Final Report - Department of Health

Transcription

WA CLINICAL TRAINING NETWORK
Profile of clinical training
placement stakeholders and
models of clinical supervision and
facilitation
Final Report
30 August 2013
Our Vision:
Our Mission:
To positively
impact people’s
lives by helping
create better
health services.
To use our management
consulting skills to provide expert
advice and support to health
funders, service providers and
users.
Healthcare Management Advisors
Helping create better health services
Table of contents
1
Introduction...................................................................................................... 1
1.1
1.2
1.3
1.4
1.5
2
BACKGROUND ...................................................................................................................... 1
PROJECT AIMS ...................................................................................................................... 1
SCOPE OF DISCIPLINE AND STAKEHOLDERS ............................................................................. 2
PROJECT METHODOLOGY ..................................................................................................... 2
PURPOSE AND STRUCTURE OF THE REPORT .............................................................................. 3
Overview of clinical placements ......................................................................... 4
2.1
CURRENT CLINICAL PLACEMENT REQUIREMENTS AND ACTIVITY LEVELS ....................................... 4
2.1.1
2.1.2
2.1.3
2.1.4
2.1.5
2.1.6
2.1.7
2.1.8
2.1.9
2.1.10
2.1.11
2.1.12
2.1.13
2.1.14
2.1.15
2.1.16
2.1.17
2.1.18
2.1.19
2.1.20
2.1.21
2.1.22
2.1.23
2.1.24
2.1.25
2.2
Aboriginal health ....................................................................................................................... 4
Audiology ...................................................................................................................................5
Chiropractic............................................................................................................................... 6
Dentistry ................................................................................................................................... 6
Dietetics ..................................................................................................................................... 7
Exercise physiology ................................................................................................................... 8
Medical laboratory science ........................................................................................................ 9
Medicine ................................................................................................................................... 9
Midwifery ................................................................................................................................. 11
Nursing ................................................................................................................................ 13
Occupational therapy .......................................................................................................... 15
Optometry .......................................................................................................................... 15
Oral health........................................................................................................................... 16
Orthoptics ........................................................................................................................... 16
Orthotics and prosthetics .................................................................................................... 17
Osteopathy ......................................................................................................................... 17
Paramedicine....................................................................................................................... 17
Pharmacy ............................................................................................................................ 18
Physiotherapy ..................................................................................................................... 19
Podiatry ...............................................................................................................................20
Psychology .......................................................................................................................... 21
Radiation Science ................................................................................................................ 23
Social work ......................................................................................................................... 24
Speech pathology ................................................................................................................25
Overview of placement activity........................................................................................... 26
ENROLMENT CAPACITY AND PLACEMENT COMPETITION ........................................................... 36
2.2.1
2.2.2
2.2.3
2.2.4
2.2.5
2.2.6
2.2.7
2.2.8
2.2.9
2.2.10
2.2.11
2.2.12
2.2.13
2.2.14
2.2.15
2.2.16
Aboriginal health worker .......................................................................................................... 36
Audiology ................................................................................................................................. 36
Chiropractic.............................................................................................................................. 37
Dentistry .................................................................................................................................. 37
Dietetics ................................................................................................................................... 37
Exercise Physiology .................................................................................................................. 38
Medical laboratory science ....................................................................................................... 39
Medicine ................................................................................................................................. 40
Midwifery ................................................................................................................................. 41
Nursing ............................................................................................................................... 42
Optometry, Orthoptics, Orthotics, Prosthetics, and Osteopathy ........................................ 44
Oral health.......................................................................................................................... 44
Paramedicine.......................................................................................................................45
Pharmacy ............................................................................................................................45
Physiotherapy .................................................................................................................... 46
WA Clinical training network
Profile of clinical training placement stakeholders and models of clinical supervision and facilitation
Final Report
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2.2.17
2.2.18
2.2.19
2.2.20
2.2.21
2.2.22
3
TERMINOLOGY ................................................................................................................... 50
MODELS OF CLINICAL SUPERVISION AND FACILITATION ............................................................ 50
3.2.1
3.2.2
3.2.3
3.2.4
3.2.5
3.2.6
3.2.7
3.2.8
3.2.9
3.2.10
3.2.11
3.2.12
3.2.13
3.2.14
3.2.15
3.2.16
3.2.17
3.2.18
3.2.19
3.2.20
3.2.21
3.2.22
3.2.23
3.2.24
3.3
3.3.1
3.3.2
3.3.3
Aboriginal health ..................................................................................................................... 50
Audiology ................................................................................................................................ 51
Chiropractic ............................................................................................................................. 51
Dentistry .................................................................................................................................. 52
Dietetics .................................................................................................................................. 52
Exercise Physiology.................................................................................................................. 53
Medical laboratory science ....................................................................................................... 54
Medicine .................................................................................................................................. 54
Midwifery ................................................................................................................................. 55
Nursing................................................................................................................................ 55
Optometry .......................................................................................................................... 56
Oral health .......................................................................................................................... 56
Orthoptics and osteopathy .................................................................................................. 57
Orthotics and prosthetics .................................................................................................... 57
Paramedicine ...................................................................................................................... 57
Pharmacy ............................................................................................................................ 57
Physiotherapy ..................................................................................................................... 58
Podiatry .............................................................................................................................. 58
Psychology .......................................................................................................................... 59
Social Work ......................................................................................................................... 60
Speech Pathology ............................................................................................................... 61
Overview of supervision and facilitation models .................................................................. 61
INTERPROFESSIONAL AND MULTIPROFESSIONAL EDUCATION ................................................... 63
Interprofessional Education ..................................................................................................... 63
Multiprofessional education ..................................................................................................... 68
Opportunities and challenges with interprofessional and multiprofessional education ............. 69
Clinical placements in regional locations ............................................................ 71
4.1
4.1.1
4.1.2
4.1.3
4.1.4
4.1.5
4.2
4.2.1
4.2.2
4.3
5
Podiatry .............................................................................................................................. 46
Psychology .......................................................................................................................... 47
Social Work ......................................................................................................................... 48
Speech pathology................................................................................................................ 48
Overview of enrolment capacity and levels of collaboration and competition ...................... 48
Models of clinical supervision and facilitation .....................................................50
3.1
3.2
4
OVERVIEW OF EDUCATION AND PLACEMENTS IN REGIONAL AREAS ............................................ 71
Broome: key health services, educational courses and placement activity ................................ 71
Bunbury: key health services, educational courses and placement activity ............................... 73
Geraldton: key health services, educational courses and placement activity ............................ 75
Narrogin: key health services, educational courses and placement activity .............................. 76
Port Hedland: key health services, educational courses and placement activity ....................... 78
REGIONAL BARRIERS AND ENABLERS TO PLACEMENT CAPACITY ................................................ 78
Key enablers to clinical placement capacity.............................................................................. 79
Key barriers to clinical placement capacity ............................................................................... 81
PRIORITIES IN STRENGTHENING PLACEMENT CAPACITY ............................................................82
Barriers and enablers to building placement capacity and quality ....................... 84
5.1
5.2
5.3
5.3.1
5.3.2
ENABLERS TO PLACEMENT ESTABLISHMENT AND CONTINUATION ACROSS THE DISCIPLINES .........84
ENABLERS THAT SUPPORT QUALITY PLACEMENTS AND EXPANSION OF CAPACITY ........................ 87
BARRIERS AND CHALLENGES ................................................................................................88
Barriers and challenges across the disciplines: education provider specific ............................... 89
Barriers and challenges across the disciplines: host agencies specific ....................................... 90
Profile of clinical training placement stakeholders and models of clinical supervision and faci
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5.3.3
6
Barriers and challenges specific to disciplines ........................................................................... 91
Key opportunities for the future ....................................................................... 99
6.1
6.2
OPPORTUNITIES ACROSS DISCIPLINES .................................................................................. 99
OPPORTUNITIES BY DISCIPLINE ........................................................................................... 100
6.2.1
6.2.2
6.2.3
6.2.4
6.2.5
6.2.6
6.2.7
6.2.8
6.2.9
6.2.10
6.2.11
6.2.12
6.2.13
6.2.14
6.2.15
6.2.16
6.2.17
6.2.18
6.2.19
6.2.20
6.3
7
Aboriginal health .................................................................................................................... 100
Audiology ............................................................................................................................... 100
Chiropractic............................................................................................................................ 100
Dentistry ................................................................................................................................ 101
Dietetics ................................................................................................................................. 101
Exercise physiology ................................................................................................................ 101
Medical laboratory science ..................................................................................................... 101
Medicine ................................................................................................................................ 101
Midwifery ............................................................................................................................... 103
Nursing .............................................................................................................................. 103
Occupational therapy ........................................................................................................ 104
Optometry, orthoptics, orthotics, prosthetics and osteopathy ........................................... 104
Paramedicine..................................................................................................................... 105
Pharmacy .......................................................................................................................... 105
Physiotherapy ................................................................................................................... 105
Podiatry ............................................................................................................................. 105
Psychology ........................................................................................................................ 106
Radiation science ............................................................................................................... 106
Social work ........................................................................................................................ 106
Speech pathology .............................................................................................................. 107
FOCUS FOR THE FUTURE .................................................................................................... 107
Current partnerships, groups, networks and committees .................................. 110
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8
7.9
7.10
7.11
7.12
7.13
7.14
7.15
7.16
7.17
7.18
7.19
8
ABORIGINAL HEALTH ......................................................................................................... 110
AUDIOLOGY ..................................................................................................................... 110
CHIROPRACTIC ................................................................................................................. 110
DENTISTRY ...................................................................................................................... 110
DIETETICS ........................................................................................................................ 111
EXERCISE PHYSIOLOGY ...................................................................................................... 111
MEDICAL LABORATORY SCIENCE ......................................................................................... 111
MEDICINE ........................................................................................................................ 111
MIDWIFERY ...................................................................................................................... 111
NURSING ......................................................................................................................... 112
OCCUPATIONAL THERAPY .................................................................................................. 113
PARAMEDCINE ................................................................................................................. 113
PHARMACY ...................................................................................................................... 113
PHYSIOTHERAPY .............................................................................................................. 113
PODIATRY........................................................................................................................ 114
PSYCHOLOGY .................................................................................................................. 114
RADIATION SCIENCE .......................................................................................................... 114
SOCIAL WORK .................................................................................................................. 115
SPEECH PATHOLOGY ......................................................................................................... 115
Appendices .................................................................................................... 117
APPENDIX A STAKEHOLDERS CONSULTED ..................................................................................... 117
APPENDIX B REFERENCES ............................................................................................................ 125
Final Report
iii
Acknowledgements
In undertaking this project HMA (Healthcare Management Advisors) has spoken with people
from a wide range of organisations including educational providers and clinical placement
providers across metropolitan Perth and the regional areas of Broome, Bunbury, Geraldton,
Narrogin and Port Hedland. HMA has visited universities, vocational education training
providers, registered training organisations as well as clinical educators, health professionals,
community workers and managers. Settings for these visits has comprised: hospitals (public
and private), community based health services, primary care services, government
departments, Aboriginal and Community Controlled Health Organisations (ACCHOs), mental
health services, aged and community care services, private practice, non-government
organisations as well as discipline specific clinics run by educational providers or public
health facilities. Additionally we have spoken with officers of the Department of Health and
WA Country Health.
HMA would like to thank all those who took part in our consultations. We greatly appreciated
the time spent with us. We have endeavoured to capture the detail of the educational programs
and the models of supervision and facilitation utilised by organisations as accurately as
possible. We particularly appreciated the insights stakeholders had into:
 the enablers that support the provision of high quality clinical placements;
 the factors that have enabled the expansion of clinical placement capacity; and
 the opportunities to continue to strengthen clinical placement quality and capacity into the
future.
We trust this report will be useful in providing the Western Australia Clinical Training
Network with: an overview of what is currently occurring in Western Australia across the 24
discipline areas examined; and useful information that will support future planning to
strengthen clinical placement quality and capacity.
HMA also wish to acknowledge the expertise of our associates who worked on this project:
Dr Kristine Battye, Dr Catherine Sefton and Jan Veitch of KBC Australia, Associate
Professor Tom Keating and Christine O’Farrell.
Final Report
v
Use of this report
This report presents the findings from the Profile of Clinical Training Placement Stakeholders
and Models of Clinical Supervision and Facilitation Project, which was commissioned by the
Western Australian Clinical Training Network (WA CTN). The project aimed to:
(1)
Identify and profile stakeholders engaged in clinical training placement activity, with a
view to identifying the level and nature of student placement activity by profession, type
of placement and health service provider type.
(2)
Identify models currently in place for the provision of clinical supervision and clinical
facilitation by profession and to support interprofessional learning.
(3)
Identify enablers and opportunities to increase placement/enrolment capacity in the
future by profession and type of placement.
(4)
Identify current partnerships, groups, networks and committees operating and their
constituent membership, purpose and activity.
This report seeks to assist the WA CTN set strategic directions to strengthen the quality of
clinical placements and expand the capacity in the health and community sector to meet future
demand for clinical placements. Whilst the focus of this report is on clinical placements, in
setting priorities, the WA CTN will need to have regard to broader policy directions at a
national and state level to strengthen health outcomes and strengthen workforce capacity.
HMA has prepared two additional documents:
(1)
Discipline Summaries for each of the 24 discipline areas examined in the project. It is
envisaged that these could be used to support discussion and planning at a discipline
level.
(2) Regional Area Summaries for each of the five regional areas visited. These could be
used to support discussion and planning within regional areas as some strong themes
emerged.
HMA is also providing to WA CTN:
(1)
(2)
A list of champions or clinical/educational leaders in clinical placement development /
expansion identified by stakeholders and in our consultation process.
The HMA stakeholder database containing contact details of people spoken with during
the consultations.
Final Report
vii
Executive Summary
The WA Clinical Training Network (WA CTN) was established to ensure that Western
Australian (WA) health services and education and training providers are optimally positioned
to offer quality clinical placements to health students, contributing to the development of a
skilled and competent health workforce that will meet the needs of the WA community. At
the inaugural meeting of the WA CTN, held in August 2012, one of the key themes to emerge
was the need for enhanced collaboration between stakeholders. This project has been initiated
in response to some of the issues identified at that meeting, specifically those relating to:
 communication between stakeholders involved in clinical training placements, and
 issues around supporting and developing clinical supervision and facilitation.
Project aims
The project aimed to:
(1)
Identify and profile stakeholders engaged in clinical training placement activity,
with a view to identifying the level and nature of student placement activity by
profession, type of placement and health service provider type. In gathering this
information, HMA has sought to understand the differences in the profile of placements
in rural and metropolitan areas, and identify the level and nature of interprofessional and
innovative placement activity.
(2)
Identify models currently in place for the provision of clinical supervision and
clinical facilitation by profession, and for interprofessional placements. This
included identifying elements of good practice associated with quality placements and
expanding placement capacity.
(3)
Identify enablers and opportunities to increase placement/enrolment capacity in
the future by profession and type of placement.
(4)
constituent membership, purpose and activity. This allows existing networks to be
mapped and identify discipline areas where there may be a need for strengthening
networks.
Consultations were held with stakeholders involved in the provision of clinical placements in
the following 24 discipline areas:
Aboriginal Health
Midwifery
Paramedicine
Audiology
Nursing
Pharmacy
Chiropractic
Occupational Therapy
Physiotherapy
Dentistry
Optometry
Podiatry
Dietetics
Oral Health
Psychology
Exercise Physiology
Orthoptics
Social Work
Medical Laboratory Science
Orthotics and Prosthetics
Speech Pathology
Medicine
Osteopathy
Radiation Science (incorporating sonography, radiography, nuclear medicine and radiation
therapy)
Final Report
ix
Overview of clinical placements
The content, structure and hours required for clinical placement required by universities and
VET providers differs significantly across the disciplines examined in this report. The design
of each discipline’s clinical placement activity is almost always underpinned by the
accreditation and competency requirements of the appropriate professional board or
association. Clinical training placements for undergraduate and postgraduate students take
place in a diverse range of settings including hospitals (public and private), community based
health services, primary care services, Aboriginal Community Controlled Health
Organisations (ACCHOs), mental health services, aged and community care services, private
practice, and non-government organisations as well as discipline specific clinics run by
educational providers or public health facilities. In particular it was noted that:
(1)
(2)
(3)
(4)
(5)
The Australian Health Practitioner Regulation Agency (AHPRA) only requires
registration of students and professionals in 14 discipline areas, namely: Aboriginal
health workers, chiropractic, dentistry, medicine, medical radiation practice, midwifery,
nursing, occupational therapy, osteopathy, optometry, oral health, pharmacy,
physiotherapy, podiatry and psychology (where students must apply to the professional
association for provisional registration).
A few disciplines require graduates to undertake an internship year before they are
able to apply for general registration to practice, notably medicine and pharmacy. On
successful completion of their internship year, graduates are able to apply for general
registration.
A number of disciplines applied models of placement where the student is employed
whilst studying. This occurs for Aboriginal Health Workers, some midwifery courses,
paramedicine and sonography.
A few courses require and/or support placements in rural areas most notably:
medicine, dentistry, occupational therapy, medical imaging and physiotherapy. Many
disciplines were supportive of rural placements. However, a few discipline areas said
they did not use placements in rural areas as it was particularly difficult to find
supervisors in regional areas.
Some courses have large volumes of students and specific setting requirements for
students, most particularly nursing and medicine.
Additionally, there were a number of disciplines for which no courses exist within WA:
nuclear medicine, optometry, orthoptics, orthotics and prosthetics, osteopathy and radiation
therapy. Some interstate universities are working with health services within WA at present to
support clinical placement and some are interested in doing so in the future.
Enrolment capacity and competition for placement
Enrolment capacity in courses across the disciplines varied significantly. Some educational
providers have capped the numbers of students they take for a range of reasons including:
available funding, costs associated with delivering the course, strategic directions of the
education provider, industry input, level of workforce demand, lack of clinical placements
available and the inability of training facilities to accommodate additional student numbers.
However, other courses have the capacity to accommodate increases in the number of
students and clear growth strategies.
The level of collaboration differs between discipline areas at present and appears dependent
on individual program coordinators’ motivation, the desire for equity of placement
opportunities, and the level of competition for placements facing a particular discipline area.
Collaboration between university program coordinators has also occurred in response to
Final Report
x
requests from services that host students. Stakeholders said that competition for placement
opportunities occurs both within and between disciplines and is influenced by: student
numbers, the placement model, the length of placement, the availability of practitioners to
supervise, and reliance on ‘traditional’ services such as hospitals.
The discipline areas facing greatest challenges in securing placements at present include:
medicine, midwifery, nursing, psychology, exercise physiology, medical laboratory, medical
imaging, paramedicine and radiation therapy.
Models of clinical supervision and facilitation
Across the different disciplines there was a range of supervision models in place. Some
disciplines predominantly utilise a one to one supervision model, whilst other models involve
having one supervisor to a number of students.
Disciplines employing the one to one supervisor to student model include: Aboriginal health
worker, audiology, exercise physiology, paramedicine, pharmacy, podiatry, psychology,
sonography, nuclear medicine, social work and speech pathology.
Some of the disciplines use a peer placement model where a supervisor(s) supports students
attending in pairs (providing peer support to each other.) These disciplines include dietetics,
occupational therapy and speech pathology.
A number of disciplines have models of supervision involving one supervisor to a number of
students (often varying from 1:2 to 1:10 in the disciplines examined). The discipline areas
using these models include: chiropractic, dentistry (after an initial period), midwifery,
nursing, occupational therapy, oral health and physiotherapy.
In medical laboratory science, medical imaging and radiation therapy and some pharmacy
placements the models of placement involve two or more supervisors for each student. Often
student supervision was shared amongst a small group of supervisors when: the placement
was over many weeks or months, supervising staff worked part time and there was a need for
full time supervision, the model of supervision was intense or complex, or the students were
required to rotate across different work areas.
The majority of models incorporated a senior staff member taking responsibility for
facilitating the placements, liaising with the universities and orientating and supporting
students whilst on placement.
There was a lot of interest across the professions in developing interprofessional
competencies. With increasing numbers of older people and those living with chronic
conditions, good practice requires multidisciplinary and interdisciplinary care. Developing
student’s competencies in working with other health professionals is essential. Health
Workforce Australia has played a key role in supporting the development of these innovative
models. Whilst there is a lot of support for these models, there are still a number of challenges
related to their operation that need to be addressed before they are introduced more widely.
Clinical placements in regional locations
Five regional centres were visited: Broome, Bunbury, Geraldton, Narrogin and Port Hedland.
Each of the five regions has unique characteristics, challenges and strengths that influence
their ability to provide quality clinical placements. However there were a number of recurrent
themes that arose in discussion related to building placement capacity and quality. Key
strengths and enablers in maintaining and increasing capacity of clinical placements across
regional and remote settings included:
Final Report
xi
 the quality of the placement offered;
 desire to attract health professionals to the region;
 funding from Health Workforce Australia to establish Interprofessional Education (IPE)
programs;
 scholarships to undertake rural placements (such as John Flynn Scholarships, and those
supported by the Combined Universities Centre for Rural Health, Services for Australian
Remote and Rural Allied Health and the WA Country Health Service);
 attractiveness of the region to students;
 individual motivation of the supervisors;
 accommodation and student resources in place: and
 remuneration provided to some clinical supervisors, services or departments.
Key barriers to the expansion of student clinical and field placement capacity across regional
and remote settings included:






the availability and cost of student accommodation;
insufficient space in facilities to host students;
lack of staff with required competencies to provide supervision;
length and model of clinical placement;
social and community isolation; and
cancellation of placements with insufficient notice to organise replacements.
Priorities identified in strengthening placement capacity in regional locations include:
(1)
(2)
(3)
Strategies that support regional areas to ‘grow their own’ health workforce.
Improving access to accommodation and transport.
Establishing coordinator roles to support placements within regions.
The Rural Clinical School model was considered to be effective and there was support for this
model being expanded / applied to other disciplines.
Enablers to building placement capacity and quality
Stakeholders were asked about enablers to building placement capacity and quality. A number
of key themes arose pertaining to enablers of clinical placement establishment and
continuation across disciplines. These included:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Organisational and management support for supervision and a culture of teaching,
including recognition of the role of supervisor within their setting.
Systems and structures that require all staff to play roles in supporting clinical
placements and availability of professional develop opportunities to strengthen their
competencies in supervising students.
A sense of partnership between educational institutions and hosting agencies.
Recruitment practices of the agencies.
Individual motivation of the supervisors.
Provision of a university supervisor / facilitator / field placement liaison officer that
provides practical support.
Educational providers’ commitment to maintaining good working relationships with
agencies and their supervisors.
Capacity to provide students sufficiently skilled/trained to deal with placement
complexity.
Sufficient staff available to provide supervision.
Final Report
xii
(10)
(11)
(12)
(13)
(14)
Good coordination between education providers.
Having students in the agency who make a valued contribution.
An ongoing connection to the university environment and resources.
Strong linkages with past graduates.
Funding from Health Workforce Australia.
A number of key themes arose relating to enablers that support quality placements for
students and the expansion of placement capacity. These included:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
A strong workforce development objective beyond the immediate objective of providing
placements.
Robust models of supervision and facilitation.
Good orientation and training manuals and resources for students and supervisors.
Consistent approaches to assessment frameworks including generic handbooks.
Tools that support preceptors/supervisors monitor student attainment of competencies
and educational provider support when student performance issues arise.
Clinical placement networks.
Supervisor training and other professional development opportunities provided by the
educational provider.
Development of career pathways and opportunities for staff interested in teaching.
Proactivity and innovation of discipline program coordinator.
Barriers to building placement capacity and quality
During consultations some barriers were reported across the education and health sectors,
whilst others were specific to disciplines.
Barriers and challenges identified across the disciplines specific to education providers
include:
(1)
(2)
(3)
(4)
(5)
(6)
Ongoing challenges of sourcing and maintaining placements.
Challenge of providing incentives to hosting agencies and supervisors.
Competition for placement opportunities from other education providers.
Access to appropriate staff to supervise.
Attractiveness of sites and quality of placement experience for the student.
Difficulty engaging private practitioners as supervisors.
Barriers and challenges identified across the disciplines specific to host agencies include:
(1)
(2)
(3)
(4)
(5)
(6)
A lack of physical space including rooms, offices, desks, computers and secure storage.
Length and model of placement.
Inability of staff to manage the demands of the supervision in conjunction with their
ongoing workload.
Lack of recognition for the role of supervisor.
Inequitable funding for some disciplines to cover the costs of supervising students.
Organisational and administrative instability.
Some of the barriers and challenges surrounding clinical placement are discipline specific.
Barriers for specific disciplines are presented in detail in Chapter 5: Barriers and enablers to
building placement capacity and quality.
Final Report
xiii
Opportunities across disciplines
Common opportunities to strengthen or expand clinical placements identified in consultations
with stakeholders include:
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Formal recognition of supervisors/preceptors: Across a number of professions,
universities and health services spoke of the importance of good quality placements. To
a large extent, enthusiastic supervisors/preceptors who go out of their way to provide a
positive learning experience for students are at the core of good quality placements. A
number of professions spoke of the importance of ensuring appropriate professional
recognition is given to those undertaking these roles.
Credentialing of preceptors/supervisors: Some disciplines spoke of significant
variations in the quality of placements, based on the interest of the supervisor, their
clinical expertise and their skills in supervising/preceptoring students. Some
stakeholders suggested consideration be given to accrediting training programs and
credentialing preceptors/supervisors (such as those to be introduced from July 2013 for
psychology).
Interprofessional learning: A number of stakeholders saw opportunities for
strengthening interprofessional learning opportunities for students in the final year
including: chiropractic, pharmacy, and speech pathology.
Consideration of simulation: The opportunity for simulated learning activities to fulfil
specific competencies normally acquired through clinical placement produced divergent
responses. Some of the university representatives could see value in simulation to
achieve certain task based competencies whereas others were less positive. Almost all
disciplines considered that simulation was an important learning and teaching method
that can enhance rather than replace clinical placement activity. Irrespective of
stakeholder views, at present the accreditation requirements of many disciplines do not
allow for simulation to replace clinical placement activity.
Greater collaboration and coordination within disciplines: Some of the disciplines
work collaboratively to identify and approach host agencies and coordinate the
allocation of placements. Others have common assessment frameworks that are utilised
by all educational providers. In anticipation of increased demand for clinical placement
opportunities and recognition of the administrative onus placed on hosting agencies,
there is value in greater collaboration between educational providers within discipline
areas to increase capacity and manage competition for placements.
New hospitals and health services recognise and incorporate sufficient space for
students into their design and construction. Spaces for students to work, for teaching
to occur and interprofessional education needs to be incorporated into the design of
facilities.
Regular review of workforce demand: To ensure that students undertaking a program
have reasonable employment opportunities at graduation, education providers need to
continue assessing workforce demand for their disciplines and capping enrolment
numbers when appropriate.
Continuation of Health Workforce Australia funding focused on increasing capacity
of services to host students and enabling a dedicated coordinator to manage the
increasing numbers and support a quality clinical placement experience.
Exploring methods of overcoming barriers to rural placement: The cost of
accommodation and transport are major barriers to students undertaking clinical
placement in regional areas at present. It is not clear how this issue can be definitively
addressed. However, options may include the expansion of rural placement scholarships
within WA, the introduction of rural incentives similar to those offered in other states or
improved promotion of rural placement within some disciplines, greater flexibility in
Final Report
xiv
placement models, and exploration of partnerships in rural areas to coordinate all
available accommodation.
(10) A strategy to build ‘on and around’ the already established Rural Clinical School
infrastructure to support and enhance clinical placement opportunities in regional
areas for students of all disciplines. The general concept of having training, mentoring,
a resource centre, collegiate support and accommodation resource base for nursing and
allied health students as well as medical students during training placements was
acknowledged by many stakeholders to be attractive, especially in opening up more
placement opportunities in the north west regions where the current logistics and costs
are unaffordable.
Future strategic directions
Key themes to be considered in future approaches to strengthen capacity and quality of
clinical placements include:
(1)
(2)
Continued support for collaborative approaches: it was apparent that disciplines that
collaborated tended to have greater success in addressing the challenges facing them.
Discipline areas that are collaborative in nature:
(a)
have educational providers working together with host agencies to address issues;
(b)
minimise competition by alignment of the placement calendars;
(c)
approach host agencies in a coordinated way to minimise duplication of effort;
(d)
ensure allocations of placements are equitable;
(e)
utilise common assessment frameworks and guides;
(f)
identify problems emerging and develop solutions to address these issues
together; and
(g)
share information about how they approach supervision to ensure consistency and
foster learning.
Support the development of new approaches to supervision: A wide range of
placement approaches are being applied across the discipline areas. However, there is a
need to increase awareness of the different models that can be utilised to supervise
students to expand capacity. Models that should be considered include:
(a)
increased and better use of telehealth/videoconferencing/iPad and tablet
technology to enable remote supervision;
(b)
joint supervision arrangements that support students to work across a range of
settings/organisations. Services may not have the capacity to support a student by
themselves. However, if they rotate a student across settings/organisations it may
be possible;
(c)
engagement of recently retired/semi-retired clinicians to provide clinical
supervision;
(d)
hybrid supervision models where a range of senior clinicians support students in a
remote setting and remote/visiting supervision is provided by a discipline specific
remote/visiting supervisors;
(e)
using public and private visiting specialists to contribute to training in areas where
they provide specialist visiting services; and
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(f)
(3)
(4)
(5)
(6)
(7)
utilising specialist registrars undertaking regional rotations and/or outreach
services to supervise junior doctors.
Support and recognition of supervisors/preceptors: Clinical supervisors, facilitators
and preceptors are the backbone of the clinical placement system. Many clinicians
supervising students on clinical placements do so on top of their already busy work role.
It is important that increased recognition is given for the work they do and that time is
allocated to allow them to supervise students. There is also a need to ensure there is
ready access to professional development and networking opportunities.
Funding to support clinical placements: Health Workforce Australia funding has
been instrumental in supporting innovations such as interprofessional education and the
expansion of clinical placements in regional areas. To continue to innovate, there is a
need to have the resources available to support the development of models. For most
health services, whether they are public or private there needs to be recognition of the
costs associated with taking students and some recompense that allows for clinical
positions to be backfilled.
Focusing on addressing issues facing rural placement: which may include flexible
models of supervision, continued Health Workforce Australia funding, shared
accommodation resources or explorations of new accommodation options. Rural
scholarships and incentives are also critical in ensuring students are able to afford to
undertake placement in non-metropolitan settings. The Rural Clinical School provides a
strong model of clinical education facilitation that could be adopted by other disciplines
with sufficient funding and resources.
Importance of improving efficiency: Placement opportunities not being undertaken or
cancelled with little notice was a key concern in discipline areas where there was a high
level of competition. To address this there is a need for sophisticated tools and models
of placement to support the efficient and effective management of high volumes of
students who need to complete a range of specified placements.
Facility design: A major barrier to supporting placements across many disciplines was
having the capacity to accommodate students. Future master planning for new hospitals
and health services need to ensure clinical placement requirements are considered.
Current partnerships, groups, networks and committees
Stakeholders are involved in partnerships, groups, networks and committees at varying levels
of formality or intensity. A high level overview of the current partnerships, groups, networks
and committees operating related to clinical placements for each of the disciplines consulted
with is provided in the final chapter.
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xvi
Abbreviations
AASW
Australian Association of Social Workers
ACCHO
Aboriginal Community Controlled Health Organisations
AEP
Accredited Exercise Physiologist
APAC
Australian Psychological Accreditation Council
APHRA
Australian Health Practitioner Regulation Agency
CEC
Clinical Education Coordinator
CPD
Continuing professional development
CTN
Clinical Training Network
ESSA
Exercise and Sports Science Australia
GP
General Practitioner
HMA
Healthcare Management Advisors Pty Ltd
HWA
Health Workforce Australia
IPE
Inter professional Education
MBS
Medicare Benefit Schedule
NGO
Non-Government Organisation
NUCAP
National University Course Accreditation Program
NZ
New Zealand
OT
RACF
Residential Aged Care Facilities
RPH
Royal Perth Hospital
SPEF-R
Student Practice Evaluation Form-Revised
VET
Vocational Education Training
WA
Western Australia
WA CTN
Western Australia Clinical Training Network
WOFT
World Federation of Occupational Therapist
Final Report
xvii
1
Introduction
1.1 BACKGROUND
Clinical training placements occur in a diverse range of settings, which include: hospitals
(public and private), community based health services, primary health care services,
Aboriginal Community Controlled Health Organisations (ACCHOs), mental health services,
aged care services, community services, private practice, non-government organisations
(NGOs), and discipline specific clinics run by education providers. The Western Australian
Clinical Training Network (WA CTN) was established to ensure that Western Australian
(WA) health services and education and training providers are optimally positioned to offer
quality clinical placements to health students. This will in turn contribute to the development
of a skilled and competent health workforce that will meet the needs of the WA community.
Although it is early days for the Network, stakeholders have shown a strong interest in
working together to make the WA CTN a success.
At the inaugural meeting of the WA CTN, held in August 2012, one of the key themes to
emerge was the need for enhanced collaboration between stakeholders. This project has been
initiated in response to some of the issues identified at that meeting, specifically those relating
to:
 communication between stakeholders involved in clinical training placements; and
 issues around supporting and developing clinical supervision and facilitation.
The WA CTN Steering Group engaged HMA (Healthcare Management Advisors) to
undertake extensive stakeholder consultations, focussing on:
 identifying and profiling clinical training placement stakeholders in WA; and
 identifying models of clinical supervision and facilitation currently applied in WA.
This WA CTN project was funded by Health Workforce Australia (HWA) as an Australian
Government initiative.
1.2 PROJECT AIMS
The project aimed to:
(1)
Identify and profile stakeholders engaged in clinical training placement activity,
with a view to identifying the level and nature of student placement activity by
profession, type of placement and health service provider type. In gathering this
information, HMA has sought to understand the differences in the profile of placements
in rural and metropolitan areas, and identify the level and nature of interprofessional and
innovative placement activity.
(2)
Identify models currently in place for the provision of clinical supervision and
clinical facilitation by profession, and for interprofessional placements. This
included identifying elements of good practice associated with quality placements and
expanding placement capacity.
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(3)
Identify enablers and opportunities to increase placement/enrolment capacity in
the future by profession and type of placement.
(4)
constituent membership, purpose and activity. This allows existing networks to be
mapped and identify discipline areas where there may be a need for strengthening
networks.
1.3 SCOPE OF DISCIPLINE AND STAKEHOLDERS
Consultations were held with a range of stakeholders involved in the provision of clinical
university, vocational education and training (VET) and Registered Training Organisation
(RTO) placements in the following 24 discipline areas:
Aboriginal Health
Midwifery
Paramedicine
Audiology
Nursing
Pharmacy
Chiropractic
Physiotherapy
Dentistry
Optometry
Podiatry
Dietetics
Oral Health
Psychology
Exercise Physiology
Orthoptics
Social Work
Orthotics and Prosthetics
Speech Pathology
Medicine
Osteopathy
Radiation Science (incorporating sonography, radiography, nuclear medicine and radiation
therapy)
The identification of appropriate stakeholders has been undertaken through a range of diverse
methods. These included:
 reviewing the WA CTN contact list;
 Steering Committee recommendations;
 suggestions by WA Country Health regional directors and university program senior staff;
and
 suggestions made by health sector and universities contacts via an online survey.
A full list of stakeholders consulted throughout the project is provided in Appendix A.
1.4 PROJECT METHODOLOGY
The project involved the following stages.
Stage 1 Project initiation: The objective of this stage was to initiate the project and confirm
the approach to be taken.
Stage 2 Develop a consultation framework: A consultation framework was developed that
guided the consultation process with education providers and health services. This stage
included the development and dissemination of an online survey to stakeholders to identify
stakeholders where good practice placements were occurring.
Stage 3 Undertake consultations: HMA scheduled and undertook consultations with a range
of educational providers, health and community services including NGOs and ACCHOs in
metropolitan Perth and five regional areas: Broome, Bunbury, Geraldton, Narrogin and Port
Hedland.
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Stage 4 Prepare a final report: findings were summarised into a final report (this
document).
1.5 PURPOSE AND STRUCTURE OF THE REPORT
The chapters of this report are structured in line with the project aims:
(1)
(2)
(3)
(4)
(5)
(6)
Chapter 2 provides information pertaining to Aim 1: Profiling the stakeholders
engaged in clinical training placement activity with a view to understanding the level
and nature of student placement activity by profession, type of placement and health
service provider type.
Chapter 3 provides discussion relevant to Aim 2: Description of the clinical
supervision and clinical facilitation models in place by profession, interprofessional
learning placements. The chapter also identifies the elements of good practice
associated with quality placements and expanding placement capacity.
Chapter 4 gives an overview of clinical placements in regional locations: Identifying
key barriers and enablers that support clinical placement activity and opportunities to
improve placement quality and/or placement capacity.
Chapters 5 and 6 present information specific to Aim 3: Identifying the key enablers
and opportunities to increase placement/enrolment capacity in the future by profession
and type of placement.
Chapter 7 provides information pertaining to Aim 4: Profiling current partnerships,
groups, networks and committees operating and their constituent membership, purpose
and activity.
Chapter 8 contains the appendices:
Appendix A details the stakeholders consulted throughout the project.
Appendix B provides a list of references.
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3
2
Overview of clinical
placements
This chapter provides an overview of: current clinical placement requirements, placement
demand, activity levels at the sites visited, educational provider’s enrolment capacity and the
level of competition amongst providers to secure placements.
2.1 CURRENT CLINICAL PLACEMENT REQUIREMENTS AND
ACTIVITY LEVELS
In this section, clinical placement requirements and activity levels identified within the scope
of the project for each of the disciplines are presented.
Please note: At the time this project commenced, universities were in the midst of preparing
data relating to the number of students undertaking placements for Health Workforce
Australia (HWA). As a consequence, HMA was asked to seek only high level information
about the number of students undertaking each course and/or placements.
Commentary on each discipline is presented in alphabetical order.
2.1.1 Aboriginal health
The Community Services and Health Industry Skills Council has responsibility for oversight
of the Aboriginal and/or Torres Strait Islander Health Worker qualifications and competency
standards to ensure they are current and relevant to existing and emerging job roles. The final
qualifications are currently under review. The Aboriginal and Torres Strait Islander Health
Practice Board of Australia requires Aboriginal Health Workers intending to practice as
Aboriginal and Torres Strait Islander Health Practitioners to be registered. However, those
workers who are not required by their employer to use the title Aboriginal and Torres Strait
Islander Health Practitioner, Aboriginal Health Practitioner or Torres Strait Islander Health
Practitioner, are not required to be registered, and can continue to work using their current
titles (for example, Aboriginal Health Worker, Drug and Alcohol Worker and Mental Health
Worker).
The approach taken to the training of Aboriginal Health Workers is quite different to all other
courses HMA examined in this project. Generally, health services recruit an Aboriginal
Health Worker from their local community and as an employee they are then enrolled in a
Certificate III or IV Aboriginal Health Worker course and released for blocks of time to
undertake studies.
Marr Mooditj Training provides Certificate III, IV and Diploma of Aboriginal and Torres
Strait Islander Primary Health Care courses. In the Certificate III course two weeks of
observation placements are required. For the Certificate IV, three placements of two to three
weeks are required. Generally, the experiential practice occurs in the work setting under the
supervision of a Senior Aboriginal Health Worker. The courses are offered in a two week
block release format. Students alternate between attending theoretical classes at Marr Mooditj
Training.
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The Aboriginal Health Council of Western Australia provides Certificate III and IV
Aboriginal and Torres Strait Primary Health Care courses in Perth and provides training on
behalf of Wirraka Maya Health Service as required. Most students complete Certificate III
before moving on to Certificate IV and undertake placements in the health service they work
in, although they may be required to work in a different area of their organisation.
Kimberley Aboriginal Medical Services Council (KAMSC) provides courses in Aboriginal
and Torres Strait Islander Primary Health Care from Certificate III to Advanced Diploma
level. Students are recruited from the Kimberley region and trained to work in KAMSC
member organisations.1 Placements occur in the towns from which the students live. Table 2.1
provides the level of placement activity occurring at the sites visited.
Table 2.1: Aboriginal Health Worker student placement activity
Health Service Type
ACCHO
ACCHO
ACCHO
Name of Health Service
Derbarl Yerrigan Health Service
Broome Regional Aboriginal Medical Service
(BRAMS)
Geraldton Regional Aboriginal Medical Service
ACCHO
Aboriginal Health Service
Mental Health
Wirraka Maya Health Service, Port Hedland
Narrogin Community Health Service
Primary Mental Health Service Narrogin
Approx. number of students each year
8 students
4 students
1 at a time for 2-6 weeks placement numbers per
year vary- generally local students
1 recent graduate and 1 new trainee.
2 students
2.1.2 Audiology
Audiology Australia is the governing body currently responsible for registration of
Audiologist in Australia and accrediting courses. Audiology Australia requires students to
complete at least 200 hours of clinical placement of which at least 100 hours must be direct
adult client contact and at least 30 hours direct paediatric client contact. The other hours can
consist of indirect client contact.
