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Introduction: It is now widely recognised that engaging consumers in research activities can enhance the quality, equity and relevance of the research. Much of the commentary about consumer engagement in research focuses on research processes and implementation, rather than dissemination in conference settings. This article offers reflections and learnings from consumers, researchers and conference organisers on the 12th Health Services Research Conference, a biennial conference hosted by the Health Services Research Association of Australia and New Zealand (HSRAANZ). Method: We were awarded funds via a competitive application process by Bellberry Limited, a national not‐for‐profit agency with a focus on improving research quality, to incorporate consumer engagement strategies in conference processes and evaluate their impact. Findings: Strategies included consumer scholarships, a buddy system, designated quiet space and consumer session co‐chairs; the reflections explored in this paper were collected in the funded, independent evaluation. Our insights suggest a need for more structured consumer involvement in conference planning and design, as well as the development of specific engagement strategies. Conclusion: To move toward active partnership in scientific conference settings, our experience reinforces the need to engage consumers as members in designing and conducting research and in presenting research and planning conference content and processes. Public Contribution: Consumer engagement in research dissemination at conferences is the focus of this viewpoint article. Consumers were involved in the conception of this article and have contributed to authorship at all stages of revisions and edits. [ABSTRACT FROM AUTHOR]

Introduction: Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well‐being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well‐being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. Methods: Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus‐based summaries, arriving at a preferred service model. Findings: This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well‐being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. Public Contribution: This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions. [ABSTRACT FROM AUTHOR]

An editorial is presented on partnering with consumers and communities in all aspects of health and social care, including research, planning, policy, service delivery, and education. Topics include increasingly common ethos and requirement from funding bodies, government, and health and social services; and aiming to partner with consumers in all aspects of decision-making, including engagement in the final decision.

Background: Dysphagia affects over half of adults after stroke. Dysphagia rehabilitation aims to improve swallowing and reduce negative outcomes for these adults. However, significant variability exists in dysphagia rehabilitation. Research is needed to explore the underlying clinician‐specific and workplace factors that contribute to variability in dysphagia rehabilitation after stroke. Aim: To explore factors influencing speech pathology practice in dysphagia rehabilitation after stroke. Methods & Procedures: We used a phenomenological approach with an interpretivist perspective. Twenty speech pathologists working in dysphagia rehabilitation participated from different workplace settings around Australia. Five semi‐structured focus groups were conducted online. Data were inductively analysed using thematic analysis with a coding reliability method. Outcomes & Results: Four themes were discussed within focus groups: (1) relationship between experienced and less experienced clinicians: 'Following what other people have done', (2) need for collaborative learning: 'A safe space to share and train', (3) variation between settings impacts on continuity of care: 'There's a difference between community and acute', and (4) working effectively with multidisciplinary teams (MDT): 'An MDT which can listen to the voice of speech pathology'. Conclusions & Implications: Relationships between senior and junior speech pathologists, within speech pathology and MDT, and across inpatient and community settings influenced speech pathology practice. Flattened hierarchies in speech pathology, collaborative learning in workplaces, mutual respect within teams and connection across inpatient and community settings could improve the quality and consistency of dysphagia rehabilitation after stroke. WHAT THIS PAPER ADDS: What is already known on this subject: Dysphagia rehabilitation can improve swallowing after a stroke. However, dysphagia rehabilitation is characterised by variability in clinical practice. Clinician‐specific and workplace factors influence clinical practice and may contribute to variability in dysphagia rehabilitation. What this study adds: Professional relationships influence speech pathologists' clinical practice, including relationships between senior and junior clinicians, between inpatient and community settings and with peers and multidisciplinary teams. Workplace norms and hierarchies, poor continuity of care between settings and competing priorities from other disciplines can hinder dysphagia rehabilitation. However, collaborative learning, positive workplace cultures and respectful transdisciplinary care can improve the quality and consistency of clinical practice. What are the clinical implications of this work?: Flattening hierarchies in the workplace can foster a safe learning space. Further, questioning workplace norms and seeking out peer learning within and across settings can build clinical skills and confidence. Developing positive workplace cultures that support continuous development may be key for empowering speech pathologists to provide high‐quality and consistent dysphagia rehabilitation. [ABSTRACT FROM AUTHOR]

Given that the number of children and young people needing care keeps rising and fewer people are becoming foster carers, efforts to support carers and workers in foster caring are essential. This paper considers the experiences of carers and foster care agency workers involved in Australia's piloting of the Mockingbird Family. With a view understanding experience, data were collected via focus groups with carers and agency workers (n = 20) involved in piloting, implementation and evaluation. Deductive analysis applied the theory of experience to generate understanding of experience, as both intrinsic and extrinsic dimensions to capture strengths in the Mockingbird Family's foster caring networks. These dimensions of experience included collective passions of carers and workers; experiential change over time; collective experiences as a moving force; and experiences as transformational. Understanding of experience associated with the perceived strengths of the Mockingbird Family, including strategies to promote strong professional relationships between carers and workers, is an important element in strengthening environments of children and young people in care. Safe and stable environments are crucial for wellbeing. [ABSTRACT FROM AUTHOR]

