Having increased the number of commencing podiatry student enrolments by almost 400% in just one-year, Associate Professor Caroline Robinson and Carol Mioduchowski share the story behind a deliberately accessible, inclusive and equitable approach to podiatry education – no matter where students are based.
Data for student enrolments in the first-year podiatry subject demonstrates a cohort of students who represent all states and territories in Australia, including 60% who live in regional and rural locations.
| Associate Professor Caroline Robinson
Adjunct Associate Professor Podiatry, Charles Sturt University Caroline has 34 years’ experience of podiatry education and curriculum design, with a particular interest in sustaining and growing the podiatry workforce, developing cultural capabilities for podiatry practice and ageing well. |
Carol Mioduchowski
Podiatry and Orthotics Governance Manager, Barwon Health carol.mioduchowski@barwonhealth.org.au Carol is a passionate public health podiatrist, clinical and health service leader, and innovator. She is a dedicated professional, having served as a former Board Director and President of both the Australasian Podiatry Council and the Podiatry Association of Victoria, during which large advocacy projects were led. |
| Acknowledgments:
The authors acknowledge that this initiative would not have been successful without the support and collaboration of the following stakeholders:
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In its simplest terms, this innovative university model enables all students enrolled in the Undergraduate Certificate in Foot Health or the Bachelor of Podiatric Medicine to have an allocated ‘base clinic’ in their home location.
Students are supported to learn in the workplace for a sustained period over several years, allowing time to build professional relationships and develop a podiatry network. This workplace learning environment is crucial to enabling students to apply theory from online classes and practise skills in authentic settings.
The Charles Sturt University (CSU) hybrid podiatry course is working with industry and each student’s home location to remove the barrier of distance for students who are not interested in moving home, or unable to relocate to the Albury, NSW area.
Enabling students to live, work and study in their home region maintains their connection with community, increases the likelihood they will remain in the area, and contributes to building the regional, rural and remote health workforce.
The focus for this article is to explore this unique collaboration between Charles Sturt University (CSU) and a network of industry partners, to develop a hybrid podiatry course[1]. This work was driven by a shared need to increase podiatry student enrolments, sustain the CSU podiatry course and build the podiatry workforce.
Developed initially from a Victorian state-based perspective, this collaboration grew over a period of 18 months to include podiatrists and allied health leaders from across the country. It offers a unique example of thinking outside the box to not only attract more podiatry students but also address workforce issues – especially in rural, regional and remote areas.
Since 2015, universities in Australia have experienced a decline in podiatry student enrolments. Lower student enrolments generate a smaller number of podiatry graduates and consequently, the available podiatry workforce decreases. The chronic shortage of podiatrists in the Victorian allied health workforce is mirrored in all states and territories of Australia.
This workforce shortage is a major threat to service provision particularly in regional, rural and remote areas – and also, the overall health and wellbeing of podiatrists. Notably, in the public health system, the increasing complexity of client presentations places a heavy burden on staff.
To sustain and grow the podiatry workforce in Australia, we need a secure pipeline of graduates. Increasing the number of registered podiatrists will maintain the scope of podiatry practice and improve opportunities for diversification and extended scope of practice.
Currently, there may be funding to support more complex work but there are not enough practitioners to fill the available positions. A larger profession generates momentum for podiatrists to move into new areas in the clinical work force and develop advanced practice models of care.
The development of a ‘podiatry cadet’ pathway is an important mechanism to supplement the registered podiatry workforce, improve the productivity of podiatry services and reduce the risk of overload and burnout for podiatrists.
Currently, various groups are advocating for dedicated podiatry cadetship positions funded by State and Territory Departments of Health. This is a strategic priority to develop a pipeline into highlighted areas of need, similar to that for nursing and medicine.
An excellent example is the podiatrist trainee program created by Queensland Health. Podiatry students accepted into this program work up to two days per week in a Queensland Health facility as a Health Practitioner Level 1 (HP1), under the supervision of a qualified podiatrist.
In the private sector, Healthia are addressing this pipeline by offering a paid casual role for students enrolled in a podiatry degree. Many independent private podiatry practitioners have also adopted this approach to supporting a student in the workplace. A podiatry cadet who is affiliated with a private podiatry practice, or a podiatry service in the public health system, is well placed to gain future employment.
The CSU hybrid podiatry course creates a novel opportunity to develop podiatry cadetships. This place-based learning is augmented by on-campus study blocks (intensives) and traditional clinical placements to ensure a diversity of experience for each student.
The value of a place-based learning model is accessibility. As previously shared, the CSU hybrid podiatry course removes the barrier of distance for students who are not interested in moving home, or unable to relocate to the Albury, NSW area. Enabling students to live, work and study in their home region maintains their connection with community, increases the likelihood they will remain in the area, and contributes to building the regional, rural and remote health workforce.
Through improved accessibility, the hybrid podiatry course has increased the number of commencing podiatry student enrolments by almost 400% in just one year. As also previously shared, data for student enrolments in the first-year podiatry subject demonstrates a cohort of students who represent all states and territories in Australia, including 60% who live in regional and rural locations.
The hybrid podiatry course is attractive to a broader and more diverse cohort of students, including people who are considering a change of career pathway. Students in the 2026 commencing cohort have an age range of 18-64 years, with a median age of 30 years. 75% of the commencing cohort are female and 41% identify as ‘first in family’. First Nations students make up 7.3% of this cohort.
The value of the hybrid course model is in enabling a student to continue living and working in their community and this is very important in relation to student support and wellbeing. Building a career pathway for First Nations podiatrists is a high priority for the profession to ensure culturally safe care for communities, improve foot health outcomes and increase overall wellbeing.
During the shared conversations between the CSU podiatry team and industry partners within and beyond the reference group, a range of misconceptions surfaced in relation to the hybrid course model.
Some people questioned whether the CSU hybrid podiatry course is a ‘real degree’ because the students attend online classes and undertake supervised practice hours in the workplace rather than a university clinic.
The reality is that online learning provides students with the flexibility they require to combine study with employment and family commitments. The ability to complete supervised practice hours in their home location creates an accessible opportunity for learning and the development of ‘work-ready’ graduates. The mandatory completion of on-campus intensives through the course, ensures that the CSU podiatry team retains the overarching responsibility for assessment of professional capabilities and safety to practice.
As each podiatry student progresses through the course, they will develop an extended range of professional capabilities and their scope of practice as a ‘podiatry cadet’ will increase incrementally. For example, a student who successfully completes their first year of study will have the relevant knowledge and skills to perform neurovascular screening and scalpel debridement for a ‘low risk’ client, as directed by their supervising podiatrist. The overarching governance which is relevant for all podiatry supervisors to ensure ethical and safe practice, is the Podiatry Board of Australia Guidance for Working with Assistants in Podiatry Practice.
It is important to differentiate a ‘podiatry cadet’ from a person employed as a ‘podiatry assistant’. A ‘podiatry cadet’ is enrolled in a university degree and on a career pathway to become a podiatrist. A ‘podiatry assistant’ is a specific clinical role with a limited scope of practice.
If you are a registered podiatrist interested in supporting a podiatry cadet and contributing to building the podiatry workforce, you could:
The profession is not the problem … ACCESS to education is!
This initiative has been possible only through respectful collaboration and co-design between the CSU podiatry team and industry representatives, with a clear vision of creating a new career pathway to build the podiatry workforce. This is a significant pivot and opportunity for the profession to create the change we need to build and sustain the podiatry workforce into the future.
© Copyright 2021 The Australian Podiatry Association