The University of Western Australia is the only university in WA offering an audiology
course and one of only five programs in Australia. Approximately 30 students undertake the
course, with a new intake of students commencing every two years. The Master in Clinical
Audiology is a two year postgraduate degree. Students are required to complete 500 hours of
clinical placement and demonstrate competency. Eighty to ninety per cent of all clinical
placements must be undertaken under a 1:1 supervision model.
There is no requirement for students to complete a rural placement as it is hard to find suitable
supervisors and no funding is available to support a rural program.
Currently there are 30 students enrolled in the course at the University of Western Australia.
The university make arrangements with a range of health services to take students on clinical
placements and many students attend the same health services several times throughout their
course. Placements occur in a range of settings including: Australian Hearing, public
hospitals, community health, private practice and specialised hearing schools.
Table 2.2 provides an overview of the level of placement activity at the sites visited.
Table 2.2: Audiology student placement activity
Health Service Type
Public hospital
NGO
NGO
Telethon Speech and Hearing
Ear Science Institute of
Australia
Number of students taken each year
34 total students completing their final year in seven week placement
100 first year day placements
30 students a year 1 day per week( students may complete multiple days)
30 Students will attend 4 days within 2 year course
Will have some students for 2 week placement blocks between Year 1 Year 2
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2.1.3 Chiropractic
The Chiropractic Board of Australia is responsible for the registration of chiropractors and
chiropractic students. Only students who have studied accredited courses are eligible to apply
to the Chiropractic Board of Australia for professional registration. Prior to commencing
clinical placements, educational providers need to ensure their students are registered with the
Chiropractic Board of Australia. The Council Chiropractic Education Australasia Inc.
formally accredits all chiropractic education courses and specifies the standards relating to
clinical placements.2
Murdoch University is the only university in WA delivering a chiropractic course. Students
graduate with a joint degree of Bachelor Science and Bachelor of Chiropractics.
Approximately 47 students are studying the course at present. Students must undertake a total
of 46 weeks of clinical placements. Within this time they are expected to undertake 400
treatments and/or see 50 new clients which equates to close to 800 hours of clinical
placements.
The majority of placements are undertaken in the chiropractic clinic established on campus by
the university. Additionally, students undertake placements at a number of outreach clinics
established and supervised by university clinical staff. The outreach clinics are based in a
number of NGOs which provide services to clients with more complex needs including: St
Patrick’s Community Support Centre (which helps people who are homeless, needy and
disadvantaged), South Ottey Family and Neighbourhood Centre (which focusses on providing
services to the local Aboriginal community) and Palmerston Farm (which supports people
facing issues with alcohol and drug use). There are currently 47 students undertaking
placements at the chiropractic clinic.
The university also facilitates additional opportunities for students to undertake health
screening assessments at cultural events such as music festivals and annual rural outreach
clinics are delivered in Aboriginal and rural communities. Informally, some students facilitate
overseas placements.
2.1.4 Dentistry
The Australian Dental Council is the authority responsible for accrediting education providers
and programs of study for the dental profession in Australia. Dental students must achieve set
competencies for accreditation rather than specific hours undertaking clinical practice. The
Dental Board of Australia is responsible for the registration of dentists and dental students.
Only students who have studied accredited courses are eligible to apply to the Dental Board of
Australia for professional registration. Prior to commencing clinical placements, educational
providers need to ensure their students are registered with the Dental Board of Australia.
The University of Western Australia is the only university in the State to offer a dentistry
program. The undergraduate program of the School of Dentistry, the Bachelor of Dental
Science degree, is being phased out from 2013 (final students to graduate 2016) and has been
replaced with the Doctor of Dental Medicine (DMD). The DMD is a four year full time
degree and its first graduate intake commenced in 2013. There are 56 students undertaking
this course. All DMD applicants must have achieved at least a bachelor degree prior to
commencing the program.
The Oral Health Centre of WA (OHCWA) provides the most significant placement activity to
dentistry students. The OHCWA is funded through a contract between The University of
Western Australia and the WA Department of Health for provision of: clinical dentistry to
eligible members of the public; and practical dental training linked with the courses provided
by the university.
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The OHCWA hosts students from all years of their postgraduate study, but predominantly
from the first three years of the DMD. The Centre also provides placements for doctorate
students and qualified post graduates who are doing advanced qualifications in specialty
dental practice fields such as dental surgery, paediatric dentistry, endodontics, prosthodontics,
periodontics, orthodontics and oral pathology (numbers can range from between 16- 35 postgraduate students per year).
The WA Dental Health Service (DHS) also provides clinical placement for dental students.
Dental students undertake a six week remote/rural rotation at Bunbury clinic or with other
organisations such as Royal Flying Doctor Service or Kimberley Dental Team.
Table 2.3 provides an overview of the levels of placement activity at each site visited.
Table 2.3: Dentistry student placement activity
Health Service Type
University run public dental service
University run public dental service
Oral Health Centre of WA- Nedlands
Oral Health Centre of WA- Bunbury
Number of students taken each year -may be approximate
56
56 approximately
4 students per rotation (dependent on chairs) for
4 week placement
2.1.5 Dietetics
Dietitians’ Association of Australia (DAA) is the peak body for dietetic and nutrition
professionals providing strategic leadership in food and nutrition through empowerment,
advocacy, education, accreditation and communication. Within the DAA, the Australian
Dietetic Council has responsibility for the implementation of accreditation and recognition of
dietetic education. It provides independent high-level strategic advice to the DAA Board on
matters concerning course accreditation and recognition, and competency standards for entrylevel dietitians.
Two universities in WA currently offer dietetics education: Edith Cowan University and
Curtin University. Currently there are 53 students undertaking the Master of Nutrition and
Dietetics at Edith Cowan University (across the two years) and 36 students undertaking the
Postgraduate Diploma in Dietetics at Curtin University.
Dietetics students from Edith Cowan University and Curtin University must undertake three
placements: clinical (10 weeks), community (5 weeks) and food service (5 weeks)
representing a total of 20 weeks during their postgraduate program. A shared assessment
framework based on the DAA’s National Competency Standards for Entry Level Dietitians in
Australia is used across the universities with set objectives to be met over the three
placements.
The ten week clinical placement can be undertaken across two settings (five weeks in one
hospital and the remaining five weeks in another). Placements occur in a breadth of settings
including hospitals, health services, community organisations and non-government
organisations, but placement activity also extends to facilities which provide food services for
institutions such as prisons, aged care services and health services. Rural placements can be
facilitated but students are not required to undertake them.
Table 2.4 provides an overview of the level of placement activity at each site visited.
Table 2.4: Dietetic student placement activity
Health Service Type
Health service
Private hospital
Swan Kalamunda Health Service
Joondalup Health Campus
Public hospital
Sir Charles Gairdner Hospital
Number of students taken each year (may be approximate)
6-8 (2 at a time for all placement rotations)
8 clinical (in pairs)
6-8 food service per rotation (12 a year)
2- 4 clinical each rotation (up to 8 per year)
Food service- 2 at a time
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Health Service Type
Non-Government
Organisation
Private hospital
WA Diabetes
Public hospital
Osborne Park Hospital
Public hospital
Princess Margaret Hospital
Residential Aged Care
Brightwater Madeley (IPE)
St John of God Hospital
4 each year
(2 per semester)
4 clinical (2 each rotation for 5 weeks)
1 food service
8 clinical a year
(2 at a time for 4 blocks)
8 students for food service
From ECU- 2 clinical
2 food service
2 research (for Master)
From Curtin- 4 food service
4 clinical
2 dietetic students for each IPE block- food service (up to 8 per year)
4 weeks (3 weeks onsite
2.1.6 Exercise physiology
Exercise and Sport Science Australia (ESSA) accredits exercise physiology courses. From 1
January 2014 onwards those seeking recognition as an Accredited Exercise Physiologist will
need to have completed a National University Course Accreditation Program (NUCAP)
Exercise Physiology course. To become an exercise physiologist, students must first complete
a three year undergraduate degree in exercise science. Exercise science courses are offered at
Curtin University, Edith Cowan University, Murdoch University, The University of Notre
Dame Australia and The University of Western Australia. To graduate, 140 hours of
placement hours are required with a population group considered healthy. Currently, there are
approximately:
 30 to 40 students completing their Bachelor of Science (Exercise Science and
Rehabilitation) at Edith Cowan University;
 35 students competing their Graduate Diploma of Exercise Science at Murdoch University;
 24 students undertaking a Graduate Diploma of Exercise Science and 24 students
undertaking a Master of Exercise Science at The University of Notre Dame Australia; and
 35 students in total undertaking their Graduate Diploma in Science (Exercise
Rehabilitation) and Graduate Diploma in Exercise Rehabilitation) at The University of
Western Australia.
The number of students undertaking their Bachelor of Science (Exercise, Sports and
Rehabilitation Science) at Curtin University was not available.
High performing students have the option to continue, converting their undergraduate studies
to a four year degree or to complete a fourth year as a postgraduate diploma, which is offered
at all universities except Edith Cowan University and Curtin University. The latter university
is planning to introduce a similar option in coming years. Murdoch University allows students
to enrol in a four year undergraduate degree that articulates with their exercise science degree
for the first three years. In 2014 Edith Cowan University will also offer a four year
undergraduate degree that articulates with the exercise science degree for the first three years.
The University of Notre Dame Australia and The University of Western Australia also offer a
two year master degrees that articulates with the first year of their postgraduate diplomas.
The fourth year is required to achieve accreditation as an exercise physiologist with ESSA. In
undertaking this fourth year students are required to undertake a further 360 hours of practical
placement. This must include 140 hours related to cardiopulmonary/metabolic conditions and
140 hours related to musculoskeletal/neurological/neuromuscular conditions. The remaining
80 hours includes other conditions that do not fall under the other two categories. For each
area a student must complete a minimum of 65% (at least 84 hours) face to face exercise
delivery and a maximum of 35% (up to 49 hours) observation and 5% (up to 7 hours)
administration.
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Clinical placement settings include private practice, community health, and vocational
rehabilitation agencies. Exercise physiologists are not employed within the public hospitals in
WA with the exception of the Royal Perth Hospital where they are employed by the Cardiac
Transplant Unit.
Table 2.5: Exercise physiology student placement activity
Health Service Type
Public hospital
Royal Perth Hospital (RPH)- cardiac
transplant unit
Private practice/gym
Hollywood Functional Rehabilitation
Clinic
Regenerate
Como Health and Fitness Centre
Guardian Exercise Physiology
Curtin Stadium Exercise
13-14 student a year
Continuous part time around university requirements
May have 2-3 students at once
Notre Dame complete hours within 5 week block. Other
students may take longer
4 students each 5 week block - part time
Students must complete hours in this time frame
Maximum 2 students at a time -part time
Numbers fluctuate
1 student at a time in 5 week block -part time
Back to back part time blocks around university requirements
12-14 a year
Students are on a part time basis generally encourage to
complete hours within 10-12 weeks
15-20 students per year
2.1.7 Medical laboratory science
The Bachelor of Science (Laboratory Medicine) is accredited by Australian Institute of
Medical Scientists. Curtin University is the only university offering a Bachelor of Science
(Laboratory Medicine) in WA and the only course accredited by the Australian Institute of
Medical Scientists. Currently there are 300 students undertaking the course across all year
levels. Students currently need to undertake 28 weeks of clinical placements.
Placements predominantly occur at PathWest Laboratory Medicine WA (which provides
medical laboratory services for all public hospitals) and with whom a strong partnership has
developed. There are also a small number of placements in larger private medical laboratories
or private hospitals with whom the university has informal relationships.
Students are able to initiate and pursue placement opportunities interstate or overseas and in
rural areas. However, placements in rural areas are not generally encouraged as it is felt
students really need to be exposed to the environment and work of a large laboratory.
Table 2.6 provides an overview of the level of placement activity at the site visited.
Table 2.6: Medical laboratory science student placement activity
Health Service Type
Public hospital
PathWest Laboratory Medicine WA
Number of students taken each year (may be
approximate)
50 students in 2013
31 students in 2012
2.1.8 Medicine
The Medical Board of Australia is responsible for the registration of doctors and medical
students. Only students who have studied accredited courses are eligible to apply to the
Medical Board of Australia for professional registration. Prior to commencing clinical
placements, educational providers need to ensure their students are registered with the
Medical Board of Australia.
The Australian Medical Council accredits basic medical courses that lead to qualifications
that permit the holder to seek general registration as a medical practitioner. Accreditation
Final Report
9
standards address the requirements for delivery of high quality medical education and covers:
the context of the medical school; the outcomes of the medical course; the medical
curriculum; the curriculum relating to teaching and learning, assessment of student learning,
monitoring and evaluation; and implementing the curriculum as it relates to students and
educational resources.
There are two universities providing medical courses in WA. The University of Western
Australia currently offers a six year undergraduate medical course. However, it will be
transitioning to a four year graduate course next year (2014). The University of Notre Dame
Australia offers a four year graduate course, The University of Western Australia currently
accepts approximately 100 students each year and The University of Notre Dame Australia
approximately 110 students. The University of Western Australia 2014 doctoral program will
accept a maximum 105 students for each admission cycle.
Universities have a wide range of formal agreements with health services that support
placement in a range of settings including: public and private hospitals, the Rural Clinical
Schools, aged care services, general practice and ACCHOs.
The Rural Clinical Training and Support (RCTS) Program (Australian Government,
Department of Health and Ageing), provides targeted funding to participating Australian
medical schools in: rural student selection; the enhancement of support systems for students;
rural medical educators; and structured rural placements. The RCTS targets include: 25% of
Commonwealth supported medical students undertaking at least one year of their clinical
training in a rural area (ASGC 2-5) prior to graduation; 25% of Commonwealth supported
medical students to be from a rural background; and for all Commonwealth supported medical
students to undertake at least four weeks of structured rural placement in an ASGC 2-5 region
which usually occurs in their final year of study.
The Rural Clinical School of Western Australia provides year long placements in a range of
regional areas including: Kununurra, Derby, Broome, Port Hedland, Karratha, Carnarvon,
Geraldton, Bunbury, Busselton, Narrogin, Albany, Esperance and Kalgoorlie. Students
undertaking the placements are in year five if studying with The University of Western
Australia, and year three if studying at The University of Notre Dame Australia.
Approximately two thirds of the students are from The University of Western Australia and
one third from The University of Notre Dame Australia.
Prevocational training
The Australian Medical Council develops standards for intern training on behalf of the
Medical Board of Australia. The Medical Board of Australia is responsible for granting
registration. The State and Territory Postgraduate Medical Councils are responsible for
accreditation of intern training posts. In Western Australia this is the Postgraduate Medical
Council of Western Australia.
Upon the completion of medical courses at university, junior doctors must complete an intern year to
become a registered practitioner. During prevocational training, junior doctors are employed by
metropolitan hospitals (who are their primary employer), but can undertake rotations in non-teaching
government hospitals.
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Table 2.7: Medical student placement activity
Health Service
Type
Public hospital
Take students from The University of Western Australia and The
University of Notre Dame Australia.
General medical ward providing an interprofessional education
placements
84 per year across 6 disciplines i.e. about 22-23 medical students
Take students from The University of Western Australia and The
University of Notre Dame Australia
Hospital has about 100 students and interns on placement at any one time
Only take UWA students
Approximately 120 students a year
Specialist hospital so only host fifth year or PGY 2 students- as
placements require students to have a higher level of skill
Broome - 8 from the Rural Clinical School with yearlong rural
placements plus students who have scholarships and elective placements
Take 106-118 students a year across both universities and a range of year
levels.
1-4 rotations for PGY1 in general medicine; general surgery;
orthopaedics; emergency department
Public hospital
Public Hospital
Public Hospital
King Edward Memorial Hospital
Obstetrics and Gynaecology
Department)
Public Hospital
Broome Hospital (indicative of the 13
sites where the RCS operates)
Hollywood Private Hospital
Private
Hospital
Public Hospital
- Regional
Public Hospital
- Regional
Public Hospital
- Regional
Public Hospital
- Regional
General
practice
General
practice
General
practice
Bunbury Hospital, with Royal Perth
Hospital the primary employing health
service
Broome Hospital with Fremantle
Hospital the primary employing health
service
Geraldton Hospital with Sir Charles
Gairdner the primary employing
health service
Port Hedland Hospital with Sir
Charles Gairdner or Royal Perth
Hospital as primary employing health
service
Rowethorpe Medical Clinic
Wheatbelt General Practice Aboriginal
Health
Derbarl Yerrigan
2 rotations for PGY 1 including general medicine, general surgery
1-2 rotations for PGY 1 including general medicine, general surgery
1 rotation general medicine or general surgery
Numbers of students varies from year to year
Take students from The University of Notre Dame Australia and The
University of Western Australia
The University of Notre Dame Australia for 4 weeks
The University of Western Australia “a taster” for general practice
placements.
3 students a year. They undertake one day a week in blocks of a month as
part of the Rural Clinical School placement.
A few registrars and first year medical students undertake clinical
placements each year.
2.1.9 Midwifery
The Nursing and Midwifery Board of Australia is responsible for the registration of
midwifery students. Only students who have studied accredited courses are eligible to apply
to the Nursing and Midwifery Board of Australia for professional registration. Prior to
commencing clinical placements, educational providers need to ensure their students are
registered with the Nursing and Midwifery Board of Australia. The Australian Nursing and
Midwifery Accreditation Council is the authority responsible for accrediting midwifery
courses.
There are now several qualification and career pathways into midwifery which include:
(1)
(2)
Bachelor of Science (Midwifery): a full three year undergraduate degree course
exclusively in midwifery where graduates are eligible to register and practice as
midwives. There are 35 students undertaking this Curtin University course for the two
intakes each year.
Graduate Diploma of Midwifery: The University of Notre Dame Australia offers an
18 month course for students who are registered nurses. This replaces the traditional one
year hospital training/university theoretical course. Currently there are six students
undertaking this course.
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(3)
(4)
Bachelor of Science (Nursing) Bachelor of Science (Midwifery): Edith Cowan
University offers dual undergraduate degrees in nursing and midwifery. There are
currently 25 students undertaking the double degree.
Master in Midwifery Practice: Edith Cowan offers a two year advanced course for
graduates offering deeper learning in pharmacology and diagnostics aimed at preparing
graduates to become registered midwives. There are currently 30 students across the
two year course.
From a clinical placement perspective, registered nurses undertaking graduate midwifery
studies are able to work in paid employment in a maternity unit whilst studying. Such
arrangements are referred to as the ‘employment model’ of placement. However, as
undergraduate midwifery students (direct entry and dual degree) have no professional scope
of practice standing in either nursing or midwifery their placements are unpaid. These
students are always fully supernumerary to the staffing roster.
Curtin University’s Bachelor of Science (Midwifery) requires students to undertake three
years of study and 1,500 hours of placement which occurs over six semesters in a mix of
public and private hospitals. They also offer a Graduate Diploma in Midwifery which requires
students to undertake one and a half years part time study and 1,500 hours of clinical
placement over the course.
The University of Notre Dame Australia’s Graduate Diploma of Midwifery is offered over 18
months. They require 1,200 hours of placements and have some rural placements arranged
with the WA Country Health Service in Kalgoorlie, Busselton, and Bunbury and in the
process of establishing placements in Geraldton. This placement program was established
with Health Workforce Australia funding to support additional placements in partnership with
the private sector. The placements are entirely supernumerary and students are engaged in an
unpaid clinical placement model
Students of Edith Cowan University’s dual Bachelor of Science (Nursing) and Bachelor of
Science (Midwifery) are required to undertake 1,080 hours of midwifery clinical placements
over four years.
Edith Cowan University, Joondalup Campus offers a Master in Midwifery Practice course for
registered nurses working in an employment model who are required to undertake 1,274 hours
of experience.
Recently it became a national registration requirement that all students demonstrate they have
provided continuity of care to 20 women. This requires students to have:
 experience of continuity with individual women through pregnancy, labour and birth and
the postnatal period;
 participated in continuity of care models involving contact with women that commences in
early pregnancy and ends four to six weeks after birth;
 a minimum of eight continuity of care experiences towards the end of the course and with
the student fully involved in providing midwifery care with appropriate supervision;
 engagement with women during pregnancy and at antenatal visits, labour and birth as well
as postnatal visits according to individual circumstances; and
 overall, it is recommended that students spend an average of 20 hours with each woman
across her maternity care episode.
Undertaking the required number of continuity of care experiences may be achieved in the
scheduled clinical placements. However, if it is not, students must complete this course
requirement in their own time. The estimated practical working time for achieving the
continuity of care experiences is approximately 400 hours. Generally, experience is gained in
Final Report
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several block placements in the first twelve months and final six months, optimising prospects
for the student to achieve their continuity of care experiences necessary for registration.
Placements occur in a wide range of public and private hospitals. Table 2.8 provides an
overview of the number of students undertaking placements at the sites visited.
Table 2.8: Midwifery student placement activity
Health service type
Public hospital
Public hospital
Kaleeya Maternity Unit – part of the
Fremantle Hospital and Health
Service
Public hospital
(operated by a private
provider)
Undergraduate students: 20 from Curtin University
Graduate students: 12 from Curtin University and 12 from Edith Cowan
University
Undergraduate students: 2 Curtin University
Graduate students: 3 from The University of Notre Dame Australia and
Curtin University
Graduate student positions: 5-6 from Edith Cowan University and
Curtin University
Undergraduate student places (for double degree and direct entry
students): 18 students
Graduate 2 year masters students: no numbers provided
2.1.10Nursing
The Nursing and Midwifery Board of Australia is responsible for the registration of nursing
students. Only students that have studied accredited courses are eligible to apply to the
Nursing and Midwifery Board of Australia for professional registration. Prior to commencing
clinical placements, educational providers need to ensure their students are registered. The
Australian Nursing and Midwifery Accreditation Council (ANMAC) is the authority
responsible for accrediting all nursing courses. In Western Australia there are a large number
of educational providers delivering nursing courses.
The University of Notre Dame Australia offers a three year Bachelor of Nursing course
requiring students to complete 1,240 hours of clinical placement over the three years of their
course. There are approximately 350 students over the two intakes of students they take a
year.
Edith Cowan University - Joondalup Campus offers a three year Bachelor of Nursing course
and a four year ‘dual degree’ course where students graduate with bachelor degrees in both
nursing and midwifery. There are approximately 570 students undertaking the Bachelor or
Nursing (over the two intakes of students they take a year) and 25 students undertaking the
dual degree. The Bachelor of Nursing students are required to do 840 hours of clinical
placement. The dual degree students are required to do 840 hours for the nursing component
and an additional 960 hours for the midwifery component as well as another 400 hours to
meet continuity of care case number requirement.
Murdoch University offers a three year Bachelor of Nursing. There are approximately 500
students across the three year levels. In each semester, students undertake at least 120 hours of
placement in aged care, primary health, medical, surgical, mental health, paediatrics,
maternity, and placements of their choice that support them consolidate their experience and
transition to a graduate nurse.
Curtin University offers a three and a half year Bachelor of Science (Nursing). There are
approximately 1,000 students across all year levels of the course. A minimum of 880 hours of
clinical placements is required. Students undertake ‘living well’ placements in community
settings, placements with patients who are critically unwell in hospital medical and surgery
areas, specialty placements and their final placement seeks to assist students consolidate their
skills in a clinical area or setting the student wants to work in.
Curtin University also offers a Master of Nursing Practice. At the time of undertaking the
consultations the program was not being offered and program was under redevelopment.
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13
The University of Western Australia offers a two years Master of Nursing Science. There are
80 students undertaking the course. A total of 880 hours of clinical placement is required.
There are placements in: medical/surgery, paediatrics and child and adolescent health, critical
care, inpatient mental health, community mental health, interprofessional learning, a clinical
area the student wants to work in and a rural area.
Challenger Institute of Technology – Murdoch Campus offers an 18 month Diploma in
Nursing. They also offer students the same course condensed into a twelve month
configuration of theoretical and experiential/clinical placement learning. There are
approximately 100 students across the two intakes of students they take each year. The
Diploma in Nursing requires a minimum of 400 hours of clinical placement. However, the
course is structured around students completing 650 hours over 17 weeks of structured
placements. Over the eighteen month course students are required to do 800/840 hours of
placement.
Challenger Institute of Technology nursing diploma students are introduced to supervised
practical care in aged care settings, subacute, mental health and acute medical/surgical care.
The Institute of Health and Nursing Australia offers an eighteen month Diploma in Nursing.
There are 24 students undertaking their course. Clinical placements occur over four stages of
the course in aged care, sub-acute care, mental health, and acute care.
The Central Institute of Nursing offers an eighteen month Diploma of Nursing. They have
approximately 125 full time and 50 part time students. The placements occur in three stages
across the course. Students must complete 80 hours of placements in aged care, 10 hours in
community care, 160 hours in acute medical care, 120 hours in surgical placement occurring
and 80 in mental health.
Marr Mooditj Training offers an eighteen month Diploma of Nursing for Aboriginal students.
There are approximately 40 students across the three intakes periods each year. Placements
occur in general nursing care (three weeks), acute care (two blacks of three weeks), palliative
care (one to two weeks), mental health (two weeks) and paediatric care (two weeks).
Placements occur in public and private hospitals, aged care services, mental health services,
ACCHOs, and community based services such as Silver Chain. Only one of the metropolitan
based nursing courses requires students to complete a rural placement, though many said they
encouraged rural placements.
Table 2.9 shows the nursing placement activity occurring at the services visited. Significantly
high volumes of placements are occurring at public and private hospitals.
Table 2.9: Nursing student placement activity
Health Service Type
Public hospital
Fremantle Hospital and Health Service
Public Hospital
Public Hospital
Public Hospital
Princess Margaret Children’s Hospital
Rockingham Hospital
Mental Health
Graylands Hospital
Private Hospital
Private Hospital
Private Hospital
Aged Care
Community health
St John of God Hospital – Subiaco
St John of God Hospital – Murdoch
Waikiki Private Hospital
Bethanie Aged Care
Child and Adolescent Community Health Service
1,600 placements including enrolled nurses, graduate and
postgraduate nurses and midwifery only students
817 placements.
294 students for 3,715 days of placement,
995 students. Of the undergraduate students: 26 first years;
236 second years and 509 third years. Of the diploma
students:
16 were from stage one; 81 from stage two; and 79 stage
from stage three.
48 students were doing a bridging course
5,779 clinical placement days (calendar 2012);
580 students
650 students for 8,000 days.
6 to 8 students
50 students for a total of 1,266 days of placement
400 – 500 (undergraduate nursing students)
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14
2.1.11Occupational therapy
The Occupational Therapy Board of Australia is responsible for the registration of
occupational therapists and occupational therapy students. Only students who have studied
accredited courses are eligible to apply to the Occupational Therapists Board of Australia for
professional registration. Prior to commencing clinical placements, educational providers
need to ensure their students are registered with the Occupational Therapists Board of
Australia. The courses are accredited by The Occupational Therapy Council (Australia &
New Zealand) Ltd3. To attain accreditation the courses must meet the World Federation of
Occupational Therapist standard of a minimum of 1,000 hours of clinical placement.
Curtin and Edith Cowan University both offer four year undergraduate Bachelor of
Occupational Therapy courses. Curtin University also offers a two and a half year graduate
entry Master of Occupational Therapy. Currently Curtin University has approximately 145
students in year four of its Bachelor of Science (Occupational Therapy) and 201 students
enrolled in year one. There are 65 students undertaking their Master of Occupational Therapy
course. There are 182 students undertaking the Edith Cowan University Bachelor of Science
(Occupational Therapy), 45 of these students are in the first year of the course. Students
undertake placements in a range of settings including: hospitals (public and private); aged
care services; community health services; NGOs; mental health services; schools; and
vocational rehabilitation services.
Neither university has a requirement for students to undertake a placement in a rural area.
However, at Curtin University approximately 60% of students in 2013 are completing one in a
rural or remote area. Edith Cowan University equally has a high success rate with rural
placements. Curtin University also has a ‘Go Global’ program. Approximately 60% of its
students complete one of their seven-week placement blocks in Cambodia, China, India,
Philippines or the Ukraine.
Table 2.10 provides an overview of the level of placement activity at each site visited. Nearly
all health services reported taking at least one student in every seven week block. Generally
this meant all staff (excluding new graduates) supervised a minimum of one to two students a
year.
Table 2.10: Occupational therapy services, placement activity
Health
Service Type
Public hospital
Royal Perth Hospital (RPH)
Public hospital
Armadale Health Service
Private
Hospital
Aged care
Aged care
Mental health
Joondalup Health Service
Mental health
Inner City Community Mental
Health
Autism Association of WA
Advanced Personnel
Management
Community
Vocational
rehabilitation
Amana Living
Silver Chain
Graylands Hospital
34 total students completing their final year seven week placement
100 first year day placements
Minimum of 12 students, in their final year for a 7 week blocks.
Have option to swap one final year for two 1 week second year students.
24 first year students for 1 day
6-8 students per year in 7 week blocks
24 students in total in their final year for a 7 week block- 4 students each block
6 students in their final year for a 7 week block (1 each block)
11 students in total.in their final year for a 7 week block. (2 in each placement
block except for 1)
6 students in total in their final year for a 7 week placement block.
10 students both 7 week final year placements and second year for 1 week
12 total final year 7 week placements offered, 6 in metropolitan Perth and 6
rural/remote areas. (the majority of the rural/remote placements don’t get used)
2.1.12Optometry
Courses in optometry are not offered in WA currently. Courses are available at five Australian
universities: Flinders University of South Australia, University of New South Wales,
Queensland University of Technology, University of Melbourne and Deakin University. Two
universities had reasonably regular arrangements in place with health services (private and
Final Report
15
public) in WA. The remaining universities reported ad hoc clinical placements in WA. Those
that occur tend to be initiated by the student themselves due to established relationships with a
service or who have family living in WA. A student from Queensland University of
Technology arranged a placement in Port Hedland and was assisted to do this with a
scholarship from Services for Australian Rural and Remote Health (SARRAH).
Flinders University of South Australia and Queensland University of Technology commented
that they would be interested in developing more formal relationships with WA health
services in the future.
The Royal Perth Hospital is one of a number of public and private optometrists that take
students from the University of New South Wales. The Optometrists Association of Australia
assists in facilitating the placements by asking its members to take students on placement for a
short period of time. The Royal Perth Hospital generally takes one or two students for a
period of one to two weeks before they rotate on to other placement settings.
2.1.13Oral health
The Oral Health Division of the Dental Board of Australia is responsible for the registration
of oral health therapists and oral health students. Only students who have studied accredited
courses are eligible to apply to the Oral Health Division of the Dental Board of Australia for
professional registration. Oral health therapist courses are accredited by the Australian Dental
Council. Courses must demonstrate their graduates are competent. However, there is no
minimum number of hours of clinical placement required.
Curtin University is the only university in WA that offers the Bachelor of Oral Health
Therapy, which is a three year undergraduate degree. It was recently established, and this is
the first year that the University has had a full cohort of students. They take 34 students a
year. The students complete around 1,150 hours of clinical placement, of which 765 involves
clinical practice and the remaining hours involves simulation.
Curtin University’s oral health course is located within the Oral Health Centre of WA
(OHCWA). The majority of their clinical placements occur at clinics run at the OHCWA or
the Mount Henry Dental Clinic, and students rotate across the two facilities. Both these
facilities have extensive simulation laboratories where regular practical sessions are
undertaken as well as clinical chairs where clients are seen. In the final year, students’ clinical
placements occur at schools, domiciliary and aged care services and special needs clinics. The
course does not have rural placements at present.
Table 2.11 provides an overview of the levels of placement activity at each site visited.
Table 2.11: Oral health student placement activity
Health Service Type
Public dental clinic
Oral health Centre of WA
Public dental clinic
Mount Henry Dental Clinic
34 students will complete multiple single days of clinic and
simulation activity during the course- makes up close to half of all
hours
34 students will complete multiple single days of clinic and
simulation during the course- makes up close to half of all hours
2.1.14Orthoptics
Courses in orthoptics are not currently offered in WA. Training in orthoptics is offered at two
universities within Australia: La Trobe University and University of Sydney. Both university
representatives reported that student placement in WA was irregular and based on the request
of students. The key barrier raised to encouraging student placement in WA was the cost of
accommodation and airfares which must be met by the students themselves. The La Trobe
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16
University representative said that from 2014, all students are required to undertake a
compulsory regional or interstate placement and anticipates that this will provide an
opportunity to work more regularly with WA health services.
2.1.15Orthotics and prosthetics
Orthotics and prosthetics are not offered in WA currently. La Trobe is the only university that
teaches orthotics and prosthetics in Australia. They have had a relationship with health
services in WA for over 20 years. Students in their final year must complete two full time
eight week external placements (one for orthotics and one for prosthetics). Students spend
four blocks a year at WA private and public health services and some organisations will host
four students in a year. In 2012 the university sent eight out of the 36 student cohort to WA.
Formal agreements are in place between La Trobe University and the health services to ensure
students are covered by the university’s insurance.
TLC Unlimited provides prosthetics clinical placement opportunities for students in their final
year for a period of eight weeks. In the past they have taken two students concurrently but due
to the number of clinicians on staff and current workload they have decided that one student
per placement is appropriate. The primary supervisor undertook their training at La Trobe
University and approached their former university with an offer to host students as a way to
promote WA to other students in this area. TLC Unlimited also try to organise affordable
accommodation options for the student.
Princess Margaret Hospital Child and Adolescent Health Service provides clinical placement
for four to six students a year from La Trobe University and also hosts students from a Hong
Kong education provider on an adhoc basis. The placements are undertaken over an eight
week block throughout the year, and the service will generally host one student at a time due
to the size of their team and workload commitments.
2.1.16Osteopathy
Osteopathy is not offered in WA currently. Training in osteopathy is offered at three
universities within Australia: Southern Cross University, RMIT, and Victoria University.
Although RMIT expressed an interest in sending more students to WA, they are restricted by
their clinical placement competency model which requires students to be under the direct
supervision of an osteopath of which there are a very small number in WA compared with
Victoria (approximately 30-40 osteopaths in private practice compared with approximately
900 privately practising clinicians).
Southern Cross University commented that at present there are sufficient placement
opportunities within Victoria and their own university clinic. However, if a student expresses
an interest to undertake a placement in WA they are willing to facilitate it.
2.1.17Paramedicine
Paramedics in Australia are not currently required to be registered with AHPRA. However
there is overwhelming support for this to occur and preliminary steps towards this have been
undertaken by Paramedics Australasia who have completed a national regulatory survey4
Curtin University and Edith Cowan University both offer three year undergraduate Bachelor
of Science courses. Additionally, Curtin University offers a one year Graduate Certificate in
Paramedicine for students already qualified as registered nurses with two years’ experience in
an acute setting. Edith Cowan University offer a two year Master of Paramedicine Science for
Final Report
17
students with a related bachelor degree. To successfully graduate, students must have
achieved the required competencies. The courses do not specify a required amount of clinical
placement hours.
Currently there are 50 students per year undertaking Curtin University’s Bachelor of Science
(Health Science) or Graduate Certificate in Paramedicine. At Edith Cowan University there
are 680 students undertaking the Bachelor of Science (Paramedical Science) and 90 students
undertaking the Master of Paramedical Science.
The structure of the clinical placements for students is very different at the two universities.
The Curtin University course was established in partnership with St John Ambulance and to
undertake the course you must have been accepted as a student ambulance officer at St John
Ambulance WA. The experience students are exposed to occurs within their employed roles
as student ambulance officers. Additionally students complete a five day anaesthetic
placement within a hospital operating theatre.
Edith Cowan University, aware of the fact that only one in three graduate paramedics work as
ambulance officers have recently restructured their clinical placements to support students
gain experience in a wide range of health settings. Clinical placements now occur in hospital
wards and within operating theatres, community organisations, aged care services and mental
health settings. Additionally, simulation experience is provided in decommissioned
ambulances.
Curtin University has no rural placements, as volunteers deliver ambulance services in rural
WA. Edith Cowan University offer students rural placements and students studying off
campus are able to complete placements in their local area. The university also has an
agreement with St John Ambulance, Northern Territory to take students for on road
placements. However, the uptake is minimal, as there is no funding for accommodation and
expenses.
Table 2.12: Paramedicine student placement activity
Health Service Type
Ambulance service
Public Hospital
Drug and Alcohol Centre
St John Ambulance
Fremantle Hospital
Fresh Start
50 students a year employed by St John Ambulance
49 students throughout the year
1-2 a week during university semester
2.1.18Pharmacy
The Pharmacy Board of Australia is responsible for the registration of pharmacists, graduates
undertaking their intern year and pharmacy students. Only students who have studied an
accredited course and undertaken an intern year are eligible to apply to the Pharmacy Board
of Australia for general registration. Prior to commencing clinical placements, educational
providers need to ensure their students are registered. The Australian Pharmacy Council is
responsible for accrediting pharmacy courses.
Curtin University has both a Bachelor of Pharmacy and a graduate entry Master of Pharmacy.
There are 110 to 140 students in year four of the Bachelor of Pharmacy and 20 to 30 students
in the second year of the Master of Pharmacy. Students undertaking the Bachelor of Pharmacy
are required to complete a total of 12 weeks of compulsory clinical placement (six weeks in a
community setting and ideally six weeks in a hospital setting). Additionally, students can
choose to undertake four weeks of elective placements in second semester. Whilst
undertaking placements in a community pharmacy opportunities are provided for students to
participate in inter-professional learning opportunities by doing a week of placements in a
range of settings including: Silver Chain clinics, Diabetes Education Units and aged care
Final Report
18
facilities. Students of the graduate entry Master of Pharmacy must complete ten weeks of
clinical placements (six weeks are in a community pharmacy and four weeks are in a
hospital).
The University of Western Australia offers a two year Master of Pharmacy. There are 40
students undertaking this course. Students are required to undertake 462 hours or 14 weeks of
placements (seven weeks of placements in a community pharmacy and seven in a hospital).
Uniquely, this course provides students with experiences in five different hospital settings
including: mental health, paediatrics, women’s’ health, public and private hospitals.
Additionally students participate in attending a home medication review.
Across universities, a small number of placements exists, allowing students to be exposed to a
broader range of career opportunities. These include the WA Health Department, Alcohol and
Other Drug Clinics, Silver Chain Clinics, Diabetes Education Units, WA Poisons Information
Centre and ACCHOs.
Table 2.13 details the level of placement activity occurring at each of the sites visited.
Table 2.13: Pharmacy student placement activity
Health Service Type
Public Hospital
Private Hospital
St John of God Hospital Subiaco
Community Pharmacy
Community Pharmacy
Craven’s Pharmacy
Gerald Burns Pharmacy
Community Pharmacy
Feelgood Pharmacy
2 bachelor student for 6 weeks x 2 rotations a year
4 graduate entry master students in groups of 10 over a week period
A few students doing 4 or 10 week research projects
2 interns a year
A few VET pharmacy technician students
From time to time students from interstate or overseas.
70 graduate entry master students over a six week periods that attend in
groups of ten for about a week for each group from both universities.
2 interns a year
1 bachelor student a year from Curtin when requested
3 bachelor students a year
2 to 3 graduate entry students a year from UWA
1 or 2 interns a year
4 bachelor students
1 graduate entry student from UWA
2 interns a year
2.1.19Physiotherapy
The Physiotherapy Board of Australia is responsible for the registration of physiotherapists
and physiotherapy students. Only students that have completed accredited courses are eligible
to apply to Physiotherapy Board of Australia for professional registration. Prior to
registered. The Australian Physiotherapy Council is an independent national body responsible
for the oversight of the guidance, development and assurance of standards for health
professional practice in the public interest including the accreditation of physiotherapy
education programs in Australian universities.
To attain accreditation through The Australian Physiotherapy Council 5 physiotherapy courses
must ensure students achieve the set standards which takes approximately 1,000 hours of
clinical placement.
Curtin University and The University of Notre Dame Australia both offer four year
undergraduate Bachelor of Physiotherapy courses. In addition to this, The University of Notre
Dame Australia offers this course as part of a double degree combined with exercise science,
whilst Curtin University offer a two and a third year graduate entry Master in Physiotherapy.
Curtin University has approximately 680 students in total undertaking a four year Bachelor of
Science (Physiotherapy) and 80 students in total undertaking a Master of Physiotherapy. At
The University of Notre Dame Australia there are 309 students in the School of
Final Report
19
Physiotherapy, the intake is approximately 80 students a year with 10-12 of these students
undertaking the double degree with exercise science.
The University of Notre Dame Australia has a requirement that all students complete a rural
placement and the majority of rural placements have accommodation attached to the
placement. When no accommodation is attached, the university offers reasonable
reimbursements to students. In the past, WACHS and Combined Universities Centre for Rural
Health (CUCRH) jointly provided a travel subsidy for students undertaking a rural placement.
These subsidies partly reimbursed the travel costs of getting to a rural location (up to $550).
CUCRH no longer provides any travel subsidy for students attending clinical placements,
whereas WACHS has continued their support but only for WACHS facilities. If students are
placed in a non-WACHS placement, The University of Notre Dame Australia reimburses an
equivalent amount to ensure students are not disadvantaged.
