Dr Miriam Grotowski

Dr Miriam Grotowski

Senior Lecturer

University of Newcastle Department of Rural Health

Career Summary

Biography

Dr Miriam Grotowski is a Senior Lecturer in Medicine at the University of Newcastle Department of Rural Health (UONDRH) based in Tamworth. Miriam Graduated from UoN with a Bachelor of Medicine in 1989, completed her FRACGP in 1995 and has undertaken a Diploma in Psychiatry (Eating Disorders). She is currently completing her Masters in Medical Education.

As a practice owner and GP VMO at TRRH, Miriam has been providing GP services to her local community for over 25 years. She has a keen interest in educating the next generation of doctors, supervising both medical students, residents and GP registrars in training.

Research interests include medical student wellbeing, management of eating disorders in primary care and medical education with a focus on clinical reasoning and feedback.


Qualifications

  • Bachelor of Medicine, University of Newcastle

Keywords

  • Clinical Reasoning
  • Interprofessional Learning
  • Medical Education
  • Medicine
  • Psychiatry (Eating Disorders)

Fields of Research

Code Description Percentage
111717 Primary Health Care 50
119999 Medical and Health Sciences not elsewhere classified 50
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Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Book (1 outputs)

Year Citation Altmetrics Link
2014 Higgs J, Croker A, Tasker D, Hummell J, Patton N, Health Practice Relationships, Sense Publishers, Rotterdam, The Netherlands, 262 (2014) [A3]
Citations Scopus - 3
Co-authors Kym Rae, Tony Smith, Karin Fisher, Anne Croker, Tracy Levett-Jones, Nicky Hudson

Chapter (6 outputs)

Year Citation Altmetrics Link
2016 Grotowski M, 'Collaborating with colleagues across distances: Face-to-face versus tele- and video-conferencing', Collaborating in Healthcare Reinterpreting Therapeutic Relationships, Sense Publishers, Rotterdam, The Netherlands 193-200 (2016) [B1]
2014 Croker AL, Grotowski M, Croker J, 'Interpersonal communication for interprofessional collaboration', Critical Conversations for Patient Safety - An Essential Guide for Health Professionals, Pearson Australia, Frenchs Forest, NSW 50-61 (2014) [B2]
Co-authors Anne Croker
2014 Fisher KA, Grotowski M, 'Caring for Patients Who Have Sexually Transmitted Infections: Getting the team on board', Health Practice Relationships, Sense Publishers, Rotterdam, The Netherlands 171-178 (2014) [B1]
Co-authors Karin Fisher
2014 Little FH, Brown L, Grotowski M, Harris D, 'Interprofessional Relationships in Healthcare Practice', Health Practice Relationships, Sense Publishers, Rotterdam, The Netherlands 143-152 (2014) [B1]
Co-authors Leanne Brown, Fiona Little
2014 Croker AL, Croker J, Grotowski M, 'Changing Directions in Healthcare', Health Practice Relationships, Sense Publishers, Rotterdam, The Netherlands 27-36 (2014) [B1]
Co-authors Anne Croker
2008 Grotowski M, Croker A, Smith M, 'Self Management: Managing yourself as a Physiotherapist', Contexts in Physiotherapy Practice, Elsevier, Sydney, Australia 289-300 (2008) [B2]
Co-authors Anne Croker
Show 3 more chapters

Journal article (12 outputs)