Introduction: Farmers face a range of factors that negatively influence their mental health and suicide risk, yet have limited access to appropriate support. Behavioural activation (BA) is an evidence‐based therapy that can be effectively delivered by nonclinical workers. Working with members of farming communities to deliver BA to their peers has the potential to overcome many well‐established barriers to mental health help‐seeking and improve outcomes for this at‐risk group. Objective: This paper describes the findings of a co‐design phase informing the development of a peer (farmer)‐led approach for delivering BA for farmers living with depression or low mood. Design: This qualitative study used a co‐design approach involving members of the target community. Focus groups were transcribed and analysed using Thematic Analysis and the Framework approach. Findings: Ten online focus groups with 22 participants were held over 3 months. Four overarching, interlinked themes were identified: (i) filling the gap in rural mental health support; (ii) alignment with the farming context—tailoring how, where and when we engage about mental health; (iii) the 'messenger' is as important as the message; and (iv) sustainability, governance and support. Discussion: Findings suggest BA could be a contextually appropriate model of support for the farming community—given its practical and solution‐focused approach—and could help improve access to support. Having peer workers deliver the intervention was viewed as appropriate. Ensuring governance structures are developed to support peers to deliver the intervention will be essential to facilitate effectiveness, safety and sustainability. Conclusion: Insights gained through co‐design have been critical to the success of developing this new model of support for members of farming communities experiencing depression or low mood. [ABSTRACT FROM AUTHOR]

Purpose/objectives: Clinical educational challenges led to the Griffith University School of Dentistry and Oral Health (DOH) introducing interprofessional team-based treatment planning (TBTP). This paper evaluates the interprofessional contribution made to student clinical learning and experience among dentistry, oral health therapy, dental prosthetics, and dental technology students., Methods: A mixed methodology approach targeting 845 students collected data annually employing a prevalidated online instrument from 2012 to 2014 to answer the question: "What is the contribution of interprofessional student team-based processes on students' perceptions of interprofessional practice at DOH?", Results: A representative study sample with a 64.4% response rate (N = 544) reported TBTP creating a supportive environment for interprofessional clinical learning. Significant improvements in learning shared across disciplines indicated improvements in mutual respect, understanding roles, and constructive communication enhancing teamwork. There were increasing significant correlations between shared learning and positive clinical experiences from 2012 (r = .642, p < .000) to 2013 (r = .678, p < .000) and 2014 (r = .719, p < .000). A combination of TBTP predictors accounted for 53% of the variance in clinical learning and experience in 2014 compared to 40% in 2012., Conclusion: Learning with other students, developing teamwork abilities, improved communication skills, and respect for other oral health professions were aspects of TBTP that positively impacted clinical learning and practice at DOH. Further study would assist to determine specific elements that made the greatest contribution to student learning experiences., (© 2022 American Dental Education Association.)

Background: Formative online multiple‐choice tests are ubiquitous in higher education and potentially powerful learning tools. However, commonly used feedback approaches in online multiple‐choice tests can discourage meaningful engagement and enable strategies, such as trial‐and‐error, that circumvent intended learning outcomes. These strategies will not prepare graduates as self‐regulated learners, nor for the complexities of contemporary work settings. Objectives: To investigate whether providing only a score after formative online multiple‐choice test attempts (score‐only feedback) increases the likelihood of students to engage in self‐regulated learning compared with more directive feedback. Measurable outcomes included deeper learning, collaboration, information seeking, and satisfaction. Methods: Data in this mixed methods study were collected from nursing students through surveys, test results, focus groups, and student discussion board contributions. A quasi‐experimental design was used for quantitative data, and qualitative data were analysed thematically against domains of self‐regulated learning. Results and Conclusions: Students receiving score‐only feedback were more cognitively engaged with the content, collaborated constructively, and sought out richer sources of information. However, it was also associated with lower satisfaction. In this study, minimal feedback created states of uncertainty, which resulted in the activation of self‐regulatory actions. Implications for Practice: Providing overly directive feedback for formative online multiple‐choice tests is conducive to surface‐level learning strategies. By minimising feedback and allowing for extended states of uncertainty, students are more likely to regulate their learning through self‐assessment and problem‐solving strategies, all of which are required by graduates to meet the challenges of real‐world work settings. Lay Description: What is already known about this topic: Formative online multiple‐choice tests are widely used in higher education.Feedback is a critical element in the design of effective online multiple‐choice tests.Formative feedback should promote self‐regulated learning.Feedback types used in multiple‐choice tests facilitate strategies not conducive to self‐regulation. What this paper adds: Online multiple‐choice test feedback can influence how students self‐regulate their learning.Less feedback can result in greater self‐evaluation and performance in summative assessment.Less feedback can encourage richer help‐seeking strategies (collaboration and information seeking).However, less feedback can result in student dissatisfaction. Implications for practice and/or policy: Judicious use of feedback is required in the design of online multiple‐choice tests.Educators should consider providing less feedback to promote learner self‐regulation.Satisfaction with online multiple‐choice tests does not necessarily equate to greater learning. [ABSTRACT FROM AUTHOR]

Background: Australian policy reports recommended schools to be leveraged to better support student mental health, with a focus on regional and rural areas where students have poorer mental health outcomes. In designing solutions to address this systemic gap, decision‐makers require an understanding of the barriers and facilitators experienced by regional and rural schools. However, current literature has focused on metropolitan schools and neglected to explore facilitators. Objective: To review the evidence on barriers and facilitators in delivering student mental health support experienced by regional and rural schools in Organisation for Economic Co‐operation and Development nations. Design: A mixed‐methods systematic review of peer‐reviewed and grey literature. Findings: The search identified 4819 studies. A full‐text review by 2 reviewers resulted in 5 papers, which met the inclusion criteria and were assessed using methodological appraisal. One study used qualitative data, 2 studies used quantitative data, and 2 studies were a mixed‐methods design. Discussion: While there was a paucity of studies, this review draws together the most up‐to‐date research. The barriers and facilitators were categorised into 3 themes: access to services and resources; mental health literacy of staff and parents; and communication and collaboration between stakeholders. Conclusion: This review presents a comprehensive synthesis of the literature and highlights opportunities to leverage rural and regional schools to support student mental health, focusing on the quality of communication and collaboration, and increasing access to services and resources, and mental health literacy. Research should explore the unique advantages of rural and regional areas to inform policy, including a focus on strengths. [ABSTRACT FROM AUTHOR]