Curtin University has no requirement for students to complete a rural placement at present.
However, a small percentage of students do complete a rural placement. Curtin University
reported that rural placements were difficult to arrange as they are not able to provide the
same level of funding as The University of Notre Dame Australia. As a consequence of there
being restricted access in rural areas, Curtin University does not consider any rural
placements in the core clinical areas of neurological, cardiorespiratory and musculoskeletal.
Table 2.14: Physiotherapy placement activity
Health Service
Type
Public Hospital
Princess Margaret Hospital (PMH)
for Children
3 Curtin University students completing self-directed placements
4 x 2nd year Curtin Students on PTA placements
36 students completing their final year 5 week placement blocks
Around 20 students per 5 week block.
Take students every block
6 x 2 week PTA placements
Support ½ day placements
20 students x 5 week block.
2 x 2nd year Curtin students on PTA placements
Support ½ day 3rd year placements
10 students x 5 week block.
Take students every block
300 students a year including blocks, PTA placements for ½ day observation
38 students x 5 week block students in 2010
48 students x 5 week block students in 2011
Fluctuates each year
6 students per 5 week blocks.(2 from each university)
4 students per 5 week blocks.(2 from each university)
12-20 preclinical or PTA
12 students for 5 week blocks per year
50 ½ day 3rd year student placements
10 students a year all Curtin University
PTA 2 week placement 2nd year
16 students in 5 week IPE placements per year
Approx. 4 shorter pre-clinical The University of Notre Dame Australia
students
Have not yet taken students however keen to explore in near future
Public Hospital
(SCGH)
Public Hospital
Fremantle Hospital
Public Hospital
Bentley Health Service
Private Hospital
Hollywood Hospital
Private Hospital
Community Health
Public Health and Ambulatory Care
Community Health
Aged Care
The Centre for Cerebral Palsy
(TCCP)
Silver Chain
Aged care
Brightwater
Medicare local GP
Perth North Metro Medicare Local
2.1.20Podiatry
The Podiatry Board of Australia is responsible for the registration of podiatrists and podiatry
students. Only students that have studied accredited courses and undertaken an intern year are
eligible to apply to Podiatry Board of Australia for professional registration. Prior to
registered. Podiatry courses are accredited though The Australia and New Zealand Podiatry
Accreditation Council which requires students complete 1,000 hours of clinical placement, of
Final Report
20
which 60% needs to be in internal clinical facilities with staff-student ratios reflective of
patient safety at 1:4 to 1:10, dependent on risk and requirements of the task.
The University of Western Australia is the only university in WA that offers courses in
podiatry. The final intake for the four year Bachelor of Podiatric Medicine occurred in 2011
and there are 30 students completing this course. These students are now in their third year.
The first intake of students enrolled in the three year Doctor of Podiatric Medicine (DPM)
occurred in 2013. This requires students to have completed an undergraduate degree prior to
commencing. There are nine students undertaking this course.
The Bachelor of Podiatric Medicine is accredited, however as the DPM is a new course it is
not yet eligible for full accreditation. All external placements occur in public hospitals, private
practice, disability and Moorditj Djena (an Aboriginal and Torres Strait Islander podiatry and
diabetic education service).
There is no requirement for students to complete a rural placement as it is hard to find suitable
supervisors and they have no funding to support the program. The University of Western
Australia’s only rural placement is in Northam for one week where they have
accommodation. Only a limited number of students can attend. Table 2.15 provides an
overview of the numbers and levels of placements activity at each site visited.
Table 2.15: Podiatry services, placement activity
Health Service Type
Public hospital
Public Hospital
Public Hospital
Fremantle Hospital
Sir Charles Gardiner Hospital
Public Hospital
Community
Disability Services CommissionMyaree
2 x year 3 students 1 day a week for 4-6 weeks
4 year 4 students 3 day a week for 4-6 weeks
Placements are continuous during university times
Occasionally will have 1 students for 2 week block over summer
Take 2-3 students from interstate as offer long block placements
2 x year 4 students 4 days a week for 4 weeks (24 students per year)
2 x year 3 students 1 day a week for 4-6 weeks
4 x year 4 students 4 days a week for 4-6 weeks
Occasionally will have 5-6 students for 2 week blocks over summer
Take 2-3 students from interstate as offer long block placements
2 students, 1 day per week, usually for 3 to 4 weeks (depending on
staff availability)
1 x 4th student 1 day a week for 4 weeks
2.1.21Psychology
The Australian Psychological Accreditation Council (APAC) is the independent international
quality and standards organisation for psychology. The guidelines for supervision and
accreditation specified by the APAC require students to undertake a minimum of 125 days or
1,000 hours of clinical placement during their postgraduate program. This supervision
placement will comprise client contact, clinical supervision (by their supervisor) and other
activities. The Australian Psychological Society (APS) College Approval Guidelines mandate
400 hours of client contact out of the 1,000 hours for a master program and 600 of the 1,500
for the doctorate program. They also require placements to provide the students with a range
of client types and settings. Clinical psychology accreditation requires different settings for
the students (child, adolescent and adult settings) whilst counselling psychology is more
flexible in the required setting types. Students undertaking neuropsychology programs are
required to be exposed to five defined patient groups: acute; neurology/neurosurgery;
rehabilitation; psychiatric; geriatric; and paediatric.
Currently, programs in psychology are offered by four universities in WA: Curtin University,
Edith Cowan University, Murdoch University and The University of Western Australia.
Within the post graduate psychology programs there are approximately:
Final Report
21
 15 students undertaking the Master of Clinical Psychology and 15 students undertaking the
Master of Counselling Psychology at Curtin University;
 20 students undertaking the Master of Psychology (Clinical Psychology) at Edith Cowan
University;
 15 fulltime and 17 part time students undertaking their Master of Applied Psychology in
Clinical Psychology and less than 10 students undertaking their Applied Psychology in
Clinical Psychology (M) and PhD. Murdoch University; and
 14 or 15 students undertaking their Master of Clinical Psychology and less than 10 students
undertaking their Combined Doctors of Philosophy and Master of Clinical Psychology at
The University of Western Australia.
Student placements will often begin within the university based psychology clinic then extend
to external placements within public hospitals, community organisations (such as Alzheimer’s
Association, Relationships Australia), disability, aged and community services, the
Department for Child Protection and mental health inpatient and outpatient settings. To
participate in internal or external placement, psychology students need to apply for
provisional registration through the Psychology Board of Australia (PBA).
Graduate School Psychologists in Western Australia are employed within the School
Psychology Service by the Department of Education. To become a school psychologist a
student is required to undertake a minimum of four years of tertiary training in psychology (or
tertiary training that is recognised by the APAC) and obtain post graduate qualifications in
education. The University of Western Australia offers school psychology as a major in their
post-graduate Diploma of Education. If employed by the Department of Education as a
graduate school psychologist following the 4 + 1 university pathway, then the student is able
to undertake two years supervision (internship) within the school psychology service setting
towards general psychology registration.
The two study areas of clinical psychology and counselling psychology within Curtin
University are accredited by separate colleges of the APS. They are also separate specialised
areas under the State Government Registration Act. Following two years of supervised
practice, graduates may be eligible to apply for membership of the APS’s College of Clinical
Psychology or Counselling Psychology, and endorsement by the PBA as a clinical
psychologist or counselling psychologist.
As part of the requirements for The University of Western Australia’s Master of Psychology,
and Master of Psychology and PhD combined course programs, students undertake three
supervised field placements in approved agencies. Students are encouraged to choose
placements that provide them with a range of experience including both outpatient and
inpatient settings. Following completion of their program (including supervision) graduates
are eligible to register with the PBA as a psychologist, and practise as a clinical psychologist.
The University of Western Australia’s Doctor of Philosophy and Master of Clinical
Neuropsychology take approximately four years full-time to complete and offers specialist
training designed to provide eligibility requirements for the APS College of Clinical
Neuropsychologists. Additional post-degree supervision by a qualified supervisor is required
for full college membership for all professional degrees.
Due to the structure of the psychology postgraduate programs (two days on placement and the
remaining at the university doing coursework and other education) regional placement is not
common. It is also difficult to find registered psychologists to provide this level of supervision
in regional settings. On occasion, at the request of a student, a block placement has been
undertaken at a regional site but the onus is on the student to seek and cover the costs of such
a placement and it therefore occurs infrequently.
Final Report
22
Table 2.16: Psychology services, placement activity
Health Service Type
Outpatient/Community
Government Department
WA Psycho-Oncology Service
WA School Psychology Service
Community
Osborne Park Older Adult Mental Health
Service
Hospital Clinic Alma Street Clinic
Community
approximate)
1 student
Each site will take 1 student per placement (2 placements a
year)
1 student
(Also Selby Older Age service take a student each year)
2 students
2.1.22Radiation Science
Radiation science encompasses medical imaging, nuclear medicine, radiation therapy and
sonography.
Medical Imaging
The Australian Institute of Radiography is the peak body representing radiographers, radiation
therapists and sonographers in Australia.
Curtin University offers a Bachelor of Science (Medical Imaging Science) over 4 years (fulltime). The Curtin University course is accredited with the Australian Institute of Radiography
and graduates can commence employment without an internship requirement, unlike many
interstate graduates. There are 56 students undertaking this course. National registration is
managed by the Medical Radiation Practice Board of Australia. Over the course duration
students undertake a total of 48 placement weeks. Placements occur in public and private
hospital settings and in community private practice. Curtin University has a compulsory
requirement that all students attend at least one placement in a regional/rural setting.
Nuclear Medicine
WA universities do not offer a course in nuclear medicine. Students attending placements in
WA are mainly from the three year University of Newcastle Bachelor of Medical Radiations
(Nuclear Medicine). This course is accredited with the Australian and New Zealand Society
of Nuclear Medicine and graduates are required to complete a 12 month internship prior to
full membership and registration. Australian registration is managed by the Medical Radiation
Practice Board of Australia.
HWA funding has provided scholarships for travel and accommodation for WA students to
attend the University of Newcastle and undertake their placements at Royal Perth Hospital or
Fremantle Hospital. The Royal Perth Hospital takes three students in total per year under this
scheme. Funding for the scholarship scheme ceases with the 2014 intake. Block placements
are balanced across the calendar years and students undertake a total of 25 weeks of
placement over the three years. Royal Perth and Fremantle Hospitals also take graduates for
their internship year.
Radiation Therapy
WA universities do not currently offer a course in radiation therapy. Curtin University is
developing a course proposal for a postgraduate Master of Radiation Therapy due to
commence in 2014. A total of 20-25 places per cohort is planned with a smaller intake of 15
students for the first year. This course will be two years full-time with block placements in
year one and continuous placement in year two. The model for this course comes from
Monash University.
Final Report
23
Current students predominantly come from Monash University’s two year master course and
they are recruited from Perth graduates. Charles Gairdner Hospital and Perth Radiation
Oncology support four students each, i.e. two per teaching year each. The Newcastle
University three year undergraduate bachelor course sources the remaining places in blocks
during the winter and summer break periods. These students are in their second or third year
only.
All four radiation oncology services in Perth provide limited placements. The new Fiona
Stanley Hospital campus is likely to further support student placements. The only site outside
Perth is Bunbury.
The courses are accredited with the Australian Institute of Radiography. Monash University
and future Curtin University graduates will commence employment without an internship
requirement, unlike Newcastle graduates who are required to complete a one year internship.
National registration is managed by the Medical Radiation Practice Board.
Sonography
Courses in sonography are accredited by the Australian Sonographer Accreditation Registry
(ASAR), which also oversee national registration. Sonography is a postgraduate master or
diploma course offered by six universities and the professional body. Curtin University offers
a Master of Medical Sonography over eight units part-time. Students seek their own
placements for the duration of the course. There is no course quota and there are currently 50
students enrolled across all units. Students take three to four years to complete all units.
Students are employed in traineeship positions in both the public and private settings. There
are three main traineeship programs running in WA: South Area Health Service network
(SAHS); Perth Radiology Clinics (PRC); and Country Ultrasound Program (CUSP). Students
choose from the available academic courses and are usually employed for the duration of their
three to four year part-time course.
SAHS students are employed 0.6 FTE in the course and 0.4 FTE as medical imaging
technologists and are graduates from a medical imaging course. PRC and CUSP take
graduates from other courses into their program, though the preference is medical imaging
graduates.
Table 2.17: Radiation science, placement activity
Health Service Type
Public hospital
Private practice, hospital and
community
Regional public hospital
community
Public hospital
community
Public hospital
Medical Imaging and Sonography
Perth Radiation Oncology
Radiation Therapy
Swan District Hospital, Medical Imaging
Perth Radiology Clinics ,Nollamara Clinic
Medical Imaging and Sonography
Princess Margaret Children’s Hospital , Medical
Imaging
SKG Radiology, Hollywood Hospital, Medical
Imaging
Royal Perth Hospital ,
Nuclear Medicine
approximate)
16 students medical imaging
5-7 students, sonography
4 students
1-2 students
65 students across 10 clinics, medical imaging
12 students across 6 clinics, sonography
12 students, one at time
2-3 students per semester at Hollywood Clinic
SKG has 26 branches most taking students, overall
numbers not available
3 students
2.1.23Social work
The Australian Association of Social Workers (AASW) sets the standards for social work as a
profession and many social work positions require employees to be eligible for AASW
Final Report
24
membership. In order to be eligible for membership, a student needs to complete one of the
AASW approved degrees. Social work is a self regulated profession and does not require
registration with AHPRA at present.
Post graduate studies in social work are offered at The University of Western Australia, and
undergraduate studies are offered at Curtin University and Edith Cowan University (Bunbury
campus). Within these programs there are approximately:
 39 year one and 30 year two students undertaking the Master of Social Work at The
University of Western Australia;
 35 to 40 students undertaking the Bachelor of Social Work at Curtin University; and
 60 students in both year three and four of Edith Cowan University’s Bachelor of Social
Work.
Social work clinical/field placements are structured in accordance with the AASW guidelines
and relevant social work program requirements. Universities are required to include a
minimum of two placements in their social work courses, which together must form a
minimum of 140 days or 980 hours of supervised practice in a workplace setting. The two
placements must occur in different calendar years and offer a range of different social work
experiences for students.
Social worker students are offered a wide range of placement settings that include the
Department for Child Protection, public and private hospitals, community mental health
services, primary schools, NGOs and the Department of Corrective Services. Regional and
remote field placements are valued and encouraged by the metropolitan universities but this is
challenging due to the cost of student accommodation, transport and living expenses while on
a lengthy remote placement. In addition, many social worker students (master students in
particular) are mature aged students and are likely to have employment, financial and family
commitments in metropolitan Perth. Table 2.18 provides an overview of the numbers and
types of placements at each site visited.
Table 2.18: Social work services, placement activity
Public hospital
Community
Fremantle Hospital
Senses
approximate)
Between 3- 6 students
1-2 students
Public Hospital
Rockingham General Hospital
2 students a year (1 per semester)
Community
Community
Private hospital
Other
Wanslea Family Services
RUAH Community Services
Department for Child Protection
1 or 2 students
6 students
No students this year but usually 2-4 students a year
18 -20 students a semester.
Health Service Type
2.1.24Speech pathology
Speech Pathology courses are accredited though Speech Pathology Australia. The
accreditation standards do not specify a minimum number of clinical placement hours a
course must include. Instead, each student must reach a minimum competency standard across
six key areas of practice. These include language, speech, swallowing, voice, fluency and
multi-modal communication. They also require students to gain experience working with both
adult and paediatric client groups.
Curtin University and Edith Cowan University both offer four year undergraduate Bachelor of
Speech Pathology courses. Forty students are undertaking the Edith Cowan University course.
Numbers were not available for the Curtin University. Thirty seven students are enrolled in
the Curtin University two year graduate entry Master of Speech Pathology.
Final Report
25
Curtin University and Edith Cowan University both have a requirement for students to
undertake a placement in a rural area. At Edith Cowan University, this generally occurs in the
fourth year for seven weeks. The majority of their students go to Geraldton where four
students attend five times a year. These placements are only possible because of HWA
funding due to expire at the end of 2013.
Table 2.19: Speech pathology services, placement activity
Health Service
Type
Public hospital
Sir Charles Gardiner Hospital
Public hospital
Private Hospital
Bentley Hospital
Private Hospital
Community
Community
Community
Next Challenge
Gosnells Community Speech Pathology Clinic
Child Development Services
88 year 3 and 4 students for 2 days a week (4-6 students in total at
once)
10 students for 4 days a week for 6 –10 weeks undertaking final year
projects.
8 x year 4 students in pairs for 10 weeks for 2-3 days/week.
Year 4students one at a time for 6-10 weeks
2-6 year 3 students 1 day a week
13 students in total consisting of year 4 students from Curtin
University Year 1, 2 and 4students from ECU.
8 students in 10 week blocks - Students attend in pairs
3-5 students every 10 weeks (closes for December and January)
3 students each year for a 8-10 week placement
2.1.25Overview of placement activity
The content, structure and hours required for clinical placement required by universities and
VET providers differs significantly across the disciplines examined in this report. The design
of each discipline’s clinical placement activity is almost always underpinned by the
accreditation and competency requirements of the appropriate professional board or
association. Clinical training placements for undergraduate and postgraduate students take
place in a diverse range of settings including hospitals (public and private), community based
health services, primary care services, ACCHOs, mental health services, aged and community
care services, private practice, and non-government organisations as well as discipline
specific clinics run by educational providers or public health facilities.
In this section, an overview of the undergraduate and postgraduate courses currently being
offered in WA, approximate numbers of students currently undertaking these courses, the
structure of placements, and settings commonly used to support clinical placement activity is
presented in Table 2.20. The term placement setting is used as not all settings in which
placements occur are clinical.
It is important to note:
a) The information presented in this table is based on the information gained through
consultations with stakeholders spoken to in this project. It may not capture all
placement settings in place within Western Australia.
b) At the time this project commenced, universities were in the midst of preparing data
relating to the number of students undertaking placements for Health Workforce
Australia. As a consequence, HMA was requested to only seek high level information
about the number of students undertaking each course and/or placements.
Some of the key points of difference across the discipline areas include:
(1)
(2)
AHPRA requires registration of students, professionals and courses in 14
discipline areas for: Aboriginal health workers, chiropractic, dentistry, medicine,
medical radiation practice, midwifery, nursing, occupational therapy, osteopathy,
optometry, oral health, pharmacy, physiotherapy, podiatry and psychology (where
students must apply to the professional association for provisional registration).
A few discipline areas require graduates to undertake an internship year before
they are able to apply for general registration to practice, notably medicine and
Final Report
26
(3)
(4)
(5)
pharmacy. On successful completion of their internship year, graduates are able to apply
for general registration.
A number of discipline areas apply models of placement in which the student is
employed whilst studying to acquire their qualification. This occurs for Aboriginal
Health Workers, some midwifery courses, paramedicine and sonography.
A few courses require and/or support clinical placements in rural areas most
notably: medicine, dentistry, occupational therapy, medical imaging and physiotherapy.
Many discipline areas were supportive of rural placements and placements. A few
discipline areas said they did not undertake regular clinical placements in rural areas as
it was particularly difficult to find supervisors (audiology and podiatry).
Some courses have large volumes of students and specific setting requirements for
students to acquire competencies, most particularly nursing and medicine.
Additionally, there are a number of health disciplines, where no courses exist within WA:
nuclear medicine, optometry, orthoptics, orthotics and prosthetics, osteopathy and radiation
therapy. Some interstate universities are working with health services within WA to support
clinical placement and some are interested in doing so in the future. Consideration should be
given to developing relationships with interstate universities in areas where workforce
shortages are identified and/or projected as part of broader workforce recruitment strategies.
Final Report
27
Table 2.20: Overview of placement activity in Western Australia
Discipline
Education provider
Aboriginal
health
Aboriginal and Torres Strait Islander Primary Health Care Cert III
and IV
6 months
Diploma Aboriginal and Torres Strait Islander Primary Health Care
(community care) or (practice)
Marr Mooditj Training Inc
Number of
students
(approx.)
N/A
Clinical placements
requirements by professional
association and training
providers
2 weeks to 600 hours depending
on course and training provider
Placement settings





ACCHO
Regional hospitals
Population health units
Dialysis Units
Child and Adolescent health services
and IV
6 months
Aboriginal Health Council of Western Australia
Audiology
Chiropractic
and IV (community care) or (practice)
6 months
Diploma Aboriginal and Torres Strait Islander Primary Health Care
(community care) or (practice)
12 months
Advanced Diploma Aboriginal and Torres Strait Islander Primary
Health Care (practice)
Kimberley Aboriginal Medical Services Council
Master of Clinical Audiology
2 year postgraduate degree
The University of Western Australia
Bachelor Science and Bachelor of Chiropractic
5 year joint undergraduate degree
Murdoch University
30 students every
2 years
250 hours required for
accreditation complete 500 hours
47 students
Close to 800 hours over 46 weeks
Final Report
28
Placements occur in:
 Australian Hearing
 hospital settings (public)
 community health
 private practice
 specialised hearing schools
The majority of placements occur in the chiropractic-teaching clinic
on the university campus (where the majority of placements occur).
In addition students participate in outreach clinics to a number of
NGOs including:
 St Patrick’s Community Support Centre;
 South Ottey Family and Neighbourhood Centre; and
 Palmerston Farm.
 The university facilitates opportunities for students to undertake
health screens at cultural events.
The university also provides the opportunity to participate in annual
rural outreach clinics to Aboriginal or rural communities.
The University is supportive of students organising overseas
placements.
Number of
students
(approx.)
Discipline
Education provider
Dentistry
Doctor of Dental Medicine
4 year
56 students
Dietetics
Postgraduate Diploma in Dietetics
1 year postgraduate diploma
Curtin University
36 students
Master of Nutrition and Dietetics
2 years postgraduate
Edith Cowan University
26 students per
year
Bachelor of Science (Exercise Science and Rehabilitation)
4 year undergraduate degree. Students can transfer across to final year from
undergraduate exercise science 3 years
30-40 students
Graduate Diploma of Exercise Science
4 year undergraduate degree. Students can transfer across to final year from
undergraduate exercise science 3 year
Murdoch University
35 students
Graduate Diploma of Exercise Science
1 year post completion of three year exercise science
Master of Exercise Science
2 years post completion of three year exercise science
The University of Notre Dame Australia
24 students
Graduate Diploma in Science (Exercise Rehabilitation)
1 year postgraduate diploma post completion of three year exercise science
Graduate Diploma in Exercise Rehabilitation
1 year post completion of three year exercise science
Bachelor of Science (Exercise, Sports and Rehabilitation Science)
3 year undergraduate degree. No course for exercise physiology- planning
is underway to commence one.
Curtin University
35 students in
total both
courses
Exercise
Physiology
Clinical placements
providers
Based on achievement of
competencies rather than specific
hours of placement
20 weeks
140 hours for exercise science
360 hours for exercise
physiology.
Placement settings
Oral Health Centre WA Nedlands and Bunbury Clinic (OHCWA)
 dental health services in metropolitan and rural locations
 special needs dentistry services
 private dental clinics
 State Dental Health Services
6 week remote/rural rotation at Bunbury clinic or with other
organisations such as Royal Flying Doctor Service or Kimberley
Dental Team.
Placements occur in a range of settings including:
 public and private hospitals;
 NGOs (such as Diabetes WA, Cancer Council, Heart
Foundation); and
 aged care settings or catering services that provide food
services for residential facilities, prisons and hospitals.
 students are permitted to travel interstate to appropriate
facilities e.g. Australian Institute of Sport placements.
Some rural placements undertaken in shorter blocks
 private practices;
 vocational rehabilitation services;
 NGOs; and
 public hospitals.
24 students
N/A
Final Report
 private practices;
 vocational rehabilitation services;
 NGOs; and
 public hospitals.
29
Discipline
Education provider
Number of
students
(approx.)
Medical
laboratory
science
Bachelor of Science (Laboratory Medicine)
4 year undergraduate degree
Curtin University
300 students
across all year
levels.
Medicine
Bachelor of Medicine and Bachelor of Surgery
4 year graduate degree
Approx.110
students per year
Bachelor of Medicine and Bachelor of Surgery
6 year undergraduate degree (no longer offered)
Approx.100
students per year
Midwifery
Doctor of Medicine to commence in 2014
Approx. 105
students will be
accepted each
admission cycle.
Bachelor of Science (Midwifery)
3year undergraduate degree
Curtin University
35 students per
intake.
2 intakes a year.
Clinical placements
providers
28 weeks
(14 weeks in the second semester
of year three and 14 weeks in first
semester year four.
Approximately 4,500 hours
There are six semesters across the
course and placements occur in
each semester.
Placement settings
Predominantly placements occur at PathWest Laboratory Medicine
WA (which provides medical laboratory services for all public
hospitals).
Some placements occur in larger private medical laboratories.
Informal opportunities exist for students to undertake placements in
rural areas, interstate or overseas.
 Aged care
 Public and private hospitals
 Rural clinical Schools
 GP Practices
 Aboriginal Community Health Organisations
Placements occur in public and private hospitals.
Placements occur in public and private hospitals.
There are three semesters and
placements occur in each
semester.
Graduate Diploma in Midwifery
18 months graduate degree
Curtin University
Nursing
Graduate Diploma of Midwifery
18 months graduate degree
6 students
25 weeks across 5 x 5 blocks in
year 1
10 weeks in year 2
Bachelor of Science (Nursing) and Bachelor of Science (Midwifery)
4 year double undergraduate degree
25 students
Master in Midwifery Practice
2 year graduate degree
Edith Cowan University –Joondalup Campus
Bachelor of Nursing
30 students across
the 2 years.
8 placements in 8 course stages.
Stage 1 40 hours; Stage 2 80
hours; Stage 3 40 hours; Stage 4
80 hours; Stage 5 80 hours; Stage
6 160 hours; Stage 7 240 hours;
and Stage 8 240 hours. Totalling
960 hours. Continuity of care
400 hours. After first 6 months: 3
semesters working 2 to 3
days/week
350 students over
2 intakes a year
Final Report
1,240 hours over 3 years
30
Placements occur in a wide range of settings in public and private
hospitals including:
Discipline
Education provider
Number of
students
(approx.)
Clinical placements
providers
Bachelor of Nursing
Edith Cowan University Joondalup Campus
Bachelor of Nursing and Bachelor of Midwifery
Edith Cowan University Joondalup Campus
570 students over
2 intakes a year
25 students
500 students
across the 3 years
728 hours over
No placements- students already
employed
Postgraduate Certificate in Community Neurological Nursing
6 months
Murdoch University – Peel Street Campus
Bachelor of Nursing
3 years
840 hours over 3 years
1,000 across the
course
880 hours over 3.5 years
Bachelor of Science (Nursing)
3.5 years
Curtin University
Not currently being offered –
program currently being
redeveloped.
Master of Nursing Practice
3.5 years
Curtin University
80 students across
the course
Master of Nursing Science
2 years
100 students
across the 2
intakes a year
Diploma of Nursing
18 months or 1 year
Challenger Institute of Technology
24 students
650 hours over 1 year
800 to 849 hours over 1.5 years
Diploma of Nursing
18 months
Institute of Health and Nursing Australia
125 full time and
50 part time
400hours over 1.5 years
Diploma of Nursing
18 months
Central Institute of Technology
40 students across
three intake
periods
450 hours over 1.5 years
Diploma of Nursing
18 months
na
600 hours over i.5 years
Final Report
31
Placement settings
 Medical ward
 Operating Suite
 Surgical ward
 Mental health
 Acute care
 Paediatrics
 Respiratory
 Cardiovascular
 Critical care
 Day procedure units
 Sub-acute care
 Palliative care
Additionally placements occur in:
 Aged care
 Community care
 Primary health
 Rehabilitation
 Disability services
 Early intervention services
 Silver Chain
Discipline
Education provider
Number of
students
(approx.)
Occupational
therapy
Bachelor of Science (Occupational Therapy)
Curtin University
201 students in
Year 1
125 in Year 4
Master of Occupational Therapy
2.5 year postgraduate degree
Curtin University
65 students
Bachelor of Science (Occupational Therapy)
182 students
Optometry
Oral health
Optometry is not offered in WA currently.
Bachelor of Oral Health Therapy
3 year undergraduate
Curtin University
Orthoptics
Orthotics and
prosthetics
Osteopathy
Paramedicine
Orthoptics is not offered in WA currently.
Orthotics and prosthetics are not offered in WA currently.
Pharmacy
Osteopathy is not offered in WA currently.
Bachelor of Science (Health Science)
Curtin University
 hospitals (public and private);
 aged care services;
 community health services;
 NGOs;
 mental health services;
 schools; and
 vocational rehabilitation service.
At Curtin University approximately 60% of students in 2013 chose
to complete a placement in a rural or remote area. Sixty per cent of
students also generally complete one of their 7 week placements
overseas.
1150 clinical placement hours
Approximately 700 hours clinical
placement treating clients with
the remaining hours being
simulation experience




50 students per
year
Employed as student ambulance
officers working full time
Students of Curtin University are employee of St John Ambulance
Western Australia.
Other universities place students in:
 public hospitals;
 patient transport service; and
 NGOs.
12 weeks compulsory and 4 week
optional elective
Postgraduate: 10 weeks at
beginning and end of academic
year.
The majority of placements occur in:
public and private hospitals ;
community pharmacies; and aged care facilities.
 A small numbers of placements occur within:
 Department of Health;
50 students per
year
Bachelor of Science (Paramedical Science)
680 students
(across all years)
Master of Pharmacy
Placement settings
34 students per
year
Graduate Certificate in Paramedicine
Curtin University
Master of Paramedical Science
Bachelor of Pharmacy
Curtin University
Clinical placements
providers
1,000 hours
University clinics
School dental services
Domiciliary and aged care services
Special needs clinics
90 students
110 to 140
students in year 4
20 to 30 students
Final Report
32
Discipline
Physiotherapy
Education provider
Curtin University
in second year
Master of Pharmacy
40 students
Bachelor of Science (Physiotherapy)
Curtin University
680 students in
total
Master of Physiotherapy
2.3 year postgraduate degree
Curtin University
Bachelor of Physiotherapy and Bachelor of Exercise & Sport Science
5 year undergraduate double degree
Bachelor of Physiotherapy
Podiatry
Psychology
Number of
students
(approx.)
Bachelor of Podiatric Medicine
Clinical placements
providers
Approximately 462 hours or 14
weeks of placements: 7 weeks in
year 1 and 7 in year 2.
Additionally all graduates must
undertake an intern year to be
eligible to register to practice.
1,000hours
80 students in
total
Placement settings
 alcohol and other drug clinics;
 WA Poisons Information Centre;
 Silver Chain Clinics;
 Diabetes education units;
 Rural Clinical Schools;
 Aboriginal Community Controlled Health Services.
Approximately 30% of Curtin University students have undertaken
placements in a rural setting.
Students undertake placements in:
 aged care services;
 community health services;
 NGOs;
 Medicare Locals; and
 vocational rehabilitation services.
80 students per
year
80 students per
year
30 students
Doctor of Podiatric Medicine
3 year post graduate
Master of Psychology (Clinical Psychology)
2 years full time postgraduate
First intake of 9
students capped at
35 students
Master of Clinical Psychology or
Master of Counselling Psychology
Curtin University
30 students (15 in
each)
Combined Doctor of Philosophy and Master of Clinical Psychology
4 year post graduate degree
Varies less than
10 students
20 students
Final Report
1,000 hours
Students undertake placements in:
 hospital settings (public)
 private practice
 university clinics
 Moorditj Djena
125 days or 1,000 hours
Clinical placements occur in:
 public hospitals;
 NGOs such as Alzheimer’s’ Association;
 disability services;
 employee assistance services;
 corrective services;
 aged services;
 Department for Child Protection;
 Relationships Australia;
 University psychology clinics; and
 mental health inpatient and outpatient settings.
33
Discipline
Radiation
Science
Social work
Education provider
Number of
students
(approx.)
Master of Clinical Psychology
Postgraduate 3 years
14-15 students per
year
Combined Doctor of Philosophy and Master of Clinical
Neuropsychology
n/a
Master of Applied Psychology in Clinical Psychology
15 fulltime and
17 part time
students
Varies less than
10 students
Applied Psychology in Clinical Psychology (M) and PhD
4-5 year postgraduate degree
Murdoch University
Bachelor of Science (Medical Imaging Science)
Curtin University
56 students
Clinical placements
providers
Approx. 39 weeks over the 4
years
Bachelor of Medical Radiations (Nuclear Medicine)
Newcastle University
Total unknown
Master of Medical Radiations (Radiation Therapy)
2 years post graduate
Monash University
Master of Medical Sonography
3-4 years part time postgraduate
Curtin University
Bachelor in Social Work
Undergraduate 4 years
Curtin University
Up to 3 students a
period
4-6/year
50 students across
all units
Total 62 weeks over 2 years
35-40 students
140 seven hour working days
(this is undertaken through two
placements)
Bachelor in Social Work
Undergraduate 4 years
Edith Cowan University (Bunbury campus)
60 students
approx. in both
Year 3 and 4
Master of Social Work
Post graduate 2 years
Placement settings
Clinical placements occur in:
 hospital settings (public and private)
 community private practices
n/a
Continuous
Year 1- 39
students
Year 2-30
students
Final Report
34
Clinical placements occur at:
 community mental health services;
 primary schools;
 NGOs;
 Department of Corrective Services; and
 other state government departments
 community mental health services;
 primary schools;
 NGOs;
Discipline
Speech
pathology
Education provider
Number of
students
(approx.)
Bachelor of Science (Speech Pathology)
4 years undergraduate
Curtin University
n/a
Master of Speech Pathology
2 years postgraduate
Curtin University
37 in 2013
Bachelor of Speech Pathology
40 students
Final Report
Clinical placements
providers
Year 3- 2xdays weekly
Year 4- 1 x 4 day a week 10 week
blocks 1x 4 day a 7 week
placement
Year 1- 1 x day per week
Year 2- ½ day a week in Sem 1.
Year 2- 2 x 4 days a week 10
week blocks
Year 3-1 day weekly
Year 4- 1 x 4 day a week 10 week
block, and 1x 4 day a 7 week
placement
35
Placement settings
 Department of Corrective Services; and
 other state government departments
 Hospitals (public and private)
 NGOs
 education settings
2.2 ENROLMENT CAPACITY AND PLACEMENT COMPETITION
The number of students trained each year by education providers dictates the total number of
clinical placements required. Until 1 January 2012, the Commonwealth government set
targets for the number of undergraduate places a university could offer. The Commonwealth
has now moved to a demand-driven system that allows universities to determine how many
undergraduate students it wishes to enrol and in what courses of study. However, medical and
postgraduate places remain capped.
Enrolment capacity in courses across the disciplines varied significantly. Some educational
providers have capped the numbers of students they take for a range of reasons including: the
level of interest from students, workforce demand, a lack of clinical placements available or
the inability of training facilities to accommodate additional students. However, other courses
have identified they have the capacity to accommodate increases in the number of students
and have clear growth strategies.
In some discipline areas, with multiple universities offering similar courses, a level of
competition to secure clinical placements exists amongst educational providers. Some
professional disciplines, despite the competition, have worked collaboratively and
transparently to maximise clinical placement opportunities for students.
This section of the report provides an overview of issues related to enrolment capacity and/or
competition identified in the consultations.
2.2.1 Aboriginal health worker
Community controlled RTOs face considerable pressure to develop sustainable business
models in an environment where VET sector reforms are likely to be more market driven and
competitive. The RTOs compete with public providers for training funding but do not receive
the same level of funding for infrastructure, core organisational establishment and running
costs. The capacity of the RTOs to maintain or increase capacity is considerably impacted by
these funding pressures and although there is considerable demand for Aboriginal Health
Workers, the ongoing capacity of community controlled RTOs to train them in the longer
term is unclear. Administrators spoke of the need for increased funding to assist in easing
these pressures.
One of the key strengths of community controlled RTOs is their ability to provide courses in a
culturally secure environment, which is particularly important for good learning outcomes for
Aboriginal students, particularly those who have not undertaken a lot of study previously.
2.2.2 Audiology
There are approximately 30 students enrolled in the Master of Clinical Audiology and only
enrols 30 students every two years. The university places a cap on enrolment numbers so they
do not saturate the market with more graduates than required. The availability of clinical
placements also limits their ability to expand enrolment numbers. There are currently no
publically employed audiologists in regional WA, which limits opportunities.
When The University of Western Australia audiology course opened in 2000, initially it was
extremely difficult to gain placements, as local audiologists had no affiliations with the
university. The course has now been running for over ten years. With more local graduates it
has been easier to arrange placements. To date, The University of Western Australia has
always managed to find enough clinical placements. However at times capacity can be tight.
Final Report
36
The University of Western Australia is the only university in WA offering audiology, so
competition for placements with other State universities is not an issue.
The University of Western Australia collaborates with the other five universities across
Australia, meeting annually face to face and at other times through teleconferences, where
clinical placements are often discussed. If students would want to complete an interstate
placement, the universities always discuss this across the jurisdictions before permission is
given. This happens frequently as many students apply from across Australia.
All the other Australian universities offering Audiology have a university-based clinic. The
University of Western Australia do not have this model given the course size is small and the
associated expense. They do however employ an audiologist to supervise students at the
Telethon Centre, which assists greatly with placement shortages. This is predominantly
undertaken to ensure there is a consistent high standard across students as it is recognised that
the quality of supervision in the field may vary.
2.2.3 Chiropractic
Murdoch University provides the only course in chiropractic science in Western Australia. As
a newer health profession, Murdoch University established its own clinic to provide clinical
placement opportunities for its students. The clinic runs as a business and patients are charged
fees. Clients are able to claim these fees back from their health insurance.
The Chiropractic Association of Australia sponsors a number of outreach clinics delivered in
NGOs. Rural outreach clinics are supported by some of the mining companies who want to
give something back to local communities.
The university clinic (where the vast majority of placements occur) has the capacity to
provide clinical placements for 72 students annually. Currently there are only 47 students
undertaking placements. Enrolment numbers have varied. Last year there were only 36
students. Whilst in a previous year enrolments were at 62 students. There is still significant
capacity to accommodate growth within the university clinic.
2.2.4 Dentistry
At present there is only one university providing dental education within WA. Whilst much of
the placement experience occurs at OHCWA, placements also occur in other settings and at
present there is no difficulty securing these clinical placements. Fourth year postgraduate
students are particularly attractive for services to take, due to the level of competency they are
expected to have acquired by this stage.
Potential competition for placements is anticipated from other state and territory dental
schools but as yet there is no issue. Within the OHCWA site there is no capacity to increase
number of student placement as they are limited by the number of dental chairs, equipment
and supervisors available. The centre was built to accommodate 46 students but currently
provides clinical placements for 56 students per year.
2.2.5 Dietetics
Curtin University and Edith Cowan University approach host sites individually and request
placement opportunities for their students. Finding agencies to host students during their
community and food service rotations is reported to be relatively easy as there is strong
demand from services to take students for these placements. However, finding agencies to
host students for their clinical placements, which requires more intensive supervision and
Final Report
37
teaching, is becoming more difficult, particularly as student numbers continue to grow each
year.
Edith Cowan University began its program in 2009 and is still establishing ongoing
relationships with organisations that host dietetic students. However, the health services
spoken with stated they tried to take students from both universities equally and had no
preference. The two universities have coordinated their placement rotations over the year so
as to minimise direct competition for placements (Edith Cowan University students undertake
placements in the first part of the year and Curtin University students in the second part of the
year).
At present the numbers at each university are comparable (up to 36 students each year). It is
anticipated that the number of places for dietetic students will increase over the next 24
months. Compared with other health disciplines, tertiary training in nutrition and dietetics is
not particularly expensive for universities to deliver. However, some of the stakeholders
consulted with expressed concern that the growing numbers of dietetic graduates is not
matched with employment opportunities and that future students may find employment in the
field challenging. Interestingly, it was suggested that employment is more likely to be found
in the community sector rather than within the acute sector, where greater intensity of
placements occurs at present.
Although all agencies spoken with considered the provision of student supervision to be
important to their organisation, all said they felt that it would be difficult to increase the
number of students they currently provided supervision for. This was almost always due to
current staffing numbers, demanding workloads and intensity of supervision (particularly for
clinical rotations). The one exception was for the food service placement where there was
perceived to be some capacity to increase numbers.
2.2.6 Exercise Physiology
All four universities offering courses that lead to registration as an exercise physiologist (The
University of Western Australia, Murdoch University, The University of Notre Dame
Australia and Edith Cowan University) have capped their course numbers. No universities are
planning to increase numbers in coming years.
The University of Notre Dame Australia has the smallest enrolment numbers with a joint total
of 24 students for the Graduate Diploma and Master courses. The course is capped as the
university seeks to provide small class sizes. Edith Cowan University, The University of
Notre Dame Australia and Murdoch University all reported capping their enrolments due to
shortages in clinical placements. Murdoch University has the largest cap (45 students).
However, actual enrolments have not been this high, remaining between 30 to 40 students
each year.