Year Citation Altmetrics Link
2019 Grotowski M, 'Margaret has dysuria', CHECK: Independent Learning Program for GP's (RACGP), Unit 549 8-12 (2019)
2017 Grotowski M, 'RACGP Chronic Conditions Check - Independent Learning Program for GPs Case 3 - John Returns from Thailand', CHECK: Programme of Self Assessment/The Royal Australian College of General Practitioners, Unit 536 13-17 (2017)
2016 Giles ML, Zapata MC, Wright ST, Petoumenos K, Grotowski M, Broom J, et al., 'How do outcomes compare between women and men living with HIV in Australia? An observational study', Sexual Health, 13 155-161 (2016) [C1]
DOI 10.1071/SH15124
Citations Scopus - 4
2016 Mulhall BP, Wright ST, De La Mata N, Allen D, Brown K, Dickson B, et al., 'Risk factors associated with incident sexually transmitted infections in HIV-positive patients in the Australian HIV Observational Database: a prospective cohort study', HIV Medicine, 17 623-630 (2016) [C1]
DOI 10.1111/hiv.12371
Citations Scopus - 3
2015 Templeton DJ, Wright ST, McManus H, Lawrence C, Russell DB, Law MG, et al., 'Antiretroviral treatment use, co-morbidities and clinical outcomes among Aboriginal participants in the Australian HIV Observational Database (AHOD)', BMC Infectious Diseases, 15 (2015)

© 2015 Templeton et al. Background: There are few data regarding clinical care and outcomes of Indigenous Australians living with HIV and it is unknown if these differ from non-In... [more]

© 2015 Templeton et al. Background: There are few data regarding clinical care and outcomes of Indigenous Australians living with HIV and it is unknown if these differ from non-Indigenous HIV-positive Australians. Methods: AHOD commenced enrolment in 1999 and is a prospective cohort of HIV-positive participants attending HIV outpatient services throughout Australia, of which 20 (74 %) sites report Indigenous status. Data were collected up until March 2013 and compared between Indigenous and non-Indigenous participants. Person-year methods were used to compare death rates, rates of loss to follow-up and rates of laboratory testing during follow-up between Indigenous and non-Indigenous participants. Factors associated with time to first combination antiretroviral therapy (cART) regimen change were assessed using Kaplan Meier and Cox Proportional hazards methods. Results: Forty-two of 2197 (1.9 %) participants were Indigenous. Follow-up amongst Indigenous and non-Indigenous participants was 332 & 16270 person-years, respectively. HIV virological suppression was achieved in similar proportions of Indigenous and non-Indigenous participants 2 years after initiation of cART (81.0 % vs 76.5 %, p = 0.635). Indigenous status was not independently associated with shorter time to change from first- to second-line cART (aHR 0.95, 95 % CI 0.51-1.76, p = 0.957). Compared with non-Indigenous participants, Indigenous participants had significantly less frequent laboratory monitoring of CD4 count (rate:2.76 tests/year vs 2.97 tests/year, p = 0.025) and HIV viral load (rate:2.53 tests/year vs 2.93 tests/year, p < 0.001), while testing rates for lipids and blood glucose were almost half that of non-indigenous participants (rate:0.43/year vs 0.71 tests/year, p < 0.001). Loss to follow-up (23.8 % vs 29.8 %, p = 0.496) and death (2.4 % vs 7.1 %, p = 0.361) occurred in similar proportions of indigenous and non-Indigenous participants, respectively, although causes of death in both groups were mostly non-HIV-related. Conclusions: As far as we are aware, these are the first data comparing clinical outcomes between Indigenous and non-Indigenous HIV-positive Australians. The forty-two Indigenous participants represent over 10 % of all Indigenous Australians ever diagnosed with HIV. Although outcomes were not significantly different, Indigenous patients had lower rates of laboratory testing for HIV and lipid/glucose parameters. Given the elevated risk of cardiovascular disease in the general Indigenous community, the additional risk factor of HIV infection warrants further focus on modifiable risk factors to maximise life expectancy in this population.

DOI 10.1186/s12879-015-1051-4
Citations Scopus - 3
2015 Wright ST, Law MG, Cooper DA, Keen P, McDonald A, Middleton M, et al., 'Temporal trends of time to antiretroviral treatment initiation, interruption and modification: Examination of patients diagnosed with advanced HIV in Australia', Journal of the International AIDS Society, 18 (2015) [C1]

© 2015 Wright ST et al; licensee International AIDS Society. Introduction: HIV prevention strategies are moving towards reducing plasma HIV RNA viral load in all HIV-positive pers... [more]