Background: Although a 'person‐centred focus' is a legislated objective for both aged‐care and disability services sectors in Australia, evidence suggests limited translation into systems and practices due to entrenched silos. This paper proposes a Best Practice Framework to mitigate these silos. Methods: Mixed‐methods research comprising key informant interviews with major stakeholders across both sectors; a survey of people with/without intellectual disability aged 60+ years; qualitative in‐depth interviews; and survey of health professionals. Results: There is an urgent need to develop inter‐sectoral 'integrated care systems'. Key components include choice in accommodation; regular assessment of health and well‐being indicators; development and adoption of nationally consistent policies/standards across integrated aged‐ and disability‐care sectors; improved strategies for workforce planning; and upskilling of existing staff including place‐based collaboration. Conclusions: An integrated service model requires collaboration on broader public policy instruments, appropriate planning and resourcing. A strategic shift is required to ensure better quality person‐centred support systems. [ABSTRACT FROM AUTHOR]

Aim: To describe the establishment of a cross‐border and multi‐university collaboration in rural Australia to mitigate potential competition, maximise Rural Health Multidisciplinary Training (RHMT) Programme investments and regional health workforce outcomes. Context: Rural Health Multidisciplinary Training programme investments have enabled the establishment of 19 Australian University Departments of Rural Health (UDRH) and 17 Rural Clinical Schools. The importance of these investments is acknowledged. However, in regional settings, due to limited clinical placement and training opportunities, there is potential for heightened competition between universities who are operating within shared geographical footprints. Competition between universities risks focusing RHMT programme activity on individual reporting requirements and activities, in preference to: regional needs; existing community–university relationships; and place‐based approaches to health workforce development. Participants: A rural New South Wales and Victorian RHMT‐funded departments, collectively known as the Sunraysia Collaboration. Approach: Strategic and operational processes, structures and actions underpinning collaboration formation and relationship consolidation will be described. Co‐design methodologies employed to collectively define collaboration vision and aims, governance framework and guiding principles, reporting structures and co‐contributions to teaching, research and service will be discussed. Collaboration sensitivity to the social, cultural, relationship and economic connectedness within the region and existing health workforce flows will also be explored. Conclusion: The Sunraysia collaboration demonstrates one approach towards mitigating potential competition between RHMT Programme funded universities within rural and remote Australia. The collaboration is an exemplar of co‐design in action providing an alternative approach to address RHMT Programme parameters and regional needs whilst supporting rural‐remote health workforce training and education innovations. [ABSTRACT FROM AUTHOR]

Introduction: This study developed a proposed set of person‐centred quality indicators (PC‐QIs) for services that assess older adults' care and support needs to determine their eligibility to receive government‐funded aged care services in Australia. Individual proposed PC‐QIs amenability for change within current organizational structures were explored. Barriers and opportunities to adapt service elements of the aged care assessment service to better align with the intent of the proposed PC‐QIs were identified. Methods: A mixed methods study was conducted over five phases. A scoping review identified domains of quality for aged care services as perceived by older adults. Service elements of an aged care assessment service were mapped alongside quality domains informing key attributes of each quality domain. Self‐determination theory was used to formulate each proposed PC‐QI to align with key attributes and quality domains. Consultation with a consumer group enabled revision of the proposed PC‐QIs. A focus group with clinicians evaluated the amenability of each proposed PC‐QI for change and identified barriers and opportunities to better align service elements with older adults' perceptions of quality. Results were informed by qualitative and quantitative data from a structured focus group. Focus group discussions were audio recorded and subsequently transcribed verbatim. Qualitative data were analyzed using a deductive thematic approach by two independent researchers. Results: Twenty‐four proposed PC‐QIs were developed. Refinement to descriptors of the proposed PC‐QIs were made by the consumer group (n = 18) and all were affirmed as being amenable to change by aged care assessors. Barriers in meeting the intent of the proposed PC‐QIs were identified across five domains including: health care staff knowledge (18.7%; n = 3); clear communication (31%; n = 5); person‐centred approach (18.7%; n = 3); respect for client (18.7%; n = 3); and collaborative partnership with client (12%; n = 2). Participants made 21 recommendations. Of the five service elements in delivering an aged care assessment service, barriers in meeting the intent of the proposed PC‐QIs were identified at the intake and booking of an assessment and during the assessment. Conclusions: Recommendations identified provide assessment services guidance on ways to adapt service elements to better align with older adults' perceptions of quality. Patient and Public Contribution: Patients and carers were involved as collaborators in this project at the protocol stage which included participating in discussions regarding the refining and modification of the protocol, refinement of the proposed PC‐QIs, data collection forms and supplementary information for participants. [ABSTRACT FROM AUTHOR]

