Translating agricultural health and medicine education across the Pacific: a United States and Australian comparison study

摘要

Background: Populations in agricultural communities require health care that is interdisciplinary and cross-sectoral to address the high rate of workplace deaths, preventable injuries and illness. These rates are compounded by limited access to services and the distinctive personal values and culture of farming populations, which both health and rural practitioners must be aware of to reduce the gap between rural and urban population health outcomes. To address the unique health and medical characteristics of agricultural populations, education in agricultural medicine was established through the College of Medicine and the College of Public Health at the University of Iowa in the USA. The course was initially developed in 1974 for teaching medical students, family medicine residents and nurses, and a postgraduate curriculum was added in 2006 to develop medical/health and rural professionals' cultural competence to work in agricultural communities. This article reviews the adaptation of the US course to Australia and the educational and practice outcomes of students who completed the agricultural medicine course in either Australia or the USA. Methods: Data were collected from students who completed either the Agricultural Medicine: Occupational and Environmental Health for Rural Health Professionals course in the state of Iowa in the USA or the Agricultural Health and Medicine course in the state of Victoria in Australia between 2010 and 2013 (inclusive). Data were analysed using descriptive statistics, frequencies and the χ2 test. Students were invited to make any other comments regarding the course. Results: One hundred and ten students completed the survey (59 from the USA and 51 from Australia) with over a 50% response from both countries, indicating the high level of commitment to this discipline. Responses were consistent across both continents, with more than 91% agreeing that the course improved their abilities to diagnose, prevent and treat rural and agricultural populations. Further, both courses successfully enabled a multidisciplinary and cross-sectoral approach to agricultural health and medicine. Conclusions: More than 72% of previous students were practising in rural and /or mixed communities at the time of the survey, demonstrating a repeatable and transferable medical education program that supports multidisciplinary care and scholarship while addressing health inequities in agricultural populations. Findings from this study indicate there are opportunities to expand globally.