Search

Background: People with intellectual disabilities are at much higher risk of preventable deaths compared to the general community. However, studies identifying the cause of death in people with intellectual disability are generally based on one primary cause which is frequently attributed to the person's disability. Therefore, the aim of this study was to identify the most common associated causes that may have contributed to the deaths of Australians with intellectual or learning disabilities, particularly those that may be avoidable. Methods: Linked data that had previously been used to identify underlying causes of deaths were re-analysed to determine other contributing causes of death in Australians with intellectual disabilities aged under 65 years who accessed disability services between July 2013 and June 2018. Findings: Two thousand three hundred and thirty-three deaths occurred among 180,790 people with intellectual disability. Contributing causes of death with the greatest disparities compared to the general community were lung diseases due to external agents (adjusted rate ratio (RR) 70.6 (95% confidence interval [95% CI] 63.7-78.2), influenza and pneumonia (RR 18.3; 95% CI 16.4-20.4), and coronary heart disease (RR 3.3; 95% CI 2.8--3.8). Conclusions: Analysing all contributing causes of death in people with intellectual disabilities can ensure that the higher rates of preventable deaths in people with intellectual disability are identified and addressed earlier in the disability and health sectors.

Background: Endovascular clot retrieval (ECR) is known to reduce global disability at 3 months post stroke however limited research exists regarding the trajectory of specific clinical impairments including language, swallowing and cognitive deficits between onset and 3 months. Aims: To assess language, swallowing, and cognitive performance following ECR and explore whether impairment severity is correlated with modified Thrombolysis in Cerebral Infarction score (mTICI), stroke severity or quality of life (QoL). Methods: Assessment was completed within 7 days (T1), 1 month (T2) and 3 months (T3) post-stroke. Performance was measured with the Functional Oral Intake Scale (FOIS), Repeatable Battery for Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT A and B) and Brixton Spatial Awareness Test. The Western Aphasia Battery (WAB) was used for left hemisphere stroke. QoL was measured with the Stroke and Aphasia Quality of Life Scale. Results: Twenty-five participants (median 72 years; 64% male) were prospectively recruited following ECR. High reperfusion success (68% mTICI 3) and low stroke severity post ECR (median 24 h NIHSS = 3, IQR 7-18) were noted. At T1, 10 participants presented with aphasia, eight required a modified diet and 20 had impaired cognition. At T3 all had recovered to a normal oral diet, 39% had persistent cognitive impairment and 45% of patients with left hemisphere stroke remained aphasic. Performance on the WAB, FOIS, RBANS and TMT changed significantly over time (all p < 0.05). The severity score at T1 for all measures, excluding TMT B and Brixton, was significantly correlated with 24 h NIHSS. WAB scores at T3 were correlated with QoL (r = 0.618; p = 0.043). Conclusion: This exploratory study found the longitudinal performance of language, swallowing and cognition significantly improved over time and severity in the first-week post-ECR was correlated with 24 h NIHSS rather than the degree of reperfusion.

Introduction: Speech Language Therapy First Point of Contact Clinic (SLT-FPOCC) models can assist assessment of low-risk patient populations referred to ear, nose and throat (ENT) services. To further improve ENT waitlist management and compliance with best-practice care, consideration of other low-risk populations that could be safely managed through this service model is needed. The aims of this paper are to evaluate the clinical and service outcomes of completing vocal cord check (VCC) assessments for patients' pre and post thyroid/parathyroid surgery within an SLT-FPOCC model and examine consumer perceptions. Methods & Procedures: The service followed existing SLT-FPOCC procedures, with ENT triaging referrals, then SLT completing pre- and postoperative VCC assessment (interview, perceptual assessment, flexible nasendoscopy), with assessment data later reviewed by ENT to diagnose laryngeal pathology. Clinical and service outcomes were collected prospectively. Patients completed an anonymous post-service satisfaction survey. Results: Of the first 100 patients referred for preoperative VCCs, SLT assessment identified 42 with dysphonia and 30 reporting dysphagia, while ENT confirmed 9 with significant preoperative anatomical findings. Eighty-three underwent surgery, with 63 (95 nerves at surgical risk) returning for a postoperative VCC. Postoperative VCC identified three temporary neuropraxias (3.2%) and three unilateral vocal fold paresis (3.2%). Patients were highly satisfied with the service. All 163 pre-/postoperative VCCs were completed with no adverse events. Conclusion & Implications: The current data support SLT-FPOCC service expansion to include pre and post thyroid/parathyroid surgery VCC checks, with positive consumer perception. The model supports delivery of best practice management (i.e., pre- and postoperative VCC) for patients receiving surgery for thyroid/parathyroid dysfunction, and associated efficiencies for ENT services.

The age of the onset of menstruation, termed menarche, has been declining for decades worldwide. Approximately 12% of Australian girls reach menarche between eight to 11 years of age. Current health and physical education subject guidelines from the Australian Curriculum Assessment and Reporting Authority state that puberty education should be introduced to students between year levels five to six (ages 10-12) when many have already begun puberty. To explore how girls experiencing early menarche are currently supported in Australian primary schools, semi-structured telephone interviews were conducted with 15 primary school staff from separate schools, including teachers, principals, a school services officer, and a school counsellor. Thematic analysis identified three main themes, (1) the prevalence of deficit models of early menarche and children's capacity to know; (2) gendered gatekeeping of menstruation knowledge; and (3) systemic barriers and inconsistencies in menstruation education. Our analysis complements but extends recent calls for improvements to menstruation education in Australian schools. Affirmative menstrual support practices and facilities are needed in primary schools to normalise and encourage conversations with students about menarche and menstruation irrespective of age, gender, class or culture.

Telephone-based services are a practical and effective behavioral support for smoking cessation, yet no in-depth analyses of this counseling have been conducted. Understanding the general content of Quitline conversations can help to improve current practices and may inform future interventions. Therefore, we aimed to independently explore conversation themes, topics, and client questions during Quitline counseling sessions with Quitline clients in Queensland, Australia. A purposive sample of 30 recorded counseling sessions, completed between January and March 2019, were de-identified, transcribed, and thematically analyzed. Seven themes, encompassing 35 topics, were derived from 26 initial calls and four follow-up calls: (1) Client details and building rapport; (2) Client history and motivation to quit; (3) Pharmacotherapy; (4) Behavioral aspects of quitting and relationship with smoking; (5) Understanding nicotine dependence and other important considerations; (6) Additional support and smoking cessation resources; and (7) Planning, goal setting and follow-up. Three themes emerged from 18 client questions including: (1) Pharmacotherapy safety and contraindications; (2) Pharmacotherapy instructions and mechanism of action; and (3) Physiology of nicotine dependence. This is the first qualitative analysis of the content of Quitline counseling sessions in Australia. Counselors collect and deliver a breadth of information to provide tailored, evidence-based health care, while building rapport and trust. Findings may be translatable into personalized self-help interventions that are more accessible or appealing to people reluctant to contact Quitline. Harnessing educational opportunities regarding pharmacotherapy adherence and misconceptions can improve client confidence in the product and smoking cessation outcomes. Further research will map conversations to motivational interviewing and behavior change techniques.