Background: Self‐directed therapy activities are not currently part of routine care during inpatient rehabilitation. Understanding patient and clinician perspectives on self‐directed therapy is key to increasing implementation. The aim of this study was to investigate barriers and facilitators to implementing a self‐directed therapy programme ("My Therapy") in adult inpatient rehabilitation settings. Methods: My Therapy was recommended by physiotherapists and occupational therapists and completed by rehabilitation inpatients independently, outside of supervised therapy sessions. Physiotherapists, occupational therapists, and patients were invited to complete an online questionnaire comprising open‐ended questions on barriers and facilitators to prescribing and participating in My Therapy. A directed content analysis of free‐text responses was undertaken, with data coded using categories of the Capability, Opportunity, and Motivation Model of Behaviour (COM‐B model). Results: Eleven patients and 20 clinicians completed the questionnaire. Patient capability was reported to be facilitated by comprehensive education by clinicians, with mixed attitudes towards the format of the programme booklet. Clinician capability was facilitated by staff collaboration. One benefit was the better use of downtime between the supervised therapy sessions, but opportunities for patients to engage in self‐directed therapy were compromised by the lack of space to complete the programme. Clinician opportunity was reported to be provided via organisational support but workload was a reported barrier. Patient motivation to engage in self‐directed therapy was reported to be fostered by feeling empowered, engaged, and encouraged to participate. Clinician motivation was associated with belief in the value of the programme. Conclusion: Despite some barriers to rehabilitation patients independently practicing therapeutic exercises and activities outside of supervised sessions, both clinicians and patients agreed it should be considered as routine practice. To do this, patient time, ward space, and staff collaboration are required. Further research is needed to scale‐up the implementation of the My Therapy programme and evaluate its effectiveness. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to summarise key evidence from recent Australian rural nutrition research and provide recommendations for future nutrition and dietetics research with rural communities. Context: Clear evidence demonstrates that diet plays a role in the health gap between rural and metropolitan Australia. Despite the opportunity to address the health of rural Australians through better nutrition, alarmingly low investment in nutrition and dietetics research has occurred historically, and over the past decade. Approach: A review of the evidence was undertaken by rural nutrition and dietetics leaders to provide a commentary piece to inform future rural nutrition research efforts. Conclusion: Establishing strong, collaborative place‐based nutrition and dietetics research teams are necessary to combat the significant gaps in the scientific knowledge of solutions to improve nutrition in rural Australia. Further, dieticians and nutritionists who live in and understand the rural contexts are yet to be fully harnessed in research, and better engaging with these professionals will have the best chance of successfully addressing the nutrition‐related disease disparity between rural and metropolitan Australia. [ABSTRACT FROM AUTHOR]

Open Dialogue is a collaborative approach to mental health care emphasizing integrated services and a dialogical psychotherapy approach. Open Dialogue training programs eschew traditional didactic teaching of technical therapeutic skills in favor of more experiential learning processes. It is unclear how these training programs affect trainees and shape their perspectives on Open Dialogue. Our aim was to follow up a group of Australian Open Dialogue trainees and explore their perspectives on learning processes and psychotherapeutic practice. We utilized a prospective focus group design with data from audio‐recorded focus groups convened before (n = 2) and after (n = 3) participants completing an advanced Open Dialogue training program. Data were subjected to reflective thematic analysis. We identified the theme "Extending possibilities by holding ideas lightly," which represented a universal principle that participants applied to multiple aspects of their practice, for example, favoring multiple perspectives and approaches to therapy, including those other than Open Dialogue. This theme had two sub‐themes: (1) "Allowing intimacy by being aware of personal biographies" and (2) "Learning by joining others," which reflected an increased willingness by participants to reflect on and share their inner experiences and an emphasis on joint experiential exercises in the training program. "Extending possibilities by holding ideas lightly" facilitated a means of incorporating a dialogical perspective into existing practices thus avoiding the potential barriers to a wholesale implementation of Open Dialogue. Findings indicated that the participants were not learning how to practice a therapeutic technique or propositional knowledge, but were socialized into a dialogical way of being. [ABSTRACT FROM AUTHOR]

The article outlines the standard of practice in mental health for pharmacy services. Topics discussed include prevalence of mental health conditions in Australia, pharmacist impact in mental health, objectives of pharmacy service, scope of mental health pharmacy services, mental health pharmacy services in diverse population groups, policies, procedures and governance that mental health pharmacists should have knowledge of, training and education, and quality improvement of health services.

Objective: To identify challenges and strategies to improve the provision of end‐of‐life (EOL) cancer care in an underserved rural and regional Australian local health district (LHD) from the perspective of general practitioners (GPs) and specialist clinicians while exploring the benefits of adopting a generalist health care approach to delivering EOL care in rural and regional communities. Setting: Rural and regional Australia. Participants: General practitioners and palliative care and cancer care specialists (medical and nursing) involved in the provision of EOL care to people with advanced cancer in the rural and regional areas of an Australian LHD. Design: Qualitative descriptive study involving 22 participants in four face‐to‐face and online focus groups. Thematic analysis of the transcripts identified key issues affecting EOL care for people with advanced cancer in rural and regional areas of the LHD. Results: Four themes including geographical remoteness, system structures, medical management and expertise and training emerged from the focus groups. Key barriers to effective EOL care included insufficient remuneration for GPs and other clinicians (especially home visits), resource limitations, limited community awareness of palliative care and lack of confidence and training of clinicians. Continuity of care was identified as an important facilitator to effective EOL care. Participants suggested greater Medicare rebates for palliative care and home visits, adequate equipment and resources, technology‐enabled clinician training and greater rural‐based training for specialist PC clinicians may improve the provision of EOL care in regional and rural communities. Conclusions: Rural‐based clinicians delivering EOL cancer care appear to be disproportionately affected by geographical challenges including resource and funding limitations. A multi‐pronged strategy aimed at greater interdisciplinary collaboration, community awareness and greater resourcing and funding could help to improve the provision of EOL care in underserved rural and remote communities of Australia. [ABSTRACT FROM AUTHOR]

