Challenging Remote Community Deficit Perspectives: An Australian Insight into the Role of These Communities in the Design of Their Health Services and the Development of Their Health Workforce

  • Debra Jones The University of Sydney
  • Lindy McAllister The University of Sydney
  • David Lyle The University of Sydney
Keywords: allied health, community-campus partnerships, practice-based service-learning, qualitative, remote Australia

Abstract

This article reports on findings from a qualitative study that explored the formation of a community-campus partnership, development and delivery of an allied health practice-based service-learning program, and impacts of partnership and program participation for community and campus participants. The partnership sought to address a protracted lack of access to allied health services for children residing in remote Australia. The program aligned occupational therapy and speech pathology student placements to the provision of allied health services to these children. Community participants – school principals and senior managers from local facilitating agencies, and campus participants – allied health students and academics were allocated to focus groups, school principals (n = 7) and allied health students (n = 10), and individual semi-structured interviews, senior managers (n = 2) and academics (n = 2). A constant comparative analysis method was used to analyse data. This article describes community perspectives of partnership initiation, catalysts for participation, and participation impacts. The role of community partners in initiating the partnership was described and conditions associated with remote contexts and health sector failures were identified catalysts. Service and learning adaptation, partnership commitment and service consistency, service acceptability and accessibility, and community investment in remote health workforce development were identified impacts. This article addresses significant gaps in the national and international practice-based service-learning literature, specifically from community and remote perspectives. Study limitations are discussed and implications for how community-campus partnerships are formed and service-learning programs are sustained in remote contexts are explored.

Author Biographies

Lindy McAllister, The University of Sydney

Faculty of Health Sciences

Professor and deputy Dean Work Integrated Learning

David Lyle, The University of Sydney

Broken Hill University Department of Rural Health

Professor and Head of Department

References

Australian Commission on Safety and Quality in Health Care (2008) Australian Charter of Healthcare Rights [online] available from http://www.safetyandquality.gov.au/wp-content/uploads/2012/01/Charter-PDf.pdf [20 August 2016]: ACQSHC

Australian Commission on Safety and Quality in Health Care (2014) National Statement on Health Literacy: Taking Action to Improve Safety and Quality [online] available from http://www.safetyandquality.gov.au/wp-content/uploads/2014/08/Health-Literacy-National-Statement.pdf [20 August 2016]

Australian Institute of Health and Welfare (2009) A Picture of Australia’s Children. Cat. no. PHE 112. Canberra: AIHW

Boeije, H. (2002) ‘A purposeful approach to the constant comparative method in the analysis of qualitative interviews’. Quality and Quantity, 36, 391–409 https://doi.org/10.1023/A:1020909529486

Bourke, L., Humphreys, J., Wakerman, J., and Taylor, J. (2010) ‘From “problem-describing” to “problem-solving”: Challenging the “deficit” view of remote and rural health’. Australian Journal of Rural Health, 18, 205-209 https://doi.org/10.1111/j.1440-1584.2010.01155.x

Boyle, J., McCartney, E., Forbes, J., and O’Hare, A. (2007) ‘A randomised controlled trial and economic evaluation of direct versus indirect and individual versus group modes of speech and language therapy for children with primary language impairment’. Health Technology Assessment, 11 (25) https://dx.doi.org/10.3310/hta11250

Bringle, R., Games, R., and Malloy, E. (eds.) (1999) Colleges and Universities as Citizens. Needham Heights: Allyn & Bacon

Bringle, R. and Hatcher, J. (2009) ‘Innovative practices in service-learning and curricular engagement’. New Directions for Higher Education, 147, 37–46 https://doi.org/10.1002/he.356

Bryson, J., Crosby, B., and Stone, M. (2006) ‘The design and implementation of cross-sector collaborations: Propositions from the literature’. Public Administration Review, 66 (s1), 44–55 https://doi.org/10.1111/j.1540-6210.2006.00665.x

Butin, D. (2010) Service-Learning in Theory and Practice: The Future of Engagement in Higher Education. New York: Palgrave https://doi.org/10.1057/9780230106154

Carlson, J. (2010) ‘Avoiding traps in member checking’. The Qualitative Report [online] 15 (5), 1102–1113 available from http://www.nova.edu/ssss/QR/QR15-5/carlson.pdf [20 August 2016]

Cashman, S. and Seifer, S. (2008) ‘Service-learning: An integral part of undergraduate public health’. American Journal Preventative Medicine, 35 (3), 273–278 https://doi.org/10.1016/j.amepre.2008.06.012

Clark, M., McKague, M., McKay, S., and Ramsden, V. (2015) ‘Deeper learning through service: Evaluation of an interprofessional community service-learning program for pharmacy and medicine students’. Journal of Research in Interprofessional Practice and Education [online] 5 (1) available from http://www.jripe.org/index.php/journal/article/view/175/113 [6 December 2016]