Research indicates that effective learner-centred feedback requires learner agency, impact and sensemaking. While scholars are focusing on supporting agency and impact, limited research has addressed sensemaking. This is problematic, because if learners fail to understand feedback, impact is likely to be reduced. In response, this study examines (non) alignment between teacher intent and student sensemaking of authentic feedback comments. The sample included four teachers and eighteen students from two Australian universities. Data were collected via stimulated recall interviews and a feedback coding task. The results suggest that sensemaking of strength-based comments, critiques and actionable information was aided when the comments were clear and specific. On the other hand, sensemaking was limited when comments were designed to mitigate against negative affect, overloaded with multiple intentions, or overly brief. This study informs theory around learner-centred feedback design which, in turn, improves the likelihood that teacher comments will be interpreted accurately by learners.

Self-efficacy is a key factor in performance success, yet little is known about how music educators nurture students' self-belief within studio and class music lessons. This study explored teachers' perceptions of pedagogical priorities in the development of self-efficacy. The goal was to understand how teachers intuitively nurture students' performance self-efficacy and determine the optimal means by which positive self-perceptions and subsequent musical achievement could be most effectively fostered within music environments. Australian music educators (n = 304) responded to a questionnaire asking them to share their strategies for helping students cope with common performance scenarios (exam, first concert, negative experience, and sub-par performance) and key performance issues such as music performance anxiety and confidence. Qualitative analyses coded to the four self-efficacy sources revealed that teachers preferred to focus on mastery experiences and employ verbal persuasion. The development of vicarious experience or the psychological performance skills that would benefit physiological and affective states were given substantially lower priority. There were also some significant between-group findings in the way that studio and school classroom teachers employed verbal persuasion which may be a reflection of the different teaching environments. Efforts to enhance performance self-efficacy could focus on the less-utilized sources. Further recommendations and implications for music pedagogy are outlined.

Menstrual management is recognized as a critical issue for young people internationally. Relatively little published research explores issues pertaining to menstruation in school education. This paper is based on the results of an Australian survey of 5007 young women aged 13-25, which examined their experiences of menstruation and dysmenorrhea. It focuses specifically on participant qualitative responses to the question, "What do you think schools could do to better support girls during their period?" Six key themes were identified across responses. These related to sanitation; pain management; removing stigma; adequate breaks; and being considerate. The findings reported herein highlight some of the challenges menstruating young people encounter at school and give voice to their needs; these have important implications for school improvement in this area.

Understanding the key physiology and anatomy of the brain, and the mechanisms underlying dementia, represents essential components within a medical curriculum. This study assessed the implementation feasibility of an augmented reality (AR) three-dimensional (3D) brain visualisation learning mode and the knowledge improvements in medical students when compared to a text-based pamphlet. The pamphlet group learnt from a double-sided information pamphlet, while the AR group used an AR app. In AR, participants held a cube in front of the camera on the tablet, rendered on-screen as a 3D brain model, and received a narrated lesson containing the same information as the pamphlet verbatim. Both resources were also evaluated for perceived usefulness via pre-post tests and written survey. A total of 24 students participated in the study. A significant overall difference in knowledge scores (p < 0.001) was found for all participants but without significant differences between groups. Prior education was a significant covariate for pre-post change (p = 0.016) across all participants but had no impact on group outcomes. Positive feedback was received on both resources where the majority perceived them as easy to use, enjoyable, and helped develop their knowledge of dementia. Both the text-based pamphlet and AR delivery modes improved knowledge, although neither was significantly superior to the other. However, the AR lesson was perceived highly for learning, and has the potential for implementation within a medical programme.

Background: Previous research suggests that children with or at risk of probable developmental coordination disorder (pDCD) activate different areas of the brain when performing certain motor skills compared with typically developing (TD) children. This study used functional near-infrared spectroscopy to compare prefrontal cortex (PFC) activity in TD and pDCD during the completion of manual (three-dimensional [3D]) and computerized versions (two-dimensional) of the Tower of Hanoi (ToH) puzzle. Method: A total of 12 children (TD and pDCD; one female/11 male, [x-bar] = 10.36, SD ± 1.52 years) performed the two-dimensional and 3D conditions of the ToH disk tasks, with equivalent executive function but different motor requirements, with functional near-infrared spectroscopy to compare PFC activity. Results: Interestingly, brain oxygenation levels were more apparent in the 3D versus two-dimensional ToH. In the 3D, there were large differences between pairs of discordant sibling sets and this was located to the right medial PFC, with pDCD exhibiting less activation in this region. Conclusion: While only exploratory, we have identified potential differences in the right medial PFC region, which differs within sibling sets with different pDCD status. These results concur with previous studies and are an area that needs to be explored further with a larger cohort of TD and pDCD.

Background: Perceptual, cognitive and previous clinical experience may influence a novice Videofluoroscopic Swallowing Study (VFSS) analyst's trajectory towards competency. Understanding these factors may allow trainees to be better prepared for VFSS training and may allow training to be developed to accommodate differences between trainees. Aims: This study explored a range of factors previously suggested in the literature as influencing the development of novice analysts' VFSS skills. We hypothesised that knowledge of swallow anatomy and physiology, visual perceptual skills, self-efficacy and interest, and prior clinical exposure would all influence VFSS novice analysts' skill development. Methods & Procedures: Participants were undergraduate speech pathology students recruited from an Australian university, who had completed the required theoretical units in dysphagia. Data assessing the factors of interest were collected--the participants identified anatomical structures on a still radiographic image, completed a physiology questionnaire, completed subsections of the Developmental Test of Visual Processing--Adults, self-reported the number of dysphagia cases they managed on placement, and self-rated their confidence and interest. Data for 64 participants relating to the factors of interest were compared with their ability to accurately identify swallowing impairments following 15 h of VFSS analytical training, using correlation and regression analysis. Outcomes & Results: Success in VFSS analytical training was best predicted by clinical exposure to dysphagia cases and the ability to identify anatomical landmarks on still radiographic images. Conclusions & Implications: Novice analysts vary in the acquisition of beginner-level VFSS analytical skill. Our findings suggest that speech pathologists who are new to VFSS may benefit from clinical exposure to dysphagia cases, sound foundational knowledge of anatomy relevant to swallowing and the ability to see the anatomical landmarks on still radiographic images. Further research is required to equip VFSS trainers and trainees for training, to understand differences between learners during skill development.

Menstrual health literacy has a direct impact on young peoples' quality of life, health, academic and professional performance. In Australia, the key learning area of Health and Physical Education [HPE] provides opportunities for students to develop menstrual health literacy. This paper reports on the findings of a survey of 5007 young Australian women aged 13-25 on their experiences of menstruation, dysmenorrhea and education. The discussion herein relates to the qualitative component that asked the question 'What was the most useful information about menstruation received in HPE [Health and Physical Education] class?' Applying a thematic analysis to the data, three key themes emerged. These include: (a) it's all just biology; (b) the cause but not the effect, and; (c) too little, too late. The findings suggest limitations in educational approaches taken by teachers potentially resulting in poor menstrual health literacy portending long-term negative health consequences for some individuals.