Objective: To describe participants' lived experience of co‐creating and implementing initiatives to improve children's health. Design: This manuscript reports an embedded case study design, which aims to describe participants' lived experiences of co‐creating community‐based initiatives. Information was gathered from an online survey and two focus groups. The two transcribed discussions from the focus groups were analysed using a 6‐step phenomenological process. Setting: Mansfield, Australia, population 4787, is one of ten local government areas (LGA) participating in the Reflexive Evidence and Systems Interventions to Prevent Obesity and Non‐communicable Disease (RESPOND) project. Participants: Participants were purposively selected from established community groups previously engaged by RESPOND using a co‐creation approach. The recruitment for the focus groups was a convenient sampling from participants that provided their email addresses in the online survey. Results: Eleven participants completed the online survey. A total of ten participants attended the two focus groups of 1‐h duration: five participants in each. Participants reported feeling empowered to create unique, locally relevant and readily adaptable community‐wide change. They were supported by a strong partnership that mobilised funding for a part‐time health promotion employee. Strengthened social connections were an unexpected though highly valued outcome. Conclusion: Co‐creation processes may assist stakeholders in delivering prevention strategies in ways that are empowering for them, responsive to the changing needs of the community, strengthen organisational partnerships and enhance community participation, social inclusion and engagement. [ABSTRACT FROM AUTHOR]

Aims: The aim is to report the results of Australia's first uterus transplantation (UTx). Methods: Following long‐standing collaboration between the Swedish and Australian teams, Human Research Ethics approval was obtained to perform six UTx procedures in a collaborative multi‐site research study (Western Sydney Local District Health 2019/ETH13038), including Royal Hospital for Women, Prince of Wales Hospital, and Westmead Hospital in New Souh Wales. Surgeries were approved in both the live donor (LD) and deceased donor models in collaboration with the inaugural Swedish UTx team. Results: This is the first UTx procedure to occur in Australia, involving a mother donating her uterus to her daughter. The total operative time for the donor was 9 h 54 min. Concurrently, recipient surgery was synchronised to minimise graft ischaemic time, and the total operative time for the recipient was 6 h 12 min. Surgery was by laparotomy in the LD and recipient. The total warm ischaemic time of the graft was 1 h 53 min, and the cold ischaemic time was 2 h 17 min (total ischaemic time 4 h 10 min). The patient's first menstruation occurred 33 days after the UTx procedure. Conclusion: Twenty‐five years of Swedish and Australian collaboration has led to Australia's first successfully performed UTx surgery at The Royal Hospital for Women, Sydney, Australia. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study was to explore the barriers and enablers to structured care delivery in rural primary care, reflecting on Australian research findings. Design: CINAHL and Scopus databases were searched in August 2021. Inclusion criteria included English language, full‐text studies, published since 2011, reporting on the barriers and enablers to the delivery of structured care within rural and remote primary care. Structured care was conceptualised as care that was organised, integrative and planned. Findings A total of 435 studies were screened. Thirty‐four met the inclusion criteria. Barriers to the provision of structured care related to workforce shortages, limited health care services and health care professional capacity, cultural safety and competency, limited resourcing, insufficient knowledge and education, geographical isolation, inadequate care coordination, unclear roles and responsibilities and poor health professional–patient relationships. Discussion: Health care system and geographical barriers and enablers encountered in rural areas are complex and multidimensional. Identification of the specific challenges to structured care delivery highlights the need for a focussed review of workforce supply and distribution challenges as well as the investigation of system integration, leadership, governance and funding reform that would be required to support rural primary care. [ABSTRACT FROM AUTHOR]

Background: Previous studies have highlighted the unmet nutritional and supportive care needs of patients with head and neck cancer (HNC) and their carers from diagnosis and throughout the treatment and survivorship period. The aim of this study was to bring patients, carers and healthcare professionals together to co‐design a framework to improve access to nutrition information and support for patients and carers with HNC from diagnosis and throughout the treatment and survivorship period. Methods: Using experience‐based co‐design (EBCD), semistructured individual interviews were conducted with patients, carers and healthcare professionals to understand their experiences in accessing information and support outside of the hospital environment. Feedback events and co‐design workshops were held to prioritise areas for service improvement. Results: Participants (10 patients, 7 carers and 15 healthcare professionals) highlighted the importance of having consistent information and support recommendations from the multidisciplinary team. The two key areas for improvement identified through group and workshop events were linking reputable HNC resources to a HNC portal on the hospital website and the development of a series of short podcasts and video blogs with fact sheets attached presented by members of the multidisciplinary team, patients and carers at four time points spanning pretreatment and throughout the survivorship period. Conclusions: Using EBCD has enabled the co‐design of a framework for resource development with patients, carers and healthcare professionals to improve access to information and resources to support nutrition intake and supportive care needs for patients with HNC with their carers. Development and implementation of resources and evaluation of outcomes is ongoing. Key point: Using experience‐based co‐design has enabled the co‐design of a framework for resource development to improve access to nutrition care information and support for patients with head and neck cancer and their carers. [ABSTRACT FROM AUTHOR]