No universities sited any difficulty associated with gaining the 140 “healthy” hours of
placements required in the three year exercise science degree.
The University of Western Australia was the only university who reported they had no
clinical placement shortages. Their course commenced in 1992, making it the oldest course in
WA. They have a strong alumni approach to clinical placements. They regularly make contact
with all their graduates once they are a few years out to request placements at their workplace.
A number of the other universities reported some health services would only take The
University of Western Australia students. However, none of the health services consulted
reported any particular university affiliations.
Final Report
38
Both The University of Notre Dame Australia and Edith Cowan University have university
run clinics where external clients attend. These clinics assist in meeting clinical placement
demands and assist with increasing the skills and professionalism of students before they
undertake external placements. Murdoch University reported the greatest difficulty finding
enough clinical placements, as it is a relatively new course and they do not have a clinic. In
addition it was reported that the cardiopulmonary placements were the hardest placements to
secure for both Edith Cowan University and Murdoch University.
All universities and the majority of health services raised concerns regarding the possibility of
a new course being established at Curtin University, as they do not believe there is a need for
another course and with health services already being at full capacity. A number of
stakeholders expressed concern regarding the increasing numbers of students and queried
their ability to find employment in this field within WA.
The universities do not collaborate regarding clinical placements, despite it being a relatively
small profession in WA. The health services consulted said there was a level of competition
between the universities for placements and would appreciate some form of formal
collaboration between the universities.
“We do not collaborate, but we are not in competition. Well we are in competition but it is not ferocious.”
University representative
2.2.7
Medical laboratory science
Curtin University is the only university delivering a course accredited by the Australian
Institute of Medical Scientists in WA. In 2009, the course structure changed in accord with
directions of other medical laboratory science courses across Australia, which resulted in a
significant increase in placements. Prior to 2009 the course was three years long and only
required four weeks of clinical placement. In 2009 the course became a four year degree,
requiring 28 weeks of clinical placement (14 weeks across second semester in year three and
14 weeks across first semester in year four). Health Workforce Australia has supported the
expansion of clinical placements through the funding of a liaison position at PathWest
Laboratory Medicine WA that helps facilitate and monitor clinical placements.
As a consequence of the changes to the course structure, enrolments initially fell off and there
were few problems in filling clinical placements. Now, as the numbers of students increases,
the pressure for placements is increasing. The university is actively seeking to recruit more
private diagnostic laboratories to address projected demand for placements.
Currently there are particular difficulties finding placements for students majoring in
diagnostic cytology. There are also shortages in preanalytical placements as PathWest
Laboratory Medicine WA can only accommodate 40 students. There is a need to expand
capacity by using private laboratories to support these placements.
Final Report
39
A number of other universities have courses requiring clinical placements in diagnostic
laboratories including:
 The University of Notre Dame Australia Bachelor of Biomedical Science;
 Edith Cowan University Bachelor of Science (Biomedical Science); and
 The University of Western Australia Bachelor of Science (Pathology and Laboratory
Medicine).
Whilst these courses do not directly compete against Curtin University’s Bachelor of Science
Laboratory Medicine (as they are not accredited by the Australian Institute of Medical
Scientists) they do place students in medical laboratories which impacts on total capacity.
Additionally, there are some laboratory courses in the VET sector that place students in
diagnostic laboratories which also impacts on total capacity available.
A contingency option is available to Curtin University if attempts to increase engagement of
the private sector are not successful. This involves reviewing the course structure and
reducing the level of clinical placements, whilst still meeting accreditation requirements.
2.2.8 Medicine
In Western Australian The University of Western Australia medical student enrolment was
150 students/year in 2007, and is now at approximately 100 students per year. The
establishment of the medical course at The University of Notre Dame Australia saw an
additional 100 training places created per year. Furthermore, Curtin University is currently
investigating the establishment of a medical course, and if this were to occur it is anticipated
that clinical placements would need to “squeeze” into existing places.
Whilst student numbers have increased, there has not been a corresponding increase in
supervision capacity. Stakeholders reported that:
 it is difficult finding sufficient placements for surgery, and at times there are up to six
students per unit, which is considered too many;
 medicine is “stretched” and as a result some placements are occurring in subspecialty areas
rather than general medical wards which limits students exposure to the ideal breadth of
clinical exposure from the placements;
 psychiatry placements are close to the limit; and
 emergency medicine placements are at the limit.
Over the last five to six years, new placement settings have been established (i.e. aged care
and peripheral hospitals) and the numbers of placements have increased at the Rural Clinical
Schools.1 Whilst there has been growth, applications for placements remain over-subscribed.
In 2014, the Rural Clinical School will have 83 (increased from 80) places and there was in
excess of 130 applications. Additionally, it has been identified that there is potential to
increase community based places in residential aged care and ambulatory care settings. But in
placing students in these settings there is a risk of creating competition for placements with
universities delivering allied health courses.
The University of Notre Dame Australia has actively pursued medical placements in aged
care centres and general practice with a focus on growing a general practice workforce and to
meet areas of unmet need. They have also split the timing of placements for students to
1
The Rural Clinical School offers a year-long placement in rural sites for medical students from University of Western
Australia and University of Notre Dame in the penultimate year of the university course. Twenty five percent of medical
students enrolled in a university must complete the year long placement in a RCS.
Final Report
40
relieve pressure on the host sites so that only half of their students are on placement at any
one time.
Student placements occur across metropolitan public hospitals (teaching and non-teaching
hospitals) and some private hospitals including St John of God Hospital and Hollywood
Private Hospital.
The new Fiona Stanley Hospital will open next year (2014). This will reduce the number of
beds at the Royal Perth Hospital. However, at this point in time key informants were unclear
whether the new hospital would be ready and accredited for teaching. Therefore, there is some
concern that training capacity may be reduced in the short to medium term.
The growth in medical training places has a flow on effect on internships. It is a requirement
that interns graduating must work in accredited training posts and at this point in time these
are only offered within government hospitals. Accredited intern posts are limited.
Consultations indicated that there were instances where three interns are doing a job that was
previously managed by one, and as a result junior doctors are not receiving the volume of
clinical exposure required, as has historically occurred.
The Rural Practice Pathway (RPP) was established in WA to provide a clear training pathway
for doctors in training wishing to become rural practitioners (whether general practice or
specialist). In 2012, the RPP was over-subscribed for all rural hospital intern rotations.
2.2.9 Midwifery
Curtin University and Edith Cowan University have provided midwifery training in WA for
over the past 10 years. Recently two new courses have been introduced:
(1)
(2)
Bachelor of Science (Nursing) and Bachelor of Science (Midwifery) at Edith Cowan
University. Its student numbers are capped under interim accreditation provisions with
its first graduates scheduled to complete their course in December 2013. It is anticipated
the course will at this time be re-accredited and based on the prevailing evidence of
demand (80 to 90 applications each year) the university is predicting scope for
enrolment growth.
Graduate Diploma of Midwifery at The University of Notre Dame Australia, which is
aiming to increase student numbers to 25 per annum.
The introduction of these new courses has introduced increased demand for placements and
there are significant levels of competition associated with securing placements which is
impacting on universities’ abilities to attract student enrolments. Concerns were raised that the
Graduate Diploma of Midwifery was established without industry consultation at a time,
when the number of midwifery students in WA was already at capacity. It was suggested that
there is a need for discussions between all stakeholders to address the issues of capacity and
sustainability of midwifery student clinical placements under the existing model of maternity
care.
Universities were concerned about the difficulties currently experienced in accessing
placements in private hospitals and public services managed by private providers, where a
large number of births occur. Given increasing numbers of public facilities are being managed
by private providers, universities were also concerned there may be a loss of access to these
placements without continued vigilance on the part of the Department in ensuring contracts
with private providers require them to support clinical placements.
King Edward Memorial Hospital is Perth’s only tertiary maternity hospital. Whilst it takes
equal numbers of graduate midwifery students from both Curtin University and Edith Cowan
University, it is unable to provide placements to meet the current level of demand.
Final Report
41
Some stakeholders referred to analysis undertaken by the Department of Health which models
the number of birthing women required each year to enable students to meet registration
requirements. This analysis was reported to show that the number of birthing women
accessible to student midwives (i.e. predominantly those occurring in traditional metropolitan
and larger regional public hospital settings) may not be sufficient to enable students to easily
achieve the experience and competencies necessary for registration. This leads to an argument
for the need to develop contemporary models of care which is beyond the scope of this
project. However, viewed through the lens of growth and competition, it underpins the need to
open up as many options as possible within the entire maternity care system to ensure:
midwives get proper training; and there is a sufficient supply of midwives.
With the establishment of the new Fiona Stanley Hospital, there is expected to be increased
capacity for more women to give birth in the public sector and therefor a greater capacity to
take more students.
Additionally, a hospital clinical coordinator expressed the view that the key issue that needs to
be considered is whether public health services should continue to be the major funder of
midwifery student education. They said the employment model is an expensive one, and if
hospitals were not having to pay students, they may be able to place more midwifery students.
Whilst the employment model of training midwives is very popular with students and
reasonably popular with health services (as it supports their recruitment efforts), some of the
newer educational providers place students in hospitals in an unpaid model. The stakeholder
raising this issue thought it was timely for the sector to discuss whether a change was required
in the approach to strengthen capacity of midwifery clinical placements.
2.2.10Nursing
Universities and VET providers expressed the view that significant demand for student
placements has been growing in recent years and with workforce shortages forecast to
continue until 2020 there will be sustained pressure to increase the number of properly
facilitated and supervised nursing clinical placement opportunities. It was also recognised that
it is much more challenging for educators and health services to plan for and manage the
demand in light of both increased volume and the varying learning needs and related setting
requirements for students in different courses and stages of their education and training.
Additionally the graduate program placements are also under pressure. This was reported to
be related to staffing/cost controls by hospitals.
Most of the educational providers interviewed did not plan to materially change their future
course placement numbers for students. However there were a few who did:
(1)
(2)
(3)
Edith Cowan University’s dual degree course yearly intake is currently capped under
existing accreditation. They anticipate the course being re-accredited in 2014 and
signalled substantial growth in student intake numbers each year after re-accreditation;
The Institute of Nursing and Health Australia advised that as a relative newcomer in
Perth they are still in ‘growth mode’ and are actively seeking to increase numbers.
Murdoch University Bachelor of Nursing, is projecting significant growth in nursing
students.
Access to Child and Adolescent Community Health placements recently became more
difficult for undergraduate students. These services now limit undergraduate placements to
one week. This is because they want to ensure postgraduate students are able to access these
placements. They expressed a preference to have undergraduate students who are well
progressed in their courses. They believe more advanced students are able to appreciate the
differences in service philosophy and that the model of care is quite different from more
Final Report
42
hands-on clinical care settings. Their experience is that more advanced students and are better
able to gain value from their community health placements.
Many of the nursing degree course coordinators have worked in one or more of the health
services and a number have also worked at other universities. This has provided these
coordinators with an understanding of the overall picture of what is happening across the
sector as well as an appreciation of the challenges different organisations face. Despite
significant levels of competition for placements, it was reported that there is a strongly shared
commitment across the nursing sector to ‘making it all work’ for all stakeholders.
A number of stakeholders voiced concerns that it is becoming more challenging to find
enough of the right type of placements for students and they need to keep looking further
afield. One VET provider reported that as initial placements for nursing students are in aged
care settings, they are finding it particularly difficult to secure places for their students. A
number of universities and VET providers said that whilst they might find a place for each
student it can be in a configuration which is costly and inefficient for their Institute or
University to supply clinical facilitators.
“It becomes problematic for us when hospitals are only able to offer us a very small number (two or three)
student placements. If a group of eight students is able to be placed with one provider or the group can be
divided between two providers in close geographical proximity to each other we can efficiently provide a clinical
supervisor to work with the students and their preceptors. However, if this same cohort of students is placed with
several different health services (especially if they are not in close geographical proximity to each other) the
direct costs of providing clinical facilitators are much higher.”
VET provider
There was general agreement amongst stakeholders that there was increasing complexity in
placing students related to the sheer volume of clinical training placements in a variety of
settings. The ‘old way’ of organising things was suggested to ‘work for some but not all’.
Some stakeholders spoke of some universities having developed priority and/or reasonably
exclusive agreements with particular health services. This was noted to have worked
reasonably well in the past as other educators would seek out opportunities and agreements
further afield or with other types of providers. However, a large number of stakeholders
believe a more sophisticated approach needs to be developed to support effective planning
and managing of clinical placements.
The School of Occupational Therapy at Curtin University currently has the largest number of
enrolments. In 2013, 125 students were enrolled in the final year of the Bachelor of
Occupational Therapy and 65 in the Master of Occupational Therapy. There are currently 201
first year Bachelor of Occupational Therapy students which represents a 60.8% increase in
enrolments over the past four years. However, Edith Cowan University’s Bachelor of Science
(Occupational Therapy) four-year undergraduate degree remains constant with approximately
45 of the total 182 students in the first year of the course. A key reason for the increase in
numbers at Curtin University’s Master of Occupational Therapy is because Edith Cowan
University recently closed their graduate entry master course.
Currently Curtin University has an oversupply of clinical placements and Edith Cowan
University’s supply of placements is meeting the level of demand. This is due to both
universities having recently commenced primary school based placements. For Curtin
University these placements occur in a 1:4 supervisor to student model, across five schools
with supervision provided for ten hours a week by an occupational therapist paid for by the
Final Report
43
university. For Edith Cowan University, these placements occur in 1:4 supervisor to student
model in seven schools with the university providing the supervision.
The majority of health services consulted with prefer to have final year students as they can
watch a student develop during the placement and by the final weeks, top performing students
can assist staff with their workload. However, a number of the health services take students
from earlier years because they are easy to support and provide experience for their more
junior staff to gain experience in supervising students.
Edith Cowan University has a seven week block of placements at the end of third year, which
they find to be the hardest block to arrange. This is despite students, having finished all core
subjects and being at the same level as a student commencing fourth year.
The universities do not collaborate in organising clinical placements, apart from aligning their
calendars. Whilst university requests go out separately and they collect offers individually,
neither university described the environment as competitive. Both universities liaise
informally as required.
2.2.12Optometry, Orthoptics, Orthotics, Prosthetics, and Osteopathy
Optometry, orthoptics, prosthetics, orthotics and osteopathy education is not currently offered
in WA. With the exception of optometry and prosthetics/orthotics, placements in WA occur
infrequently for these disciplines. The universities described adhoc clinical placements
initiated by the student themselves due to established relationships with services in WA or
having family there to provide accommodation.
La Trobe University is the only university that teaches orthotics and prosthetics in Australia
and they anticipate demand for clinical placements will grow as they seek to increase student
numbers to 50. Currently they have reached saturation for prosthetic student placements and
are interested in exploring opportunities in regional areas such as Bunbury or Mandurah.
From 2014, orthoptics students will be required to undertake a compulsory regional or
interstate placement and this may provide an opportunity to work more regularly with WA
health services. Within optometry, Queensland University of Technology and Flinders
University of South Australia are keen to develop more formal relationships with health
services and private practices in WA in the near future.
There were a range of reasons that many interstate educational providers did not seek to
establish clinical placement arrangements with WA organisations. These included:
 sufficient placement opportunity in home state or territory and no need to seek placement
in WA;
 prohibitive cost of accommodation and travel for the university and student;
 difficulty in establishing formal arrangements and consistency of supervision between
sites; and
 low student motivation to travel interstate for long placement periods.
2.2.13Oral health
The oral health course at Curtin University has an enrolment cap of 36 students. Numbers will
not increase in coming years. The degree to which they can expand is limited by the number
of dental chairs available.
Competition for clinical placements is not an issue as no other WA universities offer oral
health therapy. The University of Western Australia owns OHCWA and places it students
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here and in the Mount Henry Dental Clinic. The current supply of clinical placements meets
demand.
2.2.14Paramedicine
Of the two universities offering paramedical education, Curtin University has the smallest
enrolment levels. The number of students is controlled by how many ambulance officers St
John Ambulance require. This course is extremely competitive with over 800 applications for
50 places in the first year. As their model employs students, there is no issue with placement
shortages.
With the introduction of the Curtin University course, the placement environment has become
more competitive. This year Edith Cowan University is experiencing an extreme shortage of
placements for its students. Finding sufficient placements has involved educating health
services about the role paramedics can play in service delivery being far broader then just
working in an ambulance.
Both universities compete for anaesthetic placements within hospital settings. One of the main
difficulties in securing placements for Edith Cowan University has been they are competing
with nursing and medical students as well as other paramedic students. Edith Cowan
University are hopeful with time they will build strong relationships making this process
easier.
2.2.15Pharmacy
In developing its Master of Pharmacy, The University of Western Australia avoided conflict
for placements with the Bachelor of Pharmacy at Curtin University by using the summer
trimester for clinical placements. Curtin University placements for the Bachelor of Pharmacy
generally occur in first and second semester. However, the commencement of these
placements in January coincides with 200 graduates annually commencing their internship
year, which means that it is a difficult time to secure placements in community pharmacy
settings.
Recently Curtin University established a graduate entry Master of Pharmacy. To graduate
these students must complete four weeks of placement in a public hospital. Given the
placements requires intensive supervision of students, the university pays health services to
secure the placements. As a consequence, the graduate students are prioritised over the
Bachelor of Pharmacy to gain access to the hospital placements.
There is some concern that when the Master of Pharmacy at The University of Western
Australia changes from delivering its course from a financial year to a calendar year, there
may be increased competition between the universities to secure placements. It has been
suggested that there may be a need for greater liaison across the universities with a view to
minimising competition.
The University of Western Australia has no plans currently to increase student enrolments or
placement days. Curtin University in the near future is hoping to incorporate an additional 500
hours of clinical practice throughout its undergraduate course to assist student learning. Prior
to the establishment of AHPRA, it was a State requirement that students undertook 500 hours
of placements prior to their intern year. There is a perception that current students who are
working in pharmacies as assistants are exposed to work experiences that build their
confidence in working in a retail environment and develops their employability skills. As a
consequence there is a desire to introduce placements earlier and scaffold them throughout the
course.
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A number of pharmacies expressed a preference for taking The University of Western
Australia’s graduate entry master students compared to Curtin University’s undergraduate
degree because they were more work ready. One pharmacist stated:
“UWA students have a more professional edge. They are ready to jump into the tasks you give them and much
more patient focussed, which reflects in the way they engage with clients”
Community pharmacist
2.2.16Physiotherapy
At present the School of Physiotherapy at Curtin University has the largest numbers of
student enrolments. Currently, 680 students are enrolled in the Bachelor of Physiotherapy and
approximately 80 in the graduate entry Master of Physiotherapy. Enrolment numbers were
reported to have steadily increased in recent years, and although the School of Physiotherapy
would like to maintain or reduce current numbers, they felt that the numbers were likely to
increase. When The University of Notre Dame Australia opened their course ten years ago
they set a quota of 80 students per year level, which has only just been reached. It is unlikely
their numbers will increase any further.
The two universities providing physiotherapy education collaborate with arranging clinical
placement activity. Their calendars are aligned to ensure that the placement blocks start and
finish at the same time and some blocks are only utilised by one university at a time. The
universities send joint requests to health services and meet to negotiate placement allocation
and to provide assistance to each other to meet placement need. Health services generally
prefer to take fourth year students. However, the majority still take students from other levels
despite this preference, unless it is in a highly specialised area. Collaboration between the
universities and the recent closing of Edith Cowan University’s physiotherapy course has
reduced clinical placement demand.
2.2.17Podiatry
The University of Western Australia is the only university in the State offering study in
podiatry and there are no issues with competition for clinical placements. However, a number
of service providers reported offering interstate students placements as they enjoy having
students in large blocks, which The University of Western Australia does not offer.
There are approximately 60 students enrolled in the final two years of the undergraduate
degree, and nine students enrolled in the first year of the Doctor of Podiatric Medicine which
is currently capped at 35 students. Numbers are expected to rise to 35 as the university moves
towards a model of broad undergraduate studies followed by a postgraduate professional
qualification.
The university has difficulty finding enough placements to accommodate all its students,
heavily relying on the same health services to provide the clinical placements. Many
podiatrists in WA never take students. This is common across a variety of settings including
public and private hospitals, private practice and community services. At present podiatry
only have one aged care facility placement, which is observation based.
Health services taking students are close to maximum capacity. As the course changes from
an undergraduate to postgraduate degree, enrolment numbers have decreased. This is expected
to decrease the need for clinical placements in the short term until the new course structure is
in place and enrolment numbers increase to the 35 student cap.
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2.2.18Psychology
Placement opportunities for clinical and counselling are in great demand and highly
competitive. In the past, post-graduate psychology students were responsible for securing
their own placements and some organisations were approached by multiple students each
semester. To address this issue, university psychology placement coordinators (predominantly
clinical psychology coordinators) attend Clinical Placement Round Table meetings twice a
year at which placements are allocated between universities as equitably as possible.
For these meetings each coordinator identifies a number of agencies that can host students and
together and during the round table meeting these opportunities are shared and allocated
amongst the universities. This meeting provides coordinators with an opportunity to discuss
placement activity, allows the competition for placements to be managed, and facilitates the
development of a collegial relationship between the universities.
“It is not important to build individual relationships with the health services. We don’t like to block out other
universities. We try to maintain a non-competitive culture between us.”
University representative, Psychology
However, despite this meeting there still remains a shortfall of placements each year and the
individual university placement coordinators then need to seek out additional placements for
their students.
“After the meeting we are usually short about 30% and it is an ongoing battle to the secure those last few places.
We only just make it.”
University representative, Psychology
Some services are reported to have a preference for students from a particular university
based on historical relationships with the university, or teaching focus of a specific
postgraduate program, such as rehabilitation or disability, which aligns with their core
business.
Enrolment for postgraduate clinical and counselling psychology programs is approximately
15-20 per year for the universities. The university representatives said it would be difficult to
increase enrolment numbers without a significant increase in funding for their department. In
addition, obtaining additional clinical placements would be challenging.
2.2.19Radiation Science
All placement providers indicated a preference for WA students. Where Curtin University
offers a course there appears to be good long-standing relationships with the placement
providers.
Curtin University has recently increased its enrolments in medical imaging to 60 students
which is causing angst amongst the placement providers and at this time there are not enough
places to meet the course needs. Perth Radiology Clinics have indicated it is likely to decrease
the number of places available within their clinics due to changes in technology and service
delivery.
Curtin University is introducing a new Master in Radiation Therapy commencing in 2014
with 20 to 25 student places. Placement providers have indicated they will support the new
Curtin course but are uncertain they can meet the 20 to 25 places needed. The new Fiona
Stanley Hospital service will likely support training once it settles into regular service
delivery.
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At present there are student recruitment issues with sponsored places in the Monash
University course not being filled.
Sonography is self-regulating as students need a placement to undertake the course and are
employed. There is some competition between the course providers as all course are offered
by external delivery. This does not impact on the placement providers.
Nuclear medicine places are very limited and funded by a Health Workforce Australia grant
which finishes with the 2014 intake. Graduates are not currently meeting the level of
workforce demand. There is serious concern how the training program can continue without
further financial support after 2014. Scope exists for increasing places if support for travel and
accommodation can be found.
2.2.20Social Work
The host organisations (both health and community services) reported that they tried to take
students from each university equitably and not develop allegiances or preferences. The
university coordinators reported that there was no significant problem currently sourcing
placements but if student numbers or field placement hour requirements increased in the near
future, it may become more difficult to find sufficient numbers of sites.
Some supervisors prefer students who are on the second and subsequent placement but others
do not state preferences to the universities. Although it can be harder to locate first
placements for social work students, it was reported that as master level students have usually
had prior working experience they are often more attractive to potential placement hosts.
Until recently, universities had different placement timings, but this has changed recently, so
there may be some increased level of competition when students from the universities
undertake their second year placements at the same time. One university representative
commented that they anticipated an increased level of competition with the introduction of
online social work education. Edith Cowan University recently introduced online social work
studies to the Western Australian market.
2.2.21Speech pathology
Of those offering education in speech pathology, the School of Speech Pathology at Curtin
University currently has the largest student enrolment, with approximately three times as
many students as Edith Cowan University. The number of students enrolled in the Master of
Speech Pathology has increased from 20 students in 2012 to 37 students in 2013. Edith
Cowan University’s course commenced in 2009 with the first students graduating in 2012.
Their student numbers have gradually increased from 15 to 40 per year. The plans are for
enrolments to stay at around the 35-40 student mark due to limited placement availability.
The two universities have aligned the larger blocks of clinical placement and send out joint
requests for placements and offers are shared. As Curtin’s enrolment numbers are three times
the size, Curtin University is allocated 75% of the placements and Edith Cowan University
25%.
2.2.22Overview of enrolment capacity and levels of collaboration and
competition
The level of collaboration differs between disciplines at present and appears dependent on
individual program coordinators’ motivation, desire for equity of placement opportunities,
and the competition for placements facing a particular discipline. Collaboration between
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university program coordinators has also occurred in response to requests from services that
host students. Although at varying degrees, it is reported that competition for placement
opportunities occurs within and between disciplines at present and is influenced by: student
numbers, the placement model, length of placement, availability of specific practitioners to
supervise, and reliance on ‘traditional’ services such as hospitals.
Figure 2.1 provides a summary table of the discipline areas where there are difficulties
securing placements.
The discipline areas facing greatest challenges are shown in red and include: medicine,
midwifery, nursing, psychology, exercise physiology, medical laboratory, medical imaging,
paramedicine and radiation therapy.
The discipline areas where placement capacity is finely balanced and could become an issue
are shown in orange and include: audiology, dentistry, dietetics (clinical placements), exercise
physiology, oral health, and pharmacy.
The discipline areas where there is more than adequate placement capacity is shown in green
and includes: Aboriginal health worker, chiropractic, dietetics (food service and community
placements), occupational therapy, physiotherapy, podiatry, sonography, social work and
speech pathology.
Figure 2.1: Difficulty securing placements
Discipline area
Aboriginal health worker
Audiology
Chiropractic
Dentistry
Dietetics –clinical placements
Dietetics – food service and community placement
Exercise Physiology
Medical Laboratory – diagnostic cytology and preanalytical placements
Medicine
Midwifery
Nursing
Occupational therapy
Oral health
Paramedicine
Pharmacy
Physiotherapy
Podiatry
Psychology
Medical imaging
Radiation therapy
Sonography
Social work
Speech pathology
Difficulty securing placements
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3
Models of clinical supervision
and facilitation
This chapter provides an overview of the models of supervision and facilitation for each
discipline and discusses how professions are involved in interprofessional education (IPE) and
multi-professional placements.
3.1 TERMINOLOGY
Throughout the project the following terminology has been applied:
Supervision models describe the way in which students on placement are supervised.
As a general rule, where the term supervisor is used, it refers to the clinician at the host
organisation that has formal responsibility to supervise the student whilst on placement.
Generally, supervisors have responsibility for supporting the student, facilitating their
learning as they work alongside them and for assessing the student. Some professions prefer
to use the term preceptor, instead of supervisor.
Some professions use facilitators. The term facilitator generally refers to a skilled practitioner
who supervises students in the clinical setting to allow practical experience with patients.
Historically, faculty members have undertaken these roles. Some educational providers still
have staff members attending health services with students who provide one on one and group
support to their students. However, other educational providers now make funding available
to enable the hosting organisation to appoint internally a staff member to support the students
on placement.
Facilitation models describe the way in which placements are supported within the placement
setting. It incorporates orientation, the provision of student and supervisor guides, supervisor
training and support to supervisors.
3.2 MODELS OF CLINICAL SUPERVISION AND FACILITATION
An overview of the models of supervision and facilitation for each discipline is provided in
this section.
Students are mostly supervised in a 1:1 student to supervisor ratio. In ACCHOs, they tend to
be supervised by a senior AHW or in some cases a registered nurse. Supervision in the
government sector is mostly done by registered nurses. Competency assessment is core to
vocational education. Placements are organised so students gain access to experience in the
required competencies in the workplace.
Marr Mooditj Training has a detailed clinical log book that sets out clearly the competencies
that need to be completed for each unit of each course. Clinical supervisors need to observe
the student competently completing each set of competencies on at least three occasions
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before sign off is given. Placements are negotiated directly by Marr Mooditj training staff
based on the competency requirements of individual students.
Aboriginal Health Council of Western Australia students have a diary and a clinical
observation booklet for health services which sets out the requirements of the placement.
Aboriginal Health Council of Western Australia staff spend considerable time working with
preceptors and also make presentations to preceptors including showing them the assessment
tasks that students take with them to the placements.
3.2.2 Audiology
The majority of audiology placements are in a 1:1 supervisor to student model in accordance
with university guidelines. The other main model utilised is a 1:2 supervisor to student model.
This is often utilised in paediatric placements when a child needs to be distracted, enabling
the other student audiologist to complete the assessment.
The university contacts the health services at the start of each semester to confirm placements.
Personal relationships primarily support the organisation of clinical placements, rather than
formal contracts. The health service is responsible for the supervision and facilitation of all
placements apart from those at Telethon Speech and Hearing, where The University of
Western Australia funds the supervisor.
All students when on placement fill out a clinical diary for each client they see, documenting
their diagnoses, assessment, intervention and clinical reasoning. At the end of the placement,
the university review these. It assists in identifying how the student is going and areas they
may need to focus on. The supervisors complete the university’s competency based
assessment form at the end of each placement.
3.2.3 Chiropractic
At the university run clinic one chiropractor (with at least three years clinical experience)
supervises seven final year student clinicians. The chiropractor has responsibility for
supervising the clinical components of their placement, including the assessment of students.
Student clinicians see clients in a treatment room and are supported in taking a client’s
history, examining the client, developing a management plan and treating the client. The
supervisor is available in a central location and guidelines specify the key stages when the
student must involve the chiropractor. The supervisor examines the client to confirm the
diagnosis and treatment plan and assists students in treating the client as required.
Fourth year students (mentees) are assigned to fifth year student clinicians (mentors) and
shadow the mentor and their patients. This process enables them to become familiar with
clinic policies and procedures, and introduces them to the management of the mentor’s
patients. It also provides opportunities for student clinicians to consolidate their knowledge as
they introduce their mentee to the clinical environment.
Whilst the students work in teams (student clinician and fourth year students), all supervision
of clinical care remains with the clinical supervisor and the student clinician performs the
treatment. This model may have wider applicability for other disciplines, as an effective way
of introducing and supporting students when they commence working in a clinical
environment.
Whilst undertaking placements, students are rostered to undertake a range of rotations in the
provision of clinical treatment, reception duty, rehabilitation/physical therapy and radiology.
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A range of appropriately qualified staff in the clinic, have responsibility for supervising the
students undertaking these rotations.
The model of supervision for the outreach and rural clinics is similar. Chiropractors from the
university go out with the students and depending on the capacity of clinical facilities
supervise groups of two to seven students.
3.2.4 Dentistry
Supervisors or “clinical mentors” as referred to by the Australian Dental Association (ADA),
must: be registered as a clinical provider with the Dental Board of Australia; be at the level of
the qualification for which the student participant is training (at a minimum); and have at least
two years’ experience.
At OHCWA a graduated supervision model is used for both preliminary or specialised
training. With inexperienced students, there is a high level of supervision with a 1:1
supervisor to student model. As students advance through their course and their competencies
develop the level of supervision relaxes to a 1:4 model of supervision. At times it may
increase to 1:6 model with advanced final year students and supervisors exercise judgement
about the level of supervision required, based upon demonstrated procedural competence.
Supervisors complete a standard supervision framework for each student, including written
assessments within the rural clinical placements and special needs dentistry components. Log
books are completed for all clinical placements.
OHCWA has staff who work closely with The University of Western Australia faculty student
placement coordinator and their counterparts at Dental Health Services in coordinating the
placement of students.
3.2.5 Dietetics
Supervisors must have two years of experience post accreditation to be recognised as a
primary supervisor for clinical placement. However, first and second year qualified dieticians
are able to be secondary supervisors. The clinical placement requirements are very specific
which means that some settings are not able to host students (such as aged care settings) as
they are not able to provide students with all the required competency experiences. These
sites, however, are able to offer project based community or food service placements.
Clinical placements will almost always occur in a hospital setting. Generally a single primary
supervisor and one or more secondary supervisors supervise two students. The pairing of
students within the clinical rotation is a key philosophy in dietetics as it facilitates peer
support and collaboration. Students are encouraged to meet once a week to discuss client
cases and provide each other with feedback.
Agencies are generally able to host a greater number of students for food service placements
and the ratio of supervisors to students can be up to 1:5. Community placements will generally
have 1:1 or 2:1 supervisor to student ratio. Some of the bigger organisations may take two
students concurrently for community placement while others will only take a single student.
Within many health services, dieticians will share responsibility for student supervision
(although the primary supervisor will usually remain constant) to reduce pressure on part-time
employees.
Supervisors assess students at the mid and final stage of the placement. A university
supervisor attends the clinical placement setting once a week for two hours per student.
During this time the university supervisor will meet with the health service primary supervisor
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to discuss the progress of the student, any areas in which the student need to obtain additional
skill and any support the supervisor may require. The university supervisor also observes and
teaches the students on the ward during their visit. For students who are struggling with the
placement, both universities offer additional hours on site (up to 4 hours a week) to support
the student.
To minimise the administrative burden and increase consistency of assessments, the two
universities have collaborated to create a shared student placement competency framework.
This framework is based on accreditation competencies set by Dieticians’ Association of
Australia and contains set objectives to meet over the three placements. Although there are a
couple of competency items considered ambiguous by supervisors within the clinical rotation,
the shared framework was well received by the supervisors.
3.2.6 Exercise Physiology
Exercise physiology is still a developing profession, especially in WA. Because of this there
appears to be no uniform language used for supervision models. From discussion with health
services, the predominant model appears to be a 1:1 supervisor to student model. However,
the supervisor may change from day to day. One key staff member is generally responsible
for student placements across the facility. Feedback to students was reported to occur
immediately after seeing the client if time allowed. It was reported that supervision rarely
occurred in formal sessions unless there was a major incident.
To gain accreditation with ESSA, students are required to fill in a logbook detailing all their
clients, the length of each session, and what was involved in delivering the session. The
supervisor is required to sign off on each session. In addition, universities have their own
individual assessment forms. Health services inconsistently reported what forms existed and
were often unable to identify which universities had forms.
It is an ESSA requirement for 95% of all placement hours to involve direct client contact
only. Consequently, limited or no time is spent by students in preparing for sessions,
completing administration tasks or reporting on a client's progress. A number of health
services reported that this results in graduates, who do not understand the full role of an
exercise physiologist and who are not work ready, which requires their first employer to
provide lengthy orientation.
There was no consistent understanding amongst supervisors spoken with, as to whether
clinicians were able to pass or fail a student. Many were unsure if assessment was based on
completing the set number of hours or on the student being able to demonstrate they were
competent.
All health services reported that the universities were supportive if they experienced problems
in managing a student. Universities often said they visited students at the health services.
However, health services said it rarely or never happened. Health services were keen to see
greater involvement of the universities in supporting the students on placement.
Facilitation of clinical placements occurs throughout the year with Universities generally
calling a key contact person at the health service when a clinical placement is required.
Recently, The University of Notre Dame Australia and Hollywood Functional Rehabilitation
Clinic and Como Fitness have moved to part-time five week blocks. In general, other health
services were in favour of this model.
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3.2.7 Medical laboratory science
Curtin University has worked closely with PathWest Laboratory Medicine WA in the design
of a program to support the expansion of clinical placements for medical laboratory science
students. Curtin University currently pays PathWest for taking its students and funding from
Health Workforce Australia supported the establishment of the placement program and the
student liaison coordinator position at PathWest Laboratory Medicine WA.
The University has responsibility for defining the placement program, competencies and
experience students are required to acquire on the placements. The university unit coordinator
works closely with the liaison coordinator at Path West Laboratory Medicine WA in
facilitating, rostering and monitoring placements. The liaison coordinator, in turn works with
coordinators at each PathWest Laboratory Medicine WA site. These coordinators have
responsibility for formally supervising the students at their site. This involves the monitoring
a student’s progress, supporting and mentoring the student when required, giving formal
feedback on their progress and signing off that they have attained the required
competencies/level of experience.
On a day to day basis, laboratory staff members are assigned to particular work areas and are
involved in supervising students. Sophisticated rosters have been developed rotating students
and staff across the work areas, ensuring all staff are exposed to and have responsibility for
supervising students.
Manuals and log books for each of the seven areas of the laboratory in which a student can
undertake placements, have been developed which: define the scope of practice of the student;
and provide guidance on how to undertake key tasks.
3.2.8 Medicine
In the hospital setting, supervision is generally an apprenticeship approach, with the ratio
dependent on the discipline. Vertical supervision is a common feature of training in medicine.
Under this arrangement:
 consultants supervise the senior registrars,
 senior registrars supervise the registrars; and
 registrars supervise interns and students (often in a group).
In the general practice setting, an apprenticeship approach is used and generally on a 1:1
basis. In the general practice placements the emphasis is on teaching differential diagnosis
and the use of algorithms to support this.
There are three positions within the medical school at The University of Notre Dame
Australia to develop and coordinate clinical placements for medical students: one position is
responsible for the facilitation of pre-clinical placements in Years 1 and 2; one position is
responsible for facilitation of clinical placements in hospitals; and one position facilitates
clinical placements in general practices.
The University of Notre Dame Australia has developed study guides and learning objectives
to provide direction for pre-clinical and clinical placements. In Years 3 and 4, there are
learning guidelines for each discipline and a Mini Clinical Exam at the completion of the
placement. For general practice placements there are learning objectives and guidelines
outlining the skills to be obtained in the placement.
The University of Western Australia has study guides in place to provide direction for preclinical and clinical placements. Clinical placements are coordinated at health service level.
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The Rural Clinical School of Western Australia coordinates clinical placements across 13
rural sites. They provide formal teaching, mentoring and support to students, in addition to the
“local” supervision of the student while placed within the health setting e.g. general practice,
hospital, ACCHO, or aged care facility.
3.2.9 Midwifery
Supervision and facilitation models varied across facilities depending on whether students
were undergraduate students or postgraduate students and whether they were working under
an employed model of placement or not.
The models of supervision in midwifery care varied from 1:1 to 1:4 supervisors to students.
Undergraduate students tend to be supported by clinical facilitators. At some services the
facilitators were provided by the universities, whilst at others the health services were funded
to provide this support. Ratios of supervisors to students varied from ratios of 1:2 to 1:10.
Students have very specific areas of practice they need to cover in undertaking their
placements and these are assessed by their supervisor.
Clinical staff in patient care areas (birth suite, post natal wards, antenatal clinic) are very well
informed about student needs and scope of practice as they progress through the stages of
their training. Clinical staff are actively involved in supporting students whilst on placement.
3.2.10Nursing
All education institutions have their own in-house course clinical placement coordinators who
liaise closely with health service managers in planning and coordinating clinical placements.
Across the sector, hospitals taking large volumes of nursing students and supervise clinical
placements using one of two broad approaches:
(1)
The education institution provides a clinical educator, also known as a facilitator.
They attend the placement and supervise a group of eight students. The role of the
facilitator includes orientating the student, providing clinical education and supporting
the students, and liaising closely with the preceptors in the health service (who provide
practical support to students assigned to them). If any issues arise with the student’s
performance, the facilitators deal with these and provide extra support where
appropriate. The facilitator also assesses the student’s performance against the required
competencies associated with the placement
(2)
The health service that has students on placement takes full responsibility for
supervising the student. Under this approach, the university provides financial support
to the health service to cover the costs of supervising the students. The funding allows
the health service to appoint a staff member to supervise and facilitate the student
placements. Alternatively, if the health service does not have their own staff readily
available at the time of the placement, the health service will engage a facilitator to
support the student placements. The roles of these facilitators are generally the same
those that are supplied by the university.
Obviously, there are various in-house styles encompassed within this overall approach and the
roles vary slightly.
Generally facilitators support students on a 1:10 supervisor to student model.
As students enter into their final placements they are expected to be working autonomously.
Although there continues to be a need for a level of supervision, what is required is not as
intensive. Some universities have developed liaison officer positions that support these
Final Report
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students. The University of Western Australia calls their staff Clinical Education Liaison
Officers (CELOs), whilst Curtin University staff call these positions Clinical Liaison
Academic Support Practitioners (CLASPs). They will often spend one to two hours with
students in groups and provide support to preceptors if required. These officers may support
up to 20 students.
The most common model of supervision used was a 1:1 followed by a 2:1 supervisor to
student model. When staff members work part time or work across different areas 2:1 models
are commonly used.
All health services had formal supervision sessions with students to complete the mid-way
and final Student Practice Evaluation Form-Revised (SPEF-R)6 Assessment (the assessment
tool used by all universities teaching occupational therapy nationally). If the student is at risk
of failing the placement mid-way, the supervisor or student placement coordinator contacts
the university. All health services reported this situation happens rarely, but when it does, the
universities were seen to be supportive.
All health services had one key person responsible for facilitating student placements as part
of their role. This role is often undertaken on top of the staff member’s usual clinical caseload
or management duties. However, a number of health services reported that the funding the
organisation received for taking students went towards covering a small portion of the
facilitator’s position.