A national Task Force of 25 Australian physiology educators used the Delphi protocol to develop seven physiology core concepts that were agreed to nationally. The aim of the current study was to unpack the "physiological adaptation" core concept with the descriptor "organisms adjust and adapt to acute and chronic changes in the internal and external environments across the lifespan." This core concept was unpacked by three Task Force members and a facilitator into four themes and nine subthemes that encompass the role of stressors and disturbed homeostasis in adaptation and the capacity for, and the nature of, the physiological adaptation. Twenty-two Task Force members then provided feedback and rated the themes and subthemes for level of importance and difficulty for students to learn via an online survey using a five-point Likert scale. Seventeen respondents completed all survey questions. For all themes/subthemes, importance was typically rated 1 (Essential) or 2 (Important) (n = 17, means ±SD ranged from 1.1 ± 0.3 to 2.2 ± 0.9), and difficulty was typically rated 3 (Moderately Difficult) (n = 17, means ranged from 2.9 ± 0.7 to 3.4 ± 0.9). Subtle differences in the proportion of importance scores (n = 17, Fisher's exact: P = 0.004, ANOVA: F12,220 = 2.630, P = 0.003; n = 22, Fisher's exact: P = 0.002, ANOVA: F12,281 = 2.743, P < 0.001), but not difficulty scores, were observed between themes/subthemes, and free-text feedback was minor. The results suggest successful unpacking of the physiological adaptation core concept. The themes and subthemes can inform the design of learning outcomes, assessment, and teaching and learning activities that have commonality and consistency across curricula.

Consensus was reached on seven core concepts of physiology using the Delphi method, including "integration," outlined by the descriptor "cells, tissues, organs, and organ systems interact to create and sustain life." This core concept was unpacked by a team of 3 Australian physiology educators into hierarchical levels, identifying 5 themes and 10 subthemes, up to 1 level deep. The unpacked core concept was then circulated among 23 experienced physiology educators for comments and to rate both level of importance and level of difficulty for each theme and subtheme. Data were analyzed using a one-way ANOVA to compare between and within themes. The main theme ("theme 1: the body is organized within a hierarchy of structures, from atoms to molecules, cells, tissues, organs, and organ systems") was almost universally rated as Essential. Interestingly, the main theme was also rated between Slightly Difficult to Not Difficult, which was significantly different from all other subthemes. There were two separate subsets of themes in relation to importance, with three themes rating between Essential and Important and the two other themes rating as Important. Two subsets in the difficulty of the main themes were also identified. While many core concepts can be taught concurrently, Integration requires the application of prior knowledge, with the expectation that learners should be able to apply concepts from "cell-cell communication," "homeostasis," and "structure and function," before understanding the overall Integration core concept. As such, themes from the Integration core concept should be taught within the endmost semesters of a Physiology program. [This article was written with Task Force.]

Australia-wide consensus was reached on seven core concepts of physiology, which included homeostasis, a fundamental concept for students to understand as they develop their basic knowledge of physiological regulatory mechanisms. The term homeostasis is most commonly used to describe how the internal environment of mammalian systems maintains relative constancy. The descriptor "the internal environment of the organism is actively regulated by the responses of cells, tissues, and organs through feedback systems" was unpacked by a team of three Australian Physiology educators into 5 themes and 18 subthemes arranged in a hierarchy. Using a five-point Likert scale, the unpacked concept was rated by 24 physiology educators from 24 Australian Universities for level of importance and level of difficulty for students. Survey data were analyzed using a one-way ANOVA to compare between and within concept themes and subthemes. There were no differences in main themes for level of importance, with all ratings between essential or important. "Theme 1: the organism has regulatory mechanisms to maintain a relatively stable internal environment, a process known as homeostasis" was almost unanimously rated as essential. Difficulty ratings for unpacked concept themes averaged between slightly difficult and moderately difficult. The Australian team concurred with published literature that there are inconsistencies in the way the critical components of homeostatic systems are represented and interpreted. We aimed to simplify the components of the concept so that undergraduates would be able to easily identify the language used and build on their knowledge. [This article was written with Task Force.]

A set of core concepts ("big ideas") integral to the discipline of physiology are important for students to understand and demonstrate their capacity to apply. We found poor alignment of learning outcomes in programs with physiology majors (or equivalent) from 17 Australian universities and the 15 core concepts developed by a team in the United States. The objective of this project was to reach Australia-wide consensus on a set of core concepts for physiology, which can be embedded in curricula across Australian universities. A four-phase Delphi method was employed, starting with the assembling of a Task Force of physiology educators with extensive teaching and curriculum development expertise from 25 Australian universities. After two online meetings and a survey, the Task Force reached agreement on seven core concepts of physiology and their descriptors, which were then sent out to the physiology educator community across Australia for agreement. The seven core concepts and their associated descriptions were endorsed through this process (n = 138). In addition, embedding the core concepts across the curriculum was supported by both Task Force members (85.7%) and educators (82.1%). The seven adopted core concepts of human physiology were Cell Membrane, Cell-Cell Communication, Movement of Substances, Structure and Function, Homeostasis, Integration, and Physiological Adaptation. The core concepts were subsequently unpacked into themes and subthemes. If adopted, these core concepts will result in consistency across curricula in undergraduate physiology programs and allow for future benchmarking.

An Australia-wide consensus was reached on seven core concepts of physiology, one of which was cell-cell communication. Three physiology educators from a "core concepts" Delphi task force "unpacked" this core concept into seven different themes and 60 subthemes. Cell-cell communication, previously unpacked and validated, was modified for an Australian audience to include emerging knowledge and adapted to increase student accessibility. The unpacked hierarchical framework for this core concept was rated by 24 physiology educators from separate Australian universities, using a five-point scale for level of importance for student understanding (ranging from 1 = Essential to 5 = Not Important) and level of difficulty (ranging from 1 = Very Difficult to 5 = Not Difficult). Data were analyzed with the Kruskal-Wallis test with Dunn's multiple comparison test. The seven themes were rated within a narrow range of importance (1.13-2.4), with ratings of Essential or Important, and statistically significant differences between the themes (P < 0.0001, n = 7). The variance for the difficulty rating was higher than for importance, ranging from 2.15 (Difficult) to 3.45 (between Moderately Difficult and Slightly Difficult). Qualitatively, it was suggested that some subthemes were similar and that these could be grouped. However, all themes and subthemes were ranked as Important, validating this framework. Once finalized and adopted across Australian universities, the unpacked core concept for cell-cell communication will enable the generation of tools and resources for physiology educators and improvements in consistency across curricula. [This article was written with Task Force.]

