Extending To Rural And Remote Australia A Multidisciplinary Continuing Professional Education Program On Child And Adolescent Health

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1 Extending To Rural And Remote Australia A Multidisciplinary Continuing Professional Education Program On Child And Adolescent Health Hilary Russell Director, Education and Quality Assurance Centre for Community Child Health & Ambulatory Paediatrics Royal Children s Hospital, Melbourne. 3rd National Rural Health Conference Mt Beauty, 3-5 February 1995 Proceedings

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3 Extending To Rural And Remote Australia A Multidisciplinary Continuing Professional Education Program On Child And Adolescent Health Opening Hilary Russell Director, Education and Quality Assurance Centre for Community Child Health & Ambulatory Paediatrics Royal Children's Hospital, Melbourne. I greatly appreciate this opportunity to address the 3rd National Rural Health Conference. I want to talk to you today about a national multi disciplinary program of education and information on children and young people's health and the potential to extend this program to rural and remote communities across Australia. Addressing this audience could not have been more timely for our program. The aims of this Conference with its focus on pooling information and strengthening bonds of communication between providers, consumers research and educational sectors mirrors where our program is at in terms of developing a strategy for rural and remote Australia. I will cover the following areas : The Centre for Community Child Health & Ambulatory Paediatrics Children and Young People's Health A National Program - where we are in 1995 Extending the Program to rural and remote Australia The Centre For Community Child Health & Ambulatory Paediatrics I work at the Centre for Community Child Health & Ambulatory Paediatrics which is part of the Department of Paediatrics, University of Melbourne. I am Director of Education and Quality Assurance. The Centre was established in A key strategy for our Centre is to share and co-ordinate the expertise located throughout Australia be it in hospitals, community health centres, maternal and child health centres. The provision of education and information for those who look after the health of children and young people is central to this. 111

4 Children And Young People's Health Who looks after the health of children and young people? Children Parents, family General practitioners Community Nurses Pharmacists Allied health professionals Schools Paediatricians Hospitals Employers Government Academic and research organisations Before I describe the details of our program it's worth taking a look at who cares for the health of children and young people and the key health or ill health issues they face. And it is really from this snapshot that we have drawn our target audience and in part our curriculum for the program. Just taking two of these - GPs provide an average of 10 consultations to children in the first year of life. (Health Insurance Commission) We know that behavioural problems emerge in the school age years and that teachers are critical to the identification of learning and behavioural problems. Of course this pattern of usage shifts depending on where you live and what services you have access to. There are clearly implications for continuing professional education programs for health professionals working in isolated environments and geographically distant from service networks. A Picture of Children and Young People's Health For children, respiratory illnesses and injury are the main causes of hospitalisation. After the first year of life, injury is the leading cause of death in children and youth and also a major cause of morbidity. Most injuries are preventable. Suicide is the second most common cause of death amongst teenagers (after motor vehicle accidents). Aboriginal infant mortality rates are 3 times that of non Aboriginal infants. Measles and pertussis are still significant causes of morbidity. The risk of rubella embryopathy has not been eliminated. Diseases identified in the Commonwealth Department of Human Services and Health s Better Health Outcomes for Australians have their origin in childhooddiseases associated with poor nutrition, and low levels of fitness, alcohol and tobacco use. 112

5 This pattern of ill health has informed key policy documents such as the National Health Goals and Targets for Australian Children & Young People. Its five goals are: 1. Reduce the frequency of preventable premature mortality 2. Reduce the impact of disability 3. Reduce the incidence of vaccine preventable illness 4. Reduce the impact of conditions occurring in adulthood but which have their origins or early manifestations in childhood or adolescence 5. Enhance family and social functioning 3. A National, Multi Disciplinary Program On Children And Young People's Health - Where We Are Now? "From little things big things grow " - Paul Kelly In 1994 The Centre was successful in attracting an educational grant from Allen & Hanburys, the respiratory division of Glaxo. It is true to say that without the support of Allen & Hanburys we would not be where we are now. In 1994 we set about laying the foundation stones of a national, co-ordinated and multi-disciplinary program in children and young people's health in Australia. Phase One What I will describe is the first phase of a program which we expect will develop and adapt as it grows. With the support and partnership of rural and remote communities we hope that part of this development will be the extension of the program to rural and remote Australia in a form that is responsive and appropriate to your needs. What we do The Centre manages a national training program for general practitioners and produces four publications targeting key health providers. Curriculum and publication content is co-ordinated across all programs and publications. The Australian Paediatric Review Training Program The Australian Paediatric Review Emergency Paediatric Review Pharmacy Paediatric Review Community Paediatrics Parent/Community Education. Our Mission is to improve children s and young people's health outcomes in Australia through the provision of high quality continuing professional education 113

