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RVTS – Growing and sustaining doctors in rural, remote and First Nations communities
Volume 221, Issue 7 Supplement | The Medical Journal of Australia (mja.com.au)
Learn more about the positive findings from the recent external evaluation of the Remote Vocational Training Scheme investigating the value of program outcomes and the effectiveness of its remote supervision and support model.
The culmination of six months of detailed work by the evaluation team led by Dr Belinda O’Sullivan and A/Prof Matthew McGrail (The University of Queensland), provides a strong evidence base on which to build a continuing and expanded role for the organisation beyond 2025.
The wealth of qualitative and quantitative data has informed five articles shared in the MJA supplement. There is an accompanying editorial commentary at: Growing and sustaining doctors in rural, remote and First Nations communities | InSight+ (mja.com.au)
Having delivered GP training to more than 500 doctors in over 350 communities, with over 300 program completions to date, the RVTS has over the past 25 years, continuously provided medical workforce solution for Australia’s rural, remote, and First Nations communities.
The evaluation has provided many insights into RVTS’ performance against its objectives and revealed many exceptional aspects of the program that are unique in the environment in which RVTS operates. Key findings include: high levels of participant satisfaction; high levels of fellowship attainment; impressive workforce retention; and comparative cost-effectiveness.
Additionally, the RVTS provides a template for best practice in the support of overseas trained doctors and showcasing place-based, retention-focused workforce strategies.
The Department of Health and Aged Care (DoHAC), funded and supported the evaluation, in the spirit of disseminating outcomes and informing ongoing quality improvement in support of services for remote and First Nations communities.
We thank the Project Reference Group and the evaluation participants, including the Remote Vocational Training Scheme (RVTS) staff, supervisors, training coordinators, medical educators, registrars, board, employers, and stakeholders who gave up their valuable time to contribute insights. This evaluation would not have been possible without their contribution.
The Stakeholder Advisory Group of Prof Jenny May, A/Prof Susan Wearne, Mr Murray Newman, Ms Carla Taylor, Ms Jo-Anne Chapman, Ms Marita Cowie, Mr David Glasson, Dr James Brown, Dr Yann Guisard, Dr Simone Raye and Ms Peta Rutherford contributed policy and program insights which informed further analysis and implications.
Additional experts and researchers who contributed to theory development included Dr Greg Gladman, Dr Karin Jodlowski-Tan, Dr Taras Mikulin, Dr Murray Towne, Dr Tiana Gurney and Dr Ronda Gurney.
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A new article has been published by BMC Medical Education titled “A novel general practice registrar to supervisor feedback system for distance education in rural areas.“
The article, led by Dr. Taras Mikulin, RVTS Adjunct Research Associate, and coauthored by Dr. Pat Giddings, RVTS CEO, Dr. Ronda Gurney, RVTS Director of Training, and Dr. Belinda O’Sullivan from Monash University of QLD, explores an innovative system aimed at improving the learning experience for general practice registrars in rural areas.
This groundbreaking research is a significant step forward in advancing medical education, particularly for those in remote locations.
Check out the full article for more details on this important contribution to distance education in rural healthcare!
Abstract
Background
Quality supervision in general practice (GP) is critical for the progress and satisfaction of GP registrars and for attracting future rural GPs. However, there is limited research to inform the implementation of feedback systems for enhancing supervision by rural supervisors, and no published evidence specific to distance education where a remote supervisor may be in a different practice and supervising from afar. This study aimed to develop and explore the outcomes of an easy-to-administer, safe and constructive, registrar-to-supervisor feedback system for a distance (or remote) supervision model.
Methods
Participatory action research involved the design of a standardised short-form questionnaire and an administration, data analysis and feedback process between registrars and supervisors. The questionnaire was administered each year between 16–20 weeks of the first year of registrar training within a 3–4-year rural and remote GP training program—the Remote Vocational Training Scheme (RVTS) (2020–2022). Participation in the project was voluntary. Registrars were asked 12 standardised questions about supervision over three domains: bond strength, task agreement and goal setting. Responses were summed by domain and evaluated using set criteria of high (> 80%), medium (51% to 79%) or low (50% or lower). High- and medium-level narrative feedback reports were provided to supervisors. Low domain scores were followed up by relevant internal staff to negotiate and resolve issues.
Results
All 106 commencing registrars completed the questionnaire, of which n = 99/106 (93%) reported high performance related to the bond with their supervisor, n = 94/106 (89%) reported high performance on training tasks, and n = 53/106 (50%) reported medium or low performance for supervisor’s understanding the registrar goals. The majority of supervisors found the feedback useful. Ten registrars identified to be in need (9% of 106) were offered additional support.
Conclusions
The system was found to be feasible, safe, and constructive for reviewing the quality of a distance supervision model for rural and remote registrars. It enabled prompt resolution of issues that would have otherwise been difficult to address and facilitated more open discussions about the quality of supervision. This process has been standardised within the RVTS.
Rates of Registrar satisfaction from RVTS annual participant satisfaction survey by year
| Measure | % Satisfied/Very satisfied * | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 2024 | 2023 | 2022 | 2021 | 2020 | 2019 | 2018 | 2017 | 2016 | 2015 | |
| I feel supported by my supervisor | 100 | 99 | 100 | 97 | 100 | 93 | 92 | 96 | 96 | 91 |
| RVTS provides a supportive learning atmosphere | 99 | 99 | 100 | 100 | 100 | 97 | 97 | 96 | 94 | 93 |
| Education workshops are valuable for learning | 100 | 99 | 100 | 97 | 97 | 99 | 96 | 96 | 98 | 95 |
| Staff are helpful | 98 | 100 | 97 | 97 | 100 | 97 | 99 | 96 | 94 | 98 |
| RVTS training and support contributed to me staying in location | 94 | 97 | 88 | 91 | 92 | 88 | 86 | 89 | 88 | 93 |
| Online learning modules are valuable | 98 | 89 | 92 | 94 | 95 | 90 | 86 | 90 | 92 | 88 |
* Satisfaction categorised by agreement ‘agreeing/strongly agreeing’ not including ‘neutral/ disagree/strongly disagree’. This survey is anonymous and administered online with an average 75% response rate.