This article showcases the redesign of an introductory undergraduate vertebrate physiology unit at Murdoch University (BMS107) to promote student mastery of six Core Concepts of Physiology (Michael J, Cliff W, McFarland J, Modell H, Wright A, SpringerLink. "The Core Concepts of Physiology: a New Paradigm for Teaching Physiology," 2017). Concepts were selected for their suitability in an introductory physiology unit and their ability to scaffold advanced physiology learning. Innovative curricular and pedagogical approaches were employed to 1) create a Core Concepts structure, 2) sell the Core Concepts approach to students, 3) foreground Core Concepts in learning materials, 4) actively engage students with Core Concepts, 5) revise, and 6) assess Core Concepts understanding. Median student marks and overall satisfaction with the unit were unaffected by the introduction of a Core Concepts approach. Notably, though, there was a 14% increase in student agreement with the statement "I received feedback that helped me to learn." The challenge of the Core Concepts approach was articulated by students, but these novice learners also recognized Core Concepts as a mechanism to focus their understanding of physiology and promote critical thinking. For teaching staff, a Core Concepts approach was a reinvigorating opportunity to apply their expertise to the teaching of introductory physiology. We propose that a strong Core Concepts emphasis, while challenging, is highly rewarding for staff and provides students with a "disciplinary passport" that better prepares them to progress in diverse courses and professions.

A task force of physiology educators from 25 Australian universities generated an Australia-wide consensus on seven core concepts for physiology curricula. One adopted core concept was "cell membrane," defined as "Cell membranes determine what substances enter or leave the cell and its organelles. They are essential for cell signaling, transport, and other cellular functions." This concept was unpacked by a team of 3 Australian physiology educators into 4 themes and 33 subthemes arranged in a hierarchical structure up to 5 levels deep. The four themes related to defining the cell membrane, cell membrane structure, transport across cell membranes, and cell membrane potentials. Subsequently, 22 physiology educators with a broad range of teaching experience reviewed and assessed the 37 themes and subthemes for importance for students to understand and the level of difficulty for students on a 5-point Likert scale. The majority (28) of items evaluated were rated as either Essential or Important. "Theme 2: cell membrane structure" was rated as less important than the other three themes. "Theme 4: membrane potential" was rated most difficult, while "theme 1: defining cell membranes" was rated as the easiest. The importance of cell membranes as a key aspect of biomedical education received strong support from Australian educators. The unpacking of the themes and subthemes within the cell membrane core concept provides guidance in the development of curricula and should facilitate better identification of the more challenging aspects within this core concept and help inform the time and resources required to support student learning. [This article was written with Task Force.]

An Australia-wide consensus was reached on seven core concepts of physiology, one of which was "structure and function" with the descriptor "Structure and function are intrinsically related to all levels of the organism. In all physiological systems, the structure from a microscopic level to an organ level dictates its function." As a framework for the structure and function core concept, the renal system was unpacked by a team of 5 Australian Physiology educators from different universities with extensive teaching experience into hierarchical levels, with 5 themes and 25 subthemes up to 3 levels deep. Within "theme 1," the structures that comprise the renal system were unpacked. Within "theme 2," the physiological processes within the nephron such as filtration, reabsorption, and secretion were unpacked. Within "theme 3," the processes involved in micturition were unpacked. In "theme 4," the structures and processes involved in regulating renal blood flow and glomerular filtration were unpacked; and within "theme 5," the role of the kidney in red blood cell production was unpacked. Twenty-one academics rated the difficulty and importance of each theme/subtheme, and results were analyzed using a one-way ANOVA. All identified themes were validated as "essential" to "important"/"moderately important" and rated between "difficult" to "not difficult." A similar framework consisting of structure, physiological processes, physical processes, and regulation can be used to unpack other body systems. Unpacking of the body systems will provide a list of what students should be taught in curricula across Australian universities and inform assessment and learning activities. [This article was written with Task Force.]

Core concepts in physiology, designed by physiology educators to promote improved learning and teaching, have existed for over a decade. This study aimed to investigate the extent to which a set of 15 core concepts of physiology (developed by Michael and McFarland, U.S.-based educators) are reflected in the learning outcomes (LOs) of units (subjects) comprising physiology curricula in Australian universities. From publicly accessible online information, we identified 17 Australian universities that offered a physiology major for undergraduate degree students and downloaded 788 LOs from the 166 units that comprised the majors. Each LO was blindly mapped against the 15 core concepts by 8 physiology educators from 3 Australian universities. Additionally, text-matching software was employed to match keywords and phrases (identified as descriptors of the 15 core concepts) against the LOs. The frequency of individual words and two-word phrases for each core concept was calculated and ranked. There was variability in rating LOs for the same university among academic mappers; nevertheless, many of the 15 core concepts did not appear to be adequately covered in the LOs. Two core concepts most matched manually were in the top three most mapped by the software. These were, from most common, structure/function and interdependence. Our findings suggest a lack of alignment of LOs with the core concepts across Australian physiology curricula. This highlights the need for Australia-wide agreement on a set of core concepts in physiology as the first step in collaboratively improving assessment and learning and teaching practice in physiology.

Australia-wide consensus was reached on seven core concepts of physiology. The "movement of substances" core concept with the descriptor "the movement of substances (ions or molecules) is a fundamental process that occurs at all levels of organization in the organism" was unpacked by a team of three Australian physiology educators from the Delphi Task Force into hierarchical levels. There were 10 themes and 23 subthemes arranged in a hierarchy, some 3 levels deep. Using a 5-point Likert scale, the unpacked core concept was then rated for level of importance for students to understand (ranging from 1 = Essential to 5 = Not Important) and level of difficulty for students (ranging from 1 = Very Difficult to 5 = Not Difficult) by the 23 physiology educators from different Australian universities, all with a broad range of teaching and curriculum experience. Survey data were analyzed using a one-way ANOVA to compare between and within concept themes. The main themes all were rated on average as important. There was a wide range of difficulty ratings and more variation for this concept compared with the other core concepts. This may in part be due to the physical forces such as gravity, electrochemistry, resistance, and thermodynamics that underpin this concept, which in themselves are inherently complex. Separation of concepts into subthemes can help prioritize learning activities and time spent on difficult concepts. Embedding of core concepts across curricula will allow commonality and consistency between programs of study and inform learning outcomes, assessment, and teaching and learning activities.

Due to the emerging demands on shifting focus towards the development of more student-centered and engaging learning experiences, this systematic review elucidates the effectiveness of PeerWise introduction into the blended learning model in Physiology education based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Twenty electronic databases were utilized to access related studies between years 2010 to April 2020. A total of eight recent articles on PeerWise in physiology were analyzed. Three studies were conducted among medical students, and five studies were among other courses (i.e., Pharmacy, Biomedical Science, Optometry, and Human Physiology). Majority of the study designs were of cross-sectional quantitative and qualitative studies. Data extracted from the articles include (i) the pattern of PeerWise usage, (ii) the association between PeerWise and academic achievement, (iii) the level of student engagement, (iv) the quality of questions created and (v) students? perceptions. Four emerging themes were identified among students' perceptions; (i) learning competency, (ii) fun learning experience, (iii) engagement with peers, and (iv) motivation. Methodological quality and risk of biased were assessed; and research gaps, limitations and recommendations were addressed. The present review serves as a guide for new authors to refine their knowledge and improve future research in the topic area.

