A qualitative evaluation of remote supervision guidelines for Australian General Practice registrars in two practice locations

Early Abstract:

Introduction: The lack of a stable General Practitioner (GP) workforce in rural and remote Australia has been a topic of much discussion as there are less GPs working in many rural areas where there is a higher mortality and morbidity than in urban areas. Doctors who have been trained in rural and remote areas are more likely to continue working there, but there are many practices where supervision is not available onsite. Good supervision ensures patient safety, an educational alliance between the supervisor and trainee, and adequate clinical and professional support by the supervisor and the onsite team. This project involved the evaluation of the pilot of the newly developed guidelines for the remote supervision of GP trainees (registrars) within the Royal Australian College of General Practitioners (RACGP) Australian General Practice Training (AGPT) program.
Methods: The aim of the evaluation was to assess the appropriateness, effectiveness and efficiency of the Remote Supervision Guidelines and placement processes such as the selection process, the risk management plan, the face-to-face orientation period, the development of the onsite team, the communication strategies and the increased payment. The guidelines were implemented as a pilot in two practice localities in 2022. The remote supervisors, remotely-supervised registrars, practice managers, and training organisation stakeholders were interviewed at three time-points during the placement – before the placement, after the orientation period, and at the conclusion of the placement.  Their responses were analysed and organised into themes.
Results: Overall, the results were positive, with suggestions for improvement and challenges identified. There was an identified need to ensure that guidelines are flexible and able to be tailored to the context of the registrar, the supervisor and the placement. Both registrars in the pilot continued to work in the remotely-supervised practices at the end of their training and the three supervisors were keen to supervise remotely again.
Discussion: The RACGP Remote Supervision Guidelines were developed as an evidence-based practical means of supervising registrars in rural and remote locations where there is no onsite supervisor. The guidelines were updated where necessary and have now been published and implemented nationally.
Conclusions: The pilot and evaluation of the RACGP Remote Supervision Guidelines demonstrate that they are safe and fit-for-purpose. These guidelines form one of the training strategies to support the dwindling rural and remote GP workforce.
Keywords: general practice, registrar, remote, remote supervision, rural, workforce.