Clinical Placements in Victoria
The Department of Human Services has developed a strategy for clinical placements in Victoria to support a more cohesive and sustainable approach to addressing the range of issues identified by health services, universities and other stakeholders.
Clinical Placements in Victoria: Establishing a Statewide Approach (the Strategy) aims to ensure that sufficient university clinical training capacity exists in Victoria over the long term, and that training models are effective and efficient and produce quality outcomes that meet evolving service and community needs and expectations. In each of the five areas of reform key objectives and priority areas for action are identified to improve the clinical placement environment. These actions include a mix of discrete project-type initiatives (such as clinical placement innovation initiatives) and ongoing activities (such as participation in national health/education activities and fora).
The Strategy may be downloaded Clinical Placements in Victoria: Establishing a Statewide Approach - October 2007 (PDF file 573 KB).
A New Model of Clinical Placement Governance in Victoria: invitation to provide feedback
Following the Department of Human Services (the department) consultation in 2008 about the concept of a clinical placement agency (www.health.vic.gov.au/workforce/agency-concept), the department has been utilising stakeholder feedback to develop a plan of action to build on clinical placement initiatives in Victoria. The intent of this strategic approach is to create a clinical placements system with improved quality, capacity, flexibility, and sustainability, as well as to align with national policy initiatives. The department's Strategy document (above) provides the relevant policy context.
A key arm of this work is improving clinical placement governance in Victoria. Feedback from the consultation in 2008 indicated that stakeholders did not want a centralised system, but advocated for increased support to strengthen local initiatives and networks.
Developing a model
The Council of Victorian Health Deans (the Council) and the department have jointly initiated a project to provide advice on statewide governance arrangements for improving clinical placements in Victoria. A Clinical Placements Governance Steering Committee has been established to provide input from a range of stakeholders including nominated representatives from public, private and small rural hospitals, the aged care sector, education providers, general practice, community health, regional health and community services and the department.
The Council engaged Darcy Associates to recommend a model (in consultation with stakeholders) for clinical placements governance in Victoria. Darcy Associates conducted a literature review, considered clinical placement data, and engaged in targeted consultation with stakeholders to develop a model. This process included two roundtable consultations in metropolitan and regional Victoria with broad stakeholder representation, and bilateral meetings with specific stakeholder groups.
Based on consultation to date, Darcy Associates' report to the Council and the department is available for public consideration.
Clinical Placement Governance - Final Report (PDF file 3.38Mb)
The report's recommended governance model for clinical placements is based on a statewide council of representatives from peak bodies and underpinned by regional networks of stakeholders. Resources will be available to support staged implementation of the new governance structure.
How can you be involved?
The process for stakeholder feedback on this phase of development of governance arrangements for clinical placements in Victoria is via written submissions and public forums.
Written submissions should be sent no later, and preferably sooner, than the close of business on Monday 13 July 2009 to:
Sally Dennis, Policy Advisor, Service and Workforce Planning, Department of Human Services, sally.dennis@dhs.vic.gov.au
The public forums are for broad stakeholder input and discussion. The sessions are:
- Bendigo, 11am-3pm, Tuesday 30 June 2009, Hunter House, 57 Queen St
- Traralgon, 1-4pm, Wednesday 8 July 2009, Century Inn, 5 Airfield Road (corner Princes Highway)
- Melbourne, 10am-1pm, Friday 10 July 2009, CQ Functions, 113 Queen St
RSVP is by Thursday 25 June. Please note that places will be limited and attendees will receive confirmation and an agenda on Friday 26 June. Refreshments will be provided (light lunch in Melbourne and Bendigo; afternoon tea in Traralgon).
To register your attendance at one of these forums, please contact Sally Dennis on sally.dennis@dhs.vic.gov.au or 03 9096 7280.
Clinical Placement Agency Concept
One initiative that forms part of the Strategy involves exploring the concept of a clinical placement agency. The first stage of a consultation on this concept has been completed. For further information regarding the outcomes of the consultation, please refer to Discussion of a Clinical Placement Agency Concept.
Best Practice Clinical Learning Environments
Supporting the creation and maintenance of an education culture within health services has been identified as a critical aspect of the Victorian Department of Human Services? strategy to deliver high quality clinical training experiences for health students.