A great deal has been achieved in recent years in understanding how universities can best support the transition to higher education of an increasingly diverse student body (Kift, 2015). Numerous studies have identified transition program elements that correlate with improved success and retention for commencing students. Lizzio's 'five senses' model (2006) rationalises these diverse features into a framework consisting of five affective domains that need to be developed in students to ensure successful transition. To assess how well a program based on the Lizzio model supports transition in practice, we evaluate our Get Ready transition program, developed for a large-enrolment first year Human Physiology subject with a highly diverse student cohort. We conclude that embedding the development of Lizzio's five senses in a performative way is the key to building students' agency and nurturing their identity as thriving members of a new academic community.

Anecdotal data suggest great variation in breadth and depth of skeletal muscle coverage between undergraduate human anatomy (HA) and anatomy and physiology (A&P) courses. This manuscript is the second in a series (Reynolds A, Goodwin M, O'Loughlin V. D. "Adv Physiol Educ" 46: 309-318, 2022. doi:https://doi.org/10.1152/advan.00084.2021) that methodically assesses skeletal muscle content coverage across undergraduate HA and A&P courses. The authors developed an online skeletal muscle coverage survey and collected 342 responses worldwide, 156 from instructors of HA courses and 186 from A&P course instructors. Demographic results showed that HA courses are primarily taught at 4-year baccalaureate institutions, have relatively larger class sizes, and are more likely to use human (vs. animal) prosections or dissections. In contrast, A&P courses are primarily taught at community colleges, have relatively smaller class sizes, and are more likely to use animal (vs. human) dissections. HA courses tend to require their students to learn all skeletal muscle aspects (i.e., identification, action, attachments, innervation), whereas A&P courses tend to focus on muscle identification or action only. The proportions of courses that require identification of large, superficial skeletal muscles are similar between the two course types. However, HA courses are more likely to require their students to identify deeper and smaller muscles, including more distal appendicular muscles and pelvic muscles. These differences likely are due, in part, to the more anatomical focus of HA courses and the slightly different student populations between these courses. These findings provide much-needed information about muscular system coverage between HA and A&P courses and may guide instructor discussions about curricula. [For the first article in the series, "General Trends in Skeletal Muscle Coverage in Undergraduate Human Anatomy and Anatomy and Physiology Courses," see EJ1347509.]

Studies show teaching assistants (TAs) can positively influence the learning environment by increasing student comprehension and retention and impacting students' choices of academic and career paths. However, use of TAs in higher education is not universal. Following a fruitful panel discussion at the 2017 HAPS Conference, we conducted a survey to assess the prevalence of undergraduate and graduate TAs in human anatomy and physiology courses across a range of institutions and to evaluate how TAs are recruited, trained and compensated. Data from 329 respondents who used TAs, indicate most institutions use a formal application process, training procedures vary, and most TAs are compensated financially through hourly wages, stipends, or tuition credit. However, some TAs are unpaid but receive course credit as compensation. We highlight one of the more successful recruiting and training programs, where paid master TAs mentor unpaid apprentice TAs. This tiered training program excites and motivates student leadership, maintains high academic standards, and alleviates the lead instructor from continually training novice TAs.

There have been significant increases in the number of students studying physiology in the Bachelor of Science degree-program at our university. We thought that physiology prerequisites for graduate programs in medicine and allied-health areas were facilitating these increased numbers. Undergraduate physiology students were surveyed about their career priorities: 25% were undecided/uncertain; 22% intended to study graduate medicine; 15% wanted to get a job straight after their degree; 10% planned to study in an allied-health area. Their careers uncertainty remained high, even in their final semester, suggesting a critical need for in-curriculum careers education. With 32% of students selecting graduate programs in medicine or allied-health, this supports the idea that elevated student enrollments are driven by their future study plans. With only 5% of students putting research as their career priority, this raises concerns about how we educate our physiology students. Should we be educating them to be researchers and also developing their skills in preparation for graduate health-related programs?

Composing Territory is a research project with two main aims. The first aim is to identify optimal composition and arrangement techniques for choral works written for female singers from various linguistic backgrounds in the Northern Territory whose voices are undergoing pubertal changes. The second aim is the creation of twelve choral compositions plus an accompanying teaching resource, to provide sequential delivery appropriate to the educational context of the region, wherein the majority of choral educators have no music training. The diverse and transient nature of the Northern Territory's population and the lack of education training and resources for choral delivery make traditional choral works inaccessible and tonal homogeneity of choirs unlikely. By changing the way we compose choral works it may be possible to ensure student learning continues through the period of female vocal change, achieve more homogenous sounds from linguistically diverse choristers, and successfully establish choral blend. Underpinning the compositional process with pedagogical considerations of linguistic differences and pubertal changes delivered through appropriate teaching strategies and resources will be significant outcomes of this projects. These outcomes could ensure non-music specialists are better equipped for choral delivery and student learning continues throughout voice change processes unhindered by individual linguistic background.

Anatomy and Physiology at the University of Canberra, Australia, as in many institutions, is taught to large cohorts at the foundational level. There is a requirement for students to not only retain information regarding physiological systems and their associated anatomy, but also the integration and relationship between systems. Furthermore, students are often employed in clinical settings post-graduation and the need for real-world understanding is paramount. Assessing this type of understanding is challenging and academics must move beyond tradition exam models. Using case studies as the basis for exam questions is an exciting format for eliciting student understanding of physiological systems which, at the University of Canberra, has resulted in 7% higher grades compared to traditional short answer exams. The benefits go beyond grades, with students appearing more confident in answering questions and better able to integrate information.

Since the availability of lecture recordings, there have been limited studies of any associations between face-to-face lecture attendance and academic outcomes. The aims of the study, in an introductory pathophysiology course, where lecture recordings were available, were 1) to quantify lecture attendance and any associations between academic outcomes and lecture attendance, and 2) to determine why students do or do not attend lectures. Data were analyzed for the whole cohort before separating the nursing ([approximately]60%) and nonnursing students. Of 288 enrolled students, 205 consented to sign the attendance register, and 139 to undertake the online survey. Lecture attendance was higher (41%) before the midsemester exam than afterwards (24%), P < 0.001, due to higher attendance by the nursing than nonnursing students. Students who attended [greater than or equal to]50% of lectures consistently got higher academic outcomes than those that attended <50%, e.g., examinations, 11 percent points higher. Pearson's or Spearman's correlation coefficients for students from both the sign-in and survey showed that there were positive associations between lecture attendance and academic outcomes, which were mainly weak for nursing students (P [less than or equal to] 0.05), with no association for nonnursing students. From the survey, most students who attended lectures did so because they considered they learned more by attending lectures, whereas not liking the lecture time was the most common reason for not attending lectures. In conclusion, even though students have access to lecture recordings, lecture attendance is still a determinant of academic outcomes for some students of pathophysiology.