© 2015 Wright ST et al; licensee International AIDS Society. Introduction: HIV prevention strategies are moving towards reducing plasma HIV RNA viral load in all HIV-positive persons, including those undiagnosed, treatment naïve, on or off antiretroviral therapy. A proxy population for those undiagnosed are patients that present late to care with advanced HIV. The objectives of this analysis are to examine factors associated with patients presenting with advanced HIV, and establish rates of treatment interruption and modification after initiating ART. Methods: We deterministically linked records from the Australian HIV Observational Database to the Australian National HIV Registry to obtain information related to HIV diagnosis. Logistic regression was used to identify factors associated with advanced HIV diagnosis.We used survival methods to evaluate rates of ART initiation by diagnosis CD4 count strata and by calendar year of HIV diagnosis. Cox models were used to determine hazard of first ART treatment interruption (duration >30 days) and time to first major ART modification. Results: Factors associated (p<0.05) with increased odds of advanced HIV diagnosis were sex, older age, heterosexual mode of HIV exposure, born overseas and rural-regional care setting. Earlier initiation of ART occurred at higher rates in later periods (2007-2012) in all diagnosis CD4 count groups. We found an 83% (69, 91%) reduction in the hazard of first treatment interruption comparing 2007-2012 versus 1996-2001 (p<0.001), and no difference in ART modification for patients diagnosed with advanced HIV. Conclusions: Recent HIV diagnoses are initiating therapy earlier in all diagnosis CD4 cell count groups, potentially lowering community viral load compared to earlier time periods.We found a marked reduction in the hazard of first treatment interruption, and found no difference in rates of major modification to ART by HIV presentation status in recent periods.:

DOI 10.7448/IAS.18.1.19463
Citations Scopus - 5
2015 Han N, Wright ST, O'Connor CC, Hoy J, Ponnampalavanar S, Grotowski M, et al., 'HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD)', HIV Medicine, 16 152-160 (2015)

© 2014 British HIV Association. Objectives: The proportion of people living with HIV/AIDS in the ageing population (&gt;50 years old) is increasing. We aimed to explore the relati... [more]

© 2014 British HIV Association. Objectives: The proportion of people living with HIV/AIDS in the ageing population (>50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Methods: Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Results: A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were >50 years old. In multivariable analyses, those aged >50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio (HR) for 50-59 years: 2.27; 95% confidence interval (CI) 1.34-3.83; HR for >60 years: 4.28; 95% CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusions: The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting.

DOI 10.1111/hiv.12188
Citations Scopus - 6
2014 Mulhall BP, Wright S, Allen D, Brown K, Dickson B, Grotowski M, et al., 'High rates of sexually transmissible infections in HIV-positive patients in the Australian HIV Observational Database: A prospective cohort study', Sexual Health, 11 291-297 (2014) [C1]

© CSIRO 2014. Background In HIV-positive people, sexually transmissible infections (STIs) probably increase the infectiousness of HIV. Methods: In 2010, we established a cohort of... [more]

© CSIRO 2014. Background In HIV-positive people, sexually transmissible infections (STIs) probably increase the infectiousness of HIV. Methods: In 2010, we established a cohort of individuals (n=554) from clinics in the Australian HIV Observational Database (AHOD). We calculated retrospective rates for four STIs for 2005-10 and prospective incidence rates for 2010-11. Results: At baseline (2010), patient characteristics were similar to the rest of AHOD. Overall incidence was 12.5 per 100 person-years. Chlamydial infections increased from 3.4 per 100 person-years (95% confidence interval (CI): 1.9-5.7) in 2005 to 6.7 per 100 person-years (95% CI: 4.5-9.5) in 2011, peaking in 2010 (8.1 per 100 person-years; 95% CI: 5.6-11.2). Cases were distributed among rectal (61.9%), urethral (34%) and pharyngeal (6.3%) sites. Gonococcal infections increased, peaking in 2010 (4.7 per 100 person-years; 95% CI: 5.6-11.2; Ptrend=0.0099), distributed among rectal (63.9%), urethral (27.9%) and pharyngeal (14.8%) sites. Syphilis showed several peaks, the largest in 2008 (5.3 per 100 person-years; 95% CI: 3.3-8.0); the overall trend was not significant (P=0.113). Genital warts declined from 7.5 per 100 person-years (95% CI: 4.8-11.3) in 2005 to 2.4 per 100 person-years (95% CI: 1.1-4.5) in 2011 (Ptrend=0.0016). Conclusions: For chlamydial and gonococcal infections, incidence was higher than previous Australian estimates among HIV-infected men who have sex with men, increasing during 2005-2011. Rectal infections outnumbered infections at other sites. Syphilis incidence remained high but did not increase; that of genital warts was lower and decreased.

