看法。
四个系统利益相关者被认为会带来广泛的利益：社区、卫生服务、参与者和政策制定者。参与者和社区的预期收益包括有针对性的基于地点的支持和培训，让医生在分布式地点停留更长时间，医生与患者建立关系，以及医生通过长期护理学习。卫生服务的好处包括减少对替代医生的依赖，改善在面临重大招聘和保留问题的地区提供可及且适当服务的连续性，以及医生有更多时间为提高服务质量和提升当地工作人员技能做出贡献。政策制定者的收益是为分布广泛的高需求人群提供安全且高质量的服务。
RVTS 模式被认为为不同的系统利益相关者提供了多样化的利益，这可以提高学习、服务交付和社区护理的质量。它还符合 2021-2031 年国家医疗劳动力战略和由 Robyn Kruk 领导的海外卫生从业者监管环境独立审查设定的方向下的分布式和可持续的通才劳动力的关键政策方向。然而，像 RVTS 这样的模式在很大程度上依赖于分配杠杆来吸引更多的医生到它支持的地点。