The COVID-19 pandemic triggered university lockdowns, forcing physiology educators to rapidly pivot laboratories into a remote delivery format. This study documents the experiences of an international group of 10 physiology educators surrounding this transition. They wrote reflective narratives, framed by guiding questions, to answer the research question: "What were the changes to physiology laboratories in response to the COVID-19 pandemic?" These narratives probed educators' attitudes toward virtual laboratories before, during, and after the transition to remote delivery. Thematic analysis of the reflections found that before COVID-19 only a few respondents had utilized virtual laboratories and most felt that virtual laboratories could not replace the in-person laboratory experience. In response to university lockdowns, most respondents transitioned from traditional labs to remote formats within a week or less. The most common remote delivery formats were commercially available online physiology laboratories, homemade videos, and sample experimental data. The main challenges associated with the rapid remote transition included workload and expertise constraints, disparities in online access and workspaces, issues with academic integrity, educator and student stress, changes in learning outcomes, and reduced engagement. However, the experience generated opportunities including exploration of unfamiliar technologies, new collaborations, and revisiting the physiology laboratory curriculum and structure. Most of the respondents reported planning on retaining some aspects of the remote laboratories post-pandemic, particularly with a blended model of remote and on-campus laboratories. This study concludes with recommendations for physiology educators as to how they can successfully develop and deliver remote laboratories.

Hemolytic disease of the newborn (HDN) is a potentially fatal condition caused by a Rhesus (Rh) antigen incompatibility between a mother and fetus. As a result, determining the Rh status of expectant parents is a routine clinical assessment. Both the physiological and immunological basis of this condition are taught to undergraduate students. At the University of South Australia, some undergraduate immunology students find this topic challenging. The author designed, implemented, and assessed the impact of an interactive simulation to facilitate student learning of HDN. The students were actively engaged in determining the blood grouping and Rh status of an expectant mother and father and then determining the possibility of developing HDN. The simulation was found to take only 15 min to complete yet led to a significant increase in student performance in an end of semester exam question. Student perceived understanding was found to significantly improve following the introduction of the simulation, even though the content had been covered in a formal lecture. Student feedback was highly positive of this learning approach. In conclusion, short, interactive simulations can be used effectively to enhance student learning of challenging concepts.

Laboratory classes are a cornerstone of physiology education, enabling students to develop essential knowledge and skills. Recent moves toward utilizing blended options to support face-to-face classes with online materials are beneficial, but using solely online classes may not produce similar learning gains. During 2020, the global pandemic meant a loss of face-to-face teaching, such that laboratory classes were rapidly transitioned to online delivery. This study explores the impact of this shift on undergraduate students, evaluating their use of the online laboratory classes and the impact this had on their examination performance and their perceptions of learning. Student use of the online laboratory classes varied, with those spending more time performing better on examinations. Students valued the online classes, finding them helpful for their learning, but also felt that the lack of face-to-face laboratory classes and interactions with peers and teaching staff was detrimental to their learning experience. Overall, academic performance of online learners was comparable to previous years but may indicate some underlying deficits.

The amalgamation of educational technologies in higher education is widespread and has become essential for contemporary practice on a large scale. Foundational anatomy and physiology knowledge is integral to all courses in health education. To tackle the volume and complexity of the content taught at the foundation level, the incorporation of online tools embedded within curricula provides a unique opportunity to engage students through active learning strategies in a blended design (Means B, Toyama Y, Murphy R, Baki M. "Teach Coll Rec" 115: 1-47, 2013). This article reports on the use of H5P as a platform to foster self-paced and self-directed learning, critically outlining the developmental process involved in scaffolding activities to learning outcomes. The H5P activities were embedded within the online learning management system, which enabled tracking of student access to these resources. Students were asked to complete an online survey about their perspectives on the effectiveness of H5P activities. This work is part of a comprehensive study evaluating the blended design for delivery of first-year physiology subjects.

While completing a science test and science survey, 155 high school students wore a biometric wristband (measuring electrodermal activity; EDA) and self-reported their science self-efficacy and science anxiety. Adopting a challenge-threat appraisal perspective and latent profile analysis, we explored how students were psychologically (self-efficacy, anxiety) and physiologically (EDA) oriented to science. We identified three groups (profiles), representing different challenge-threat profiles. The largest group was the 'composed challenge-and-threat' group (modest EDA, average anxiety, average self-efficacy). The next largest was the 'aroused high-threat' group (elevated EDA, elevated anxiety, low self-efficacy). The third represented 'composed high-challenge' students (modest EDA, elevated self-efficacy, low anxiety). The aroused high-threat group scored significantly lower than composed high-challenge and composed challenge-and-threat groups in science test performance and flow. Notably, the composed high-challenge and composed challenge-and-threat groups did not significantly differ in test performance; however, the composed high-challenge group was significantly higher in flow than the composed challenge-and-threat group.

Authentic assessment has long been recommended as valuable for engaging and motivating students. However, given the choices available to students in completing authentic tasks, the products of such assessment may vary in authenticity. This study aimed to evaluate the authenticity of students' assessment products and their perceptions regarding the task. Occupational therapy students created an information sheet for other health professionals about a disease or condition, and were awarded marks for content but not presentation. The students' products (n = 59) were evaluated for authenticity using a novel rubric developed during this study. Students' perceptions regarding what made their information sheet real and their approach to creating it were also evaluated. The authenticity of the information sheets was variable, with most having moderate to high authenticity. However, there was no correlation between authenticity and course grade. Students said the presentation and content of their information sheets increased its realism, and that they were influenced by a desire to provide information appropriate for their target audience. Few were deterred by the lack of presentation marks. When given choice over product design, students tend to create products that are authentic. They are strongly influenced by the defined audience, despite the challenge this poses.

Anatomy and physiology teaching has undergone significant changes to keep up with advances in technology and to cater for a wide array of student specific learning approaches. This paper examines perceptions towards a variety of teaching instruments, techniques, and innovations used in the delivery and teaching of anatomy and physiology for health science students, and asks whether active learning through more progressive methods of teaching is beneficial for students across health science disciplines. In total, 138 health science students consisting of 32 biomedical science students, 52 exercise and sports science students, and 54 health and physical education students completed the retrospective study. Biomedical science students were least receptive to progressive teaching modalities, preferring anatomical dissections to laboratory workbooks (p <0.05) and body painting (p <0.05). In comparison, students from health and sport related degrees responded significantly better to anatomical models and laboratory workbooks than anatomical dissections (p <0.001). While gender differences were subtle, males responded positively to online multiple-choice question resources (p < 0.05) in comparison to females. Following a multimodal delivery of anatomy and physiology, students from all cohorts reported feeling significantly more confident (p < 0.005) when discussing all material in the course. The results obtained demonstrate differences amongst cohorts, which indicate that student perceptions to learning anatomy and physiology are dependent on individual course expectations. Moreover, these results support "hands on" practical teaching, and the use of a variety of teaching tools to foster learning and enjoyment of anatomy and physiology in health sciences.

There has been an increasing movement towards the introduction of inquiry based learning in undergraduate physiology laboratories. Students can however find this challenging when there is a sudden transition from traditional didactic practicals to full inquiry based activities. One reason for this could be the students' perceptions about the introduction of inquiry based learning. The aim of this preliminary scoping investigation was to judge students' attitudes towards inquiry based learning following a practical containing an element of inquiry. Students were supplied with approximately 2.5cm gastrointestinal ileal loops from guinea-pigs which they connected via a force transducer to recording equipment. Students were also provided with 4 agonists and 4 antagonists for which they had to determine which antagonist paired with which agonist and which order to add the drugs. After the practical students completed a questionnaire and survey. Twenty nine percent of students strongly agreed and 54% agreed that detailed instructions should be given about how to carry out each practical. In answer to the statement I'd value the opportunity to design and carry out my own experiments, 12% strongly agreed, whilst 27% agreed and 48% were neutral. The commonest anxieties expressed by the students were that they would not understand the practical and not getting the right results. These findings suggest that considerable thought needs to be given as to how to best introduce physiology students to inquiry based practicals and that these student cohorts may benefit from some more scoping activities. Some ideas for these scoping activities are presented.