3.2.12Optometry
Models of supervision in place for optometry students varies. For some students they will
observe and for others they will have a greater opportunity to participate in development of a
treatment plan and patient management. The Royal Perth Hospital generally takes one or two
students for a period of one to two weeks from the University of New South Wales. The
Optometry Association facilitates these placements and students and whilst in WA students
rotate to a range of other placement settings. Sir Charles Gairdner Hospital was taking
students until recently. However they are currently not accredited to teach students. The
supervisor to student ratio preferred is 1:1 but sometimes there will be two students to one
specialist.
3.2.13Oral health
When students commence clinical placements they are supervised under a 1:3 supervisor to
student ratio and as they develop their competence the ratio is relaxed to a 1:4 model.
To ensure standards of care remain high, students are monitored closely. The open plan clinic
allows the supervisors to monitor what is occurring at all times. There are strict procedures
that require students to gain authority from the supervisor to commence treatment. At critical
stages through treatment the student must involve the supervisor, including prior to the client
leaving when the supervisor signs off on the treatment provided in the client’s dental record.
The supervisor grades each treatment on a number of dimensions and scores are collated for
each student. The results are provided to students twice a semester. The quantitative data
provides the capacity to measure improvements in performance as well as identifying
dimensions where improvement is needed. This is complemented with qualitative feedback
from the student’s supervisor.
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3.2.14Orthoptics and osteopathy
There are no regular clinical placements undertaken in WA for orthoptics and osteopathy and
HMA is unable to comment on the supervision model in place for these two non-WA
university programs.
3.2.15Orthotics and prosthetics
Students in their final year must complete two full time eight week external placements (one
for orthotics and one for prosthetics). Students spend four blocks a year at WA private and
public health services and some organisations will host up to six students in a year. Dependent
on the size of the service or practice the ratio will be one to one supervisor to student or one
supervisor to two students. Representatives from the Princess Margaret Hospital Child and
Adolescent Health and TLC Unlimited reported providing a 1:1 supervisor to student model.
Supervision is graduated over the eight weeks and the student will be able to undertake more
independent work later in the placement.
3.2.16Paramedicine
Curtin University students are student ambulance officers who work alongside ‘on the road’
tutors (who are paramedics and have undertaken mentoring training) under a 1:1 supervisor to
student model. Additionally students receive support from The College of Pre Hospital Care.
Call outs to emergencies are graded on a severity rating which assists in ensuring learning
opportunities are graded to student’s skills and experience. Curtin University and St John
Ambulance work collaboratively to roster the students around class times.
Edith Cowan University places some students in a range of settings including operating
theatres, hospitals and drug and alcohol services. These students receive supervision under a
1:1 supervision model.
HMA did not consult with any health services taking students in hospital ward-based settings,
as they have not yet commenced. Edith Cowan University intends that these placements will
utilise a preceptor with a 1:8 supervisor to student model similar to nursing, with a single
facilitator to support the students. Edith Cowan University does not fund health services to
take students on placement.
Edith Cowan University coordinates with health services the number of students and the days
of the week they will attend early in the year, with names of students being sent to health
services in the days leading up to the placements.
The assessment tool for each university is particular to each university.
3.2.17Pharmacy
Students undertaking Curtin University’s Bachelor of Pharmacy are generally supervised
under a 1:1 supervisor to student model in both community pharmacies and hospitals. This is
also the case for their Master of Pharmacy students undertaking placements in community
pharmacies. Across placement settings, pharmacists spoke of the need for very close
observation and checking of all work associated with dispensing medicines. In some larger
community pharmacies and hospitals, there will be more than one supervising pharmacist
available to supervise the students. For each placement a pharmacist takes prime
responsibility for the supervision of the student and signing off that that they have achieved
the required competencies. Curtin University does not make payments for its undergraduate
students.
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Students undertaking the Curtin University Master of Pharmacy go to hospitals in small
groups (six to eight students). The university pays for the postgraduate placements, and a
hospital pharmacist preceptors the students in the group. They also have responsibility for
assessing student’s achievements against the required competencies.
The University of Western Australia’s Master of Pharmacy students undertake placements in
groups of ten. The facilitator has responsibility for: clinical teaching, preceptoring and
assessing the students. At some sites, facilitation is undertaken by a hospital pharmacist,
whilst at others by a university facilitator. Arrangements vary depending on the preference of
the hospital.
Community pharmacists do not receive any payment for supervising undergraduate or
postgraduate students.
3.2.18Physiotherapy
The model of supervision used in clinical placements varies both between and within settings.
In tertiary hospitals several different models may operate depending on the clinical area. For
example, in musculoskeletal outpatients 1:6 or 1:4 supervisor to student models are
commonly used. However in highly specialised areas such as women’s health a 1:1 model is
used. Some supervision positions are entirely funded by the university and others by the
health service. Smaller health services predominantly use 1:1 or 1:2 supervisor to student
models.
Both universities use a common assessment tool, the Assessment of Physiotherapy Practice
(APP). The APP is completed mid-way and at the end of the placement. Both universities
employ university supervisors who visit students for two to three hours per student over the
four of the five weeks of their placement. In this time, they observe students with patients and
talk through any problems they are having. For Curtin University, the university supervisors
complete an assessment form for the student, in addition to the health service supervisor.
The University of Notre Dame Australia supervisors do not assess students and would prefer
not to use a university supervisor model. However as Curtin University has always offered
this, many health services will not take The University of Notre Dame Australia students
unless university supervisors are offered. The University of Notre Dame Australia does offer
a payment in lieu of university supervisors.
3.2.19
Podiatry
In both community and hospital podiatry placements the predominant model is a 1:1
supervisor to student ratio, apart from the university clinic where the ratio is higher. Across
placement settings, podiatrists spoke of the need for very close observation and checking of
all work, especially involving ulcer and wound care. For each placement a podiatrist takes
prime responsibility for the supervision of the student and signing off that this supervision
occurs. In some hospitals, students may spend time with other podiatrists if required or if their
clinical area offers a specific learning experience. The University of Western Australia does
not make payments for its students.
Facilitation of clinical placements is commonly the responsibility of one staff member at a
health service. The number of students and the days of the week they attend stay relatively
consistent from year to year, with names of students sent to health services in the days leading
up to the placement. The assessment tool used on placement is specific to The University of
Western Australia.
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3.2.20
Psychology
All supervisors of provisional psychologists must be accredited by the Psychology Board of
Australia (PBA). The Australian Psychological Society College Approval Guidelines mandate
one hour of clinical supervision to be provided by the supervisor per seven hour day and a
minimum of 180 hours for the 1,000 hours undertaken during the master programs. For the
doctorate program the required supervision time requires an additional 50 hours (on top of the
master’s requirement). Direct contact supervision may occur through telephone or video
conference contact for some of this time (no more than 40%). As required by Australian
Psychology Accreditation Council (APAC) all postgraduate students must maintain a detailed
log book of practical, casework and supervision activities which is regularly viewed and
signed off by the relevant supervisor. The university psychology departments now utilise a
common framework for competency assessment to assist with consistency of assessment and
to minimise the administrative burden on the supervisors.
The APAC has prescriptive set guidelines for supervision and psychology students
(specifically clinical, neuropsychology and counselling) and they must achieve minimum
hours of supervision throughout their postgraduate study. This is generally undertaken two
days a week, largely independently with their own small client load, but actively supervised (a
minimum of two hours per week by their supervisor). One to one supervisor to student models
were used at the sites spoken with in this project. Where there is an appropriate site identified
that does not employ a registered psychologist able to provide supervision, the university can
appoint a psychologist to provide this role as an external supervisor. In some cases the
organisation themselves will employ or assume the costs of this supervisor themselves to
support the arrangement and opportunity to have access to a psychologist.
The university placement coordinator usually contacts the field supervisors to monitor
progress of the student at mid-placement and will organise a meeting if considered necessary
by the student, placement coordinator or supervisor. The purpose of the mid-placement
review is to assess progress against goals, provide feedback to the student, discuss any issues
that may have arisen, and set targets for the second half of the placement. On completion of
the placement, both student and supervisor are required to complete a placement report, and
the student submits copies of their log book, reports and other fieldwork material which is
provided to the university placement coordinator.
Most hosting agencies have an individual person who is the key contact for the universities.
This person may be the supervisor themselves or somebody who is responsible for the
coordination of all student placements. Individual sites generally meet with a prospective
student prior to placement to ensure the student will be the ‘right fit’ for the organisation and
that their individual learning needs and goals can be accommodated. If the student and field
supervisor agree to the placement then a placement contract is signed.
Hosting agencies supervising provisional psychology students are rarely paid for supervision
undertaken through a university program.
3.2.21
Radiation Science
The courses offered by Curtin University provide good supervisor support with both
written/online guides and personal contact. Each course has an Advisory Committee which
consults on placements, however not all providers are included. University supervisors attend
every site each semester or placement block. Clinical supervisor training is offered each year
and there is open communication on a one-to-one basis as required.
A 2:1 supervisor to student model is used for medical imaging and radiation therapy and a 1:1
model for sonography and nuclear medicine. There are professional and radiation safety
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requirements governing these limits. Additionally the type of technology and service delivery
limits the number of students in any single service suite for each of these professions.
Each of the placement providers interviewed has a nominated supervisor responsible for
student training. The clinical educator role is internally funded and is responsible for student
orientation, rostering, mentorship and assessment. They are usually also responsible for staff
development. This position plays a key role in ensuring the student is well supported and able
to progress through their identified competencies. Day to day supervision is shared between
the staff as the student rotates through the service delivery suites. Assessment is a shared
responsibility between the clinical supervisors and the clinical educator, who submits any
final report and liaises with the university as required. Placement providers have developed
their own resources to support students on placement.
Interstate courses offer limited support beyond written/online assessment documentation.
There appears to be very limited communication between the placement provider and the
universities unless a student situation arises.
Placements for radiation science tend to be arranged based on long-term partnerships and
individual negotiation on a needs basis. There is a sustainability risk in the dependence on
individual relationships rather than an open collegial model.
Individual placement providers have little knowledge of the practice and placement issues of
their peers and misinformation of peer contributions to the state placement program is
common across all the radiation science professions. There is no forum for clinical
supervisors to meet and mentor.
3.2.22
Social Work
For all universities the social work ‘field educator’ is the primary supervisor of the student on
site. The field educator must be a qualified social worker with a minimum of two year’s
practice experience and be eligible for membership of the AASW. Field educators must
provide a minimum of 1.5 hours of supervision (including formal and informal) for each five
days on placement. This can be provided individually or in a group. Students on placement
can participate in a range of individual case work or group activity dependent on the stage of
their study, level of competence and skill, and working experience.
The model of supervision within social work is predominantly 1:1 or 2:1 supervisors to
students, complemented by group teaching in some larger facilities. The social work field
placements are structured in accordance with AASW guidelines and relevant social work
program requirements. Clear expectations for learning goals and performance outcomes,
based on the AASW Practice Standards and Code of Ethics are established through a
consultative process between the university, field educator and student. The goals are
documented in a learning plan. There is one placement assessment report due mid placement
and a longer final report at completion of the placement.
The ‘university liaison person’ is the university’s representative for the field placement and is
responsible for supporting, monitoring and evaluating the placement. The liaison person is
available for support, advice and direction for both the student and the field educator/practice
educator and can assist with issues as they arise. Generally, the liaison person will visit the
student at their sites twice during placement: beginning and mid placement. At The University
of Western Australia, students are expected to attend a number of integration sessions with
their liaison person and other students. This provides a forum in which to integrate theory,
knowledge and practice as well as to explore any concerns with the students.
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Where the agency is not able to provide a field educator, an external field educator will be
provided by the university. The external field educator will provide supervision in accord with
AASW guideline. However, the student is also supported by an agency supervisor or
‘practice/task educator’ who provides orientation to the agency, informal supervision of
placement activities, and oversees their daily tasks and activities (but is not necessarily a
social worker themselves).
3.2.23Speech Pathology
A 1:1 supervisor to student model predominates in speech pathology, although some
placements can involve multiple students (up to a 1:4 supervisor: student ratio). Despite
having one student per supervisor in many placements, students frequently attend placements
in pairs. This encourages peer learning and reflective practice. Speech pathologists reported
that clinicians are generally considered able to supervise after three years in the field
(although some speech pathologists are able to undertake this role after two years of
employment).
There were a number of innovative models of supervision observed.
Next Challenge utilises a 1:2 supervisor to student model with pairs of students going out to
schools without a speech pathologist present. Each student is assigned a small caseload of
students whom teachers have identified will benefit from speech pathology input. The
students may also run activities together. The peer support gives the students the confidence
and a sounding board for ideas they would not have otherwise. The tasks the students
undertake do not require direct supervision and mechanisms have been established that allow
for the supervisors to monitor their performance, including videoing of sessions. This model
is innovative, as it has enabled a private practice to take students without negatively
influencing their business.
Another innovative model is the Gosnells Community Speech Pathology Clinic run by Curtin
University. Three to five students receive supervision from the one supervisor under a peerlearning model that has achieved significant reductions in public hospital waiting lists.
Speech pathology has a national competency assessment tool called COMPASS which is used
to assess all student placements. It can be completed online and both universities offer
training in its use. The majority of health services spoken to acknowledged that COMPASS
provides benchmarks and encourages a collaborative process for assessment. However, many
health services said it was very time consuming to complete and too subjective.
3.2.24
Overview of supervision and facilitation models
Across the different disciplines there was a range of supervision models in place. Some
disciplines utilise predominantly a one to one supervision model, whilst other models involve
having one supervisor to a number of students. Disciplines employing the one to one
supervisor to student model include: Aboriginal health worker, audiology, exercise
physiology, paramedicine, pharmacy, podiatry, psychology, sonography, nuclear medicine,
social work and speech pathology.
Some of the disciplines use peer placement model where a supervisor(s) supports students
attending in pairs (providing peer support to each other.) These disciplines include dietetics,
occupational therapy and speech pathology.
A number of disciplines have models of supervision involving one supervisor to a number of
students (often varying from 1:2 to 1:10 in the disciplines examined). The discipline areas
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using these models include: chiropractic, dentistry (after an initial period), midwifery,
nursing, occupational therapy, oral health and physiotherapy.
In medical laboratory science, medical imaging and radiation therapy and some pharmacy
placements the models of placement involve two or more supervisors for each student. Often
student supervision was shared amongst a small group of supervisors when: the placement
was over many weeks or months, supervising staff worked part time and there was a need for
full time supervision, the model of supervision was intense or complex, or the students were
required to rotate across different work areas.
The majority of models incorporated a senior staff member taking responsibility for
facilitating the placements, liaising with the universities and orientating and supporting
students whilst on placement. Table 3.1 provides an overview of the supervision and
facilitation models in place across the 24 disciplines.
Table 3.1: Supervision and facilitation models by discipline
Discipline
Aboriginal health worker
Audiology
Chiropractic
Dentistry
Dietetics
Exercise physiology
Medicine
Midwifery
Nursing
Occupational therapy
Optometry
Supervision and facilitation models in place
 Predominantly 1:1 model under the supervision of a senior Aboriginal health worker or nurse
 RTO liaises with health services about required competencies to be developed by student and
appropriate experiences in the workplace.
 Predominantly 1:1 model
 University contacts health services at the commencement of each semester
 Within the university clinic, 1 chiropractor provides clinical supervision to 7 students. Each of the
students has a room within which they treat their allocated clients. The student takes the patient’s
history, examines the patient, develops a management plan and treats the patient under the supervision
of the chiropractor who is available to all the students and who also examines the patient to confirm the
diagnosis and treatment plan.
 Additionally, students are rotated through a number of areas including: reception, rehabilitation gym
and radiology. In each area, a supervisor supervises the students.
 Australasian College of Chiropractors establishes the standards that guide the model of supervision.
 Direct supervision and guidance of practice. Level of supervision is 'graduated' and is more intense and
constant at the beginning with inexperienced students and reducing as the student becomes more adept
and demonstrates sufficient competence at various tasks, usually once they have performed procedures
many times.
 Initially with inexperienced students 1:1. As students advance it relaxes to 1:4 and for advanced final
year students it may relax further to 1:6.
 1:1 for specialist training (e.g. oral surgery) or for students struggling
 Clinical placements are generally 1:2 supervisor to student ratio (in accord with peer support
philosophy)
 Food service placement can be 1:5 supervisor to student ratio in some settings
 For community placement usually 1:1 or 1:2 supervisor to student ratio
 Shared competency framework based on accreditation competencies set by DAA used across the
universities with set objectives to meet over the three placements.
 Jointly developed standard placement manual and framework from both universities.
 Developing profession – no clear language around supervision models
 Predominantly 1:1 supervisor to student models in use. There is often 1 key person responsible for all
the placements in a health service. However, on a day to day basis, the supervisor may change.
 Students complete a log book of clinical placement hours that supervisor signs off.
 A coordinator at each site has the formal responsibility for supervising the student and is supported by
staff in each area of the laboratory supervising students. Under this model there are a number of medical
laboratory scientists supervising each student.
 Vertical integrated supervision model
 Supervisor to student ratio varies significantly dependent on setting from 1:1 to 1:12.
 Informal and formal tutorials, participation in ward rounds, observations and work within clinics
 “Do, Observe, Teach other professions” approach
 Students manage the patients on the ward under supervision of nurse educator and profession
supervisors.
 Models of supervision vary from 1:1 to 1:4 supervisor to students.
 Undergraduate students supported by clinical facilitators in ratios of 1:2 to 1:10.
 Clinical staff in patient care areas (birth suite, post natal wards and antenatal clinics) are well informed
about student needs and provide support.
 In hospital settings 1: 8 facilitator to student ratio and each student is buddied with a nurse preceptor.
 As students enter into final placements they are expected to be working autonomously and liaison
officer positions have been developed to support these students.
 1: 3 or 1:4 supervisor to student models
 Will be 1:1 on occasion if student is struggling or due to other patient/case factors
 Predominantly 1:1 supervisor to student model but may be 1:2 on occasion
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Discipline
Oral health
Orthoptics and Osteopathy
Orthotics and prosthetics
Paramedicine
Pharmacy
Physiotherapy
Podiatry
Psychology
Radiation science
Social work
Speech pathology
Supervision and facilitation models in place
 1:3 to 1:4 model of supervision depending on competence of student
 Each student has own dental chair and own clients. Students examine and treat clients liaising with
supervisor at key stages of the treatment in accordance with clinic’s guidelines.
No formal arrangements in place in WA at present
 Dependent on service or practice size and staff but predominantly 1:1 supervisor to student model and
may be 1:2 on occasion
 Student ambulance officers are supervised by an experienced paramedic who has trained as an “on road
tutor” in a 1:1 model.
 Students in health services supervised under 1:1 model.
 Students undertaking the undergraduate degree are generally supervised under a 1: 1 supervisor to
student model. In larger community pharmacies, there may be more than one supervising pharmacist
available to supervise students. In dispensing of medications very close observation and checking of all
work is required.
 Students from The University of Western Australia and Curtin University undertaking postgraduate
courses go to hospitals in groups. Supervision occurs under a group model with one supervisor to 6 to
10 students. A facilitator may accompany the students and be responsible for their supervision or a
member of the hospital staff may provide the supervision.
 Supervision models vary across setting type and within settings.
 Public Hospitals may have multiple student models operating within the same hospital which may vary
from 1:6,1:4,1:2 and in some areas 1:1 supervisors to students
 Smaller health services tend to utilise 1:1 or 1:2 models
 Universities send out university-employed supervisors once a week for 2-3 hours for the 4 of the 5
weeks of placements. They observe students with the clients and provide support.
 For students of Curtin University, the University supervisor completes assessment as well as Health
service Supervisor
 For The University of Notre Dame Australia only health service supervisor completes assessment
 A uniform assessment tool called the APP is utilised to assess students.
 Mid-way and end of placement formal feedback sessions are provided.
 In both community and hospital podiatry placements the predominant model is a 1:1 supervisor to
student, apart from the university clinic where the ratio is higher.
 Facilitation of clinical placements is commonly the responsibility for 1 staff member at a health service.
 Clinical and counselling psychology placements are undertaken in 1:1 supervisor to student models
 Placements completed within university clinic prior to external placements
 Work independently with clients with direct supervision for 2 hours each week.
 2:1 supervision model for medical imaging and radiation therapy
 1:1supervsion model for sonography and nuclear medicine.
 There are professional and radiation safety requirements governing these limits.
 Clinical educator role is internally funded and oversees student orientation, rostering, mentorship and
assessment.
 Dependent on placement but predominantly 1:1 or 1:2 supervisors to students
 Some group work and facilitation
 Predominant supervision is a 1:1 model
 Peer support is a big feature of placements
 National assessment tool called the COMPASS
3.3 INTERPROFESSIONAL AND MULTIPROFESSIONAL EDUCATION
In this section, interprofessional and multiprofessional education opportunities are discussed.
3.3.1 Interprofessional Education
Curtin University through the Curtin Health Innovation Research Institute interprofessional
practice program (IPP) has developed placements that provide an opportunity for a range of
health students to learn with each other whilst developing interprofessional collaborative
practice capabilities required to deliver safe, high quality client-centred care. The
Interprofessional Education (IPE) program is offered across a diverse range of settings and
students from a range of WA universities are able to participate. The development of IPE
programs have been largely made possible as a result of significant investment by HWA.
As part of this project, consultations occurred with a small number of IPE programs that exist
across WA. Representatives were spoken to from Brightwater Care Group- Madeley,
Rowethorpe Aged Care- Uniting Church Homes, Student Training Ward- Royal Perth
Hospital, the WA Country Health Service Geraldton Subacute Aged Care IPEs, Great
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Southern Mental Health Service Albany and Alzheimer’s Australia WA. A summary of these
models are detailed below.
Brightwater Madeley
Brightwater Madeley offers high and low care residential accommodation for older people.
The facility has 110 private rooms including dementia and high care beds. There are a number
of health professionals on staff including a doctor, occupational therapists, physiotherapists,
podiatrists, speech pathologists and social workers. A full time IPE coordinator coordinates
and oversees the program which runs throughout the year. At present there are students from
Curtin University, The University of Western Australia and The University of Notre Dame
Australia participating in the program. Disciplines include dietetics (food service placement),
occupational therapy, nursing, physiotherapy, pharmacy (community placement) and
medicine. Although speech pathology students have been involved in the past, the
competency requirements of COMPASS are difficult to meet within this setting and they are
not included in the program at present.
The length of placement varies between disciplines from two weeks to seven weeks, with
approximately nine students per week at any one time. The students undertake work within
their own specific scope of practice with residents and competencies are assessed by a
discipline specific supervisor (which may be external or on staff). In addition, students are
involved in structured group activities such as weekly case study presentations, medical
rounds, student run groups and information sessions undertaken by the residential physician
who specialises in cognitive decline and dementia. All students are based in a specially
designed student area with access to computers, telephone and a wide range of equipment on
which they can practice or demonstrate skills to other students.
Anecdotally, the IPE program has been very well received by residents. They appreciate the
additional time students spend with them and the personalised care they receive. The residents
and their family have reported improvements in mobility, confidence, motivation and social
interaction. The students also bring energy and enthusiasm to their learning which the
residents and their families appreciate. Staff have responded positively to the presence of
students due to the extra assistance with tasks, the opportunity for health issues to be resolved
more quickly and increased social interaction for residents.
The students themselves report enjoying the opportunity to work with a number of other
disciplines and being exposed to a setting and population group they had not considered
before. It provides them with an in-depth experience of aged care and addresses some of the
stigmas or misunderstandings they may have had about older people and residential aged care.
The coordinator of the program is passionate about IPE and attracting students into the aged
care setting. An additional but unexpected advantage of the program observed has been a
reduction in unnecessary emergency department presentations. Sixth year medical students
are required to be on call throughout the night and when a resident becomes ill they will
attend them in the residential facility in the first instance. This has increased access to primary
medical care therefore reducing the need to transfer residents to the local emergency
department.
Rowethorpe Aged Care: Uniting Church Homes
Based in a residential care facility for older people, the Rowethorpe Aged Care IPE hosts
pharmacy, speech pathology, occupational therapy, counselling psychology, nursing and
physiotherapy students. The students are provided the opportunity to care for residents of the
high care and dementia house in particular. The length of placement for each discipline ranges
from one week (pharmacy) to a full year (one day each week for counselling psychologist
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student). The placements will overlap throughout the year, rather than be undertaken in
discreet blocks of times and there will usually be approximately ten students at any one time
throughout the year (with nursing students comprising the largest proportion of the group).
Dependent on their stage of education and competency, students will assume their own
individual case load, undertake group work and IPE specific activities.
Anecdotally the residents and staff are reported to enjoy the presence of students at
Rowethorpe. The coordinator of the program is passionate about providing students of
different health professions with an opportunity to experience and gain skills working within
the aged care setting and particularly with older people with dementia.
Student Training Ward Royal Perth Hospital
Health students are responsible for the care and clinical management of general medical
patients in the six bed Student Training Ward (STW) within the Royal Perth Hospital. The
STW IPE program runs for two weeks each rotation across the year (approximately twelve
rotations were undertaken in 2012 and nine rotations are planned for 2013). Each rotation
comprises a maximum of eight students from disciplines such as occupational therapy,
physiotherapy, social work, medicine, nursing, and pharmacy.
Two registered nurses are the key IPE facilitators and provide ongoing support and
supervision to students. The students are taught and observed by their profession specific
supervisor who also oversees the patient care plans. Students are expected to work
independently and autonomously as much as possible in the ward but have immediate access
to support by an IPE facilitator, a consultant or their own supervisor as needed. A patient
advocate attends one day each week and provides feedback to students.
All appropriate patients are invited to receive care in the student ward and admission is on a
voluntary basis. The patients are reported to enjoy the specialised and intensive care the
students provide in this setting. Students have reported a greater understanding of other health
professions’ roles and responsibilities, improved confidence when working within a
multidisciplinary team, and a better appreciation of patient-centred care.
WA Country Health Services Geraldton Subacute Aged Care
The WA Country Health Services (WACHS) Geraldton Subacute Aged Care program offers
speech pathology, occupational therapy, physiotherapy, and pharmacy students the
opportunity to work together in the sub-acute rehabilitation program. In addition to the
experience of learning within an interprofessional team, this placement allows each student to
learn more about working within a rural setting. A dedicated clinical educator organises
placements, allocates staff to students and provides IPE supervision to students.
The length of placement is dependent on the discipline and will range from five weeks to
seven weeks and there is usually one student on placement at the day therapy unit from each
discipline at any one time. The program has hosted nursing students in the past but is unable
to currently as there is not a registered nurse available to supervise. Pharmacy students will
spend a one day placement at the day therapy unit in 2013.
Students within the IPE work within several settings including the Day Therapy Unit,
Community Rehabilitation and the Early Supported Stroke Discharge. A diverse range of
learning experiences are provided such as comprehensive assessment, care planning and case
management of frail aged inpatient and outpatients, exposure to the continence clinic and
exercise, cooking and cognitive groups, supervision of therapy assistants, and community
based multidisciplinary stroke rehabilitation. Each student assumes case management
responsibility for a small group of patients, and participates in a weekly meeting to review
Final Report
65
and discuss new and existing client cases with other students. Supervision is shared amongst
clinicians from a variety of disciplines in the department, giving students further appreciation
to other disciplines’ approaches. Students also liaise with a GP and are involved in the patient
discharge process.
Student response to participation in the IPE program is positive and they report a greater
understanding of working within a multidisciplinary team, and the importance of a holistic
approach to client care.
Great Southern Mental Health Service Albany
Great Southern Mental Health Service Albany hosts nursing, occupational therapy, social
work, psychology and, for the first time this year, paramedicine students for Interprofessional
Education (IPE) placements to attract students into careers in mental health.
The placement program is a scaffolded one, which seeks to tailor the placement to meet the
needs of the student with the intention of helping them meet their learning goals. In
customising the placement, regard is given to the discipline the student is studying, the length
of their placement and whether they are an undergraduate or postgraduate student. In
providing the placement there are generally three key goals:
 Developing students mental health skills in undertaking a mental health state examination
and a mental health risk assessment. These are skills that all practitioners can utilise
irrespective of where they ultimately practice.
 Providing opportunities for students to work in an interprofessional environment and build
their interdisciplinary skills; and
 Developing discipline specific competencies related to placement goals of the student;
Placements run from two days to four weeks, with the exception of social work placements
that run for 70 days. Students on four week placements or longer have the opportunity to
undertake more specialised placement related to their discipline in particular mental health
settings or with population groups.
A 2:1 supervision model is used where students have a clinical supervisor, who provides
discipline specific supervision, and a task based supervisor, who can be from any discipline.
The placements are facilitated by a coordinator whose role includes: regularly liaising with
the universities; allocating students to staff; liaising with students before they commence to
prepare them for placement; meeting the students on the weekend they arrive and orientating
them to the local community; providing a full day induction for students when they start their
placement; and providing ongoing support to students during their placement.
Since the establishment of the program the Great Southern Mental Health Service Albany has
significantly increased its student placement numbers from taking one or two students a year
to an expected total of 26 to 30 students this year. The service is now starting to see clear
outcomes with previous graduates being employed and students expressing a desire to be
employed at the service.
Alzheimer’s Australia WA
Alzheimer’s Australia WA provides a range of specialised services for people with dementia,
their families/carers and the wider community. Nursing, occupational therapy, physiotherapy
and psychology students participate in the program that aims to promote interprofessional
team work and learning while imparting specific skills in dementia. The students work across
a range of areas such as the day respite centre, the behaviour management unit and
participating in community education workshops. Alzheimer’s Australia WA take
Final Report
66
approximately six students each block throughout the year with length of placement
dependent on discipline requirements (range from two weeks to three months for psychology
students).
Assessment tools
For all students an Interprofessional Capabilities Assessment Tool (ICAT) as well as a
profession specific assessment (except OT students who do not need to do their Spef-R) is
completed. Examples of the interprofessional capabilities assessed within the ICAT include
the ability to:





communicate effectively in a respectful manner;
establish and maintain effective working relationships;
demonstrate confidence in understanding their own role as well as others;
reflect on team structure, function and roles; and
participate in and lead team meetings.
The ICAT is conducted at the middle and end of the placement for each student. For shorter
placements of two weeks or less than the ICAT is undertaken at the placement conclusion
only.
Sustainability
Whilst many innovative models have been established with the support of HWA funding,
significant concern exists amongst stakeholders about the sustainability of these projects
without continued funding.
In addition to Curtin University’s IPE program stakeholders spoke of the Go Global program
(overseas field work placement program); and Edith Cowan University’s Interprofessional
Ambulatory Care (IpAC) program.
Interprofessional Ambulatory Care (IpAC) program
Edith Cowan University established the IpAC program to provide an interprofessional
learning environment for students from nine health disciplines. The IpAC comprises a
community clinic on the University’s Joondalup campus (the IpAC Unit) and an external
program of IPL placements within community based agencies. The IpAC program provides
students with the opportunity to learn and work with students from other disciplines through
the delivery of care to community members with chronic health conditions. The focus is on
educating clients and providing them with the support for patients to better self manage their
conditions. Patients are initially assessed and a care plan developed, with patients seeing
students from across a range of disciplines in accord with the treatment plan. The supervisor
to student ratio varies from 1:4 to 1:8.
Students in the program gain experience in how to provide education and support to assist
clients manage their ongoing health issues and students are assessed through an IpAC
program tool. Clients are reportedly positive about their involvement about the care they
receive and the opportunity to participate in the education of future clinicians. In addition, the
program has resulted in significant health benefits for patients and significantly increased
capacity to provide student placements. The IpAC Program is funded by the Commonwealth
Government to provide health students with an interprofessional learning experience.
Final Report
67
The ECU Health Simulation Centre offers simulation programs for undergraduates, post
graduates and health professionals to develop their skills in communication, collaboration and
team work within a range of interprofessional courses and scenarios. The Centre offers the
capacity for all levels of fidelity in simulation training, and is equipped with a broad range of
simulation manikin and task trainers.
3.3.2 Multiprofessional education
Apart from the IPE placements discussed in section 3.3, opportunities for multiprofessional
education or interdisciplinary placement opportunities were largely incidental or ad hoc for
the services consulted. A key difficulty of the interdisciplinary model is the logistics of
synchronising clinical placement across disciplines within a service. In addition, balancing the
differing level of competencies and skills for students at different stages of their education is
challenging.
Based on discussions with a range of education providers and agency representatives there
was support for the principle of multiprofessional education opportunities but it was not
considered a priority for many. To actively implement such learning opportunities at a service
or organisation required a motivated person (champion) to drive the process.
Table 3.2 presents some brief commentary by discipline on their opportunities for
multiprofessional education and placement. Commentary on courses not offered in WA
(optometry, orthotics, prosthetics, osteopathy and orthoptics) is not included.
Table 3.2: Interprofessional and multiprofessional education opportunities by discipline
Discipline
Aboriginal Health
Audiology
Chiropractic
Dentistry
Dietetics
Exercise
physiology
Medical
laboratory
Science
Medicine
Nursing
Occupational
therapy
Oral health
Interprofessional and multiprofessional education opportunities
Multiprofessional placements were not an identified priority of placements. However
many students would be exposed to multidisciplinary aspects of health care in ACCHO
placements.
There are no formal opportunities for audiology students to participate in
multiprofessional education. Depending on their placement type students experience
working with other professions if this is part of the audiologist’s usual role.
No multiprofessional placements currently exist. The university is keen to develop
interdisciplinary placement opportunities for its students.
Although the representatives spoken with considered there would some value in dental
students working with other students such as oral health, there is no regular or formalised
program in place to facilitate this at present.
Curtin University has strong focus on IPE and its dietetic students are encouraged to enrol
in these programs. Dietetic students work with other disciplines such as speech pathology
and occupational therapy within the Royal Perth Hospital student ward.
There are limited opportunities for students to work with health professionals from other
disciplines, as the majority of placements are in private practices only staffed by exercise
physiologists.
There are no opportunities for multiprofessional education.
Some medical students participate in the formal IPE programs.
Medical students have the opportunity to work closely with midwifery students and be
instructed by midwifery staff during their obstetric rotation at King Edwards Memorial
Hospital.
Nursing students are core participants in the IPE programs.
OT students are regular participants in the available IPE programs. Alternative
interdisciplinary placements were not identified through the consultations. However many
students would be exposed to multidisciplinary aspects of health care in primary health
care placements.
Oral heath students do not participate in regular or formalised interdisciplinary education
Final Report
68
Discipline
Paramedicine
Pharmacy
Physiotherapy
Podiatry
Psychology
Radiation science
Social work
Speech pathology
Interprofessional and multiprofessional education opportunities
opportunities at present.
There are no formal opportunities for paramedic students to participate in IPE currently.
However, during their placements students receive supervision from nurses and doctors.
Pharmacy students from Curtin University are regularly involved in IPE programs (Royal
Perth and Madeley for example).
Craven’s Pharmacy works in an interdisciplinary way in the delivery of shared care of
patients with a mental illness with the local mental health service at Royal Perth Hospital
and the pharmacy has a nurse educator who undertakes metabolic tests for clients with a
view to identifying those with or at risk of developing chronic health condition. Where
possible opportunities for the student to spend a day at the mental health service with the
occupational therapist and psychiatrist are incorporated.
Curtin University students may complete one of their six block placements in a formal
IPE placement site.
All health services reported opportunities for students to work with health professionals
within the multidisciplinary or interdisciplinary teams. This often includes attending team
and discharge planning meetings. On an informal basis, health services allow students to
spend time observing clinicians from other disciplines.
There are no formal opportunities for podiatry students to participate in interprofessional
education. Depending on their placement setting, students may experience working with
other professions when this is part of the podiatrist’s usual role.
Interdisciplinary education opportunities happen on an ad hoc basis. Taking into account
the potential sensitivities of clinical psychology practice it was suggested students could
be involved in multi-professional education through case study discussion in a mock or
simulated context.
Curtin University students do have the opportunity to undertake an eight week placement
within the Albany Mental Health IPE program. In this setting the students work in a team
with social work, occupational therapy and nursing students.
Interprofessional learning was identified was in medical imaging where students have
been invited to participate in the Royal Perth Hospital specialised interprofessional
training ward. This has proved popular with students and staff.
There were examples of clinical educators opening student teaching sessions to all service
staff. These sessions are more opportunistic than structured as multiprofessional.
Social work students are encouraged to enrol in the IPE programs where offered. Other
multiprofessional student training opportunities are ad hoc.
Some students have the opportunity to participate in IPE programs.
There were no formal opportunities identified of students participating in
multiprofessional placements at the health services visited.
3.3.3 Opportunities and challenges with interprofessional and
multiprofessional education
There is a lot of interest across the professions in developing interprofessional competencies.
With increasing numbers of older people and those living with chronic conditions good
practice care requires multidisciplinary and interprofessional care. Developing students’
competencies in working with other health professionals is essential. HWA has played a key
role in supporting the development of these innovative models.
Whilst there is a lot of support for these models, there are still a number of barriers related to
their operation that need to be addressed before they can be more widespread:
(1)
Facility designs of hospitals do not easily accommodate groups of students: New
hospitals and health care facilities need to be designed in ways that support the
education of students in interprofessional models of care. Central to this capability is
having student facilities that support multiprofessional learning. Master planning for
health facilities need to incorporate student units and facilities that support
interprofessional education.
Final Report
69
(2)
(3)
In hospitals, many groups of health professions work within and/or are managed
in professional ‘silos’: Whilst delivering services to patients in accord with treatment
plans, the opportunities for delivery of interprofessional models of care is limited.
Opportunities to develop greater interprofessional education approaches are most likely
to exist in areas where interprofessional models of care are required, such as in the
management of chronic diseases and rehabilitation. These clinical areas are more likely
to have matrix models of management that support interprofessional practice.
Some clinicians do not support IPE placements. These clinicians believe students
need to understand their scope of practice in their own discipline before being able to
appreciate and understand the differences in another profession’s scope.
Final Report
70
4
Clinical placements in
regional locations
This chapter presents a summary of the education providers, placement activities and enablers
and barriers to seeking and hosting clinical placement specific to regional settings. It also
discusses key stakeholders involved in the support, delivery and facilitation of student clinical
placement in regional WA. Additional detail regarding health service consultations
undertaken within each region is provided in a complementary standalone resource paper
entitled Clinical Placements Summaries in Regional Locations.
4.1 OVERVIEW OF EDUCATION AND PLACEMENTS IN REGIONAL
AREAS
In this section, an overview of key health services, educational courses and placement activity
is provided for the regional areas visited: Bunbury, Broome, Geraldton, Narrogin and Port
Hedland. The information presented in the tables is specific to the education providers within
each region only and does not describe metropolitan based providers already discussed in
preceding chapters. However, later sections in this chapter that focus on barriers and enablers
to placement quality and capacity, encompass commentary gained from all participating
stakeholders consulted and pertain to clinical placement activity that derives from relevant
local, metropolitan and interstate education providers.
4.1.1 Broome: key health services, educational courses and placement
activity
Health Service Overview: Broome Hospital has 36 beds, including six nursing home beds. It caters for medical,
surgical, paediatric, mental health, maternity, emergency care and allied health services. There are six GPs that
work at the hospital. Two of the hospital GPs staff the Caesarean section service for the town, and GPs also
provide the anaesthetic service. Broome has a resident general surgeon, a general physician and a public health
physician. There are also regular visits from the Derby-based regional paediatrician and
obstetrician/gynaecologist. Two psychiatrists and a psychiatric registrar, provide services to the Kimberley and
Pilbara regions. The mental health unit provides acute psychiatric inpatient care to people in the Kimberley and
Pilbara. The Kimberley Mental Health and Drug Service is collocated on the site and provides community based
mental health and alcohol and other drug services to the Kimberley region.
Two private practices in Broome employ the equivalent of about four full-time private GPs, and there are also
several GP registrars in town.
The Broome Regional Aboriginal Medical Service (BRAMS) hosts a four-doctor primary care facility and a new
ten station haemodialysis unit. The Kimberley Aboriginal Medical Services Council is based next door and
provides a teaching campus for Aboriginal health workers and medical students as well as support for Aboriginal
health services throughout the Kimberley. There are four general practitioners at BRAMS
Additionally there are a range of primary care services including Boab Health Services and the Broome
Community and Child Health Centre.
The Broome Rural Clinical School is located in the Kimberley Aboriginal Medical Services
Council (KAMSC) and currently supports fourteen students. Eight of the fourteen students are
located in Broome, three in Derby and three in Kununurra. The clinical school also facilitates
Final Report
71
placements not funded specifically by Department of Health and Ageing Rural Clinical
Training Support Program. This includes a total of seven medical students from both WA
universities for the majority of the year and four students under the John Flynn Placement
Program (JFPP). Student in JFPP are from any Australian university that offer medicine and
they come to Broome for two weeks every year of their medical degree. The structure of
clinical placements at the Broome Rural Clinical School for medical students is the same
regardless of funding. All students gain experience in a wide variety of health service settings
within Broome and the Kimberley region, participating in trips to remote town’s communities
and clinics. Students attend clinical teaching sessions at the Broome Rural Clinical School on
a Wednesday and Friday afternoon. The Broome Rural Clinical School provides
accommodation for students locally.