DOI 10.1071/SH13074
Citations Scopus - 3
2013 Wright ST, Petoumenos K, Boyd M, Carr A, Downing S, O'Connor CC, et al., 'Ageing and long-term CD4 cell count trends in HIV-positive patients with 5 years or more combination antiretroviral therapy experience', HIV Medicine, 14 208-216 (2013)

Objectives: The aim of this study was to describe the long-term changes in CD4 cell counts beyond 5 years of combination antiretroviral therapy (cART). If natural ageing leads to ... [more]

Objectives: The aim of this study was to describe the long-term changes in CD4 cell counts beyond 5 years of combination antiretroviral therapy (cART). If natural ageing leads to a long-term decline in the immune system via low-grade chronic immune activation/inflammation, then one might expect to see a greater or earlier decline in CD4 counts in older HIV-positive patients with increasing duration of cART. Methods: Retrospective and prospective data were examined from long-term virologically stable HIV-positive adults from the Australian HIV Observational Database. We estimated mean CD4 cell count changes following the completion of 5 years of cART using linear mixed models. Results: A total of 37916 CD4 measurements were observed for 892 patients over a combined total of 9753 patient-years. Older patients (>50 years old) at cART initiation had estimated mean (95% confidence interval) changes in CD4 counts by year-5 CD4 count strata (<500, 500-750 and >750 cells/µL) of 14 (7 to 21), 3 (-5 to 11) and -6 (-17 to 4) cells/µL/year. Of the CD4 cell count rates of change estimated, none were indicative of long-term declines in CD4 cell counts. Conclusions: Our results suggest that duration of cART and increasing age do not result in decreasing mean changes in CD4 cell counts for long-term virologically suppressed patients, indicating that the level of immune recovery achieved during the first 5 years of treatment is sustained through long-term cART. © 2012 British HIV Association.

DOI 10.1111/j.1468-1293.2012.01053.x
Citations Scopus - 15
2012 Little FH, Brown LJ, Grotowski M, Harris D, 'Nourishing networks: An interprofessional learning model and its application to the Australian rural health workforce', Rural and Remote Health, 12 1-7 (2012) [C1]
Citations Scopus - 5Web of Science - 5
Co-authors Leanne Brown, Fiona Little
2008 Grotowski M, May JA, 'HPV vaccine catch up schedule: An opportunity for chlamydia screening', Australian Family Physician, 37 529-530 (2008) [C2]
Citations Scopus - 1Web of Science - 1
Co-authors Jennifer May
2005 Grotowski M, 'Banda Aceh', Australian Family Physician, 34 592-592 (2005)
Show 9 more journal articles

Conference (9 outputs)