Students commencing tertiary education enter through a number of traditional and alternative academic pathways. As a result, tertiary institutions encounter a broad range of students, varying in demographic, previous education, characteristics and academic achievement. In recent years, the relatively constant increase in tertiary applications in Australia has not translated to an increase in student retention or graduate numbers. The Health Sciences discipline typically falls within this paradigm, prompting various approaches to promote academic success and overall student retention. In this study, the demographic and previous education of health science students at an Australian University, were analysed along with first year science grades from a core first year anatomy and physiology unit. A generalized linear model (GLM) demonstrated statistically significant relationships between performance in the unit (measured by grade point average) and year 12 Australian Tertiary Admissions Rank (ATAR) subjects (human biology and chemistry; p<0.001) and gender (p<0.001). No significant performance correlation was observed with household socioeconomic status, as measured by socio-economic indexes for areas. Taken together, the results from this study facilitate estimation of academic success by some parameters prior to their commencement at University.

To properly understand sex education, it is important to consider the informal education that takes place outside the classroom. Students often seek out other resources to supplement the education they receive in school, especially to cover topics which are absent or underdeveloped in the formal sex education curriculum. A key resource for this, especially among young women, is the magazine advice column. Advice columns create a direct interaction between the reader and the magazine and encourage the disclosure of intimate, confidential information, making them a ready medium for the production and consumption of sex education. This study uses the advice columns in "Dolly," a popular Australian magazine, to investigate adolescents' concerns about normality. This research is based on a corpus of 88,000 words, with data from advice columns published 20 years apart (mid-1990s and mid-2010s), which is analyzed using keywords and concordancing. This is a unique corpus study in that it considers similarity as well as difference in the data by investigating the recurring concern with normality that is evident in both decades of the corpus.

Flipped classroom teaching has been used by many educators to promote active learning in higher education. This andragogy is thought to increase student engagement by making them more accountable for their learning and increase time on task in the classroom. While there are several systematic reviews that point to improved student results, it remains unclear if flipped classrooms have positive learning effects in physiology education. Flipped classroom teaching was introduced in two advanced physiology subjects (advanced neuroscience, "semester 1," and cardiorespiratory and renal physiology, "semester 2"). Changing the mode of content delivery reduced the time students needed to spend listening to lectures by one-third, without sacrificing either learning content or academic standards. Higher pass rates were observed with larger number of students earning distinction and high-distinction grades. Statistically significant improvements in final grades were observed from both subjects ("semester 1": 2017, 49.28 ± 20.16; 2018, 53.29 ± 19.77, t[subscript 268] = 2.058, P = 0.0405; "semester 2": 2017, 58.87 ± 21.19; 2018, 67.91 ± 20.40, t[subscript 111] = 2.306, P = 0.023). Finally, students' perception of their learning experience remained at or above the university benchmarks (median score of [greater than] 80% for all iterations of the subjects). While the most frequent and persistent area that students suggested could be improved was reduction of content, equal numbers of students commented that no improvement in the subjects was required. Despite the generally positive attitude to recorded didactic teaching content, classroom attendance remained very low, and students did not engage with the active learning content. This suggests that more emphasis needs to be placed on promoting class attendance by developing better active learning content.

Learning anatomy and physiology at university can be challenging, as students need to understand both the language of the discipline and complex topics, such as system integration. Yet learning strategies are rarely taught at university, making it difficult for students to adopt new strategies, if their approach to learning has not been effective or efficient. This study evaluated the use of small-group peer discussion boards as an avenue for sharing learning strategies between students in a first-year anatomy and physiology course. The majority of students (91%) identified strategies from the discussion board worth trying before they completed the midsemester exam. The most frequently reported type of strategy was transforming records. By the end of semester, 76% of students had adopted at least one new strategy; however, these students performed significantly worse on the exam compared with students who did not adopt new strategies. The students who adopted new strategies learned about them from peers (33%), the discussion board (32%), or through self-discovery (32%). The majority of students (83%) found the discussion boards to be useful as a source of new learning strategies and for insight into how others learn. Although the discussion boards provided an avenue for students to learn about new strategies from each other, further guidance from instructors may be required to help students evaluate the effectiveness of these learning strategies.

An accurate self-assessment of student work can enhance student learning and subsequently improve academic performance. Instructors can facilitate this process by providing "standards" that students can utilize as feedback when self-evaluating their understanding. Traditional forms of feedback, such as marked assessment tasks, are limited in their ability to serve as standards, as they do not adequately capture variations corresponding to different levels of understanding. To develop a complex understanding in physiology, students have to integrate concepts pertaining to different subcomponents of body systems. The present study attempted to ascertain if exposing students to variations in complexity would refine their ability to self-evaluate their understanding and capacity to integrate concepts. Students were tasked to answer an essay-length, open-ended physiology question to expose their current understanding of the topic. The change in students' self-marking of their answer before and after being exposed to the variations in conceptual understanding of the topic were used to determine whether improvements in self-evaluation accuracy occurred. These variations were presented as instructor-generated answers to the open-ended question, framed using the structure of the observed learning outcome (SOLO) taxonomy. Student scores in the integrative questions of the end-of-semester exam were used as a measure of student ability to integrate concepts. Findings indicated that this intervention led to improvements in student self-evaluation and exam performance, and the positive outcomes were replicated across multiple iterations of the activity.

Promoting student engagement and academic achievement in first-year anatomy and physiology courses. "Adv Physiol Educ" 43: 443-450, 2019; doi:10.1152/advan.00205.2018. Students from three undergraduate programs at James Cook University, Queensland, Australia, studying combined first-year anatomy and physiology courses, showed different academic achievement in physiology. Physiotherapy students were more active and social when completing learning tasks and achieved significantly higher grades in physiology compared with students enrolled in Sport and Exercise Science and Occupational Therapy programs. To promote academic engagement and achievement by all three groups, discussion questions, case studies, and study guides were included. The aim of this study was to investigate the effectiveness of using these modified resources to promote active learning, enhance academic social interactions, and provide a supportive learning environment. The occupational therapy students showed increased academic achievement (from 57.9 to 66.5%) following implementation of the new resources, but there was no change in the already high-performing physiotherapy students (73.1%) and, more concerningly, the sport and exercise science students (from 54.6 to 56.7%). Fewer sport and exercise science students had prior learning in chemistry (30.4% of participants) and also spent little time outside class studying (8 h/wk), compared with the physiotherapy cohort (70.0% chemistry; 13 h/wk studying). Findings of this research demonstrate that creating a supportive and active learning environment are important factors in promoting the learning of physiology for some cohorts. Background knowledge, academic self-regulatory skills, and the experience of teaching staff are factors that must be considered when endeavoring to increase student academic achievement. Future studies should examine the effect of students' academic self-regulation and the use of remedial chemistry classes when learning physiology.

