Rural health is close to my heart. Raising a family and working as a nurse, midwife, educator, and manager in rural NSW has embedded within me the challenges faced by those on the frontline. These experiences now guide my work as Chief Nursing Officer at Ausmed, positioning me at the intersection of technology, governance, and human capability. Our shared purpose is to leverage our differences, from clinical experts to software engineers, to innovate for better care, much like collaborating in a rural community.
This piece articulates how reflective, digital, and generative learning can create equity in access to capability building, regardless of location.
Distance Changes Everything
Across rural and remote Australia, distance changes everything. Single staff members often cover multiple roles, resources are thin, and isolation weighs heavily. These extraordinary professionals do complex work in challenging conditions. The recent report, 'The Forgotten Health Spend: A Report on the Expenditure Deficit in Rural Australia' commissioned by the National Rural Health Alliance, highlights that this gap is widening, with worsening health outcomes and entrenched workforce shortages.
Thin margins, workforce shortages, isolation, and limited connectivity severely impact this workforce. Meanwhile, the Strengthened Aged Care Quality Standards now demand more than compliance; they require evidence of investment in a capable and sustained workforce. Access to professional growth should never be defined by a postcode.
Capability isn't nice to have. It's the essence of providing safe, person-centred care
Reflection: Quiet Engine of Capability
Based on my experience in safety culture, I call reflection the quiet engine of capability. It's often overlooked until an issue arises, yet it is what turns experience into insight, and insight into improvement.
When care professionals pause to reflect, they move from reacting to responding. This habit is the foundation of sound judgement and sustained empathy. Reflection is an internal system that drives human learning, converting:
Experience → Confidence → Competence → Capability
Reflection strengthens care.
It doesn't slow it down. It preserves professionalism and humanity under pressure.
Training Isn't the Same as Learning
Traditional training models were built on the assumption we can gather people in a room at the same time and place. It was designed for stable teams, predictable rosters, and easy access to educators or supervisors in the workplace.
These assumptions rarely stand up in the aged and home-care setting, and even less so when located in rural or remote areas. The workforce is mobile, diverse, and time-poor. Workers need learning that travels with them, not modules that wait for them to find time.
Systematic reviews show that when training is delivered as a one-off, didactic session, long-term knowledge retention and application are significantly lower compared to ongoing, reflective, interactive methods (Aulakh et al., 2025; Lee et al., 2022). Capability stalls without ongoing feedback and reinforcement. Learning has to be experiential, meet people where they are, in real time, with relevance.
More training is not the answer.
Digital Learning and Equity
When e-learning first scaled across the sector, an unintended consequence was that the formative phase of learning began to disappear. Immediate recall and completion rates became the focus.
Learning turned into a transaction: clean, efficient, countable — but no longer personal or transformative. The system rewarded compliance, not capability.
I challenge the mental shortcut that digital learning is just about screens. When designed well, digital learning is about access and inclusion. Endorsed by the World Health Organisation, it brings fairness by providing everyone the same opportunity to learn and grow. For remote teams, a mobile-first platform that works offline is the difference between exclusion and participation.
Imagine if we reframed the 'e' in e-learning to stand for equity—that's the true promise of digital learning.
Generative Learning: From Content to Conversation
Generative AI (GAI) is here now, and it's transformative. Unlike traditional systems, GAI generates new, contextual content in real time. It can create explanations, simulate conversations, and adapt to a learner's context, literacy level, and language. It can genuinely enable critical thinking and reasoning, something traditionally reserved for a face-to-face environment, simulation, or classroom.
The experiential phase of learning largely disappeared when e-learning scaled, rewarding compliance over capability. Generative Learning is Ausmed's concept for restoring what was lost: the dialogue, curiosity, and human reflection that fuels growth.
It's where a reflective mindset meets formative mechanisms, turning training from a transaction into a relationship.
Common Scenario:
Imagine you're a home care worker. You've just finished a home visit. Although you completed all the required tasks, there was something different today. Whenever possible, you like to process your thoughts about what's happened so you can be fully present for the next person you are visiting. You take a lot of pride in your work, and you know the people you visit are vulnerable. You often see their families down the street.
As usual, you don't have anyone else to talk things through with or much time. You feel a bit guilty about reflecting; it's a bit of a luxury, above your pay grade. So you write up your notes on the laptop, that will keep the bosses of your back, you check your messages on your mobile device, start your car and drive off – you're feeling ok, but you know this is going to bug you for the rest of the day, you hope the persons ok – this is what drains you, makes you wonder how long you can keep doing this.
You wonder if there was something you could have done better…
Guided Reflection using GAI
Now, imagine if the home care worker could talk or type their thoughts and reflections into their digital device. In the background, a trained, closed GAI tool, would go to work, analysing what had been shared. It highlights strengths in their reasoning, and offers a tailored learning suggestion or reflective prompt based on what they'd shared. It's private, contextual, and builds confidence immediately after care.
It's not more training, its improving care.
This is why, at Ausmed, where we are in the unique position of having expertise in both content development and software development, we have focused our attention on the learning experience itself: how learning touches, connects with the person, and care.
When we improve the learning experience, we improve the care provided.
The TRUSTED AI Framework
The sector shows openness but caution toward using GAI in learning; the key factor is trust. We conducted a survey of 273 people who reinforced this: most were interested but required assurance on privacy, reliability, and human oversight. Respondents who knew Ausmed associated us with trust, reliability, and educational integrity. Our takeaway is clear: we must govern for trust by being transparent, protecting privacy, and ensuring human oversight.
To this end, I established our TRUSTED AI Governance framework at Ausmed, guiding leadership, software design, and content creation. Embedded within this framework are the Australian AI Safety Standard and the AI Ethics Principles, translating ethics into daily practice through transparent processes, reliable monitoring, human oversight, and privacy protection built in from the start.
Capability Shared Across the System
Responding to the lift in expectations, we need a system that makes capability visible, equitable, and grounded in daily practice. Generative learning is a way to show, in real time, that capability is a living thing that resides in people, not paperwork.
| Stakeholder | Generative Learning Benefit |
| People Receiving Care | Safer, more consistent, and more human-centred care; clearer communication builds trust. |
| Workforce | Confidence, connection, and reduced isolation/burnout (especially isolated and itinerant workforces); safe space for reflection and support. |
| Provider/Service | Visibility into capability (not just compliance); strengthened capability leads to reduced turnover and quality that is visible in every interaction. |
We began with reflection and ended with generative learning - two sides of the same idea: learning that listens. Everything we've discussed comes back to one word: trust.
Trust is what allows a worker to seek help, a provider to innovate safely, and a family to have confidence in the care received. Technology, governance, and learning are only the tools. People are the purpose.
When we lead with integrity, design with empathy, and stay transparent, capability grows naturally. And when capability grows, confidence follows, and so does connection.
The paper was recently presented at the Australasian College of Health Service Management (ACHSM) Asia-Pacific Leadership Congress in Darwin, October 2025.