The University of Notre Dame Australia offers a wide variety of nursing courses at their
Broome campus. These include a Bachelor of Nursing, a Diploma of Nursing and Certificate
III in health services assistance and Certificate III for aboriginal health workers. Courses
articulate with each other, meaning students can gain recognition of prior learning (RPL)
starting at a certificate level and move all the way through to complete the Bachelor of
Nursing and work as a Registered Nurse (RN). Students living within the Kimberley region
can complete most of the course remotely and only have to occasionally come to Broome for
one week blocks. Having a campus in Broome, a program that recognises prior learning and
allow students to study in Broome is key to attracting a local workforce that are likely to stay
in the area. Placements for the local courses exist across the Kimberley region and students
are required to complete at least one remote placement outside Broome or their hometown
within their course. The University of Notre Dame Australia has a Student Hostel which
provides short term accommodation for 30 students who attend ‘block study’ programs. The
University also has accommodation available for longer term accommodation for 45 students
Table 4.1Table 4.5: presents an overview of educational providers delivering courses in
Broome, the duration of the course, hours of clinical placement required and the range of
settings in which clinical placements occur for students of these educational providers.
Table 4.1: Placement activity associated with courses delivered in Broome
Education
provider or
organisation
Broome Rural
Clinical
School of WA
Programs
that require
placement
Bachelor of
Medicine /
Bachelor of
Surgery (The
University of
Western
Australia)
Bachelor of
Medicine /
Bachelor of
Surgery (The
University of
Notre Dame
Australia)
Medical
students
completing
the John
Flynn
Placement
Program
Course
duration
6 years
undergraduate
Placement
length and year
level
10 months in 5th
year
The majority of
6th year
4 years
postgraduate
10 month
placements in 5th
year
The majority of
6th year
Dependent on
Australian
university
enrolled in
2 weeks in
Broome every
year of their
medicine degree
Approx.
number of
students
14 students
attend in second
last year of
course
8 located in
Broome
3 located in
Derby
3 located in
Kununurra
7 students
attend in their
final year*
4 students*
Placement structure
Placement settings
Placement structure
includes:
 rural experiences in
primary care at
BRAMS
 rotations at the hospital
 trips to remote clinics
and communities
 supervised by doctors
at the health service
 formal teaching ward
rounds, tutorials,
classes facilitated by
clinical school staff
 Students in Derby and
Kununurra attend
tutorials via video link
Final Report
Placements occur
in:
 public
Hospitals
 private general
practices
 ACCHOs
 community and
remote clinics
72
Education
provider or
organisation
The
University of
Notre Dame
Australia
Kimberley
Aboriginal
Medical
Health
Service
Council
Programs
that require
placement
Bachelor of
Nursing
Course
duration
3 years
Diploma of
Nursing
1.5 years
Certificate III
and IV
Aboriginal
Health
Worker
Diploma and
Advanced
Diploma of
Aboriginal
&/or Torres
Strait Islander
Primary
Health Care
Approx. 18
months
Placement
length and year
level
Accreditation
requires 800
hours
Complete 1240
hours
Students
complete one
block of
placement every
semester
5x 5 week blocks
1x6 week block
Accreditation
requires 800
hours
Complete 600
hours
Complete one
block every
semester
1 x 2 week block
1x 6 week block
1 x7 week block
Generally
students are
employees of
health services
and are released
in two week
blocks to attend
training. All
clinical
experience occurs
within the service
the AHW is
working in.
Approx.
number of
students
13 in Year 1
15 in Year 2
26 in Year 3
Number
increases due to
articulation
with other
courses
Placement structure
10 each
semester
Placements are all in
Broome and Kimberley
region
Students supervised by RNs
and ENs in a 1:1 mentor
model
30 students a
year
region
Students supervised by RNs
and ENs in a 1:1 mentor
model
Placement settings



region
Students are supervised
by RNs in a 1:1
mentor model
The complexity of
clinical area student
placed in increases
though the course
Placements occur
in:
 residential
aged care
facility
 hospital (public
and private)
 multi-purpose
hospital
 acute care
facilities
 acute mental
health
 community and
child health
centre
Placements occur
in:
 ACCHOs
4.1.2 Bunbury: key health services, educational courses and placement
activity
Health Service Overview: Bunbury's private and public hospitals are both located at the South West Health
Campus. They share many facilities, including an emergency department. Suites for a radiology practice,
pathology service and for specialists, both resident and visiting, are located in the St John of God Medical
Centre. There is a Primary Health Division offering services for inpatients and outpatients including
physiotherapy, occupational therapy, dietitians, incontinence and diabetes educators, speech therapy and social
workers.
St John of God Health Care offers maternity, surgical, and medical services. This private facility also: offers an
allied health service with physiotherapists and occupational therapists; and provides the community with
oncology, renal and palliative care services. Between the two facilities, there are 10 theatres, including Day Stay
and Endoscopy units. Bunbury is also serviced by approximately 55 general practitioners in 13 general practices.
The Bunbury Rural Clinical School supports medical students from The University of Notre
Dame Australia and The University of Western Australia with the goal of attracting more
doctors to regional, rural and remote practice. Whilst at the Bunbury Rural Clinical School
students participate in a formal university curriculum for approximately 30% of their time,
and spend the other 70% of their time in clinical settings. Each year approximately 11 medical
students undertake placements across a range of settings and clinical areas during their year
long placement.
Edith Cowan University offers education in social work and nursing. They also offer a one
year conversion for registered nurses with a diploma or college certificate but rarely have
students come through this stream. The Bachelor of Social work is a four year undergraduate
Final Report
73
course and approximately half of the students will study the program off campus. Students
complete 28 weeks of clinical placements across their third and fourth years, in a range of
settings and organisations including public health, child protection, Centrelink, corrections,
non-profit and community. There are a total of 60 students in both years three and four.
Between 60 and 90 students each year enter the Edith Cowan University’s three year Bachelor
of Science (Nursing). Nursing students complete 23 weeks of clinical placements across all
six semesters of their course. In semester one and two, students complete a one and three
week placement in an aged care setting, respectively. In semester three, students undertake a
four week medical / surgical ward placement and in semester four, students undertake a mix
of medical / surgical ward, midwifery, paediatric and mental health placements for four
weeks. In semester five, students can chose to spend four weeks in either a medical / surgical
ward or in another speciality placement. Semester six involves a six week placement in a
medical / surgical ward.
South West Institute of Technology has two intakes of 20 students per year into the 18 month
Diploma of Nursing (Enrolled/Division 2 Nursing). Students complete a two week aged care
placement and one week in a country hospital placement in semester one. In semester two,
students undertake a two week hospital placement at each of the Bunbury Regional Hospital
and St John of God Hospital. Semester three involves a two week health campus placement, a
one week aged care placement, and a two week community placement.
Table 4.2 presents an overview of educational providers delivering courses in Bunbury, the
duration of the course, hours of clinical placement required and the range of settings in which
clinical placements occur.
Table 4.2: Placement activity associated with courses delivered in Bunbury
Education
provider or
organisation
Edith Cowan
University
Programs that
require
placement
Bachelor of
Social Work
Undergraduate
Approx.
number of
students
Approx. 60
students in
both Year 3
and 4
(Bunbury
campus)
Bachelor of
Science
(Nursing)
Undergraduate
Between 60
and 90
students in
each year of
the course.
(approx.. 77
students for
placement
each rotation)
Course
Duration
4years
(on and
off
campus
modes)
3 years
Placement Structure
Approximate hours/days
Placement Settings
Year 3 Semester 1
Year 4
Semester 2
140 seven hour working days
(at least 980 hours) undertaken
over two placements (70 days
per semester).
No placement is to be shorter
than 40 days
May vary from 5 days per
week to 2 days per week (with
two five day blocks within the
rotation)
15 weeks each placement.
23 weeks across 6 semesters:
Semester 1:
 1 week aged care
Semester 2:
Semester 3:
 4 week medical / surgical
ward
Semester 4:
 4 week mix of medical /
surgical ward, midwifery,
paediatric and mental
health
Semester 5:
ward and speciality
Semester 6:
 2 week community
placement
ward (soon to be 6 weeks
from 2015)





Students complete
clinical placements
throughout the course
Final Report







public health settings
child protection
Centrelink
corrections
non-profit
organisations
community
organisations
residential aged care
facility
hospital (public and
private)
acute care facilities
community based
care facilities (e.g.
Silver Chain)
the mining sector
schools
74
Education
provider or
organisation
South West
Institute of
Technology
Programs that
require
placement
Diploma of
Nursing
Approx.
number of
students
Two intakes
per year with
20 students per
intake
Course
Duration
1.5 years
Up to 4
years part
time
Placement Structure
Placement Settings
Students complete
clinical placements
throughout the course
12 weeks (510 hours):
Semester 1:
 1 week country hospital
Semester 2:
 2 week Bunbury Regional
Hospital
 2 week St John of God
Hospital
Semester 3:
 2 week health campus
 2 week community




residential aged care
facilities
hospital (public and
private)
acute care facilities
community based
care facilities (e.g.
Silver Chain, doctor
surgeries)
4.1.3 Geraldton: key health services, educational courses and placement
activity
Health Service Overview: Geraldton Regional Hospital is a 55-bed hospital comprising accident and
emergency, medical, surgical, children's (there is a resident paediatrician available), maternity, intensive nursing,
chemotherapy unit, day surgery and a renal dialysis unit. Allied health services (speech pathology,
physiotherapy, occupational therapy, pharmacy and audiology) are also available at the hospital.
St John of God Hospital is a 60-bed hospital with medical, surgical, acute care and palliative care. There is also
an adjoining specialist centre where some of the residential specialists (three general surgeons, orthopaedic
surgeon, obstetrician/gynaecologist, physician and anaesthetist) and visiting specialists' rooms are based. There
are 42 private practitioners now residing in Geraldton, including four general practitioners employed by the
Geraldton Regional Aboriginal Medical Service (GRAMS). Most of the GPs in Geraldton are involved in
teaching Rural Clinical School students. Geraldton has three consultant general surgeons, one orthopaedic
surgeon, one obstetrician/gynaecologist, one paediatrician, one physician, one anaesthetist, one ophthalmologist,
three radiologists, three psychiatrists, one psychologist and one vascular surgeon.
The Geraldton Rural Clinical School supports approximately nine students each year in
completing their second last year of their medical degree (year five of the undergraduate
course or year three of the postgraduate course). Students undertake clinical supervision
within the Geraldton Hospital and local GP practices, and participate in the 1.5 days of
university curriculum (formal teaching, exams and tutorials). The Geraldton Rural Clinical
School provides accommodation for students locally.
The Combined Universities Centre for Rural Health (CUCRH) is an academic centre of all
five WA universities that aims to improve rural, remote and Indigenous health through
innovative health education programs, research and community service activities. CUCRH
has two 12 bedroom units in Geraldton and will have an education simulation centre finished
at the end of 2013. CUCRH employees act as supervisors for students on placement in health
services that allows students to be exposed to placements in numerous health services. At
present CUCRH has two occupational therapy and two speech pathology students from Curtin
University on placement.
Durack Institute of Technology offers an 18 month full time (four years part time) Diploma of
Nursing (Enrolled/Division 2 Nursing). Approximately 12 students are enrolled each year.
Full time students complete 13 weeks of clinical placements throughout the course including a
two week placement at a residential care facility and a one week placement in an acute care
facility in semester one. In semester two, students complete a three week acute care facility
placement, and in semester three, a three week medical/surgical ward placement and a four
week mixed placement involving placements in medical wards, midwifery care, paediatric
care, palliative care, community nursing, hospital in the home and theatre.
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Table 4.3 presents an overview of educational providers delivering courses, the duration of
the course, hours of clinical placement required and the range of settings in which clinical
placements occur.
Table 4.3: Placement activity associated with courses delivered in Geraldton
Education
provider or
organisation
Programs that
require
placement
Durack
Institute of
Technology
Diploma of
Nursing
Bachelor of
Medicine and
Bachelor of
Surgery
(MBBS)
Geraldton
Rural Clinical
School of
Western
Australia
Approx.
number
of
students
12
students
in each
year
9 -11
students
each year
Course
Duration
Placement
Structure
Approximate
hours/days
1.5 years full
time and up to 4
years part time
Students complete
clinical placements
throughout the
course
6 years
Students attend
Rural Clinical
School in year 5
Students complete
clinical placements
at the Geraldton
Rural Clinical
School in year 5
13 weeks across 3
semesters:
Semester 1:
 2 week residential
care facility
 1 week acute care
facility
Semester 2:
 3 week acute care
facility
Semester 3:
 3 week medical /
surgical ward
 4 week mix of
medical ward,
midwifery,
paediatric,
palliative care,
community
nursing, hospital
in the home and
theatre
At the Geraldton
Rural Clinical School
students complete 48
weeks in regional
placement (44 weeks
in Geraldton
approximately)
4 years
Students attend
Rural Clinical
School in year 3
4 years
Students attend
Rural Clinical
School in year 3.
The University
of Western
Australia
Bachelor of
Medicine and
Bachelor of
Surgery
(MBBS)
The University
of Notre Dame
Australia
Placement Settings
 residential aged care
facilities
 hospital (public and
private)
 acute care facilities
 community based
care facilities
 Geraldton Regional
Public Hospital
 private general
practice
 ACCHO
 community and
remote clinics
At the Geraldton
weeks in regional
placement (44 weeks
in Geraldton
approximately)
4.1.4 Narrogin: key health services, educational courses and placement
activity
Health Service Overview: Narrogin Hospital provides emergency, obstetric, paediatric, acute, surgical, medical,
psychiatric, cancer support and palliative care to the community. The hospital provides support to the smaller
surrounding towns, many of which do not have doctors available 24 hours a day. Narrogin has two general
practices employing seven full-time and two part-time GPs, and a general surgeon lives in the town. The
Wheatbelt General Practice Aboriginal Health Service is co-located with the Narrogin Community Health
Service.
The Great Southern Mental Health Service Narrogin provides community based mental health treatment and
support for clients with a mental illness.
There are also a number of community based services such as Silver Chain, a community health centre and five
aged care specific services and facilities. There is also a School Psychology Service at the local primary school.
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The Narrogin Rural Clinical School supports four students each year. Whilst at the Narrogin
Rural Clinical School students participate in a formal university curriculum for approximately
30% of their time, and spend the other 70% of their time in clinical settings. The Narrogin
Rural Clinical School provides accommodation for students locally.
The C.Y. O'Connor Institute offers an 18 month Diploma of Nursing (Enrolled/Division 2
Nursing). In semester one, students complete a three week residential aged care placement in
which are generally located within local multi-purpose hospitals. In semester two, students
undertake a four week placement focussed on gaining experience in a general ward and the
emergency department of a local multipurpose hospital, as well as a one week placement at an
acute mental health service in Perth, usually Swan District Hospital. Semester three involves a
four week acute hospital placement in Perth (usually Swan District Hospital, St John of God
Hospital Subiaco or South Perth Hospital) and a one week community based care placement
that often occurs at Silver Chain or a Home and Community Care Service.
Table 4.5: presents an overview of educational providers delivering courses in Narrogin, the
duration of the course, hours of clinical placement required and the range of settings in which
clinical placements occur.
Table 4.4: Placement activity associated with courses delivered in Narrogin
Education
provider or
organisation
Narrogin
Rural
Clinical
School of
Western
Australia
C.Y.
O'Connor
Institute
Programs that
require
placement
Bachelor of
Medicine /
Bachelor of
Surgery (The
University of
Western
Australia)
Bachelor of
Medicine /
Bachelor of
Surgery (The
University of
Notre Dame
Australia)
Approx.
number of
students
3 students
attend the
Narrogin Rural
Clinical School
Diploma of
Nursing
Course
duration
Placement
structure
Approximate
hours/days
Placement
settings
6 years
undergraduate
Students complete
clinical placements
at the Narrogin
Rural Clinical
School in 5th year
At the Narrogin Rural
Clinical School
weeks of placements
1 student
attends at the
Narrogin Rural
Clinical School
4 years
postgraduate
Students complete
clinical placements
at the Narrogin
Rural Clinical
School in 3rd year
20
1.5 years
Students complete
clinical placements
throughout the
course
Placements
occur in:
 Narrogin
Hospital
 private
general
practice
 Aboriginal
health
service
based in
community
health
service
 community
and remote
clinics
Placements
occur in:
 residential
aged care
facility
 hospital
(public and
private)
 multipurpose
hospital
 acute care
facilities
 acute mental
health
 community
based care
facility such
as Silver
Chain or a
Home and
Community
Care Service
13 weeks across 3
semesters:
Semester 1:
 3 week local
residential aged
care placement
Semester 2:
 4 week local
general hospital
ward and
Emergency
Department
placement
 1 week acute
mental health
placement in
Perth
Semester 3:
 4 week hospital
placement in
Perth
 1 week
community
based placement
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4.1.5 Port Hedland: key health services, educational courses and placement
activity
Health Service Overview: Port Hedland Regional Hospital provides 50 acute beds catering for medical,
surgical, paediatric, and obstetrics and gynaecology. Attached to the hospital is Yulanya Nursing Home (25
beds). The hospital has eight full-time GPs, two registrars, two interns and seven resident specialists. There are
three GP practices in town. Resident specialists include a general surgeon, radiologist, anaesthetist, two
physicians, a paediatrician and an obstetrician/gynaecologist.
Wirraka Maya Health Services delivers range of services to meet the medical, health, social and cultural needs of
the Aboriginal Community.
Other services include the Port Hedland Community Health Centre and Southern Cross Care. People in remote
areas are supported by the Royal Flying Doctor Service.
Ten students each year are placed at the Port Hedland Rural Clinical School, five at Port
Hedland and five at Karratha. Students undertake approximately 70% of their time in the
clinical setting and 30% undertaking formal teaching by the university. Students are housed in
the Rural Clinical School owned accommodation.
The students undertake placements across five different areas of the hospital and health
services: Emergency, Obstetrics, Paediatrics, Internal Medicine/Surgery, Primary Care
(including private practice, RFDS, community health and AMS). A rapid rotation model is
used where students do two week placements and rotate through each discipline. During the
course of a year they will rotate through each one on multiple occasions. Hospital staff are
required to rate students and identify an area for improvement on each rotation but RCS staff
are responsible for signing off on completion of required learning.
Wirraka Maya is a Registered Training Organisation (RTO) but is not currently providing
training in Port Hedland. Training is outsourced and provided by the Aboriginal Health
Council of Western Australia (AHCWA) who deliver training on site in Port Hedland. The
service employs a number of people who are undertaking training as Aboriginal Health
Workers and their placements are incorporated into their job roles.
Table 4.5: presents an overview of educational providers delivering courses, the duration of
the course, hours of clinical placement required and the range of settings in which clinical
placements occur.
Table 4.5: Placement activity associated with courses delivered in Port Hedland
University/VET
The Rural Clinical
School Port Hedland
Wirraka Maya
Programs that
require
placement
Medicine
AHW Cert IV
Course
Duration
Placement
Structure
Placement Settings
4 or 6 years
1 year rural
70% of university year
-
-
150 hours
Hospital, community
GP, RFDS
Aboriginal Medical
Service
4.2 REGIONAL BARRIERS AND ENABLERS TO PLACEMENT
CAPACITY
Each region visited through this project has unique characteristics, challenges and strengths
that influence their ability to provide quality clinical placements. However there were a
number of recurrent themes that arose in discussion related to building placement capacity
and quality. This section provides a summary of these recurrent themes.
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4.2.1 Key enablers to clinical placement capacity
Key strengths and enablers in maintaining and increasing capacity of clinical placements
across regional and remote setting included:
(1)
The quality of the placement offered: across consultations, stakeholders commented
on the diversity, breadth and complexity of the placement experience in regional
settings, which they would not gain in a metropolitan setting. Students are offered
opportunities to work with a wide range of population groups, social issues,
departments and programs. Students also have a greater opportunity to work with a
number of other health professionals in smaller teams.
“It’s more eclectic here. We have patients across the spectrum of ages, and series of illnesses. There are unique
experiences that are not as narrow or siloed as you get in a metropolitan acute department.”
Clinician, Geraldton.
“Students get a different experience here. They get greater exposure and involvement, and diverse scope and
experience”
Regional Director
“Prac students see so much and do so much more. They step up quicker, get more skilled, and it enables them to
work in high level jobs. Their competency development is fast tracked in some areas.”
Clinician, Bunbury
“In metropolitan areas the level of learning might be higher in relation to one particular field and you may get
more resources. But here you learn how to be a generalist and get skills in resource management.”
Clinician, Geraldton
“It’s a different experience doing your placement here. You have more of a personalised experience; you get to
know the patient, doctor, the nurse and the whole system very well. You also get better access to patients.”
Clinician, Narrogin.
(2)
Attracting health professionals to the regions: many stakeholders suggested that a
key motivating factor for them to host students was to attract graduates to the region.
There was general agreement that longer placements (five or more weeks) are more
beneficial, both to students, the health service and the local community.
“There is a real need for audiologists in the region and that is one of the reasons I take students. It is harder to
get established professionals to move to a new town when they are married and have a family so it is good to
target the young graduates.”
Clinician, Geraldton.
“We have been working hard over the last ten years to ‘grow our own doctors’ and we are now starting to see
doctors coming back to do there placements here as fifth year students, sixth year students, interns and RMOs.
Whether they finally settle in Broome or not, they have a clear career goal to work in a rural area. We have
good partnerships with the rural clinical school and other service providers in our area and we work together to
achieve that goal.”
Clinician, Broome
“We treat this placement as a nine week job interview. We hired four students last year; three of whom said they
wouldn’t have gone regional without having done the Geraldton prac.”
(3)
Funding from Health Workforce Australia: at a number of sites visited, funding had
been provided with the specific aim of increasing the capacity of students. The funding
has supported the establishment of student coordinator positions, the development of
infrastructure to support the expansion of clinical placements (i.e. training resource
manuals and accommodation in rural areas) and creation of student training
coordinators/facilitator roles. With a full time coordinator it has been possible over
Final Report
79
relatively short time period to build a culture where it is expected that staff will take
placements.
“We could not take the number of students we have without the funding. At the moment we take 25 students a
year but if that funding stops we will have to go back to eight again at most.”
“It’s common for staff to now ask: ‘Where are our students?”
Clinician, Albany
(4)
Scholarships to undertake rural placements: The scholarships available for students
such as the John Flynn Scholarships, and those supported by the Combined Universities
Centre for Rural Health, Services for Australian Remote and Rural Allied Health and
the WA Country Health Service assist with the cost of student placements.
(5)
Interprofessional Education (IPE) program funding: The IPE programs’ success and
capacity to host a large number of students in the regional settings can be largely
attributed to the motivation and dedication of the program coordinators at each site.
However, the program funding has also enabled the lease of a hire car for students,
student accommodation, computer resources and treatment rooms in some regions.
Since implementation of the IPE program the Great Southern Mental Health Service in
Albany has significantly increased its student placement numbers. Prior to HWA
funding for the program, they could only take one or two students a year. During 2013
they expect to take 26 to 30 students.
(6)
Attractiveness of the region: a significant proportion of allied health students selfselect to attend a particular region and will cover the costs of their own placement.
Some of the regions are considered to me more ‘popular’ with students for a range of
reasons and therefore will attract greater numbers.
(7)
Individual motivation of the supervisors: Team leaders, managers and clinicians
commit to student supervision for many reasons. They include: altruism, the desire to
‘give back’ to their profession, providing a positive role model for students, imparting
knowledge to ensure sustainability of the profession into the future, diversity in their
work load, opportunity to self-reflect and learn of new research and contemporary
practice taught in the universities, opportunity for professional development, and the
enjoyment they receive from supervising students.
“Students keep the staff young; they breathe life back into the service.”
Clinician, Narrogin
“There is a sense of continuity; our staff got to go on clinical placements and now they can offer clinical
placements.”
Clinician, Bunbury
“Staff like having students to teach and share their knowledge and expertise with.”
(8)
(9)
Accommodation and student resources in place: Access to quality accommodation
and resources required by the students during their placement, such as computers and
internet, provided a better quality placement for the students in the region. Relative to
other disciplines clinical placements for medical students receive large amount of
funding, with students incurring no personal costs for accommodation or travel
expenses.
Remuneration provided to some clinical supervisors, services or departments: For
some disciplines the universities will provide some payment for the hosting of students.
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(10) Support or programs to encourage community involvement: In many of the towns
visited, students were encouraged to participate in social events and community
activities. Some stakeholders report that staff have embraced the students and include
them in their sporting teams and social lives outside of work. They are conscious of the
importance of giving students a positive experience, in the hope that they will decide to
come back and work at the service after they graduate.
(11) Shared health resources and facilities: The combined facilities agreement between St
John of God Hospital and Bunbury Regional Hospital has allowed for Bunbury
Regional Hospital to grow much faster than it would have on its own and be able to
offer a large number of clinical placements. The hospitals share facilities and services to
avoid duplication.
4.2.2 Key barriers to clinical placement capacity
Key barriers for the continuation and increase of student clinical and field placement capacity
across regional and remote settings included:
(1)
(2)
(3)
The availability and cost of accommodation: The cost of accommodation in regional
and rural placements was raised consistently as a major barrier to placements in nonmetropolitan settings. For those regions that had accommodation options available, they
were not necessarily affordable to a student on placement. Some of towns, such as Port
Hedland and Broome, are particularly expensive to host a student but even those towns
in which accommodation is more reasonable, the onus is often on the student to cover
the cost themselves. This in addition to the cost of living and transport means that only
those students with family in town, or who are particularly motivated or have the
capacity to pay the associated costs, will seek placements in regional settings.
Space: As with the metropolitan agencies, sufficient space to accommodate students
within the work place is an ongoing issue for many services.
Sufficient and appropriate staff to provide supervision: Hosting agencies report that
it is difficult for staff to manage the responsibilities of supervision and their own
ongoing case workload. Often there is no reduction of their caseload, which means staff
have to supervise students on top of an already busy workload. This can be particularly
challenging for small teams of clinicians comprising part time staff and job share roles.
In addition, some health professionals in regional settings may have just graduated
themselves and still consolidating their own clinical practices.
“The number of clinical placements we can offer is very dependent on our workforce. Lack of staff is the biggest
barrier”
“We would love to send our students out to our smaller hospitals in the region, and they would be of service to
us out there but there are not enough supervisors available out there. We need more doctors in our small
towns.”
Clinician, Bunbury
“I only work two days a week and one of those days is a short day. If the rostering of the medical students could
occur earlier and I could have them with me longer I would be able to provide them with a more in-depth
experience in working with Aboriginal clients – the biggest problem is there is so much to be covered in the
course.”
Clinician, Narrogin
(4)
Discipline specific staff available: Within regions if there are not the appropriate
clinicians available to supervise or provide sufficient hours of supervision necessary for
the placement requirements then a student will not be able to undertake clinical
Final Report
81
(5)
placement in that region (which can further perpetuate the scarcity of professionals in
some regions).
Length and model of clinical placement or lack of clarity in clinical competencies
required: For some disciplines the length or model of supervision required are not able
to be accommodated by the available clinicians. This is often the case where a particular
clinical service within a region is provided by a locum. Tele-link is not often recognised
by professional accrediting bodies or universities, which makes the use of nontraditional /remote modes of supervision difficult. In addition a particular hospital or
health service may not be able to provide a student with all necessary clinical
opportunities required to achieve curriculum competency. A couple of the hospital
representatives felt that sometimes they were asked to take students to make up clinical
placement hours without a clear placement objective in place.
“This blurs the outcomes. There needs to be goals and objectives for the students. We have to be able to provide
the competencies they actually need: not just make up the hours necessary.”
“Communication back to the schools can be problematic. We are not always given a clear understanding of
what the outcomes of the placement are to be. They are not always clear about what they want from the
placement with us.”
Student placement coordinator, health service
(6)
Social and community isolation: Some students are reluctant to participate in a rural or
remote placement due to concerns that they may feel isolated while away from their
families and social networks. Social isolation can also occur when a student does not
have access to transport during placement. Some stakeholders also identified the
difficulties for supervisors and preceptors in maintaining a supervisor/student
relationship when they feel obliged to assist students by picking them up or arranging
social activities for them in order to support them and provide them with a positive
placement. The extent to which this occurs differs between individuals but can place
additional pressure on supervising staff.
“We could have more students out at outlying/smaller communities around Geraldton but travel takes such a
long time and it’s expensive. Loneliness and isolation also comes into play. It’s also hard to offer direct
supervision if students need it.”
(7)
Cancellations of placements with insufficient notice or time to organise a
replacement: Cancellation of placements was raised by stakeholders across the sites
and was said to cause frustration with the agency offering the placement but was also
unfair on other students who may have been able to take that placement opportunity
from the same or alternative discipline.
4.3 PRIORITIES IN STRENGTHENING PLACEMENT CAPACITY
This section identifies priorities for strengthening placement capacity in regional areas
articulated by stakeholders in these areas.
Strategies that support regional areas to ‘grow their own health workforce’
There was strong support in regional areas to ‘grow their own’ workforce, given the evidence
that students who come from rural areas are more likely to return to rural areas to work. For
this to occur, systems need to be developed that give priority to students from rural areas (who
Final Report
82
are studying in metropolitan Perth) to undertake placements in their home town or in an area
they would like to work in permanently on graduation.
Improving access to accommodation and transport
Health services in regional and remote areas are willing to take students. However the key
barrier to the expansion of placements in regional areas is having access to affordable
accommodation and transport.
The provision of accommodation for Rural Clinical School students makes placements for
medical students possible. There is a need for students from nursing and allied health
discipline areas to be able to have access to supported accommodation. Some of the HWA
funded initiatives in rural areas have accommodation provided, where this has been the case it
has proved to be a key enabler to the success of the initiatives.
To expand clinical placements in regional areas, significant infrastructure investment is
required.
Strengthening coordinators to support regional hubs
A key enabler of the HWA funded initiatives in regional areas has been having full time
coordinators who are familiar with the local service system, play a key role in facilitating the
placements at a local level, and support students on arrival and during their placements.
The Rural Clinical School model was considered to be effective and there was support for this
model being expanded/applied to other disciplines areas To expand capacity further,
consideration needs to be given to establishing coordinator roles within each of the rural
regions.
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83
5
Barriers and enablers to
building placement capacity and
quality
This chapter provides an overview of the common barriers and enablers to building placement
capacity and quality. In particular it discusses what supports are required to sustain quality
placements and enable the expansion of clinical placement capacity. The chapter also presents
issues particular to each of the disciplines.
Unless specific to a particular setting, throughout this chapter the term “hosting agency” or
“agency” will be used to encapsulate the broad range of health, non-health, government,
private and other settings in which students undertake a clinical placement.
5.1 ENABLERS TO PLACEMENT ESTABLISHMENT AND
CONTINUATION ACROSS THE DISCIPLINES
A number of key themes arose pertaining to enablers of clinical placement establishment and
continuation across disciplines. These include:
(1)
(2)
(3)
(4)
(5)
Strong leadership or organisational culture within hosting agencies: It is important
that the senior management and the organisation as a whole are committed to and value
the creation and maintenance of a learning culture, which includes a commitment to
clinical teaching and provision of clinical placements.
Organisational recognition of and support for the role of supervisor within their
setting: Some hosting agencies recognise and value the importance of providing
supervision for students, as well as professional development opportunities for their
staff through student supervision. These hosting agencies see the value in providing
opportunities for staff to develop their supervision skills as it provides opportunities for
self-reflection, exposure to new research and practices, consolidation of skills through
the mentoring of students, the provision of diversity in their work roles and the
development of career pathways for staff.
Systems and structures that require all staff to play roles in supporting clinical
placements and support to staff to develop their competencies in supervising
students. This includes accommodating this role into their work and providing support
to backfill or reduce clinical work load when necessary.
A sense of partnership between educational institutions and hosting agencies that
enables both organisations’ objectives to be achieved, including appropriate recognition
and reimbursement of the costs associated with clinical placements. This can also mean
universities providing the opportunity for hosting agencies and supervisors to give
feedback on placement processes and requirements to minimise administrative or other
burdens.
Recruitment practices of the agencies: For some hosting agencies, the placement of
students plays an important role in staff recruitment. The student supervision period
provides an excellent opportunity for agencies to see students in their working
environment, orientate them to their organisational culture and introduce students to the
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84
opportunities of a rewarding career in less traditional settings, settings that students may
not have considered prior to their placement.
“There are a fantastic range of placements available now that provide students with real and up to date
practical experience. What is great about taking students is that students get good exposure to what is required
in a modern laboratory and you as an employer get the opportunity to see people in action prior to a job
interview. You are able to “cherry pick” from amongst the best students.”
Medical laboratory scientist
“We employ about 60% of our students. It is a very important method of recruitment for our team.”
Hospital senior social worker
The Western Australian Network of Alcohol and Other Drug Agencies as a peak body has developed a placement
program that supports its members attract people who wouldn’t normally see drug and alcohol as a natural
career choice. Amongst the students undertaking placements, there have been psychologists, exercise
physiologists and dieticians. The placements often involve action research projects, supervised by a University
Supervisor with the support of a drug and alcohol worker at the service where the placement is based. Fifty
percent of students who have undertaken the program have gone on to be employed in the sector.
Program manager
(6)
Individual motivation of the supervisors: Although a supervisor may be working
within an organisation or team that fosters teaching and supervision, the choice of
taking on student placements in some organisations is largely individual. Supervisors
commit to student supervision for many reasons. They include: altruism, the desire to
‘give back’ to their profession, providing a positive role model for students, imparting
knowledge to ensure sustainability of the profession into the future, diversity in their
work load, opportunity to self-reflect and learn of new research and contemporary
practices taught in the universities, opportunity for professional development it provides
and the enjoyment they receive from supervising students.
“We take students as a commitment to our profession. It also helps the staff professional development and to
self-reflect. We hear new ideas which can change our own practice.”
Senior social worker
“It is my passion for the industry. I want the industry to grow, and to do that we need to make sure graduates are
of a high quality”
Health service manager
“We just get some fantastic students who motivate and challenge you to become a better professional.”
Senior OT
“It’s our culture that makes it work. We have tutors with a lot of drive and ability to pass on their knowledge and
expertise to students. They are committed to making a difference and are very proud of the oral health outcomes
they have achieved for people.”
Oral Health Student supervisor
(7)
The provision of university supervisors / facilitators / field placement liaison
officers that provide practical support: Supervisors who reported more satisfaction
with the placement process often described a good working relationship with the
education provider and regular contact with the program coordinator or liaison officer.
Many disciplines have a university supervisor / facilitator / field placement officer who
attends the hosting agency site with the students or who attends at regular periods
throughout the placement to provide support to supervisors and students. These
positions provide supervisors at the hosting agency with an opportunity to discuss any
emerging issues and the progress of the student(s). The time these supervisors
/facilitators / field placement officers spend with students on placement, also allows
hosting agency supervisors with some time to ‘catch up’ or attend to their own clinical
work load.
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85
(8)
Commitment to maintaining good working relationships with the agencies and
supervisors: Universities discussed the importance of working with agencies and
maintaining collegial relationships. This included investing considerable time and effort
into matching of student preferences and skills required at a particular site and ensuring
that issues with student performance were dealt with quickly and professionally.
“We get to know the students ourselves and are aware of their strengths and weaknesses before they go out to
external placements. We would never jeopardise a relationship with a supervisor by not being honest about a
student or sending them somebody that we think may not work well within that organisation.”
University program coordinator, Psychology
(9)
Capacity to provide students who are able to deal with placement complexity:
Between and within disciplines there may be placements that are less onerous on the
hosting agency and the supervisor. For example, the ‘normal’ healthy population study
placement for exercise physiology or the food service placement for dietetics. Some
agencies will express a preference for students on second or subsequent placements as
they consider they are often more work ready and better able to manage the complexity
of their client base.
(10) Sufficient staff available to provide supervision: Sufficient numbers of appropriately
qualified and interested staff available to undertake supervision is critical to the decision
of whether to take on a student.
(11) Coordination between education providers: For many agencies the coordination of
clinical placement activity between universities was acknowledged and appreciated.
This included the use of cross university assessment frameworks and guidelines for
particular disciplines (such as dietetics), the coordination of students by the relevant
university departments (within clinical psychology and physiotherapy) so that the
agencies are not approached multiple times by different universities, and the staggering
of student placements across the year.
(12) The value add of trained students in the agency: For many disciplines, students are
productive and active members of a team and assume their own (albeit smaller) clinical
or other work load. This provides assistance to organisations in managing service
demand. The presence of students can also allow the hosting agency to undertake
valuable projects that they would not be able to do as part of their regular core business.
“I always ask for older more experienced students for placement, preferably second placement. They are an
excellent resource to be honest. If I can provide more services to our clients and they are a good fit for the
organisation then I will definitely take them.”
“The fourth years we have at the moment are just fantastic, they are just so enthusiastic and always go above
and beyond what they are required to as a student. Offering to stay late to help get things done.”
Hospital representative
(13) An ongoing connection to the university environment and resources: For some
supervisors an ongoing interaction with academia is an important factor in their
continued involvement in supporting clinical placements. Some supervisors were
themselves involved in research, study or teaching with a particular educational
provider. In addition, the opportunity to access university library resources was
considered very valuable for some professionals and desired by others who currently did
not have access them.
(14) Strong linkages with past graduates: Many universities spoke of the altruism of
health professionals wanting to give back to the profession as a motivator for their
participation as student supervisors. Some of these universities also spoke of the loyalty
many graduates had to supporting students from the university they themselves
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attended. A number of universities see the continued maintenance of links with previous
graduates as an enabler for recruiting supervisors and maintaining their involvement.
We have both enjoyed our careers in hospital pharmacy. We want to support younger people as they decide
where to go in their career. We have a commitment to developing the future workforce and seeing the
opportunities available to them in hospital pharmacy.
Hospital pharmacist
(15) Funding: Some disciplines provided funding to agencies to host students or a particular
number of students. This funding enables the services to finance backfill for supervising
staff, purchase resources or contribute toward the costs associated with the provision of
clinical supervision and support professional development required for the supervisors
themselves to undertake this role.
(16) Health service funding: A number of health services have recognised the need for a
clinical educator role and have decided to fund this position internally. This role may be
responsible for the facilitation of a number of disciplines or supervision of students in
one discipline. This reduces the burden on individual clinicians, adding to the overall
placement quality.
“What resources would help? Cloning [NAME & NAME] the clinical coordinators would help! They are
brilliant and very involved in this role.”
Hospital clinician, public hospital
(17) Funding from Health Workforce Australia: At a number of sites visited, funding had
been provided with the specific aim of increasing the capacity of students. The funding
has supported the establishment of student coordinator positions, the development of
infrastructure to support the expansion of clinical placements (i.e training resource
manuals and accommodation in rural areas) and the creation of student training
coordinators/facilitator roles.
5.2 ENABLERS THAT SUPPORT QUALITY PLACEMENTS AND
EXPANSION OF CAPACITY
A number of key themes arose pertaining to enablers that support quality placements for the
students and the expansion of placement capacity. These included:
(1)
(2)
(3)
A strong workforce development objective beyond the immediate objective of
providing placements. Good practice was observed where there was a key motivator
beyond the immediate objective of taking students on placement. A range of higher
order objectives that motivated the delivery of high quality placements included:
regional health services aiming to ‘grow their own’ workforce, attracting students to
work in regional areas on graduation, or providing opportunities for clinicians to
develop their clinical leadership skills.
Robust models of supervision and facilitation particularly in organisations taking
large numbers of students. These models tend to standardise the roles of
supervisors/preceptors/facilitators, define the scope of practice for students and
prescribe processes that support the provision of high quality of care, articulate clear
learning goals for placements and are often supported by good rostering systems.
Standardisation assists in streamlining the processes for staff with responsibilities for
supervising student placements.
The ability to think creatively and identify new sectors, and new models that will
allow for the capacity and quality of placements to be expanded.
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(4)
Good orientation and training manuals and resources for students and
supervisors: These resources support students and supervisors to undertake the roles
expected of them and provide all involved with clearly defined expectations,
responsibilities and methods of communication. For students, these guidelines may
contain structured approaches with clearly articulated learning goals that support
students understanding in what placements are about, what is expected of them and how
they can maximise the opportunities provided in a placement.
(5) Consistent approaches to assessment frameworks including generic handbooks:
The implementation of a discipline specific single policy guide books and assessment
frameworks for students and supervisors across the universities helps to streamline
reporting requirements and also consistency of expectations for universities, hosting
agencies and students alike.
(6) Tools that support preceptors/supervisors monitor student attainment of
competencies and support when student performance issues arise: Clearly
articulated and designed competency frameworks assist supervisors provide assessments
as effectively and efficiently as possible. Robust support from universities when issues
related to student performance emerge enables strategies to be put in place promptly to
support students meet their learning objectives.