This independent report identifies the key elements and objectives of a positive training environment for undergraduate and early graduate learners. Based upon a range of data sources, a Best Practice Clinical Learning Environment (BPCLE) framework has been developed to guide health services and training providers in the delivery of high quality clinical experiences for learners. In contrast to many existing discipline or health-service specific frameworks, the BPCLE framework is intended to work across any discipline or model of clinical education. As such, it aims to be flexible enough to support the effective use of any education model.
The framework seeks to inform consistency and excellence in clinical education, complementing existing clinical training strategies. The report outlines a range of recommendations which will need to be considered in consultation with the sector prior to any decisions on implementation.
The department will ensure that the BPCLE framework is distributed to key stakeholders throughout Victoria. This will include the development of tools and guidelines to ensure the framework is available and easily utilised. As part of the framework dissemination, consultation with sectors not involved in the original project phase (including additional health disciplines and placement settings) will also be undertaken to ensure the framework is accessible to all those involved in clinical training.
The final report can be downloaded below. Best Practice Clinical Learning Environments (PDF file 1.34Mb)Innovation Projects
The department has funded a range of projects to pilot innovative approaches to the organisation and delivery of clinical placements.These projects aim to identify more efficient and effective training models, promote interdisciplinary and multidisciplinary models of training, expand overall clinical placement capacity, and increase the number of suitable placements to incorporate growth across Victoria. In doing so, the goal is to promote an optimal alignment between training models and service and patient needs, and identify opportunities for broader implementation across Victoria.
A useful summary and overview of all projects (the Clinical Placement Innovation Projects Report) is available for download below.
Clinical Placement Innovation Projects Report (2007) (PDF file 573 KB)
Following circulation of a call for submissions to universities and health services, 19 DHS-funded clinical placement innovation projects were funded. A symposium was held in October 2007 to provide a forum to communicate the outcomes of these innovation projects.
Project documents for 9 nursing-specific projects will be available shortly at the Nursing in Victoria website.
For the remaining projects, individual reports can be viewed below.
Building capacity for placements in East Gippsland (PDF File - 643.4 kb) - Monash University, Bairnsdale Regional Health Service, East Gippsland Institute of TAFE, RMIT University - August 2007
Critical reflection program for third year physiotherapy students (PDF File - 1.1 mb) - University of Melbourne - March 2007
Implementation and evaluation of alternative clinical supervision models in dietetics undergraduate training: supplementing supervision with peer assisted learning and a clinical reasoning framework (PDF File - 821.4 kb) - Deakin University, Austin Health, St Vincent's Health - July 2007
Learning together to work together: facilitating effective and cost-effective interprofessional clinical education - the interprofessional clinical education (IPCE) project (PDF File - 291.2 kb) - La Trobe University, Northern Health - July 2007
Providing structured clinical experience: the trial and evaluation of live video-linked patient/therapist sessions to replace a clinical placement for second-year physiotherapy students (PDF File - 185.7 kb) - La Trobe University - December 2006
Reducing the clinical burden on health services - creating a contemporary model of simulated clinical education using innovative teaching methods for multiple health care professions (PDF File - 566.3 kb) - Monash University, Alfred Hospital - June 2007
Support program for education and clinical training of rural undergraduates at Mildura - a model (SPECTRUM) (PDF File - 470.7 kb) - Mildura Base Hospital, Monash University, Mildura Private Hospital, Sunraysia Community Health Service, Mildura Aboriginal Corporation, La Trobe University - June 2007
Telemedicine clinical observation for allied health students (PDF File - 272.0 kb) - Royal Children's Hospital, Charles Sturt University, Deakin University, La Trobe University, University of Melbourne, Monash University - July 2007
Training and mentoring program for new clinical educators (PDF File - 115.9 kb) - Eastern Health - June 2007
Scoping Projects
At the COAG meeting in July 2006, Victoria secured substantial increases in the number of university places in medicine, nursing and allied health. This included a total of 220 medical and 410 nursing Commonwealth-supported places, which represents 37% and 28% of the national allocations respectively. In addition, the Victorian Government has committed to an extra 1500 division 2 nurses by 2009/10.Although welcome, considerable planning work will be required to effectively manage this growth in medical, nursing and allied health places and in particular, ensure that there is sufficient capacity to support the growth in clinical placements and associated demands on infrastructure and other resources.
