Research into rural health professionals’ skills
31st October 2019
Rural communities set to benefit from research into rural health professionals’ skills
Sarah Walker knows first-hand what it takes to be a practising physiotherapist in a rural community, and now she aims to determine whether rural allied health professionals in New Zealand require fundamentally different skills to their urban counterparts.
Walker has just been awarded a $204,000 Clinical Research Training Fellowship from the Health Research Council of New Zealand (HRC) to investigate the scope of practice, challenges and complexities experienced by rural allied health professionals.
She describes it as a first step in addressing the skills shortage in rural areas and reducing the ‘huge disadvantages’ faced by rural communities when it comes to accessing healthcare.
“Of all the geographic categories, New Zealand’s rural towns have the lowest socioeconomic status, highest proportion of Maori, and highest avoidable mortality rates,” says Walker.
Yet despite the higher health needs, rural residents have poorer access to health services and greater costs in accessing these services, which is largely due to workforce shortages in rural areas.
Currently in New Zealand, only 3 per cent of physiotherapists hold an annual practicing certificate to work in rural areas, and a similar pattern is repeated across a number of health professions, she says.
As well as not having a large presence in rural areas, health professionals from all disciplines in rural areas have been found to sustain a heavier workload and carry a higher level of clinical responsibility as a result of carrying out a wider range of services.
In Dunstan Hospital, where Sarah works for Central Otago Health Services, she’s required to treat acute in-patients and carry out rehabilitation both in hospital and in homes. “It’s the complexities that you get – rural hospitals don’t have specialist neuro-physiotherapists, or physios that have an interest in respiratory conditions – we have to take up those roles for ourselves.”
To date, there is no recognition of the ‘rural generalist’ skillset required, says Walker, nor are there rural-specific career-pathways for allied health professionals.
Her research will help determine if there’s a need for a distinct area of specialty within rural allied health and a need for extra support and training, to ensure that rural communities are provided with a skilled and relevant health workforce to meet their needs.
“When you consider the disparities in health needs and socio-economic standards in rural areas, it feels remiss to further disadvantage those communities by not providing health professionals that are experts in providing treatment for that population,” says Walker.
“Rural communities have been left behind, which I guess is partly because of the general New Zealand rural attitude that we just band together and get it done. But it’s not necessarily fair or necessarily right, and it could definitely be better.”
The HRC Fellowship will help Sarah Walker complete her PhD at the University of Otago. She is one of 67 researchers selected for funding in the HRC’s 2020 Career Development Awards announced today. The awards help foster and sustain New Zealand's health research workforce, and this year more than $13.4 million was awarded to researchers in clinical and academic roles, including Māori and Pacific health researchers.
These awards play a critical role in building capability and capacity in our research workforce, says the HRC’s acting chief executive Dr Vernon Choy. He says Sarah Walker’s proposal was notable, not only as it would establish her as New Zealand’s only rurally-based clinical academic physiotherapist but for its potential to inform future development and training of the rural health workforce.
“There’s increasing recognition of the health disparities within rural communities, and a clear goal of the HRC is to reduce inequities where they exist in New Zealand. We expect this research will contribute much-needed knowledge and evidence towards future rural health initiatives.”
See below for the 2020 Career Development Award recipients (in the General category). To read lay summaries of the research proposals (once the embargo is lifted) go to www.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Career Development Awards’ and ‘2020’. For our Māori Career Development Award recipients, filter for ‘Māori Health Research’ and ‘2020’; for Pacific Career Development Award recipients, filter for ‘Pacific Health Research’ and ‘2020’.
2020 HRC Career Development Awards
General & Advanced Fellowships
Clinical Practitioner Research Fellowship
Dr Malcolm Battin, Auckland DHB Charitable Trust
Improving care and outcomes for babies at risk of brain injury
60 months, $823,756
Dr Craig Jefferies, Auckland DHB Charitable Trust
Improving outcomes for children and adolescents with diabetes
60 months, $896,261
Clinical Research Training Fellowship
Dr Scott Bolam, The University of Auckland
Understanding and treating obesity’s harmful effects on rotator cuff healing
36 months, $315,618
Ms Esther Calje, The University of Auckland
Optimising the care and outcomes for women with severe postpartum anaemia
36 months, $315,174
Dr Emme Chacko, The University of Auckland
Mindfulness-based cognitive therapy for family carers of people with dementia
48 months, $319,802
Dr Charlotte Chen, The University of Auckland
Understanding dyspnoea and exercise limitation in interstitial lung disease
36 months, $316,975
Ms Louise Fangupo, University of Otago
Does a sleep intervention reduce weight gain in infancy? A novel approach
36 months, $320,000
Dr Amanda Landers, University of Otago, Christchurch
Evaluating a model of care for patients with COPD in their last year of life
36 months, $319,850
Dr Karen Oldfield, Medical Research Institute of New Zealand
The Use of Cannabis as a Medicine in New Zealand
15 months, $129,933
Dr Matt Richardson, University of Otago
Nocebo Hypothesis Cognitive Behavioural Therapy (NH-CBT): an RCT
36 months, $320,000
Dr Peter Russell, The University of Auckland
The Role of Oedema and Lymphatic Dysfunction in Critical Illness
34 months, $281,630
Mrs Sarah Walker, University of Otago
Supporting Allied Health Professionals in Rural Areas
36 months, $204,586
Dr Michael Tzu Min Wang, The University of Auckland
Exploring the diagnostic methodology and epidemiology of dry eye disease
24 months, $212,036
Dr Melanie Woodfield, Auckland DHB Charitable Trust
Implementing Effective Treatments: Parent training for conduct problems
48 months, $320,000
Dr Josh Faulkner, Auckland University of Technology
The Role of Psychological Flexibility in Recovery following a Concussion
24 months, $98,232
Sir Charles Hercus Health Research Fellowship
Dr Nicholas Fleming, University of Otago
Rational extension of immunotherapy in colorectal cancer.
48 months, $600,000
Dr Christoph Goebl, University of Otago, Christchurch
Understanding the role of the aryl hydrocarbon receptor in cancer
48 months, $587,351
Dr Natasha Grimsey, The University of Auckland
Novel strategies to harness therapeutic potential of CB2 in the immune system
48 months, $565,312
Dr June-Chiew Han, The University of Auckland
Vulnerability of the female heart
48 months, $593,057
Dr Muhammad Hanif, The University of Auckland
Tickling Cancer Cells to Provoke an Antitumour Immune Response
48 months, $580,348
Dr Rachel Purcell, University of Otago, Christchurch
Molecular mechanisms and the gut microbiome in CRC
48 months, $598,972
Dr Hayley Reynolds, The University of Auckland
Precision cancer treatment using predictive software and imaging biomarkers
48 months, $469,821
Dr Jie Zhang, The University of Auckland
Adult stem cell treatments for corneal endothelial diseases
48 months, $575,742