(7) Clinical placement groups: Within some disciplines, clinical coordinators across
universities and/or hosting agencies meet regularly to discuss placements issues and
provide support to each other. Some meetings involve participants showcasing their
approaches, which allows for opportunities to compare what is happening across
placement sites and identify ways to support consistency in approaches across
placement settings.
(8) University based supervisory training and other professional development
opportunities: Most of the universities offer introductory supervisor training on a
regular basis to those agencies hosting students. This can be taken over half a day or full
day and participants may receive continuing professional development (CPD) points for
their involvement. Some of the disciplines also invite their supervisors to seminars or
other professional development opportunities at no charge.
(9) Development of career pathways and opportunities for staff interested in teaching:
The development of clinical tutors, clinical facilitators or coordinator positions, and
University-Health Service joint appointments are important elements associated with
quality placements and workforce retention of clinicians.
(10) Proactivity and innovation of discipline program coordinator: Some of the
discipline coordinators commented that they were constantly pursuing new
opportunities for placement. They kept abreast of health sector systemic changes (such
as the introduction of GP Super Clinics) and proactively approached former students to
supervise students in ‘new’ settings.
5.3 BARRIERS AND CHALLENGES
During consultations some of the barriers raised were reported across the education and health
sectors, while others were specific to disciplines. To assist with analysis and discussion the
barriers derived from discussions have been categorised in accord with the perspectives of
education providers, host agencies, or disciplines.
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5.3.1 Barriers and challenges across the disciplines: education provider
specific
Barriers and challenges identified across the disciplines specific to education providers
include:
(1)
(2)
Ongoing challenges of sourcing and maintaining placements: education providers
invest considerable ongoing time and energy in sourcing new placements and
maintaining relationships with hosting agencies where placements are in place.
Dependent on the number of students in a program this role can be particularly time and
resource intensive.
Challenge of providing incentives: many education providers recognise the demand on
supervisors and hosting agencies and how much of the commitment is dependent on
goodwill. Some disciplines try hard to provide some form of acknowledgement to the
supervisors such as lunches, awards and university recognition, library resources and
opportunities to attend training or other professional development opportunities.
“I know that a few disciplines provide funding or new equipment to the services. If we had to provide payment
for clinical placement we just could not do it. It makes me worried that this may become more of a problem in
the future.”
University program coordinator
(3)
(4)
(5)
Competition from other education providers: it is generally recognised that there
exists some level of competition between program coordinators within many of the
disciplines. However, educational providers can experience competition for clinical
placements between health disciplines also. Some organisations can only host a set
number of students due to physical space availability or the indirect cost of having a
student (i.e. impact on supervisor workload), and therefore some educational providers
may miss out from one semester to another.
Access to appropriate staff to supervise: although a potential agency may be open to
hosting students, if there is not a relevant practitioner on staff to provide supervision for
a particular discipline then this cannot occur. Some services, such as aged care
residential facilities, have access to a range of health professionals, but often on a very
part-time basis which is insufficient to fulfil the supervision requirements. External
practitioners are employed to provide supervision at some sites by a small number of
education providers, but it is a costly exercise and not always the preferred approach by
host agencies or universities.
Attractiveness of sites: although there are sites at present that are ‘un-tapped’ or nontraditional, education providers commented that many students are reluctant to go to
placements where they perceive little career prospects or opportunities in the future.
Some students will often have preference for more traditional settings where they know
career progression is possible.
“We know that we could work out something with a service such as a primary school but many students have a
good idea of where the work is in the future and want placements in that organisation. There is no point in
putting the effort in to establishing a placement in a service where there are no job opportunities after
graduation.”
Social work university representative
(6)
Student quality and placement experience: many of the hosting agencies and
university representatives commented on the impact that one negative experience can
have on the willingness of hosting agencies to continue taking students. If a particular
placement is problematic, then this has the potential to influence the reputation of the
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(7)
education provider and program as a whole. Managing this risk is an ongoing priority
for many education providers.
Private practitioners as supervisors: private practitioners, particularly sole operators
or those running a small practice are difficult to engage due to the direct impact
supervision has on their ability to generate income. They are often less willing to be
involved in taking students.
5.3.2 Barriers and challenges across the disciplines: host agencies specific
Barriers and challenges identified across the disciplines specific to host agencies include:
(1)
Space: a lack of physical space including rooms, offices, desks, computers and secure
storage for personal belongings was consistently raised as a significant barrier to hosting
students or to increasing the number of students on site. This was more prevalent
amongst hospitals and health services but many organisations experienced problems
with physical accommodation of students. Concern was expressed by a number of
stakeholders that these issues are not being adequately addressed in the new hospitals
currently being built.
“We, the staff, have to desk hop ourselves we are so limited in office space. When I ask my staff who are
interested in supervising a student I ask them to consider where the student can actually sit!”
Community services organisation
“Access to a private room is a big problem and we are always juggling staff around. Even if we could have
another student there would honestly be nowhere for them to see clients.”
Clinical psychologist
(2)
(3)
Length and model of placement: the length and model of supervision differs
significantly across disciplines and can impact on the number of students an agency is
able to host. Some disciplines, such as dietetics for example, will have short discreet
placement periods where as others such as social work require a significant commitment
of time (up to four months).
Staff ability to manage the demands of the supervision: Hosting agencies report that
it is difficult for staff to manage the responsibilities of supervision and their own
ongoing case workload. Often there is no reduction of their caseload, which means staff
have to supervise students on top of an already busy workload. This can be particularly
challenging for part time staff.
“I really enjoy supervising students, and I have had great students but I just don’t think I can do it again next
semester. It is just too hard to manage as a part timer and I had to complete the reporting requirements after
hours so I would not compromise my clinical load during working hours.”
Hospital clinical supervisor
(4)
(5)
(6)
Lack of recognition for the role of supervisor: the student supervision role is not
always recognised or valued by some organisations or by the discipline itself. This
impacts on staff members’ willingness to be involved.
Inequitable funding: some of the agencies expressed concern that there is significant
inequity in the funding available between disciplines to cover the costs of supervising
students. Some disciplines have the resources to provide funding or resources to host
agencies to cover the costs of taking students on clinical placement, whilst others are
not able to do so, and rely solely on the goodwill of participating organisations and
health professionals.
Organisational and administrative stability: if a hosting agency is undergoing
significant organisational change or instability then they will be less able to host student
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placements. This is also the case where there may be uncertainty surrounding renewal of
clinician/staff contracts.
5.3.3
Barriers and challenges specific to disciplines
Some of the barriers and challenges surrounding, clinical placement are discipline specific.
The following barriers for specific disciplines are presented below.
Aboriginal Health
Barriers to health services taking students on placements included:
(1)
(2)
(3)
(4)
Opportunities for placements in WA Health facilities being limited: Outside the
ACCHO sector it is perceived that there is a lack of understanding of the role of AHWs
which limits placement opportunities and restricts what students are able to do on
placements. This is exacerbated by a lack of a nationally agreed scope of practice.
Students often have family and community commitments: that inhibit their capacity
to attend training and complete placements. Training programs need to be able to have a
degree of flexibility to accommodate these issues.
Lack of funding: means that placements need to be organised where people live as
there is often no capacity to fund accommodation and travel.
Funding for RTOs: is no longer guaranteed and some funding is allocated annually on
a competitive basis. This has the potential to create competition between training
providers and limit their capacity to provide training.
Derbarl Yerrigan indicated that finding the time to develop a student placement program is
difficult, when they are inundated with community need. The service recognises that students
could play an important role in helping address community need and that student programs
are important in recruiting staff. The service is interested in strengthening and developing a
comprehensive student program. Resourcing for a student coordinator would greatly assist in
supporting such a development.
Chiropractic
Currently there are few chiropractors working in the public health system, and there is
perceived to be limited recognition of the contribution chiropractors can make to the delivery
of multidisciplinary care. Few funding models support their engagement in the public health
system.
Dentistry
Although finding placements to date has been reasonably straightforward there are some
factors that affect the willingness of private dental clinicians to provide supervision. These
include:
 the financial impact on private dental clinics which host students as they must reduce their
own client load to provide supervision and also manage the administration involved in the
competency assessments;
 providing the scope needed for the student to achieve competency is sometimes
challenging in a small practice; and
 issues with liability for students has made some private clinicians hesitant about taking on
a student.
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Exercise Physiology
Exercise physiology is still a developing profession and it is therefore difficult to find
accredited supervisors in a range of settings, particularly in public hospitals. In addition, there
is a lack of clarity regarding clinical placement requirements and ongoing accreditation
processes. The majority of health services provide supervision and feedback only if there is
time between sessions. Only two health services reported that they would sit down at the end
of a placement to provide feedback and advice on the student’s performance and assess the
student at the end of the placement. The ability to do this is limited by the structure of
placements that revolve around class times. This means students are never around during
down time, when it would be appropriate to provide feedback. Students have limited
motivation to push for feedback, as these hours do not contribute towards their registration
requirements.
Currently there are few private providers involved in taking students. They generally seek to
run their organisations leanly so that they can deliver clinical results to doctors quickly. Often
senior staff involved in supervising students are very efficient in their work and there can be
concern that the turnaround time of delivering results may be compromised if they are
involved in training and supervising students.
Medicine
Within medicine, there are a number of limitations to the expansion of clinical placement and
quality of placements. Those not shared with other disciplines and include:
(1)
(2)
(3)
(4)
(5)
Changing caseloads which are impacting on clinical exposure for the student and
junior doctor. For example, Charles Gairdner Hospital has 600 beds, the average
length of stay is three days, so this results in approximately 200 new patients per day
that have to be shared across 100 interns and students. Therefore, the student/junior
doctor is only exposed to 2 new patients a day.
Hospital/health service driving the four hour rule to admit or discharge patients.
Time pressure is on staff to do more clinical work which results in less encouragement
for clinicians to undertake teaching, training, and research in emergency departments.
This may be further exacerbated by the introduction of Activity Based Funding if time
for education and training is not factored into the funding formula.
In teaching hospitals consultants are expected to teach and most are willing to
teach registrars but not students. This reinforces the need for vertical supervision
models.
Expansion of clinical placements in non-hospital settings is limited by student
willingness to undertake the placement, as they don’t “value” the setting compared
with a hospital placement. Placements in settings such as aged care facilities might be
more acceptable if all students had to undertake an aged care placement.
The lack of appropriate incentives to support the involvement of GPs prevents
many from being involved.
Midwifery
Within midwifery there are a number of barriers and challenges:
(1)
Concern that there may not be sufficient women delivering babies in metropolitan Perth
to enable students to acquire the continuity of care experiences required by the Nursing
and Midwifery Board of Australia.
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(2)
(3)
Limited access to training opportunities in private hospitals and public services
managed by private providers. There is concern that the model of care delivered in
private hospitals is not conducive to clinical placements. Additionally, as increasing
numbers of public facilities are being managed by private providers there is concern
there will be a loss of access to placements in the public services.
Where students were not supernumerary, there was some concern that there was not
sufficient time for learning with their preceptor.
Nursing
A number of barriers and challenges identified related to the efficiency and effectiveness of
scheduling high volumes of placements. Key barriers identified include:
(1)
(2)
(3)
(4)
(5)
(6)
Offers or requirements that result in inefficient placements. Currently some health
services only offer a small number of placements yet still require they provide an
external facilitator. Educational providers need a cohort of eight students for the
engagement of a facilitator to be efficient. Currently an educator will manage this by
having a facilitator support students over two sites or by educational providers coming
together and sharing the costs of employing a joint facilitator.
Cancellation of placements. There is concern that some education providers overbook
what is required as a strategy to secure the placements they require. Health service
providers report when this occurs it creates inefficiencies. One health service reported
that 16% of their placements were cancelled which contributed to significant wastage or
inefficiency.
Established alliances between hospitals and health services that restrict access. A
number of strong alliances have developed over time and there is concern that the
exclusive relationships are preventing new entrant universities accessing placements for
their students. The newer entrants are keen for processes to be established that are more
transparent.
Fees charged by Ramsay Health for student placements are viewed by many
educational providers as too expensive and is preventing access to a wide range of
placements.
Requirements for a direct supervision approach. One stakeholder questioned
whether direct supervision was required for all activities given a number of allied health
disciplines utilise direct, indirect and remote supervision models. This stakeholder
suggested opportunities may exist for more efficient models of supervision to be
developed.
Many of the students do not drive until they are 25 years of age and are unwilling
to take early shifts. The lack of transport in some locations combined with students’
inability to drive creates challenges for rostering.
A number of enrolled nurse training providers expressed concerns that hospitals, particularly
in rural areas were reluctant to employ enrolled nurses and therefore reluctant to take students
on placement. Marr Mooditj expressed that it often experienced difficulties in securing
placements for its enrolled nurses in mainstream health settings.
Optometry, orthoptics, orthotics, prosthetics and osteopathy
There were a range of reasons that many interstate educational providers did not seek to
establish clinical placement arrangements with WA organisations. These included:
 sufficient placement opportunity in home state or territory and no need to seek placement
in WA;
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 cost of accommodation and travel for the university and student was prohibitive. Students
who choose to undertake placements in WA will often arrange and fund them
independently;
 competition from other states that offer financial incentives to undertake placement in their
region such as New South Wales ($1000 bursary per student available and the Queensland
Graduate Package);
 difficulty in establishing formal arrangements and consistency of supervision between
sites; and
 low student motivation to travel interstate for long placement periods.
Paramedicine
Edith Cowan University has restructured their placements this year to be within health
services. This has required significant amounts of engagement with health services regarding
the role paramedics can play within services. There is still a significant barrier in finding
enough placements for students.
Pharmacy
A number of stakeholders said many pharmacists had not been taught to train students. They
identified a need to strengthen access to courses that support pharmacists develop
preceptorship skills. “Teaching on the run”, was identified as a positive program that supports
the development of preceptorship skills and is contextually appropriate given the busy work
context within which clinicians operate.
A few stakeholders articulated the lack of standards requiring preceptors to be accredited
limited the capacity of the profession to ensure all placements were of an appropriate quality.
These stakeholders wanted AHPRA to set accredit all preceptors.
It was reported that currently, each hospital requires students to fill out applications when
applying to be a graduate, which can be burdensome for students and health services. Some
pharmacists consider there may be more efficient ways to work together to streamline the
application process.
Physiotherapy
The university provided supervisor model is popular with staff as it gives them a break from
students. However, the majority of health services and both universities said there are some
issues. Barriers identified with the university supervisor model include:
 university supervisors not having enough clinical experience to treat patients and supervise
the student;
 inefficiency where multiple supervisors are all filling out separate APP forms;
 lack of capacity to employ suitably experienced university supervisors, especially for
highly specialised areas; and
 too many people in attendance to treat one client especially in the community or for home
based sessions.
Podiatry
Health services reported facilitation of podiatry placements is difficult due to the late notice
the university provide and limited information about the characteristics of the students prior to
them commencing the placement. A number of health services reported they would prefer
longer block placements as they:
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 reduce the number of times orientation is undertaken;
 increases the enjoyment in supervising as supervisors are able to see students develop; and
 students increase their independence.
Several health services reported they felt pressure from the university to pass students and
frustration regarding the lack of control they had to fail students. A number of health services
reported concerns regarding the quality of students and a lack of processes for reporting cases
of incompetent students to the university.
Multiple health services reported that podiatry students, especially in the third year of the
undergraduate course were rude to their supervising podiatrist, clients and other professionals
on staff, suggesting they require increased pre-clinical training on professional behaviour.
One health service said the assessment form from The University of Western Australia was
vague.
Psychology
Barriers identified to placing and hosting student specific to psychology included:
(1)
(2)
(3)
(4)
(5)
(6)
Department of Health employment practice: The public hospitals within WA do not
currently employ counselling psychologists and therefore provisional counselling
psychologists are rarely able to undertake clinical placement or seek employment
following graduation and registration within these settings.
Access to appropriate staff to supervise: Although a potential agency may be open to
hosting students, if there is not a registered clinical, counselling or neuropsychologist on
staff to provide supervision, a placement cannot occur. External practitioners are
employed to provide supervision at some sites by the psychology departments, but it is a
costly exercise and not always the preferred approach by host agencies or universities.
Length and model of placement: The length and model of the clinical supervision for
a provisional psychologist requires a significant commitment by an agency. The number
of FTE per team and their workload will also influence the organisation’s willingness to
host a student.
Changes to supervisor accreditation: As of 1 July 2013 all new supervisors of
provisional psychology students will be required to complete Psychology Board of
Australia recognised supervision training course to perform the role of supervisor.
Accredited training will also need to be undertaken every five years to maintain
supervision registration. Although this is seen to be important from a quality of
placement perspective, universities fear that the introduction of compulsory training
(not yet available in WA) will reduce the involvement of psychologists. This training
will incur a cost and as psychologists under the current university based program do not
generally receive payment for their role in supervising students, this is an additional
onus that is expected to affect the numbers of available supervisors.
The introduction of MBS items for psychologists under the Better Access to Mental
Health Initiative: has impacted negatively on the number of psychologists in public
settings providing supervision as many psychologists have moved out of the public
sector to establish their own private practice. Accordingly, over the past few years there
has been a decrease in the number of clinicians available to provide supervision. This
issue is exacerbated by a workforce where a significant proportion of psychologists only
work part time.
Placement timing: At present most of the universities follow a reasonably consistent
placement calendar (January-July and August-December). The health services
commented that they would appreciate it if there was not a gap between placements to
enable the client workload to be consistently managed and maintained.
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Radiation Science
The major barrier to placement growth is the technology and service practice of these
professions. Service delivering radiation services requires the incorporation of safety and as a
consequence there are a number of restrictive suite design barriers. Each service delivery suite
can incorporate at best one student placement.
Recent advances in digital imaging are shortening patient encounters and decreasing the
number of x-ray suites required. In addition, professional supervision requirements are set at
2:1 for medical imaging and radiation therapy which limits the number of potential student
places. These constraints are the most serious barriers to further expansion.
The development of new services like the Fiona Stanley Hospital may be at the expense of
existing services and placements. Likewise re-developments in the private sector are seeing a
transfer of medical imaging services rather than creation of additional suites. As a
consequence, there is a need for careful planning between the university and its partnering
placement providers.
There is the potential for further development of placements in medical imaging in rural and
regional settings. At present some sites are being accessed where accommodation can be
identified. Further expansion would need to address issues in accommodation and travel.
Given these are areas of workforce need in WA it is reasonable to identify this as a priority
for the WA government to address.
Social Work
Barriers identified to placing and hosting student specific to social work included:
(1)
(2)
(3)
Length and model of placement: the length and model of supervision for the social
work field placement is significant compared with some other disciplines
(approximately four months in a setting). Although recognising the value of having
students, not all sites are able to commit to the length or intensity of the supervision
period.
Attractiveness of sites: although there are sites at present that are ‘un-tapped’ or nontraditional, education providers commented that many students are reluctant to go to
placements where they perceive little career prospects or opportunities in the future.
Some students in particular will express a preference for more traditional settings where
they believe career progression is possible.
Lack of collaboration between universities regarding placements and expressions
of interest: At present the three universities approach sites individually and at different
times of the year. One of the agencies suggested that this creates additional work each
time they are approached. The stakeholder suggested that it would be less onerous if the
universities were able to coordinate the placement needs and timings together and
approach once or twice a year with clearly defined requests for them to consider in a
single review or management meeting. In addition, the actual “expression of interest”
paperwork varies between universities.
Speech pathology
Barriers identified to placing and hosting student specific to social work included:
 insufficient clients for the students to see;
 insufficient opportunity to provide industry input into course development; and
 part time working structure of speech pathology workforce.
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Increasing enrolment numbers and the commencement of a new course at Edith Cowan
University concerned some health services, as they already feel stretched and under
resourced.
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6
Key opportunities for the
future
This chapter details opportunities to: improve the quality of clinical placements; expand
clinical placement and enrolment capacity; and strengthen clinical supervision and facilitation
models. Opportunities across and specific to disciplines are also considered.
6.1 OPPORTUNITIES ACROSS DISCIPLINES
A number of common opportunities to strengthen or expand clinical placements across the
profession were identified, which include:
(1)
(2)
(3)
(4)
(5)
(6)
Formal recognition of supervisors / preceptors: Across a number of professions,
universities and health services spoke of the importance of good quality placements. To
a large extent good quality placements are provided by enthusiastic supervisors
/preceptors that go out of their way to provide a positive learning experience. A number
of professions spoke of the importance of ensuring professional recognition is given to
those undertaking these roles.
Credentialing of preceptors/supervisors: Some disciplines spoke of significant
variations in the quality of placements, based on the interest of the supervisor, their
clinical expertise and their skills in supervising/preceptoring students. Some
stakeholders suggested consideration be given to accrediting training programs and
credentialing preceptors/supervisor (such as those to be introduced from July 2013 for
psychology).
Interprofessional learning: A number of stakeholders saw opportunities for
strengthening inter-professional learning opportunities for students in the final year
including: chiropractic, pharmacy, and speech pathology.
Consideration of simulation: The opportunity for simulated learning activities to fulfil
specific competencies normally acquired through clinical placement produced divergent
responses. Some of the university representatives could see value in simulation to
achieve certain task based competencies whereas others were less positive. Almost all
disciplines considered that simulation was an important learning and teaching method
that can enhance rather than replace clinical placement activity. Irrespective of
stakeholder views at present the accreditation requirements of many disciplines do not
allow for simulation to replace clinical placement activity.
Greater collaboration and coordination within disciplines: Some of the disciplines
work in collaboration in regards to identifying and approaching host agencies and
coordinating the allocation of placements. Others have in place a cross-university
assessment framework. In anticipation of increased demand for clinical placement
opportunities and recognition of the administrative onus placed on hosting agencies,
there is value in greater collaboration between educational providers within disciplines
to better manage this demand.
Future infrastructure such as new hospitals and health services recognise and
incorporate sufficient space for students into their design and construction. Student
wards such as that in place at the Royal Perth Hospital are well regarded.
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(7)
Regular review of workforce demand: To ensure that students undertaking a program
have reasonable employment opportunities at graduation, education providers need to
continue assessing workforce demand for their disciplines and capping enrolment
numbers when appropriate.
(8) Continuation of HWA funding focused on increasing capacity of services to host
students and enabling a dedicated coordinator to manage the increasing numbers and
supporting a quality clinical placement experience.
(9) Exploring methods of overcoming barriers to rural placement: The cost of
accommodation and transport are major barriers to students undertaking clinical
placement in rural areas at present. It is not clear how this issue can be definitively
addressed. However, options may include expansion or increase of rural placement
scholarships within WA, introduction of rural incentives similar to those offered in
other states or improved promotion of rural placement within some disciplines, greater
flexibility in placement models, and exploration of partnerships in rural areas to
coordinate all available accommodation, particularly in the ‘off season’ in tourist areas.
(10) A strategy to build ‘on and around’ the already established Rural Clinical School
infrastructure to support and enhance clinical placement opportunities in regional
areas for students of all disciplines. The general concept of having a training,
mentoring, resource centre, collegiate support and accommodation resource base for
nursing and allied health students as well as medical students during training placements
was acknowledged by many stakeholders to be attractive, especially in opening up more
placement opportunities in the north west regions where the current logistics and costs
are unaffordable.
6.2 OPPORTUNITIES BY DISCIPLINE
In this section opportunities to strengthen the quality of clinical placements and expand
placement capacity by discipline are presented.
Opportunities identified to increase and improve placement capacity in the future included an
increased focus on working with public health services to understand the role of Aboriginal
Health Workers and to identify opportunities for clinical placements. Derbarl Yerrigan
identified it had capacity to take more Aboriginal Health Worker students along with a range
of medical, nursing and allied health students.
6.2.2 Audiology
The current supply of audiology clinical placements meet demand, with health services
indicating they are not at full capacity. Expanding opportunities for clinical placements in a
rural setting through dedicated funding may assist in increasing the audiology rural workforce
in the future.
6.2.3 Chiropractic
Murdoch University is keen to see new models of placements developed that enable
chiropractic students to participate in interdisciplinary placements in a public health
environment. The university would like its students to gain a greater appreciation of the roles
different professions play in the provision of holistic care. Potential exists for this to occur in
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a range of settings including: acute, outpatient or primary care environments and in specialty
areas such as chronic pain management. To facilitate these opportunities, it will be important
to identify the most appropriate profession to supervise chiropractic students, given no
chiropractors currently work in the public sector.
Murdoch University is also keen to explore opportunities for students to undertake placements
in Workplace Rehabilitation Services and with Exercise Physiologists.
6.2.4
Dentistry
Key opportunities were considered to lie in rural WA or remote areas of the Northern
Territory (NT). Given the high level of need for dental services in remote areas, the
establishment of other satellite clinics such as that established in Bunbury would benefit not
only the local community but also provide students with a breadth of experience.
6.2.5
Dietetics
Dietitians and managers in community organisations and health services were keen for the
opportunity to meet with the university program coordinators once a year to discuss potential
student placement projects for community organisations / health services and universities. It
was suggested that the opportunity to brainstorm could lead to the creation of more innovative
projects that would benefit students, organisations, universities and the community alike.
The program coordinators suggested that they are now exploring opportunities in settings
such as: rural and remote settings; private practice; aged care services; and in the mining
sector.
6.2.6
Exercise physiology
Currently, the opportunities for clinical placements in exercise physiology are limited by a
lack of exercise physiologists working in public hospitals and community sectors. Exercise
physiology in WA is still a developing profession and as such the models of clinical
supervision are still developing and not as widely established as in other professions.
Currently, there is a lack of professional development programs available to support exercise
physiologists in clinical education.
Strengthening the models of supervision and providing professional development
opportunities in supervision will be important steps in strengthening the capacity of
professions to provide quality placements.
6.2.7
Opportunities to expand clinical placements capacity have been identified to include:
strengthening the involvement of private medical laboratories; and encouraging medical
laboratories in new hospitals being established, to commit to taking students.
6.2.8
Medicine
A number of opportunities were identified to increase medical student and intern placement
capacity. These included:
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(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
Mandatory requirements for medical students to undertake placements in community
based settings such as aged care facilities in preclinical years (and potentially clinical
years).
Providing funding to large private hospitals such as St John of God to establish the
infrastructure to support intern placements.
Establishing part-time medical educator positions in hospital settings, as currently
occurs in the Rural Clinical School to offer stability to the education and training
functions of a facility/ cluster of facilities.
Greater use of outer metropolitan and regional hospitals for clinical placements and
internships.
Recent changes by the Medical Board, to the registration standard for intern placements
provides flexibility in the setting i.e. opportunity for general practice to be included for
emergency medical care. This will support opportunities to expand intern training
capacity in metropolitan and regional locations and potentially introduction of
community internships through integrated posts.
Expanding prevocational placements in rural and regional locations through
establishment of integrated prevocational training posts i.e. composite models where a
junior doctor works across regional hospitals, general practice and small hospitals i.e.
expanded composite GP/hospital rotations.
Recognising and addressing the learning needs of International Medical Graduates that
staff rural and regional hospitals such that they can be become / be recognised as
supervisors to increase training placement capacity in rural and regional hospitals.
Expansion of interdisciplinary training and education through the establishment of
student learning wards for geriatrics, orthopaedics, general surgery, maternity,
paediatrics.
Simulation is a critical component of medical student training throughout their study,
particularly for the opportunity to participate in ‘high risk’ or ‘high stress’ experiences. There
are opportunities for some of the more basic tasks to be undertaken in a simulated
environment as a component of clinical placement.
Supervision capacity can be enhanced by establishing flexible models that draw upon and
support existing resources and opportunities. Opportunities relevant for student and
prevocational training particularly in regional and rural areas include:
(1)
(2)
(3)
(4)
(5)
Using public and private visiting specialists to contribute to training in locations where
they are providing specialist visiting services.
Utilising specialist registrars undertaking regional rotations and/or outreach services to
supervise junior doctors.
Increased and better use of telehealth/videoconferencing for specialists to provide
remote support to the rural workforce including remote consultation/ward rounds by
metropolitan specialists.
Joint supervision arrangements to cover the whole practice of a junior doctor working
across hospital and community settings i.e. joint supervision by specialists and GPs
Hybrid supervision model. Under this arrangement an accredited training post has in
place on-site support to the junior doctor provided by an experienced registered nurse/
remote area nurse, paramedics, Aboriginal health practitioners/workers, i.e. support
from local resources, with remote supervision/visiting supervision by senior doctor.
This type of model would be a mechanism to increase training capacity within
ACCHOs and remote health settings.
Derbarl Yerrigan is interested in expanding its capacity to take students. The service
recognises that students can play an important role in address community need and student
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placement programs are important in attracting health workers to careers in Aboriginal health.
Whilst the service is finding it difficult to create time to develop the program when they are
inundated with community need, planning to do so has commenced. The service wants to
develop a comprehensive student program that will enable medical students, nurses,
Aboriginal health workers and allied health to be exposed to Aboriginal health across their
four facilities. They have a lot of visiting specialists and range of clinicians who are interested
in teaching students. Resourcing for a student coordinator to support the development and
coordination of such a program would greatly assist in building their capacity.
6.2.9
Midwifery
Future prospects to strengthen clinical placement capacity within midwifery include greater
opportunities for student midwives that give them a well rounded exposure to hospital, home
and community based models of care for women, and opportunities to work within systems
designed for both high risk/complex cases and low risk/uncomplicated cases are a shared
goal. Establishment of woman centred midwifery models such as Midwifery Group Practices
could provide many more continuity of care training opportunities for training students.
6.2.10 Nursing
Nursing stakeholders identified a range of opportunities to strengthen the capacity of clinical
placements. These included:
(1)
Evolving to a more sophisticated, formalised and sustainable system for planning
and managing student placements. There is a need for a more sophisticated and
transparent system that supports good planning and efficient allocation of placements
guided by agreed principles based on students learning and competency attainment
needs and equitable access to placements and across placement settings. Data
management tools that are able to estimate placement supply and demand, show
placement demand peaks and supervisory capacity would assist the sector to plan.
(2)
Strengthening efficiency of placements: Health service providers need to be aware the
cost structure associated with funding facilitators and the preference of educational
providers to have groups of eight students undertaking placements. Additionally
education providers need to be aware that overbooking of placements and cancellations
at the last minute leads to significant inefficiencies for health services and opportunity
costs for the system as a whole. Understanding the cost drivers and working together to
improve the efficiency of the placement system is a priority with nursing placements
projected to increase over the foreseeable future. A number of stakeholders suggested
the broad adoption of home warding models across hospitals could strengthen capacity
and placement efficiency. The approach taken by St John of God Subiaco Hospital was
also described as very efficient by stakeholders.
“We need to work smartly and think of ways of getting rid of the administrative components so we can focus on
students when they get on placements.”
Nurse Manager
(3)
Strengthening opportunities for placements in new and innovative areas including
aged care settings, disability services, new super clinics, emergency departments,
community settings, emergency response services such as Royal Life Saving and Big
Day Out events.
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(4)
Streamlining of processes including common position descriptions for students and
facilitators, the development of common tools to support placements and processes to
ensure police checks, working with children certificates and immunisations are
undertaken. Stakeholders spoke of work being duplicated by a large number of
organisations. Agreement on common approaches could maximise effective and
efficient use of valuable resources across the sector. It has been suggested that a
national clearance system and the issuing of a card to students that they can carry with
them indicating they are compliant with mandatory requirements could assist in
simplifying processes.
“What we need is a provider that can manage all the compliance checking of students to ensure they are ready
for placement. This task has to be done but it is very inefficient to do it ourselves.”
Clinical Coordinator
(5)
Expansion of placements across all shifts and across the calendar year. There are
opportunities to increase capacity for placements if all shifts were utilised, including
weekends. Some hospitals require their students to be available to be rostered over all
shifts. It was reported that Ramsay Health is currently piloting surgery placements at
night. However, this is not always relevant. Graylands Hospital said that use of night
shifts was inappropriate for mental health placements (where patients are encouraged to
develop healthy sleeping patterns). The hospitals that provide placements over all shifts
believe that whilst it improves their capacity to take students it also prepares students to
be work ready. Currently many educational providers contain their placements to the
academic year. By expanding placements across the calendar year, capacity of health
services could be expanded.
(6)
Establishment of new facilities. It is presumed that the new Fiona Stanley Hospital and
children’s hospital will be positive/enabling forces in clinical placement opportunities
for students although there is some concern about the impact on placements in the short
term.
(7)
Continuing to promote and engage nurses in preceptoring. A number of
stakeholders said that preceptors attitudes to placements influence the quality of
placement for the students. Health services need to continue to engage and support
nurses in taking on this role. A range of strategies are required to maximise nurse
engagement including: easy access to preceptorship training, access to support when
preceptors have a difficult student, mechanisms to look after preceptors so they do not
suffer training fatigue and recognising the contribution they make.
6.2.11 Occupational therapy
Opportunities to expand the numbers of clinical placements have been identified in the
disability services sector. However, some stakeholders have suggested that this may be
difficult as these services tend to have limited funding and their capacity to support students
may be limited. However, this may well change with the introduction of the new National
Disability Insurance Scheme.
6.2.12Optometry, orthoptics, orthotics, prosthetics and osteopathy
Some interstate universities work with WA health services and practices through regular,
formalised clinical placement arrangements and some have expressed interested in doing so
into the future. However, the level of motivation to seek placement opportunities within WA
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is strongly influenced by ability to meet placement requirements at present in their own
jurisdiction, access to appropriate supervisors in WA, competency or credentialing
requirements, and costs incurred by the student to undertake placements in WA.
Enablers to clinical placements being undertaken in other states (not necessarily WA) include:
 financial support to undertake placement in particular states such as New South Wales
($1000 bursary per student available and the Queensland Graduate Package);
 personal motivation of the student for whom WA may be their home state or who have
family living there. The student may also be interested in a region in WA for a particular
population or speciality focus;
 historical and ongoing relationship with a health service in WA; and
 supervisor themselves undertook their education at a non-WA university and offers
placement opportunity to subsequent students.
6.2.13 Paramedicine
Currently, Edith Cowan University hospital placements are at a very limited number of
hospitals. They hope to expand capacity to a broader range of health services. Potential
facilities that could assist in increasing clinical placement capacity include: corrective
services, health centres and mining industry health centres.
6.2.14 Pharmacy
Opportunities were identified to strengthen placement capacity in regional areas and in
developing countries. The Pharmacy Guild is reported to assist with facilitating student
placements in rural areas.
Pharmacists are developing new roles for themselves as primary care. In strengthening the
quality of placements, it will be important that clinical placements are exposing students to
these emerging roles and interdisciplinary care.
Each hospital currently requires students to fill out individual applications when applying to
undertake their internship year. For graduates it may mean that they have to complete many
applications. It is felt there may be ways pharmacies could collaborate to streamline the
application process.
6.2.15 Physiotherapy
Both universities and health service providers stated that most places where it is possible to
place students were currently being utilised. Medicare Locals and GP Super Clinics have been
identified as potential avenues for increasing physiotherapy placements. Curtin University are
planning to have large numbers of physiotherapy placements at the new Cockburn and
Wanneroo GP Super Clinics from 2014. Perth North Metro Medicare Local is also interested
in having students in the future.
Some stakeholders spoke of the fact that the scope of placements is limited by the prescriptive
accreditation guidelines that specify placement setting and hours that need to be completed. It
may be timely for the review of these guidelines.
6.2.16 Podiatry
As the course is changing from undergraduate to a Doctor of Podiatric Medicine over the next
few years there will be a decrease in the number of The University of Western Australia
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podiatry students, until they reach their 35-student cap. Hospitals are hopeful this may
increase the opportunities for longer block placements.
The University of Western Australia reported that it is exploring ways to increase the number
of health services taking students, acknowledging there are many sectors that are underutilised
including, private practices, aged care, community health, ACCHOs and private hospitals.
6.2.17 Psychology
With the expansion of psychology services in general practice through increased use of
Medicare Benefits Schedule items, there is potential for counselling and clinical psychology
students to undertake clinical placements in GP Super Clinics. The university program
coordinators suggested that it is possible to increase the provision of external supervisors to
enable student placement at sites at which they do not have psychologists on staff, but this
would require an increase in funding to implement.
6.2.18 Radiation science
Placement providers spoken with suggested there are further opportunities for development of
clinical placements in:




private sector small practices not currently taking students;
out of hours rosters, e.g. night call and weekends in public hospitals;
regional and rural practices where accommodation and travel can be supported; and
new and redeveloped hospitals and practices offering services in excess of existing local
services.
Simulation is a standard tool in radiation science education programs and already
incorporated into university teaching. Virtual reality programs have proved very effective in
radiation therapy education and are likely to become more useful in medical imaging. In
medical imaging and sonography university clinics in partnership with public or private
providers has proved most beneficial to the student learning experience. These have also
proved successful interstate.
Through the consultations, the need for opportunities for clinicians to share their knowledge
to improve the quality of the experience for students and clinical staff and plan together was
identified. There was very real concern over future directions in university student numbers,
the level of commitment of all services to training, the impact of new services and leadership
in clinical education and training. These are big items that could be collectively addressed
with minimal financial input but acceptance of the need for facilitation and time to participate.
6.2.19 Social work
All three universities endeavour to seek new placement opportunities each year. Edith Cowan
University aims to develop and explore one or two new or ‘non-traditional’ placement sites
each year for their social work students. The University of Western Australia offers
placements in community development settings, for example at the UWA Future Farm in
Pengelly and in primary schools.
“It is hard work finding places for our students each year and we must always look outside of the square for new
opportunities. We can’t just stick with the traditional services.”
Social work university representative
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Opportunities to provide field placement in regional areas such as Port Hedland have been
identified, and universities indicated they would need support to do this. In particular, The
University of Western Australia would like to establish regional training centres in the
Wheatbelt to attract social workers to the area.
Opportunities were identified for greater collaboration in research between universities and
health services that could lead to the development of a range of projects and placement
opportunities.
To strengthen the quality of placements, a need for greater access to professional development
programs was identified. Stakeholders spoke of the La Trobe University course which offers
accredited supervisor workshop from introductory, advanced to ‘master’ class levels. The
University also offer supervisor support circles and Supervisor Excellence Awards. Access to
similar levels of professional development opportunities and formal accreditation of the
courses were seen by stakeholders as important ways of strengthening the capacity of the
sector to provide quality placements.
Additional settings considered for the future include: local government (community
development office); community centres, aged care services (including residential care), and
schools.
6.2.20 Speech pathology
Student-led clinics like Gosnells Speech Pathology Clinic are a potential model for placement
expansion. However these models requires significant amount of funding.
One of the site representatives spoken with expressed a desire to work in greater collaboration
with the universities and the opportunity to input into the setting and structure of the clinical
placement.
“They should ask us our opinion more about what skills students actually need to work as speech pathologists
and about where the population demand is. I feel they don’t get enough exposure to those population groups
were there is huge demand for speech pathology.”
Senior speech pathologist
6.3 FOCUS FOR THE FUTURE
In this section, key themes that need to be considered in future approaches to strengthen
capacity and quality of clinical placements are summarised.
Continued support for collaborative approaches
What is apparent from the wide range of supervision and facilitation models operating is that
those disciplines that collaborate tend to have greater success in addressing the challenges that
face them. Discipline areas that are collaborative in nature:
(1)
(2)
(3)
(4)
(5)
(6)
Have educational providers working together with host agencies to address issues.
Minimise competition by alignment of the placement calendars.
Approach host agencies in a coordinated way to minimise duplication of effort.
Ensure allocations of placements are equitable.
Utilise common assessment frameworks and guides.
Identify problems emerging and develop solutions to address these issues together.
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(7)
Share information about how they approach supervision to ensure consistency and
foster learning.
Opportunities also exist across the disciplines to work together to streamline approaches
including the development of standardised materials and processes related to orientation such
as health and safety, infection control, manual handling, immunisation and working with
children checks.
Collaborative approaches should continue to be supported along with opportunities for
supervisors to come together to network and share their approaches and learnings and thereby
strengthening the capacity of the sector to deliver high quality placements.
Support the development of new approaches to supervision
There are a wide range of approaches to clinical placements across the discipline areas. At
one end of the spectrum, placement models can be characterised as individualised craft or
apprenticeship models, where an individual clinician works directly with a student in
achieving their individual learning goals. The student observes and learns by doing under the
mentorship of the clinician.
At the other end of the spectrum, there are placement models involving high volumes of
students, which requires an ‘industrialised’ or ‘standardised’ approach involving group
orientations, clinical placements guidelines that provide structure to the placement and
facilitators with a dedicated role in educating and supporting students, and preceptors
providing one on one support in the clinical environment.
There is a need to increase awareness of the different types of models that can be utilised to
supervise students to expand capacity of placements.
WACHS is developing an e-learning package to support nursing and allied health clinician
involvement in rural areas. The e-learning package describes three common approaches:
(1)
(2)
(3)
Substitution model: where a student follows a clinician and undertakes some aspects of
care under supervision.
Participation model: where the student and supervisor come together and identify
tasks that need to be done, and the student is given particular tasks they are responsible
for.
Student led placement: where students are trained to deliver the care to the patient
under the supervision of a clinician who oversees their work.