Council of Australian Governments (2009) Investing in the Early Years – A National Early Childhood Development Strategy: An Initiative of the Council of Australian Governments [online] available from https://www.coag.gov.au/sites/default/files/national_ECD_strategy.pdf [10 May 2016]: COAG

Creswell, J. (2007) Qualitative Inquiry and Research Design: Choosing Among Five Approaches. 2nd edn. London: Sage

Cruz, N., and Giles, D. (2000) ‘Where’s the community in service-learning research?’ Michigan Journal of Community Service-Learning [online] Fall, 28–34. available from http://hdl.handle.net/2027/spo.3239521.spec.104 [10 May 2016]

Dunston, R., Lee, A., Boud, D., Brodie, P., and Chiarella, M. (2009) ‘Co-production and health system reform – From re-imagining to re-making’. The Australian Journal of Public Administration, 68 (1), 39–52 https://doi.org/10.1111/j.1467-8500.2008.00608.x

Enos, S. and Morton, K. (2003) ‘Developing a theory and practice of campus-community partnerships’. in Building Partnerships for Service-Learning. ed. by Jacoby, B. San Francisco: Jossey-Bass, 20–41

Fitzakerley, J. and Westra, R. (2008) ‘Service learning in rural communities. Medical students teach children about the brain’. Minnesota Medicine, 91 (12), 38–40

Fram, S. (2013) ‘The constant comparative analysis method outside of grounded theory’. The Qualitative Report [online] 18 (1), 1–25 available from http://nsuworks.nova.edu/tqr/vol18/iss1/1 [6 May 2016]

Gilson, L., Doherty, J., Loewenson, R., and Francis, V. (2007) Challenging Inequity Through Health Systems: Final Report of the Knowledge Network on Health Systems. [online] available from http://www.who.int/social_determinants/resources/csdh_media/hskn_final_2007_en.pdf [10 April 2016]

Glover, R. and Silka, L. (2013) ‘Choice, power and perspective: The neglected question of who initiates engaged campus-community partnerships’. Gateways: International Journal of Community Research and Engagement, 6, 38–56 http://dx.doi.org/10.5130/ijcre.v6i1.3192

Hammersley, L. (2013) ‘Community-based service-learning: Partnerships of reciprocal exchange?’ Asia-Pacific Journal of Cooperative Education [online] 14 (3), 171–184 available from http://www.apjce.org/files/APJCE_14_3_171_184.pdf [16 February 2016]

Health Workforce Australia. (2013) ‘National Rural and Remote Heath Workforce Innovation and Reform Strategy’. [online] available from http://pandora.nla.gov.au/pan/133228/20150419-0017/www.hwa.gov.au/sites/uploads/HWA13WIR013_Rural-and-Remote-Workforce-Innovation-and-Reform-Strategy_v4-1.pdf [12 December 2014]

Jacoby, B. (ed.) (2003) Building Partnerships for Service-Learning. San Francisco: Jossey-Bass

Janke, E. (2008) Shared Partnership Identity Between Faculty and Community Partners. Dissertation. [online] available from http://etda.libraries.psu.edu/theses/approved/WorldWideIndex/ETD-2962/index.html

Jones, D., Lyle, D., Brunero, C., McAllister, L., Webb, T., and Riley, S. (2015) ‘Improving health and education outcomes for children in remote communities: A cross-sector and developmental evaluation approach’. International Journal of Community Research and Engagement, 8 (1), 1–22. https://doi.org/10.5130/ijcre.v8i1.4163

Jones, D., McAllister, L., and Lyle, D. (2015a) ‘Stepping out of the shadows: Allied health student and academic perceptions of the impact of a service-learning experience on student’s work-readiness and employability’. Journal of Teaching and Learning for Graduate Employability, 6 (1), 66–87 https://doi.org/10.21153/jtlge2015vol6no1art574

Jones, D., McAllister, L., and Lyle, D. (2015b) ‘Interprofessional Academic Service-Learning in Rural Australia: Exploring the impact on allied health student knowledge, skills, and practice. A qualitative study’. International Journal of Practice-Based Learning in Health and Social Care, 3 (2), 1–16. https://doi.org/10.18552/ijpblhsc.v3i2.217

Jones, D., McAllister, L., and Lyle, D. (In Press), ‘Community-based service-learning: A rural Australian perspective on student and academic outcomes of participation’, International Journal of Research on Service-Learning and Community Engagement Research

Kernick, D. (ed.) (2004) Complexity and Healthcare Organization: A View from the Street. Oxford: Radcliffe Medical Press

Lambert, S. and Loiselle, C. (2008) ‘Combining individual interviews and focus groups to enhance data richness’. Journal of Advanced Nursing, 62(2), 228–237 https://doi.org/10.1111/j.1365-2648.2007.04559.x