Purpose: Introductory anatomy and physiology provide a core knowledge base to students within clinical health science courses. Increased student numbers, as well as reduced access to laboratory-based cadaveric resources, have created a need for enhanced learning approaches to support learning. The streamlining of courses has also resulted in the need to effectively engage course sub-groups within large units. The purpose of this paper is to utilize the eLearning activities to investigate engagement and satisfaction levels within students undertaking an anatomy and physiology unit. Design/methodology/approach: A total of 19 formative quizzes were made available to students. Online practical anatomy laboratories covered anatomical content, and physiology quizzes covered physiological content. Student engagement was compared using frequency analysis across students studying varying courses. Satisfaction was determined by analyzing student's feedback using frequency analysis. Findings: Students accessed the learning activities 29,898 times over semester, with the peak access (37 percent) prior to the closed book exams. The resources were utilized primarily as an exam preparation tool rather than consistently throughout semester. Out of the various courses, the Paramedicine, Physiotherapy and Podiatry students were the most engaged, with the highest percent of "engaged/highly engaged" students. Students from various courses shared very similar views of the perceived benefit of the eLearning activities. Practical implications: These results indicated a difference in engagement levels between the students of various course sub-groups, and therefore suggests that the development of course-specific eLearning activities is necessary in large, streamlined units to achieve a more focused approach to support students' learning, engagement and success, so that positive and beneficial learning experiences are ensured for all students. Originality/value: These results suggest that in the future, development of eLearning activities is necessary to achieve a more focused approach to support students' learning, engagement and success, so that positive and beneficial learning experiences are ensured for all.

Two experiments tested whether a peak-shifted generalization gradient could be explained by the averaging of distinct gradients displayed in subgroups reporting different generalization rules. Across experiments using a causal judgment task (Experiment 1) and a fear conditioning paradigm (Experiment 2), we found a close concordance between self-reported rules and generalization gradients using a continuous stimulus dimension (hue). Both experiments also showed an overall peak-shifted gradient after differential conditioning, but not after single cue conditioning. Importantly, the peak shift could be decomposed into linear and peaked gradients when participants were divided into rule subgroups. Our results highlight the need to consider individual differences in the rules that participants derive in human generalization studies and suggest that in some situations, peak shift may be a consequence of averaging across diverse rule subgroups.

This study examined primary school teachers' knowledge of anxiety and excessive anxiety symptoms in children. Three hundred and fifteen primary school teachers completed a questionnaire exploring their definitions of anxiety and the indications they associated with excessive anxiety in primary school children. Results showed that teachers had an understanding of what anxiety was in general but did not consistently distinguish normal anxiety from excessive anxiety, often defining all anxiety as a negative experience. Teachers were able to identify symptoms of excessive anxiety in children by recognizing anxiety-specific and general problem indications. The results provided preliminary evidence that teachers' knowledge of anxiety and anxiety disorders does not appear to be a barrier in preventing children's referrals for mental health treatment. Implications for practice and directions for future research are discussed. (Contains 2 tables.)

Demand for clinical placements in physiotherapy education continues to outstrip supply. Peer assisted learning, in various formats, has been trialled to increase training capacity and facilitate student learning during clinical education. There are no documented examples of measurable or repeatable peer assisted learning models to aid clinicians in implementing these strategies. The aim of this research was to develop a repeatable and quantifiable peer assisted learning model of clinical education for paired undergraduate physiotherapy students. Additionally, the project aimed to evaluate the impact of clinician engagement in the model development process on their self-rated ability to facilitate peer assisted learning. A series of four workshops was conducted to facilitate development and refinement of a peer assisted learning model by physiotherapy clinical educators. The workshops introduced relevant peer learning principles and a range of clinically relevant educational tools to educators. Consensus was targeted on the tools and approaches that would underpin the peer assisted learning model. A survey investigating participants' self-rated ability to facilitate components of peer assisted learning was administered prior to, and on completion of, the workshop series. Educators agreed on a model to facilitate student peer interaction in clinical reasoning, observation of performance, risk identification and mitigation, and feedback and coaching. Tools to evaluate student and clinical educator outcomes were developed. On completion of the workshops, participants reported significantly more confidence in their ability to facilitate peer assisted learning. Development of a peer assisted learning model of clinical education that is acceptable to clinical educators was achieved through stakeholder involvement from concept stage. Assessment of educator knowledge and confidence, combined with critical review of stakeholder feedback at multiple stages in model development, appeared effective in conveying ownership of the model to clinical educators and identifying the support required for confidence in facilitating peer assisted learning.

In 2011, the Department of Human Biosciences introduced two physiology capstone subjects as part of the Design for Learning Project at La Trobe University. Consistent with the project, the aims of these subjects were to provide an effective culmination point for the Bachelor of Health Science course and to offer students orientation to opportunities for further study, employment and career development. The aim of this paper is to provide an overview of the skills-related assessment tasks of the newly introduced capstone program and an evaluation of the capstone program based on student performance and feedback scores in conjunction with staff perceptions. The skills-related assessment tasks were designed to facilitate the development of research skills and graduate capabilities such as writing, speaking, creative problem-solving, inquiry/research and team work. Student performance determined by mean scores on the skills-based assessment tasks ranged from A to C. Final grades were significantly higher (p less than 0.01) in 2011 when compared with final grades in 2010 and 2009. Students reported that the skills-based assessments contributed to their learning and skill development and satisfaction level was high. Staff noted a higher degree of student-centred learning, a vastly increased workload and a greater need for infrastructure services and support staff. Universities and departments should therefore consider staff and resource requirements when implementing curriculum that has a student-centred approach. In conclusion, the revised curriculum successfully promoted the development of research skills and graduate capabilities, thereby leading to work-readiness and/or entry to graduate studies in the Health and Biological Sciences. (Contains 4 tables and 3 figures.)

Physiology courses are considered to be challenging for students to master due to the highly conceptual nature of the discipline and the substantial cognitive effort required to understand disciplinary knowledge. Students must choose appropriate learning strategies to develop their understanding, as their choices may influence both their understanding and their academic achievement. The primary aim of this study was to develop an understanding of why students experience difficulties with physiology and how they respond when facing the challenge of learning this discipline. Undergraduate allied health students (n=231) studying physiology were asked to identify the topics they had difficulty understanding, the strategies they used to deal with that difficult knowledge, and the reasons for their difficulties. Consenting students' responses were subjected to inductive and deductive thematic analyses, and their performance on examinations were collated. Students reported that they found physiology difficult due to their lack of familiarity with it and the level of detail required. To aid their understanding of difficult topics, students commonly reported reviewing information, seeking further information, and seeking social assistance, with more high-achieving students reporting reviewing records, and fewer reporting seeking social assistance than poor achieving students. Most notably, a disconnect was found between students' reporting of difficult modules and their academic achievement on those modules, with students who cited difficulties performing equally well, if not better, than those who do not. Importantly, these findings suggest that students, in recognizing their difficulties and the reasons for them, can implement effective learning strategies to overcome them.