Background: Communities of practice have been proposed as a workforce development strategy for developing dietitians, yet little is known about how they work and for whom, as well as under what circumstances. We aimed to understand the mechanisms by which dietitians working in Aboriginal and Torres Strait Islander health benefit from communities of practice. Methods: A realist evaluation of 29 interviews with non‐Indigenous dietitians and nutritionists was employed, which was conducted over the course of two communities of practice (2013 and 2014) and follow‐up interviews in 2019. Programme theory was developed from analysis of initial interviews and used to recode all interviews and test theory. The identification of patterns refined the programme theory. Results: Six refined theories were identified: (1) a community of practice fosters the relationships that support navigation of the many tasks required to become more responsive health professionals; (2) committed and open participants feel supported and guided to be reflexive; (3) sharing, reflexivity, feedback and support shift awareness to one's own practice to be able to manoeuvre in intercultural spaces; (4) through sharing, feedback, support and collaboration, participants feel assured and affirmed; (5) connection through feelings of understanding and being understood contributes to commitment to remain working in the area; and (6) through sharing, feedback, support and collaboration, participants with varied experience and roles see the value of and gain confidence in new perspectives, skills and practices. Conclusions: Further research is required to test this model on a much larger scale, with communities of practice inclusive of Aboriginal and non‐Aboriginal health professionals together, and across a diverse group of dietitians. Key points: We conducted a realist evaluation of 29 interviews with non‐Indigenous dietitians and nutritionists engaged in communities of practice to understand how communities of practice work and for whom, as well as under what circumstances.Using a series of interviews over a period of 6 years, the evaluation found that a range of outcomes (responsive health professionals, ability to manoeuvre in intercultural spaces, retention in this area of practice, increased confidence) were possible in contexts where participants were committed, open and willing to share and were activated by being supported and guided through reflexive practice, peer feedback and being understood.Engaging in reflexive practice and peer feedback with people who understand your work experiences (empathy) where new perspectives and practices are valued, were critical for supporting achievement of outcomes. [ABSTRACT FROM AUTHOR]

Children placed in residential care are significantly over‐represented in youth justice systems. Drawing on interviews and focus groups with service providers, this exploratory study examines practice factors that impact on the criminalization of this group of children across multiple services and systems, including in the residential care environment, police, lawyers, courts and youth justice systems, as well as multi‐systems practice with this group in one Australian state. Positive outcomes were observed for children in residential care where well‐functioning care teams existed, as well as for children in therapeutic residential care settings. However, clear limitations were identified across all phases of children's youth justice system involvement, including placement with offending peers, the criminalization of behaviours of concern, greater use of remand and detention, limited support to navigate legal and youth justice processes, challenges to service collaboration, and limited applicability of sentencing considerations. The findings indicate a pervasive level of systemic disadvantage for this group of children, and imply that a holistic strategy underpinned by affirmative action across several systems will be necessary to address the ongoing criminalization of children in residential care. [ABSTRACT FROM AUTHOR]

This study explored the impact of Strengths Model training, supervision and mentorship on the practice of a group of multi‐disciplinary mental health clinicians that included mental health nurses, social workers, psychologists, and occupational therapists. A qualitative approach that combined critical realism and grounded theory was used. The findings demonstrated how a substantive category, Getting to Know Clients Better, facilitated participants' progression through a basic social psychological process, Becoming a Strengths‐Informed Practitioner. This process consisted of a discernible and sustained change towards more person‐centred, hopeful, and recovery‐oriented practice. The findings also described an underlying generative mechanism for this, the Client Becomes Visible, which accorded with theoretical models of empathy, based on enhanced cognitive processing. The strength‐based approach to practice facilitated the establishment of a collaborative relationship and a stronger therapeutic alliance between the client and clinician. The research demonstrated that Strengths Model is an effective vehicle for improving recovery‐orientated mental health services. [ABSTRACT FROM AUTHOR]

Gendered violence, specifically, domestic violence, continues to be a global issue impacting the health and well‐being of women despite the improvements to women's rights and the expansion of women's health and well‐being services in the 1970s. While considerable attention has been given to this period of time, scant attention has been given to understanding the resources and change processes involved in the opening of Australia's feminist‐led women's health and wellbeing services from a theoretical perspective. During a Visiting Scholar appointment at the State Library of New South Wales, Sydney, Australia I undertook a review of historical documentation and academic literature search pertaining to the opening of Australia's first feminist‐led safe accommodation for women fleeing domestic violence: Elsie's Place. The concepts of Bourdieu (1977) Theory of Practice informed my understanding of resources, while Lewin (1947) Change Theory provided a conceptual lens through which to view change within the textual and graphical documents. The findings from this project point to the importance of capital, particularly social capital, in the forms of cooperation, collaboration, and networking, in the supporting of change within this sector during the opening of foundational services for women in Australia. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists may recommend and support technology use for facilitating independence, safety, wellbeing, and participation. There are high expectations for technology for people living with dementia. However, there is recognition that technologies will need to improve to deliver these expected benefits. People living with dementia have historically been excluded from direct involvement in research and design. A program of participatory research was undertaken to codesign technologies and technology research with people living with dementia and care partners. This work aims to capture the requirements, actions, and barriers experienced in forming these partnerships in technology research and design. Methods: A shared metareflection of experiences was conducted by members (5) of the research teams involved in three participatory research and technology design studies. The team comprising living experience experts, an occupational therapist, and interaction designer reflected on their experiences and derived recommendations. Key considerations for effective partnerships were drawn inductively by the authors from study experiences, materials, and reflexive discussion. Findings: Six core areas were identified. These were four action areas—(1) Agree on the value; (2) The time to start partnering is now; (3) Ask not assume; and (4) Push back on 'we always have'—(5) barriers and tensions, and (6) unexpected benefits. The reflections indicated that genuine partnerships and engagements were possible with living experience experts in research and design teams. These required resourcing and focussed actions to promote partnership. Despite some structural changes that encourage partnering, there are considerable barriers to this engagement; however, benefits beyond the expected ones can be realised. Conclusion: Genuine partnerships in technology research and design with living experience experts are possible and lead to benefits for the team, research outcomes, and technologies. Recommended actions could support expansion of effective partnerships with people living with dementia and care partners as well as other partnerships in research. [ABSTRACT FROM AUTHOR]

