Four students on clinical placement with Flinders NT have formed part of a research project to evaluate the effectiveness of using students in remote areas to fill gaps in services where there are little or no existing allied health services.
A Hot North grant from Menzies Institute has enabled the joint initiative between Flinders University, James Cook University and Indigenous Allied Health Australia to pilot a student-led clinic in remote East Arnhem Land, Northern Territory.
Over an eight-week period, between February and April 2019, two Occupational Therapy (OT) and two Speech Pathology (SP) students worked with people receiving home care packages who are supported by Anglicare in Nhulunbuy and/or East Arnhem Regional Council in Yirrkala.
In the early stages of placement, meetings were held with key people including the local interpreter service, the Centre for Disease Control and the local art gallery. Students also worked closely with two local Yolŋu elders and attended formal cultural awareness sessions including a trip to the Homelands with Laynhapuy Health. This helped the students to gain an understanding of how lifestyles of the families in the area differ from their own, the needs of people and their families, and how services are delivered. They then developed projects to address needs identified by the agencies or service recipients, in consultation with relevant providers and supervisors.
A total of 21 people were seen, including service recipients and family members. Interventions were wide and varied and included things such as:
• Upper limb exercises and education
• Home assessment and modifications
• Worksite ergonomic assessments
• Review of menu with recommendations for foods to enable safe swallowing
• Assessment of ability to operate hearing aid appropriately
• Review of swallowing
• Cognitive stimulation activities
A wide range of resources were developed including:
• Guidelines for staff re safe manual handling for car transfers
• Exercises for the pool
• Resource for family to support passive upper limb exercises
• Communication booklet with key Yolŋu signs
• Client profiles for staff to enhance communication
• Visual sequencing cards and education for ADL activities
• Education re speech pathology and occupational therapy
A number of referrals were made for further intervention from visiting professionals to ensure ongoing support for service recipients.
Evaluations completed to date indicate the students made very strong connections with people and families. They have highlighted that working together with a local person significantly enhances communication in language and helps to build relationships. With appropriate supervision to guide interventions, students can provide effective services in remote areas.
Students had this to say about their experience:
“I have learnt so much about my profession in a rural environment that will follow me wherever I go! The rapport built with the community is something I have never experienced elsewhere and has found a way into my heart. This work is rewarding beyond my wildest imagination and I am so lucky to have been a part of a service that has assisted in improving the quality of life of people all over the Nhulunbuy area”. (Jess Garard, OT Student)
“I highly recommend rural and remote placements for student experience. After a short eight weeks I feel I have grown so much and developed great skills that I know will be valuable for when I start my career, such as being flexible to change and able to think quickly on my feet. I also thoroughly enjoyed working with the clients and our cultural consultants Murphy and Djerrkŋu, who made us feel so welcome and enriched our experience even more so”. (Beth Bailey, SP Student)
“The learning opportunities have been invaluable. Working in communities like Yirrkala and Gunyaŋara has been one of the most rewarding experiences which I will never forget. The Yolŋu truly are some very special people and I will forever cherish the friendships I have made during my time in East Arnhem Land”. (Maddie Cappler, OT Student)
“It was so great getting out in the community and learning all about a culture totally different to our own. The Yolŋu people were so welcoming and willing to share their stories with us and seeing how appreciative they were of our presence and service provision made the experience even more worthwhile. It is one I will not forget.” (Shannon Day, SP Student)
Quotes from service recipients:
“They were beautiful girls. They brought sunshine into my life. They took time and saw me again. They had a wider view, not a narrow focus and didn’t just ask questions and then leave” (Djerrkŋu Marika, service recipient and cultural consultant).
“The students worked well with my family and within my home and it was a good experience for them coming to community. They can learn from us and we can learn from them. I did not want to reject anything they said or did. They spoke well and had good ideas” (Anon, Service Recipient)
• Paul Bampton for IT support
• Gemma Porteous for local contacts and professional / admin support
• Chloe Lyons for evaluations
• Murphy Yunupingu and Djerrkŋu Marika for cultural guidance and support
• Ruth, Louise, Narelle and Emily for research guidance and support
• Anglicare and East Arnhem Regional Council