6 The Australian Paediatric Review Training Program - GP meetings Quarterly GP education meetings are held in all capital cities in Australia. The meetings have been accorded 9 CME points by the RACGP. Participants complete a pre-meeting quiz which establishes knowledge prior to attendance at the meeting. The 2 hour meeting is case and practice-focussed and involves small and large group discussion. A post meeting quiz is completed by participants five weeks after the meeting and aims to establish the extent to which participants have acquired and retained knowledge. The Australian Paediatric Review This is a quarterly publication distributed to every GP in Australia. It is an insert in the Australian Family Physician. The publication carries feature articles and regular columns on preventive medicine with content guided by the RACGP - Preventive and Community Medicine Committee. From June 1995 it will incorporate a regular two page feature on adolescent health. The content of the publication and the curriculum of the training program is guided by: A National Advisory Panel A National Editorial Board Commonwealth Policy - Health Goals and Targets for Australian Children and Youth National Survey of all GPs in Australia Other surveys - Bridges Webb. The National Advisory Panel comprises representatives from : The Royal Australian College of General Practitioners Australian College of Paediatrics NH&MRC Faculty of Rural Medicine Australian Family Physician. The National Editorial Board draws on expertise of paediatricians and GPs in every State. It includes representatives from the Faculty of Rural Medicine. GPs are nominees of the RACGP s QA Committee and paediatricians are nominees of the ACP. All Australian paediatric hospitals are represented by the paediatricians in each State. The Australian Paediatric Review Training Program and The Australian Paediatric Review are endorsed by The Royal Australian College of General Practitioners and The Australian College of Paediatrics. 1994/1995 Curriculum GP meetings Vomiting and Diarrhoea 114

7 Behaviour Problems in School Age Children Immunisation The Child with Cough Problems of Infancy The link to National Health Goals and Targets is evident. Pharmacy Paediatric Review is endorsed by the Pharmaceutical Society of Australia and recognised as a continuing education activity of the Society. Pharmacy Paediatric Review is endorsed by the Pharmaceutical Society of Australia and is recognised as a continuing education activity of the Society. It is produced on a quarterly basis and is distributed as an insert in Australian Pharmacist. Emergency Paediatric Review Emergency Paediatric Review is distributed to every emergency room in Australia and addresses issues relating to the emergency management of children and adolescents. Community Paediatrics Community Paediatrics is distributed to every community nurse in Australia and New Zealand. It is produced on a quarterly basis. Just to reiterate, all publications and training program address a core curriculum. This means all targeted health professionals are receiving consistent information. Parent Leaflets These are distributed to GPs throughout Australia. In 1995 an additional 9 leaflets will be added to this stable. Products for non English speaking communities will be trialed. A Consumer/Community Editorial Board will be established to guide the development of parent and children and young people's products. Common membership of the Editorial Boards of all publications ensures a coordinated approach to the content of all publications. All publications have addressed vomiting and diarrhoea and aspects of behaviour problems. For example : Community Paediatrics - Aggression in children Australian Paediatric Review - Suicide Emergency Paediatric Review - Suicide Pharmacy Paediatric Review - Behaviour Problems - hyperactivity 115

8 Extending The Program To Rural And Remote Australia The program has considerable merit and is distinctive in its endeavour to take a coordinated approach to continuing professional education in children and young people s health and in linking curriculum to national policy and research. However a shortcoming of the program is its capital city focus. What We Might Achieve Just as we have established a publication and related training program for general practitioners - The Australian Paediatric Review and the Australian Paediatric Review Training Program - there is potential to establish training programs linked to each publication. For example, a national training program for pharmacists could be established which would be linked to Pharmacy Paediatric Review. In regard to rural and remote health professionals a discrete rural program could be developed targeting a multi-disciplinary audience. Alternatively a rural/remote dimension could be included in each of the training programs. We are very keen to enter discussions with representatives of rural and remote health professional groups inter-state in the field of continuing professional education. The educational modules which form the basis of the Australian Paediatric Review Training Program will be available for purchase with the Program Team providing infrastructure support to training facilities which elect to purchase the module. In the short term this is one strategy for the program extending to rural and remote Australia. Again the program is keen to enter discussions with rural and remote training facilities and health professionals who are keen to work on a multi-disciplinary basis. 116