Introduction: Collaborating with consumers in designing, delivering, and evaluating curricula is an ongoing initiative within occupational therapy tertiary courses in Australia. Within the Australian educational context, consumers are involved in on‐campus educational activities. Student occupational therapists must complete 1000 hours of practice placements as part of their education. To date, no research has explored how consumers could contribute to student occupational therapists' learning during practice placements. This study aimed to explore Australian occupational therapists' perceptions of consumers providing feedback to students during practice placements. Methods: A qualitative descriptive approach was adopted to engage with the diversity of practice contexts and gain a rich dataset from the occupational therapy profession. A qualitative questionnaire was developed and distributed using snowballing techniques. The questionnaire asked recipients to reflect on the risks, challenges, and benefits of consumers providing feedback to student occupational therapists from all stakeholders' perspectives. Demographic data were collated, and reflexive thematic analysis was used to construct themes. Findings: Responses were received from 81 participants. Most respondents identified as experienced occupational therapists from metropolitan locations across Australia. Reflective thematic analysis was used to construct three themes: Personal capability of consumers and students will enable, inhibit, and be developed by engaging in a feedback process; an educator‐controlled process to ensure safety for all stakeholders is required for time‐poor practice contexts; and us versus them: Shifting control to consumers can disempower practice educators. Conclusion: Engaging with consumers throughout all aspects of student occupational therapists' educational programme is required, including practice placements. New educational initiatives need to consider all stakeholders' concerns to ensure that authentic contribution from consumers is made within the various practice contexts. A co‐design approach that involves all stakeholders to develop a feedback process may result in high‐quality learning experiences that assist students to become safer, consumer‐centred health professionals. [ABSTRACT FROM AUTHOR]

Introduction: Experts by Experience involvement in the education of health professionals has gained momentum as an important strategy in ensuring quality, person‐centred education. Despite being a requirement for occupational therapy programs in Australia and internationally, involvement is variable and limited. Barriers to the implementation of academic roles have been identified, including negative attitudes of colleagues, systemic barriers, and insufficient evidence of their value. Mental health academics who do not identify as having lived experience (referred to as allies) have provided crucial support for Experts by Experience. Understanding their perspectives on implementation barriers and how they can be addressed is crucial to facilitating a broader level of meaningful involvement. Methods: A qualitative exploratory research project was conducted, involving in‐depth interviews with mental health academic allies (n = 16) from Australia, Ireland, and New Zealand. Participants were from the disciplines of nursing, occupational therapy, social work, and psychiatry. Data were analysed thematically. Findings: Two main themes were identified from the data analysis process: convincing colleagues and dealing with university barriers. Participants described varying attitudes from colleagues towards Experts by Experience, with many not understanding or appreciating their contribution to education and student outcomes. At the university level, reluctance to embrace innovation and funding and other resource shortages presented impediments to the implementation of Expert by Experience roles. Participants described using creative measures to overcome institutional barriers and encourage greater acceptance of such roles by colleagues. Conclusion: This research describes how allies experienced and overcame barriers they faced when supporting the implementation of academic positions for Experts by Experience. Allies have an important role to play in overcoming systemic barriers, and the approaches they have taken to achieve this may be an important source of learning for others with similar aspirations. [ABSTRACT FROM AUTHOR]

Aim: To describe the strength of a cross‐sector and multi‐university collaboration in co‐designing an extended nursing placement innovation in rural and remote Australia. Context: Registered nurses are Australia's largest health workforce. Short‐duration placements can limit nursing student exposure to rural and remote practice, impacting student capacity to tailor and contextualise their practice, navigate complex inequities, establish a sense of belonging and consider rural practice post‐registration. Extended nursing placements have been recommended to address these challenges, but there are no guidelines governing their development and limited resources to support implementation. Approach: Methods adopted in program development included the following: (1) collaboration establishment; (2) co‐defining challenges confronting nurse education in these contexts; (3) co‐developing guiding principles; (4) co‐designing a new approach to nurse education, the Extended Nursing Placement Program (ENPP); and (5) the co‐contribution of stakeholders to program design, implementation and evaluation. Regional stakeholders include a NSW and Victorian Local Health District/Service, three Aboriginal health services and the Royal Flying Doctor Service of Australia. University participants include two metropolitan universities, a University Department of Rural Health and final‐year Bachelor of Nursing students. Program implementation in Semester 1 of 2022 with seven final‐year nursing students. Conclusion: The authors propose that the adoption of collaborative approaches can contribute to re‐framing student nurse education and the development of a rural‐ready nursing workforce. These approaches can provide regions and universities with the opportunity to avoid student churn whilst promoting the attainment of skills required to work, live and thrive in these locations. [ABSTRACT FROM AUTHOR]