Year Citation Altmetrics Link
2019 Little A, Ferns J, Edgar A, Grotowski M, De Silva L, Croker A, 'Putting the spotlight on clinical reasoning: Implications for facilitating interprofessional education', Canberra, ACT (2019)
Co-authors Jane Ferns, Alexandra Little, Lani Desilva, Anne Croker
2018 May JA, Stokes-Parish J, Cone L, Grotowski M, 'Guiding eprofessionalism-developing social media workshops for health students', Basel, SWITZERLAND (2018)
Co-authors Jessica Stokes, Lauren Cone, Jennifer May
2018 Grotowski M, May J, Cone L, 'Vertical training-leveraging the gain, train and retain theory. ', Basel, SWITZERLAND (2018)
Co-authors Jennifer May, Lauren Cone
2018 Crowley ET, Harris D, Dignam Q, Grotowski M, 'Twenty One Years of Courageous Conversations', Melbourne, VIC (2018)
Co-authors Elesa Crowley
2017 Grotowski M, Crowley E, Harris D, Dignam Q, Peters K, 'Making Treatment Permanently Seaworthy', Sydney, NSW (2017)
Co-authors Elesa Crowley
2016 Croker AL, Grotowski M, 'Interprofessional Educators Working Together? Using 'critical creativity' to foster educators' interprofessional rapport', Cleveland, Ohio (2016)
Co-authors Anne Croker
2016 Bourne C, Grotowski M, 'HIV Diagnosis in General Practice', Sydney (2016)
2015 Harris D, Grotowski M, Brown L, Little F, 'Riding the wave of success: revamping the Nourishing Networks education program', ANZAED's 13th Annual Conference, Gold Coast (2015) [E3]
Co-authors Leanne Brown, Fiona Little
2010 Brown LJ, Harris D, Little FH, Grotowski M, 'Challenges of delivering an inter-professional education program for rural clinicians working with eating disorder clients', National SARRAH Conference 2010 Conference. Program, Broome, WA (2010) [E3]
Co-authors Leanne Brown, Fiona Little
Show 6 more conferences
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Grants and Funding

Summary

Number of grants 4
Total funding $469,664

Click on a grant title below to expand the full details for that specific grant.


20192 grants / $354,729

Certificate in Clinical Teaching and Supervision - General Practice $349,729

Funding body: Valley to Coast Charitable Trust

Funding body Valley to Coast Charitable Trust
Project Team Professor Brian Jolly, Doctor Cathy Regan, Doctor Miriam Grotowski, Doctor Nicole Ryan, Mrs Kerry Peek, Professor Dimity Pond, Professor Jennifer May
Scheme Research Grant
Role Investigator
Funding Start 2019
Funding Finish 2020
GNo G1801157
Type Of Funding C3112 - Aust Not for profit
Category 3112
UON Y

“Knots to know?": Making visible, untangling and exploring tensions associated with different pedagogical approaches to interprofessional education for healthcare students$5,000

Funding body: the Educator Network (tEN)

Funding body the Educator Network (tEN)
Project Team

Mrs Alexandra Little, Mrs Anna Edgar, Mrs Jane Ferns, Dr Miriam Grotowski, Ms Lani De Silva, Dr Anne Croker

Scheme Teaching and Innovation Investment Scheme (TI2)
Role Investigator
Funding Start 2019
Funding Finish 2019
GNo
Type Of Funding Internal
Category INTE
UON N

20181 grants / $114,185

The development and implementation of a GP-specific Certificate in Clinical Teaching and Supervision$114,185

Funding body: Valley to Coast Charitable Trust

Funding body Valley to Coast Charitable Trust
Project Team Mrs Kerry Peek, Professor Brian Jolly, Doctor Cathy Regan, Professor Dimity Pond, Professor Jennifer May, Doctor Miriam Grotowski, Ms Natalie Dodd
Scheme Research Grant
Role Investigator
Funding Start 2018
Funding Finish 2018
GNo G1701233
Type Of Funding C3112 - Aust Not for profit
Category 3112
UON Y

20151 grants / $750

ANZAED 2015 Conference, Gold Coast Australia, 21-22 August 2015$750

Funding body: University of Newcastle - Faculty of Health and Medicine

Funding body University of Newcastle - Faculty of Health and Medicine
Project Team Doctor Miriam Grotowski
Scheme Travel Grant
Role Lead
Funding Start 2015
Funding Finish 2015
GNo G1501048
Type Of Funding Internal
Category INTE
UON Y
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Dr Miriam Grotowski

Position

Senior Lecturer
University of Newcastle Department of Rural Health
Faculty of Health and Medicine

Contact Details

Email miriam.grotowski@newcastle.edu.au
Phone (02) 6755 3506
Fax (02) 67612355

Office

Room Tamworth Education Centre
Building Tamworth Education Centre
Location Callaghan
University Drive
Callaghan, NSW 2308
Australia
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