Benson Jill, Borthwick Josephine, Linton Tim, Cotter Stacey, Jodlowski-Tan Karin, Brown James
Royal Australian College of General Practitioners, East Melbourne, Vic. 3002, Australia.
Discipline of General Practice, University of Adelaide, Adelaide, SA 5005, Australia.
Rural Remote Health. 2025 Jun;25(2):9675. doi: 10.22605/RRH9675. Epub 2025 Jun 22.
The lack of a stable general practice workforce in rural and remote Australia has been a topic of much discussion as there are fewer GPs working in many rural areas, where mortality and morbidity are higher than in urban areas. Doctors who have been trained in rural and remote areas are more likely to continue working there, but in many practices supervision is not available onsite. Good supervision ensures patient safety, an educational alliance between the supervisor and trainee, and adequate clinical and professional support by the supervisor and the onsite team. This project involved the evaluation of the pilot of the newly developed guidelines for the remote supervision of GP trainees (registrars) within the Royal Australian College of General Practitioners (RACGP) Australian General Practice Training program: Remote supervision: Guidelines for safe and effective general practice training utilising remote supervision.
The aim of the evaluation was to assess the appropriateness, effectiveness and efficiency of the remote supervision guidelines and placement processes such as the selection process, risk management plan, face-to-face orientation period, development of the onsite team, communication strategies and increased payment. The guidelines were implemented as a pilot in two practice localities in 2022. The remote supervisors, remotely supervised registrars, practice managers and training organisation stakeholders were interviewed at three time points during the placement: before the placement, after the orientation period and at the conclusion of the placement. Their responses were analysed and organised into themes.
Overall, the results were positive, with suggestions for improvement and challenges identified. There was an identified need to ensure that guidelines are flexible and able to be tailored to the context of the registrar, the supervisor and the placement. Both registrars in the pilot continued to work in the remotely supervised practices at the end of their training and the three supervisors were keen to supervise remotely again.
The RACGP remote supervision guidelines were developed as an evidence-based practical means of supervising registrars in rural and remote locations where there is no onsite supervisor. The guidelines were updated where necessary and have now been published and implemented nationally.
The pilot and evaluation of the RACGP remote supervision guidelines demonstrate that they are safe and fit for purpose. These guidelines form one of the training strategies to support the dwindling rural and remote general practice workforce.
澳大利亚农村和偏远地区缺乏稳定的全科医生队伍一直是备受讨论的话题，因为在许多农村地区工作的全科医生较少，而这些地区的死亡率和发病率高于城市地区。在农村和偏远地区接受培训的医生更有可能继续在那里工作，但在许多诊所，现场监督无法提供。良好的监督可确保患者安全、监督者与实习生之间形成教育联盟，以及监督者和现场团队提供充分的临床和专业支持。本项目涉及对澳大利亚皇家全科医生学院（RACGP）澳大利亚全科医生培训项目中针对全科医生实习生（注册医生）远程监督新制定指南的试点进行评估：《远程监督：利用远程监督进行安全有效的全科医生培训指南》。
评估的目的是评估远程监督指南及安置流程的适当性、有效性和效率，这些流程包括选拔过程、风险管理计划、面对面入职培训期、现场团队的组建、沟通策略以及增加薪酬。该指南于2022年在两个诊所地区作为试点实施。在安置期间的三个时间点对远程监督者、接受远程监督的注册医生、诊所经理和培训组织利益相关者进行了访谈：安置前、入职培训期后以及安置结束时。对他们的回答进行了分析并归纳为主题。
总体而言，结果是积极的，同时也提出了改进建议并识别出了挑战。已确定需要确保指南具有灵活性，并能够根据注册医生、监督者和安置环境进行调整。试点中的两名注册医生在培训结束后继续在接受远程监督的诊所工作，三位监督者也渴望再次进行远程监督。
RACGP远程监督指南是作为一种基于证据的实用手段而制定的，用于在没有现场监督者的农村和偏远地区监督注册医生。必要时对指南进行了更新，现已在全国发布并实施。
RACGP远程监督指南的试点和评估表明，它们是安全且符合目的的。这些指南构成了支持日益减少的农村和偏远地区全科医生队伍的培训策略之一。