Leiderman, S., Furco, A., Zapf, J., and Goss, M. (2003) Building Partnerships with College Campuses: Community Perspectives. Washington, DC: The Council of Independent Colleges/Consortium for the Advancement of Private Higher Education’s Engaging Communities and Campuses Grant Program

Lincoln, Y., and Guba, E. (1985) Naturalistic Inquiry. Beverly Hills: Sage

Loiselle, C., Profetto-McGrath, J., Polit, D., and Beck, C. (2007) Canadian Essentials of Nursing Research. 2nd edn. Philadelphia, PA: Lippincott Williams & Wilkins

Mason, J. (2013) Review of Australian Government Health Workforce Programs. Canberra. [online] available from https://www.health.gov.au/internet/main/publishing.nsf/Content/D26858F4B68834EACA257BF0001A8DDC/$File/Review%20of%20Health%20Workforce%20programs.pdf [7 October 2014]

Morgan, D. (2014) ‘Pragmatism as a paradigm for social research’. Qualitative Inquiry, 20, 1045-1053 https://doi.org/10.1177/1077800413513733

National Health and Hospitals Reform Commission (2009) A Healthier Future for all Australians: Final Report June 2009. [online] available from http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/1AFDEAF1FB76A1D8CA257600000B5BE2/$File/Final_Report_of_the%20nhhrc_June_2009.pdf [20 May 2015]

NSW Department of Education and Communities (2013) Rural and Remote Education: A Blueprint for Action. [online] available from https://www.det.nsw.edu.au/media/downloads/about-us/our-reforms/rural-and-remote-education/randr-blueprint.pdf [11 February 2015]

Petri, A. (2015) ‘Service-learning from the perspective of community organizations’. Journal of Public Scholarship in Higher Education [online] 5, 93-110 available from http://jpshe.missouristate.edu/assets/missouricompact/Article-PetriFINAL_1.pdf [2 April 2016]

Queensland Government (Department of Education and Training) (2009) Speech-Language Therapy Services in State Schools (rev. ed.) [online] available from http://education.qld.gov.au/studentservices/learning/disability/specialists/slt/docs/aa-slt_services_in_ss.pdf [16 September 2016]

Sandelowski, M. (2000) ‘Whatever happened to qualitative description?’ Research in Nursing and Health, 23, 334–340 https://doi.org/10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G

Sandy, M. and Holland, B. (2006) ‘Different worlds and common ground: Community partner perspectives on campus-community partnerships’. Michigan Journal of Community Service Learning [online] 13, 30–43 available from http://files.eric.ed.gov/fulltext/EJ843845.pdf [21 January 2016]

Sessa, V., Grabowski, S., and Shashidar, A. (2013) ‘Service-learning pedagogy, civic engagement, and academic engagement: Multiple bidirectional relationships in college freshmen’. International Journal of Research on Service-Learning and Community Engagement [online] 1 (1) available from http://journals.sfu.ca/iarslce/index.php/journal/article/view/6/7 [11 November 2015]

Smith, J., Bekker, H., and Cheater, F. (2011) ‘Theoretical versus pragmatic design in qualitative research’. Nurse Researcher, 18 (2), 39–51 https://doi.org/10.7748/nr2011.01.18.2.39.c8283

Spiers, M. and Harris, M. (2015) ‘Challenges to student transition in allied health undergraduate education in the Australian rural and remote context: A synthesis of barriers and enablers’. Rural and Remote Health [online] 15 (2) available from http://www.rrh.org.au/publishedarticles/article_print_3069.pdf [18 June 2015]

Standing Council on Health (2013) National Primary Health Care Strategic Framework’.Canberra. [online] Available from http://www.health.gov.au/internet/main/publishing.nsf/content/6084A04118674329CA257BF0001A349E/$File/NPHCframe.pdf [7 March 2015]

Strasser, R. (2003) ‘Rural health around the world: Challenges and solutions’. Family Practice [online] 20 (4), 457–463 available from http://fampra.oxfordjournals.org/content/20/4/457.full [1 August 2016]

Victoria State Government (Education and Training) (2013) Student Support Services. [online] available from http://www.education.vic.gov.au/school/principals/health/Pages/ssso.aspx?Redirect=1 [10 August 2016]

World Health Organization (2011) Transformative Scale Up of Health Professional Education: An Effort to Increase the Numbers of Health Professionals and to Strengthen Their Impact on Population Health. [online] available from http://apps.who.int/iris/bitstream/10665/70573/1/WHO_HSS_HRH_HEP2011.01_eng.pdf [15 July 2016]

Published
2016-12-15
How to Cite
Jones, D., McAllister, L., & Lyle, D. (2016). Challenging Remote Community Deficit Perspectives: An Australian Insight into the Role of These Communities in the Design of Their Health Services and the Development of Their Health Workforce. International Journal of Practice-Based Learning in Health and Social Care, 4(2), 19-34. https://doi.org/10.18552/ijpblhsc.v4i2.364

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