In addition, this project identified a wide range of placement approaches being utilised across
a range of discipline areas including:
(1)
(2)
(3)
(4)
(5)
Vertical training models that are predominantly utilised in medicine.
Peer support models where students come in pairs, which is operating in occupational
therapy, dietetics and speech pathologists.
Team leader models in nursing, where a registered nurse supervises both a graduate
nurse and a student. Together they worked as a team with the registered nurse
supervising and supporting the team members.
Senior students on placement familiarising students to the clinical environment.
Interdisciplinary education models, where there is usually both a discipline specific and
task supervisor involved in the supervision of students.
There is a need to continue to explore new ways of providing supervision that will open up
opportunities to enable more placements to occur. Models that should be considered include:
(1)
Increased and better use of telehealth/videoconferencing/iPad and tablet technology to
enable remote supervision.
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(2)
(3)
(4)
(5)
(6)
Joint supervision arrangements that support students to work across a range of
settings/organisations. Services may not have the capacity to support a student by
themselves. However if they rotate a student across settings/organisations it may be
possible.
Use of recently retired/semi-retired clinicians being engaged to provide clinical
supervision.
Hybrid supervision models where a range of senior clinicians support the student in a
remote setting and remote/visiting supervision is provided by a discipline specific
remote/visiting supervisor.
Using public and private visiting specialists to contribute to training in areas where they
provide specialist visiting services.
Utilising specialist registrars undertaking regional rotations and/or outreach services to
supervise junior doctors.
Support and recognition of supervisors/preceptors
Clinical supervisors, facilitators and preceptors are the backbone of clinical placements. Many
clinicians supervising students on clinical placements do so on top of their already busy work
role. It is important that increased recognition is given for the work they do and time is
allocated to allow them to supervise students.
There is also a need to ensure there is ready access to professional development opportunities
to support new and more experienced clinicians develop their supervision skills.
Whilst some discipline areas have networks that allow clinicians come together to network
and share learnings and innovation approaches, others do not. These forums are important for
placement development and consideration should be given to developing such forums where
needed.
Funding to support clinical placements
HWA funding has been instrumental in supporting innovations in interprofessional education
and the expansion of placements in regional areas. There is significant concern that a number
of the initiatives will not be sustainable without continued funding. To continue to innovate,
there is a need to have the resources available to support the development of models.
For most health services, whether they are public or private there needs to be recognition of
the costs associated with taking students and some recompense that allows for clinical
positions to be backfilled. This provides opportunities for organisations to develop clinical
placement coordinator roles that can have a key role focussed on providing good quality
placements.
Importance to improve efficiency
“Wastage” of placements was a key concern in discipline areas where there were high level of
competition. To address this there is a need sophisticated tools and models of placement to
support the efficient and effective management of high volumes of students who need to
complete a range of specified placements.
Facility design
A major barrier to supporting placements across many disciplines was having the capacity to
accommodating students. Future master planning for new hospitals and health services need
to ensure clinical placement requirements are considered.
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7
Current partnerships, groups,
networks and committees
This chapter provides a high level overview of the current partnerships, groups, networks and
committees operating related to clinical placements for each of the disciplines consulted with.
7.1 ABORIGINAL HEALTH
The Community Controlled RTOs are all members of Aboriginal Torres Strait Islander Health
Registered Training Organisation National Network, which is a national network supported
by a small secretariat funded to facilitate a streamlined and coordinated approach to planning
and delivery of culturally relevant education and training in Aboriginal and Torres Strait
Islander health; strengthen links with community, industry and funding bodies, and strengthen
the capacity of the Aboriginal RTOs within the VET sector.
7.2 AUDIOLOGY
In audiology are no current partnerships or networks specifically designed to support clinical
placements. A high proportion of supervisors working in private practice are time poor, which
limits the feasibility of active networks being developed.
7.3 CHIROPRACTIC
University staff participate in meetings of the Heads of Schools of Chiropractic Colleges of
Australasia, where networking occurs on issues related to clinical placements.
7.4 DENTISTRY
The Head of the School of Dentistry is a member of the Australasian Council of Dental
Schools (ACODS) which was established to collaborate with stakeholders and to enable
informed decision-making in the area of Oral Health Education in both Australia and New
Zealand. ACODS consists of the Deans and Heads of Dental and Oral Health education
providers in Australia and New Zealand, which includes dentistry, dental hygiene, dental
therapy, oral health therapy, dental prosthetics, and dental technology.
ACODS meet formally twice each year in June and December. The annual general meeting is
held in the second half of each year. The meeting is held in conjunction with the Australian
Dental Association, Australian Dental Council and relevant specialist bodies. It is an
opportunity for the members of ACODS to discuss priority issues and policy matters affecting
all dental and oral health education.
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7.5 DIETETICS
A Metropolitan Dietetics Management Meeting held every six weeks is attended by the head
of the dietetics department from a range of public and private hospitals. During this meeting
the managers discuss a range of issues including clinical placement activity. University
representatives are also invited to attend some of these meetings. At these meetings, managers
are able to discuss any concerns they have with the placement process.
Curtin University and Edith Cowan University hold quarterly meetings at which they discuss
and coordinate clinical placement activities and training opportunities.
7.6 EXERCISE PHYSIOLOGY
There are no partnerships groups or networks in WA specifically set up to discuss clinical
placements in exercise physiology. Exercise physiology is small professional community,
well connected through professional association events. Informally issues related to student
placements come up in discussions.
Although the majority of health services were keen for the universities to collaborate more,
many felt it would be difficult for their businesses to collaborate due to financial and time
restraints
7.7 MEDICAL LABORATORY SCIENCE
Currently Curtin University has a partnership with PathWest Laboratory Medicine WA. They
have been working together to expand clinical placement capacity since the introduction of
the Bachelor of Science (Laboratory Medicine) in 2009. A key focus over the coming year
will be to develop and strengthen working relationships with private medical laboratories to
take students on placement.
7.8 MEDICINE
There has previously been a Joint Consultative Committee to support management of medical
student placements but this was said to be dysfunctional and lacked understanding of what
was needed at “the coal face”.
7.9 MIDWIFERY
The groups and networks identified for midwifery include:
(1)
(2)
(3)
(4)
Nursing and midwifery course clinical coordinators meetings at state and national levels
which discuss common issues associated with clinical placements such as workplace
safety and immunisation status policies.
The WA Country Health Service which has a Clinical Supervision Steering Committee.
A regular heads of departments meeting once or twice each year across the South
Metropolitan Health Service where issues are identified and responses and coordination
mechanisms agreed.
The Nursing and Midwifery Office in the Department of Health is currently scoping a
midwifery workforce plan which will include mapping workforce training needs which
involves all education providers and educating nurses and midwives.
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(5)
(6)
(7)
(8)
(9)
The Nursing and Midwifery Office has a Midwifery Workforce Advisory Committee
which has Executive Director of Nursing and Midwifery sponsorship and
representatives from public and private maternity services
The Women and Newborn Health Service has a workforce development group which
leaders from public sector maternity services participate in.
Curriculum consultative committees of Universities involve industry members,
consumer advocates and professional associations to enable broad input into the design
of midwifery education and training courses.
There is a Fiona Stanley Clinical Services Planning Group which is planning for the relocation of their maternity service to the Fiona Stanley campus. This planning process is
considering the impact of the transition process on clinical placements.
There is a Continuity of Care Committee facilitating the establishment of midwifery
continuity of care models in WA. The Principal Midwifery Advisor, Midwifery Director
State Obstetrics Support Unit, Executive Director of Midwifery, Nursing and Patient
Support Services WNHS and midwifery service leaders from the public sector
participate. Proliferation of services offering women centred continuity of care by
midwives is seen as pivotal in strategic reform to improve choices and services to
women and create service models aligned to contemporary midwifery education and
training.
7.10
NURSING
A number of groups and networks were identified relating to nursing, including:
(1)
(2)
(3)
(4)
(5)
(6)
The Clinical Coordinators Network which involves coordinators and clinical service
managers from across the State. They meet bimonthly to plan and work on issues of
common concern. They like to get the student numbers and needs of educators out on
the table so everyone knows what the demand is going to be and then seek to resolve
any anticipated barriers to executing forthcoming student placement arrangements.
Guest speakers are often invited to the meeting to bring participants up to date on
current or emerging issues. Many stakeholders said they valued the opportunity to
network with other coordinators and health managers. Currently the network is working
on developing a guide on the role of the clinical facilitator for use across universities
and health services.
A national clinical coordinators network exists. They have an annual meeting involving
a wide range of stakeholders from across Australia. They work together on core issues
such as workplace safety for students, immunisation status and legal and indemnity
issues. They have an e-mail network that allows coordinators experiencing challenges to
pose questions to their colleagues to seek their advice.
WA Country Health Services has a Clinical Supervision Steering Committee. However,
the stakeholder who advised of this was not able to describe the role it undertakes.
The RTOs have representatives that sit on the Community Services, Health and
Education Training Council and on the Community Services and Health Industry Skills
Council. These organisations have a key role in enabling the industry and educators to
input into the design and development of course modules.
A number of universities spoke of the curriculum advisory committees they had
established to get industry input into the design of their courses.
There is a three monthly meeting between the university deans and the Chief Nursing
Officer in the WA Department of Health. These meetings allow the universities and the
office of the chief nurse to discuss current and emerging workforce issues on a regular
basis.
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7.11
OCCUPATIONAL THERAPY
The universities have Clinical Advisory Committee meetings that allow health services to
discuss issues relating to clinical placements.
In general, most health services reported that they did not feel a need for more partnerships or
groups due to insufficient time available to participate in such groups, and a belief that the
clinical placements are currently working well.
7.12
PARAMEDICINE
Apart from the formal partnership between St John Ambulance and Curtin University there
were no other WA based groups or partnerships identified relating to paramedicine
placements.
Edith Cowan University is currently collaborating with Griffith University in a project that is
looking to expand capacity in placements in a plus two model. This model would add two
non-nursing students to a traditional 1:8 nursing placements increasing the ratio to 1:10.
7.13
PHARMACY
No formal pharmacy clinical placement networks exist related to clinical placements,
although strong informal connections exist across the profession. However, the Chief Officer
in Pharmacy for the State organises meetings from time to time to discuss clinical workforce
issues.
The School of Pharmacy, Curtin University has recently established a Hospital Fieldwork
Reference Group (HFRG) as an arm of the existing Pharmacy Advisory Committee. The aim
of the HFRG is to provide input into the strategic directions of placements and hospital based
research, develop policies, procedures and guidelines for hospital placements, and assist in the
review and development of fieldwork coursework.
HFRG meetings will be held bi-annually at Curtin University and the group will include the
Head of the School of Pharmacy, field work coordinators, six hospital pharmacists from a
range of practice areas and a student representative.
7.14
PHYSIOTHERAPY
Some time ago a “clinical supervisor working party” was established to align university
placement calendars and increase collaboration across universities and health services. The
working party achieved its purpose and currently there was a general feeling amongst
stakeholders that no other meetings are required.
Both universities reported that once a year they meet with all universities interstate and in NZ
who offer clinical placements, under the umbrella of the Council of Physiotherapy Deans
Australia and New Zealand Inc. (CPDANZ). Both heads of school and clinical placement
coordinators attend and talk about clinical placements.
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7.15
PODIATRY
There are no formal partnerships or groups in podiatry to discuss clinical placements. The
heads of hospital departments meet once every two months and students come up as part of
their agenda. The podiatry community in WA is small, with health services frequently
reporting they call each other or the university if they had major concerns.
7.16
PSYCHOLOGY
A Clinical Coordination Committee of clinical coordinators of psychology from across the
four universities meets twice a year. These meetings have a practical focus of student
allocation but also discuss other issues including changes to the provisional psychology
accreditation and supervision requirements.
Murdoch University runs a psychology discipline specific meeting twice a year where the
university staff and representatives of host agencies meet to talk about the psychology
program and its content. It is an Australian Psychology Accreditation Council requirement
that the ‘market’ is involved in the development of education and training.
In response to anticipated future health workforce needs the Northern Metropolitan Older
Adult Mental Health Services Clinical Training Unit was established. The clinical training
unit has partnered with a number of universities to provide student placements across a range
of disciplines including medical, nursing, social work, occupational therapy, speech pathology
and physiotherapy. The clinical training unit has been set up to provide a coordinated
approach to interprofessional education, manage student placements for the Northern Metro
services and to provide students with experience in the area of older adult mental health.
The School Psychology Service has a network through which they provide newsletters,
training and networking opportunities on a regular basis for graduates, students and school
psychologists. Training includes professional development workshops such as supervision of
provisional psychologists.
7.17
RADIATION SCIENCE
Loose training partnerships exist between placement providers and semi-structured
committees with Curtin University. There are no state-wide training networks or mentorship
programs for these professions.
Curtin University hosts Course Advisory Committees for each of its courses at least once a
year. Other interactions with its training providers are by individual communication. There is
limited interaction between providers.
In medical imaging there is pairing of the public and private sectors to enhance training
experiences and some local regional partnering of larger to smaller service/placement
providers. In the private sector, training networks have developed in line with the broader
practice groups, e.g. Perth Radiology Clinics and SKG Radiology. Most of these
arrangements have been built on individual relationships. There is little interaction outside
existing relationships and no mentoring of the clinical educators. A forum for the clinical
educators to interact and share experiences would be beneficial.
Nuclear medicine is a small professional group that is unlikely to ever host a course in WA.
There are no formal networks and little interaction with the interstate universities. There
would be considerable benefit from mentoring with interstate colleagues in similar roles and
responsibilities regarding education and training.
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Radiation therapy will benefit from the new course development processes and it is likely the
project management at Curtin University will evolve into a Clinical Advisory Group. There
are early signs of interactions between the current placement sites and the university that are
promising.
Sonography has in existence training networks in the private sector, public metropolitan
(south) and regional areas (Country Ultrasound Program). Whilst each of these networks are
said to be functioning well, there is minimal interaction between the networks to mentor and
share experiences. Due to the number of courses feeding into this training it is unlikely that
Curtin University can provide overall leadership through its Course Advisory Committee.
There would be benefits in developing forums that could support supervisors and provide
opportunities to sharing program experiences.
The quality of the training experience in these professions is high and the commitment of the
staff at the sites visited is commendable. Functionally the current training structures are
working and senior staff are satisfied with maintaining their current level of control of their
programs. It was noted that most providers were keen to interact more and share experiences.
An opportunity exists to bring all the training providers for each of these professions together
and develop a state-wide mentorship and leadership program that has great potential to further
enhance the training experience for all involved.
7.18
SOCIAL WORK
Social work coordinators across the tertiary hospitals hold a Student Coordinators Group
twice a year to discuss case studies, student modules, and other information about social work
student field/clinical placements. Each hospital takes a turn in presenting about the program
they provide for students. This is done to compare what is happening in the field and in
clinical placement, discuss issues and maintain some consistency across placement settings.
7.19
SPEECH PATHOLOGY
There were few partnerships and collaborations identified by stakeholders within speech
pathology.
Clinicians in private practices expressed the view that they had limited capacity to participate
in networks. Whilst employers are generally supportive, no allowance is made within
workloads and additional meetings have to occur in personal time. Private hospital staff said
they felt relatively isolated about what was happening at other services. They receive positive
feedback from students who attend on placements but report not knowing how this compares
with other services.
Clinicians identified their relationship with their professional association as important. An
Adult Interagency Group encourages collaboration across the adult speech pathology sector.
This has student placements as part of its agenda, but is a minor component.
The universities saw value in the establishment of a Speech Pathology Clinical Education
Committee that would comprise the universities, health care providers, education providers,
disability agencies, rural providers and private providers.
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8
Appendices
APPENDIX A STAKEHOLDERS CONSULTED
Table 8.1 and Table 8.2 provide lists of the stakeholders we spoke with in metropolitan and
regional areas.
Table 8.1 Stakeholders consulted in metropolitan areas
Discipline
Aboriginal Health
Worker
Audiology
Chiropractic
Dentistry
Dietetics
Name
Margaret
Quartermaine
Sharon Bushy
Title
Chief Executive Officer
Organisation
Manager Workforce
Development/WIPO
Karen Glenn
Dr David Atkinson
Health Service Manager
Medical Education Officer at Broome
Rural Clinical School located at
Kimberley Aboriginal Medical Service
Associate Primary Health Manager
Lecture/Clinical Coordinator
General Manager
Clinical Supervisor
Senior Audiologist/Clinical Supervisor
Clinic Director
Senior Supervising Clinician
Supervising Clinician
Head - School of Dentistry
Director - Oral Health Centre of WA
General Manager
Professor, The University of Western
Australia School of Dentistry Clinic
Placement Coordinator and Lecturer
Clinical Placement Coordinator
Nutrition and Dietetics
Aboriginal Health Council of Western
Australia (AHCWA) Training and
Development Centre
Wirraka Maya Health Service
Kimberley Aboriginal Medical Council
Karen Dunmore
Dee Hollett
Dr Helen Goulios
Brett Robertson
Rebecca Bennett
Carl Chase
Vincenzo Casciolo
Lyndon Woods
Barrett Losco
Professor Andrew
Smith
John Cochrane
Professor Kimble
Halliday
Janica Bell
Associate Professor
Philippa LyonsWall
Belinda Martin
Sarah Yoo
Hayley Parker
Emily Jeffery
Deborah Schofield
Karin Cook
Nicole Sander
Rob Malekin
Tammy Farrell
Lynda Massey
Exercise Physiology
Kylie Cormack
Dr Tim Fairchild
Raelene Walton
Tanya Blee
Kerry Smith
Lecturer, Nutrition and Dietetics
Program
Acting Coordinator - Nutrition and
Dietetics
Dietetics Coordinator / Acting Dietetics
Manager
Clinical Dietitian
Diabetes Education Services Manager
Senior Clinical Dietitian
Clinical Dietitian
Coordinator of Dietetics
Associate Senior Dietitian, Nutrition and
Dietetics Department and
Student Coordinator
Training Officer, Strategic Learning and
Growth
Senior Lecturer
Deputy Dean (Head of Discipline) Exercise Science
Practicum Coordinator
Lecturer
Course Controller / Director of
Derbarl Yerrigan
Narrogin Community Health Unit
Ear Science Institute of Australia
Ear Science Institute of Australia
Telethon Speech and Hearing
Murdoch University
Murdoch University
Murdoch University
Oral Health Centre of WA Nedlands
Oral Health Centre of Bunbury
Curtin University
Swan Kalamunda Health Service
Diabetes WA
St John of God Hospital - Murdoch
St John of God Hospital - Murdoch
Osborne Park Hospital
Princess Margaret
Brightwater Madeley
Murdoch University
Murdoch University
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Discipline
Medical Laboratory
Science
Medicine
Name
Dr Andrew
Maiorana
Andrew Maiorana
Dr Brendan Joss
Ben Barnard
Rebecca Moroney
Damian Amsuss
Damian
Pavlinovich
Martin Finn
Samantha Cramer
Paul Martin
Professor Fiona
Lake
Professor Neil
Boudville
Winthrop Professor
Tony Celenza
Dr Ted (Edward)
Stewart-Wynne
Dr Nick Bentley
Maria Saldahna
Anne Goldstein
Professor Geoff
Riley
Natalie
Katrina Calvert
Daniel Heredia
Dr Ross Duncan
Dr Samir Heble, Dr
John Ward and Dr
Beacom
Dr David Atkinson
Sue Phillips
Midwifery
Title
Programs
Associate Professor
Curtin University
Senior Exercise Physiologist
Clinic Director
Gym Coordinator
Exercise physiologist
State Manager
Exercise physiologist
Royal Perth cardiac transplant unit
Hollywood Functional Rehabilitation Clinic
Regenerate
Curtin Stadium Exercise
Guardian Exercise Physiology
Como Fitness
Deputy Head of School, Health Sciences
PathWest Training Co-ordinator
Senior Medical Scientist
Duty Manager
Professor of Medicine, School of
Medicine and Pharmacology and
Respiratory Physician
School of Medicine and Pharmacology
(Renal Medicine)
Director of the Education Centre,
Faculty Medicine, Dentistry and Health
Sciences (Emergency Medicine)
Consultant neurologist
Consultant neurologist
General practitioner
General Practice Placement
Coordinator, School of Medicine
Clinical Nurse Educator/ Senior
Lecturer, School of Medicine
Head of the Rural Clinical School
Curtin University
PathWest Laboratory Medicine WA
Placement Administration Coordinator
Medical Education Registrar
St John of God Subiaco
King Edward Memorial Hospital Obstetrics
and Gynaecology Department
Bunbury Hospital, with Royal Perth Hospital
the primary employing health service
Bunbury Hospital, with Royal Perth Hospital
the primary employing health service
Director of Medical Services
Acting South West Regional Medical
Director
Medical Directors and Coordinators
Medical Education Officer at Broome
Rural Clinical School located at
Senior Medical Officer, WACHS
Bec Courtis
Associate Professor
Katy Templeman
Dr Andrew
Jamieson
Rob Whitehead
Practice Manager
Medical Coordinator
Dr Jennifer Connell
Dr Daniel Heredia
Karen Dunmore
Corinne Kusel
Professor Selma
Alliex
Janet Cooke
Sheena McChlery
Liz Frehner
Janice Butt
Debbie Ewing,
General Practitioner
Lecturer/Clinical Placement Officer
Dean, School of Nursing
Medical Coordinator (Port Headland
Rural Clinical School)
A/Clinical Coordinator
Midwifery Course Coordinator
Associate Director Clinical Education
Coordinator Midwifery
Assistant to Executive Director Hospital
& Health Services
Organisation
CliniPath Pathology
Rowenthorpe Medical Centre
Rural Clinical School of Western Australia
Broome Hospital with Fremantle Hospital the
primary employing health service
Broome Hospital with Fremantle Hospital the
primary employing health service
Broome Medical Practice
The Geraldton Rural Clinical School of WA
Geraldton Hospital with Sir Charles Gardiner
the primary employing health
Port Hedland Hospital with Sir Charles
Gardiner or Royal Perth Hospital as primary
employing health service
Wheatbelt General Practice Aboriginal Health
Derbarl Yerrigan
Curtin University
Mercy Hospital
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Discipline
Nursing
Name
Susan Cantwell
Linda Bowie
Henrietta Reynolds
Audrey McKay
Professor Di Twigg
Gina Mata
Fiona Foxall
Kate Andre
Margaret Lee
Diana Player
Nancy de Costa
Title
Director of Nursing, Administration
Education Manager
Midwifery Program Coordinator
Graduate Program Coordinator Midwifery
Head of School
Undergraduate Clinical Coordinator
Undergraduate Coordinator
Program Director Nursing Education
Clinical Practice Team
Clinical Midwifery Consultant
Julie Manning
Program Manager - Health
Natalie Goldman
Program Manager
Professor Selma
Alliex
Janet Cooke
Professor Di Twig
Gina Mata
Fiona Foxall
Kate Andre
Margaret Lee
Jill Schofield
Corinne Du Plooy
Dean, School of Nursing
Fiona Davies
Leonie Cross
Asadah Sidon
Sue Thistlethwaite
Jodee Eaves
Jo Camilleri
Janine Kane
Louise Maton
Sarah McCarthy
Christine Stean
Martinque Sandy
Liz Frehner
Associate Professor
Helene Metcalfe
Robert
Nigel Gribble
Abraham Kurien
Gail Nesci
Helen Margria
Alicia Davey
Louise Jones
Shane Thomas
Karen Dickson
Brad Bond
Rachael Clark
Helen McDonald
Karen Long
Associate Clinical Coordinator
Head of School
Undergraduate Clinical Coordinator
Undergraduate Coordinator
Program Director Nursing Education
Clinical Practice Team
Educational Placement Coordinator
Clinical Nurse Unit Manager of the
Wards
Manager Learning and Development
SDE - Coordinator for Undergraduate
Student Placement, Partnership
Undergraduate Programme and Annual
Competency Education
Coordinator Staff Development &
Research
Adjunct Senior Lecturer (Murdoch)
Coordinator Paediatric Nursing
Education
A/SDE Undergraduate Coordinator
Industry Area Program Manager
Industry Area Program Manager
Lecturer
Associate Director Clinical Education
Course Coordinator (Master of Nursing
Science)
Manager of Workforce Development
Director of Fieldwork and Lecturer
Student Coordinator
Occupational Therapy Manger
Occupational Therapy Manager
Senior Occupational Therapist
Dementia Care Specialist - Occupational
Therapy
A/Manager
Student Coordinator
Student Coordinator
Student Coordinator – Senior Allied
Health Manager
Course Coordinator
Organisation
Mercy Hospital
Mercy Hospital
Edith Cowan University – Joondalup Campus
Kaleeya Hospital
Child and Adolescent Community Health
Service
Challenger Institute of Technology – Murdoch
Campus
Institute of Nursing and Health Australia, Perth
Office
University of Notre Dame
University of Notre Dame
Bethanie Aged Care
Waikiki Private Hospital
St John of God Hospital – Murdoch
St John of God Hospital – Subiaco
Rockingham Hospital
Princess Margaret Children’s Hospital
Fremantle Hospital and Health Service
Curtin University
Curtin University
Armadale Kelmscott Health Service
Armadale Kelmscott Health Service
Autism Association WA
Amana Living
Graylands Hospital
Inner City Mental Health
APM (Vocational Rehab)
Silver Circle aged care
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Discipline
Optometry
Name
Kerry Haarsma
Kathleen Watt
Ben Ashby
Peter Hendicott
Oral Health
Orthoptics
Orthotics and
Prosthetics
Osteopathy
Paramedicine
Pharmacy
Anthea Cochrane
Ian Sims
Russ Kendall
Bob Fisher
Connie Koklanis
Michelle CourtneyHarris
Stephanie Barnard
Jane Hardy
Helke Melville (nee
Thorpe)
Maryanne Bristow
Dr Ray Myers
Gary Fyer
Carole Donaldson
Nathan Ross
Mrs Dianne
Schwagermann
Professor Gavin
Leslie
Judy Frere
Rachael Byrne
Patrick Yapp
David McKnight
Judith Kristensen
Professor Rhonda
Clifford
Liza Seubert
Amanda Bryce
Sue White
Marc Segler
Physiotherapy
Podiatry
Ron Stuurstraat
Kim Laird
Ian Cooper
Tracy-HebdenTodd
Sue Chegwidden
Andrew Walton
Leah Epton
Lynley Ward
Kate Gray
Kathryn Devereux
Li Yen Chong
Susan Ayres
Noleen Philippe
Ben Horgan
Andrew Know
Laurence Foley
Title
Optometry Team Placement Coordinator
Clinic Director, School of Optometry
and Vision Science
Associate Lecturer, School of
Optometry and Vision Science
Head of School/Course Co-ordinator for
Optomtery
Senior Lecturer
Optometrist Consultant
Head of Department
Head of Unit
Clinical Orthoptics
Associate Lecturer
Organisation
Flinders University of South Australia
Clinical Education Co-ordinator
Head of Department
Prosthetist/Orthotist
La Trobe University
Child and Adolescent Health Service Princess
Margaret Hospital
TLC Unlimited
Team Leader Clinical Placement Unit
Discipline Head
Discipline Head
Manager Clinical Education
Undergraduate Course Coordinator
Coordinator of Clinical Placement
Southern Cross University
RMIT University
Victoria University
St John Ambulance WA
Director, Research and Development
Curtin University
Volunteer Coordinator
Coordinator of Clinical Education
Chief Pharmacist
Deputy Chief Pharmacist
Pharmacist
Professor;
Director of Pharmacy, Division of
Pharmacy; and
Deputy Director, Pharmacology,
Pharmacy and Anaesthesiology Unit
Assistant Professor
School of Medicine and Pharmacology Community Pharmacist
Fourth Year Co-ordinator/Director of
Clinical Placements
Proprietor
Fresh Start
Fremantle Hospital
St John of God Subiaco Hospital
Propprietor
Physiotherapy Manager
Deputy Head of Department
Student Placement Coordinator
Senior Allied Health Physiotherapist
Senior Student Co-Ordinator
Arthritis & Community Engagement
Project Officer
Assistant Professor
Associate Professor
University of New South Wales
University of New South Wales
Queensland University of Technology
University of Melbourne
Eye Clinic Royal Perth Hospital
Curtin University
Mount Henry Dental Clinic
La Trobe University
University of Sydney
Gerald Burns Pharmacy
Curtin University
Angelo Street Pharmacy
Noranda Feelgood Pharmacy
Craven’s Pharmacy
Princess Margaret Hospital for Children
Fremantle Hospital
Hollywood Hospital
Public Health and Ambulatory Care
The Centre for Cerebral Palsy
Silver Chain
Perth North Metro Medicare Local
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Discipline
Psychology
Name
Reza Naraghi
Cara Westphal
Associate Professor
Laurence Foley
Rachele Humbert
Meredith Wilkinson
Mark Higham
Dr Deborah
Gardner
Dr Maxine
Braithwaite
Dr Jenny Thornton
James Penhale
John Gardiner
Margot Willox
Ian Sweetman
Chris Gostelow
Neil McLean
Radiation Science
Social Work
Chris Whennan
A/Professor Jan
Mackay
Louise Deshon
Dr Anson Chau
Dr Diane Fisher
David Cutt
Dr Chris Harper
Adam Hallsworth
Mr Paul Luke
Shing
Kylie Sheldrick
Anseley Forgus
Kristina Boyton
Kathryn Linn
Robyn Martin
Tammy Ryan
Lynelle Watts,
Associate Professor
Wendy Giles
David Hodgson
Susan Bailey
Carolyn Johnson
Donna Chung
Karen Upton-Davis
Chris Perriam
Karen Wickham
Kate Duncanson
Anne McGerr
Stephan Lund
Lee Bax
Title
Associate Professor
Manager, Podiatry
Manager, Podiatry
Organisation
Fremantle Hospital
Manager, Podiatry
Manager, Podiatry
Manager, Podiatry
Psychology Clinic Director
Sir Charles Gardiner
Disability Services Commission- Myaree
Psychology Clinic Director/Senior
Lecturer and
Placement Co-ordinator
Programme Director, Counselling
Psychology
Clinical Psychologist & Team Leader
Senior Lecturer, Clinic Director &
Placement Coordinator Psychology
Specialist Clinical Psychologist
Specialist Clinical Psychologist and
Coordinator
Manager
Lecturer, External placement
coordinator
Chief Medical Imaging Technologist
Head of Program
Curtin University
WA Psycho-Oncology Service
Murdoch University
Osborne Park Older Adult Mental Health
Service
Hospital Clinic Alma Street Clinic
School Psychology Service
Curtin University
Lecturer
Senior Lecturer
Lecturer
Clinical Educator and Senior Radiation
Therapist
Director and Radiation Oncologist
Chief Sonographer
Clinical Educator
Senior Medical Imaging Technologist
Chief Nuclear Medicine Technologist
Coordinator Fieldwork Social Work /
Lecturer
Senior lecturer
Curtin University
Curtin University
Curtin University
Perth Radiation Oncology, Wembly
Senior Lecturer
Assistant professor for Social Work and
Social Policy
Social Policy
Winthrop Professor, Chair of School of
Social Work and Social Policy
Social Policy
Senior Social Worker and Team Leader
for the Ambulatory Team
Coordinator Fieldwork Social Work /
Lecturer
Coordinator Social Work
Executive Manager Out-of-Home Care
and Specialist Services
Social Work Coordinator
Perth Radiation Oncology, Wembly
Swan District Hospital
Perth Radiology Clinics, Nollamara Clinic
Princes Margaret Hospital
SKG Radiology, Hollywood Hospital
Curtin University
Curtin University
Fremantle Hospital
Senses
Curtin University
Rockingham General Hospital
Wanslea Family Services
RUAH Community Services
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Discipline
Speech Pathology
Name
Samantha Luong
Sherry Conduit
Brooke Sanderson
Michelle Quail
Abigail Lewis
Kim Brookes
Geraldine Harris
Jonathan Rafols
Amy Altheer
Meg Ledger
Renee Davis
Alexandra Jones
Claire Overheu
Interprofessional
Education
Michelle Quail
Casey Magee
Lynda Massey
Denise Griffiths
Nigel Holmes
Fiona MacDonald
Noleen Philippe
Caron Shuttleworth
Julian Henderson
Strategic conversations
Sarah Rheinberger
Title
Department Manager
Coordinator Social Work Student
Placements
Clinical Coordinator/Lecturer
Clinical Coordinator/Lecturer
Allied Health Coordinator / Speech
Pathology Head of Department
Senior Speech Pathologist
Coordinator Speech Pathology
Specialist Co-ordinator
Speech Pathology Manager (CPSP)
Clinical Co-ordinator
Curtin University / Gosnells Community
Speech Pathology Clinic
Clinical Placement Supervisor
Associate Manager
Clinical coordinator
Speech pathologist
Training Officer, Strategic Learning &
Growth and IPE Coordinator
IPE Facilitator and TRACS
Grant Rowethorpe Coordinator
Senior Rehabilitation Health Worker
and IPE Coordinator
Staff Development Educator and IPE
Coordinator
Senior Student Coordinator
Manager, Strategic Health Projects
Director Community Based Health
Initiatives
Senior Project Officer
Organisation
Department for Child Protection
Curtin University
Curtin University
Hollywood Hospital
Gosnells Community Speech Pathology Clinic
Curtin Interprofessional Education placement
Child Development Service / Child and
Adolescent Community Health
Next Challenge
Next Challenge
Brightwater Madeley
Rowethorpe Aged Care: Uniting Church
WACHS Geraldton Subacute Aged Care
Service
Student Training Ward Royal Perth Hospital
WA Country Health
Table 8.2: Stakeholders consulted in regional areas
Region
Bunbury
Consultations
Name
Title
Professor Kimble
Halliday
Grace Ley
Christine Bevis
Professor
Diane Pope
Naomi Lillywhite
Anna Flannery
Alison Smith
Acting Workforce Learning Coordinator
Chief Pharmacist
Associate Community Health Manager
Wellington Community Health
Manager, Collie Community
Health/Acting Acute Allie Health
Manager,
Acting Regional Medical Director
Senior Lecturer and Program
Coordinator
Senior lecturer
Associate Professor
Clinical Director of Mental Health
WACHS South West Region.
Director of Clinical Training
Head of General Medicine and ICU
Nursing Manager of Workforce
Development
Bunbury Nursing Program Coordinator
Senior Lecturer
Workplace Learning Coordinator
Acting Portfolio Manager: Health and
Dr Ross Duncan
Lynelle Watts
David Hodgson
Wendy Giles
Dr Samir Heble
Dr John Ward
Dr Graeme Beacom
Sue Hennessy
Sue Tencer
Jenny McLeery
Ruth Phillip
Regional Director
Administration Assistant
Organisation
The University of Western Australia School of
Dentistry Clinic
WACHS – South West Region
WACHS – South West Learning and
Development Unit
Bunbury Regional Hospital
Bunbury / Harvey Community Health Service
Bunbury Health Campus; WACHS
WACHS – South West Region
WACHS
South West Institute of Technology
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Region
Name
Broome
Consultations
Geraldton
Consultations
Christine Kowalski
Amanda Pierce
Belinda Swanson
Sue Phillips
Madelaine Connolly
Gloria Naverette
Kate Baxter
Dr David Atkinson
Professor Jennifer
McConnell
Sally Clarke
Associate Dean (Rural, Remote &
Indigenous)
Associate Dean of Nursing
Henry Counsellor
Janey Glauser
Associate Professor
Siva Bala
Sue Castellarin
Andrew McGaw
Chief Executive Officer
Senior Social Worker
Consultant Psychiatrist
Margie Ware
Dr Andrew Jamieson
Acting CEO
Regional Medical Director
Medical coordinator
Associate Professor
Katy Templeman
Jenni Hall
Ken Thomson
Kerry May
Corcyra Kentish
Acting Nurse Manager
Facility Manager
Practice Manager
Organisation
South West Institute of Technology
Statewide School Psychology Service
Broome Hospital
Broome Hospital
Broome Hospital
WACHS
Broome Rural Clinical School located at
Broome Rural Clinical School, The University
of Notre Dame AustraliaThe University of Notre Dame AustraliaBroome Campus
Broome Aboriginal Medical Service
Kimberley Mental Health and Drug Service
Kimberley Mental Health and Drug Service
Broome Community Health Services
Southern Cross Care, Germanus Kent House ,
Bran Nue Day
Boab Health Services
Geraldton Regional Hospital
WACHS Midwest
Geraldton Regional Aboriginal Medical
Service
Central West Mental Health Service
WACHS Midwest
WACHS Midwest
Judy Riggs
Maeva Hall
Jodi Ullrich
Regional Manager
Regional Physiotherapy Coordinator
Senior Speech Pathologist / Clinical
Educator
Director Population Health
Chair in Rural Health (UWA) / Director
of the Combined Universities Centre for
Rural Health (CUCRH)
Rural Student Support
A/Professor, Rural Health
Lecturer
Michele Holloway
Dr Barbara Nattabi
Senior Research Officer
A/Professor, Rural Health
Combined Universities Centre for Rural Health
Kathryn Fitzgerald
Assistant Professor
Michelle Soares
Mendes
Yvette Tormey
Audiologist / Director
Hearing West
School Psychology Regional
Professional Leader- Mid West
A/Regional Clinical Coordinator for
Nursing Students and Graduate Nurses
Senior Rehabilitation Health Worker
and IPE Coordinator
Lecturer in Nursing
School Psychology Service
WACHS Midwest
Kylie Eastwood
Occupational Therapist / Clinical
Educator
Senior mental health professional
Marcelle Cannon
David Richardson
Sandy Thompson and
six colleagues
Alana Horsham and
colleagues
Nigel Holmes
Minnetta Desmond
and colleagues
Celeste Russo
Narrogin
Consultations
Title
Community Service
Managing Director
Educational and Developmental
Psychologist, MAPS Lead School
Psychologist
Senior Dietitian
Senior Speech Pathologist
Clinical Educator/Senior Physiotherapist
Senior Medical Officer, WACHS
Regional Nurse Director
Nurse Educator
Allied Health Manager Kimberley
Medical Education Officer
Duncan Anderson
Margaret Rutter
WACHS Midwest
WACHS Midwest
WACHS Geraldton Subacute Aged Care
Service
Durack Institute of Technology
Great Southern Mental Health Service
Narrogin
Great Southern Mental Health Services
Final Report
123
Region
Name
Melinda Missen
Dee Hollet
Kerry Fisher
Megan Thurkle
Bernie Garnier
Alan Power
Dr Peter McGuire
Robin Hoysted
Claire Shepherd
Port Headland
Consultations
Kylie Bosich, Rebecca
Butler and Julia
Peacock
Rob Whitehead
Di Nicholl Bull
Margaret Abernethy,
Scott, Claire and
Sharon
Francis
Gan Sakarapari
Sarah McEwen
Manoj
Karen Glen
Denise Allen
Julie Broad
Title
Organisation
Clinical Education
A/Primary Health Manager
Hospital Manager
Nursing Coordinator and Lecturer in
Health and Nursing
Lecturer in Health and Nursing
Professional Leader
Principal Narrogin Rural Clinical
School and Narrogin GP
Senior Coordinator
EACH Coordinator and Registered
Nurse
Learning and Development
Coordinators
Great Southern Mental Health Services Albany
Medical Coordinator
Senior Flight Nurse
Allied Health Professionals
RFDS
Community Health, PH Health Campus
Physiotherapist
Senior Medical Officer
Medical Officer
Senior Dentist
Senior Nurse
Area Manager
Tom Price
PH Health Campus
PH Health Campus
PH Health Campus
Wirraka Maya
Pilbara Mental Health and Drug Service
Southern Cross Care
Narrogin Community Health Unit
Narrogin Hospital
C.Y. O'Connor Institute
C.Y. O'Connor Institute
Narrogin Education Office
Earl Street Surgery and Rural Clinical School
of Western Australia
Silver Chain, Narrogin
Silver Chain, Narrogin
Port Hedland Health Campus
Final Report
124
APPENDIX B REFERENCES
1
Kristine Battye Consulting (2102) Review of Community Controlled Registered Training Organisations
Funded through The Health Workforce Division, Department of Health and Ageing
2
Council Chiropractic Education Australasia Inc Educational Standards for First Professional Award Programs
in
Chiropractic is available at:
http://www.ccea.com.au/Documents/Accreditation/Standards%20-%20First%20Professional%20%20December%202009.pdf
3
Occupational Therapy Council (Australia and New Zealand) LTD. Accreditation Standards for Entry Level
Occupational Therapy Education Programs. Pert WA December 2012
4
Ray Bange and Wayne van Biljon (2012). Paramedic Registration- A progress Report. Paramedics Australasia
(WA Chapter). Accessed on the 28/05/2013 from: http://www.paramedics.org.au/content/2012/09/ParamedicRegistration-Report-0609.09.pdf
5
Australian Physiotherapy Council. Accreditation Standards for Entry Level Physiotherapy Education Programs.
Accessed on 26th of April 2012
6
University of Queensland. Occupational Therapy- Student Practice Evaluation Form. Accessed on 23 April
2013 http://www.uq.edu.au/spef/index.html
Final Report
125

Final Report - Department of Health

Transcription

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