Given the extent of the changes created by the increase in student numbers, the department is undertaking scoping work to gather information on existing arrangements through which clinical placements are provided, assess impacts of growth in undergraduate numbers
Medical
The scoping work for medicine is complete. The data from this exercise has been used to support decisions on the $32.5M (to date) investment by the Victorian Government in new teaching infrastructure in public health services, as part of the Healthy Futures initiative, and will be used to inform funding of $7.6M to 2009/2010 (with additional ongoing funding) to assist health services establish the clinical academic staffing and infrastructure required to deliver medical clinical placements in rural locations.
on demand for placements, and the timing/magnitude of these, and identify potential opportunities to expand capacity.
Undergraduate Medical Scoping Project (PDF File 702 KB)
An update to the report is available here:
Undergraduate Medical Scoping Report Update July 2007 (PDF File 215 KB)
Allied Health
Stage one allied health scoping is now completed, with the project covering the following disciplines:
- Occupational therapy, physiotherapy, podiatry, social work and speech pathology
The stage one project involved a systematic and comprehensive assessment of the current and projected undergraduate and postgraduate allied health clinical placement arrangements for the above five disciplines. The department chose to focus this project on these specified allied health disciplines as they comprise the largest numbers of allied health student placements.
The objectives of this project were to collect quantitative and qualitative data that specified:
- existing arrangements through which allied health clinical placements are organised and provided;
- current clinical placement requirements for each Victorian training provider delivering courses of training in occupational therapy, physiotherapy, podiatry, social work and speech pathology;
- current clinical placement activity at each health service that identifies the quantity, duration and key characteristics of placements at each site including:
- public health services (metropolitan and rural, approx 58 services).
- community health services (up to 95 services [40 stand alone and 55 integrated services]).
- public sub-acute and aged residential care facilities (up to 210 services).
- public area mental health services (up to 21 services);
- summary information regarding the overall number and duration of clinical placements undertaken in non-public health settings (private hospitals, general practices, other private settings, and non-government organisations);
- a stock take of Victorian students undertaking clinical placements interstate and the extent of interstate universities placing students in Victoria;
- projections of demand for allied health placements to 2012 given the expected growth in number of student places over the next five years;
- potential opportunities to expand clinical placement capacity;
- potential barriers to expanding capacity and resources/strategies that might be employed to address these; and
- identification of any other issues that might inform future planning of clinical placements for allied health disciplines.
The stage one report will inform planning around the growth in allied health students in Victoria. Stage two (more information below) will be available at this website once complete, and will cover all remaining allied health disciplines.
The stage one report of the allied health scoping project is available here:
Stage One Allied Health Scoping Report (PDF 1.5mb)
Arising from the stage one scoping project, two additional projects have been identified as key components of Victoria?s clinical placements strategy for 2008. These projects are:
- Stage two allied health clinical placement scoping of the remaining 14 allied disciplines not assessed by stage one, including audiology, biomedical science, diagnostic radiography, dietetics and nutrition, health information management, medical laboratory science, medical physics, nuclear medicine, optometry, orthoptics, pharmacy, prosthetics and orthotics, psychology and radiation therapy
- Based on the stage one findings, the design and implementation of a strategy to help to:
- manage and facilitate the accommodation of the projected allied health clinical placement requirements for the period to 2012 for the five allied health disciplines mapped by the stage 1 report, namely occupational therapy, physiotherapy, podiatry, social work and speech pathology; and
- analyse clinical placement projections to identify health services that have underutilised clinical placement capacity, and how they could expand their capacity to take on additional placements.
The department is currently in the process of engaging contractors for both projects. The timeline for the completion of both these projects is the end of 2008.
Nursing
The nursing (divisions 1 and 2) scoping project has commenced and the report will be published at this website once available.
Relationship Agreement for the Public Hospital Sector
The Relationship Agreement for the Public Hospital Sector has been developed jointly between the Department of Human Services and representatives from health services and higher education providers. It provides a template for use by public health services and higher education providers in formalising roles and responsibilities (including cost-sharing arrangements) for medical and nursing university clinical placements in Victorian public health services.
The agreement will be updated periodically to reflect changes in the organisation of clinical placements and contribution arrangements. It also includes a degree of flexibility by giving higher education providers and health services the opportunity to incorporate specific clauses relevant to their particular needs.
For more information on the medical and nursing relationship agreement, please refer to the Relationship Agreement for the Public Hospital Sector.
Development of an extended agreement covering allied health students is planned for 2009.