Sonographers possess a unique and complex body of knowledge and skills, providing real health benefits to the community. The value of competency frameworks rests on their capacity to support and facilitate professional practice in the interests of public safety. The commitment to act in the service of others carries with it a professional and ethical obligation to practice within the boundaries of accepted competency standards. The well‐accepted Australasian Sonographers Association (ASA) competency standards for entry‐level Australian sonographers were introduced a decade ago. At this time, ultrasound technology, its application and the sonographer's role as a critical interface to this technology continue to evolve. The article provides an overview of research used to develop a contemporary competency framework for sonographers. It describes each framework component and how these components have a potential role in sonographer education and clinical practice at different levels of expertise. Sonographer competencies were developed via a national collaborative research project led by a multi‐institutional research team of academic and industry professionals. A Delphi study design elicited consensus on multiple competency characteristics from an expert panel of 55 sonographers. The expert panel contained representatives from all Australian states and territories and represented all domains of practice. The resulting project outcome consisted of a competency framework containing four significant components: sonographer competency standards, sonographer knowledge, sonographer attitudes and a holistic competency matrix. [ABSTRACT FROM AUTHOR]

Clinical learning experiences are known to exacerbate nursing student anxiety, causing them to present to clinical placement in distressed, meaning anxious, states. Students already living with anxiety are also more likely to suffer setbacks at this time. Supervising Registered Nurses (RNs), in the clinical settings, struggle to support this student cohort. A professional development activity was designed to introduce RNs to higher education and nursing students' known mental health concerns (such as anxiety) and to arm them with strategies for working with distressed students. A research approach that enabled researchers to collaborate with participants was employed to design the intervention. A study evaluated the impact of the educational intervention with 45 Australian RN supervisors. Two tailed T‐tests were chosen to explore the statistical difference between pre‐ and post‐test mean results across the survey items. A 95% confidence interval was used. Statistical significance was set at <0.05. The evaluation indicated the activity could be useful for improving supervising RNs' mental health literacy, thus enhancing their understanding of how to work with distressed students. Participants recommended the activity be offered to any staff supporting student clinical learning. Collaboration between nursing researchers and nursing clinical staff produced a meaningful professional development activity and motivated the participants to increase their mental health literacy and understanding of strategies to support distressed students. Future projects should adopt similar approaches that would support both RNs' ability to support students' during clinical learning and students in distress would also benefit. [ABSTRACT FROM AUTHOR]

Aims: An emerging group of people with type 1 diabetes are not waiting for commercial solutions, choosing to manage their condition with open‐source artificial pancreas systems (APS). Our aim was to explore their perspectives on the future of APS. Methods: Semi‐structured telephone interviews were conducted (in Australia, October 2018 to January 2019) with 23 adults with type 1 diabetes currently using open‐source APS. Interviews were recorded, transcribed and analysed thematically. Results: Participants described five key features of open‐source APS they value: compatibility, user‐led design, customisability, ability to evolve faster and community‐driven. They attributed the success of the open‐source APS movement to benefits they derive from these features: choice, solutions that meet their needs, ownership, staying one step ahead and real‐time support. They expressed hope that future commercial products and healthcare would benefit from their learnings and from collaboration with the open‐source APS community. Conclusions: Participants believed that there will always be a place for the open‐source community. It will continue to build on and advance commercial products, respond to user needs, offering a higher degree of control and customisation than afforded by commercial products and generating optimism for the future. Participants desired that future commercial diabetes technologies would be inspired by the open‐source community and developed collaboratively with people with diabetes. [ABSTRACT FROM AUTHOR]

Objective: The unprecedented rise in synthetic drugs, many containing unknown toxic agents, has made timely analytical diagnosis more difficult, and has reduced the confidence of clinicians providing ED management to this population of patients. This has also impacted the quality of evidence informing harm reduction responses. The Emerging Drugs Network of Australia (EDNA) brings together emergency physicians, toxicologists and forensic laboratories to establish a standardised ED toxicosurveillance system in Australia. Methods: Blood analysis of intoxicated patients will be conducted by forensic laboratories to enable precise identification of the substances causing acute toxicity. This will be linked with clinical data collected at the time of ED presentation to enable analysis of the clinical effects and outcomes associated with different illicit and emerging drugs. Toxicological and clinical data collected across sentinel sites will align with a nationally endorsed minimum dataset. Results: EDNA's collaborative network will establish a national system of surveillance and reporting of illicit and emerging drugs causing acute toxicity. Standardisation of data collection recorded in a national clinical registry will provide more robust data on epidemiology and associated harms. This will facilitate the translation of clinical and toxicological evidence into timely, appropriate harm reduction and policy. Conclusion: Our work represents a collaborative response to calls for more sophisticated data on emerging drug trends in Australia. EDNA will improve coordination between clinicians and analytical services by way of its standardised approach to surveillance and reporting. [ABSTRACT FROM AUTHOR]

Background: Pharmacist‐assisted prescribing (also known as pharmacist charting) has been adopted widely across Australia. The perspectives of medical and nursing staff, however, is poorly understood. Aim: To explore the perceived benefits and drawbacks of pharmacist‐assisted prescribing on admission and discharge, from the perspective of hospital medical officers (HMOs) and nurses. Methods: Face‐to‐face, semi‐structured interviews were conducted with orthopaedic junior HMOs, the orthogeriatric HMO and nurses during a study evaluating pharmacist‐assisted prescribing in an orthopaedic unit. Participants were individually interviewed to explore the perceived impacts of pharmacist‐assisted prescribing on patient safety, workflow and HMO skill development. Interviews were audio‐recorded and verbatim transcriptions were analysed independently by two investigators using a simple thematic analysis. Results: Interviews were conducted with six HMOs and six nurses. Emergent themes highlighted various factors which may affect the ability of HMOs to prescribe medications accurately and in a timely manner when there is no pharmacist assisting with prescribing, and the impact of pharmacist‐assisted prescribing on patient flow, safety and staff workload. Participants felt that having a pharmacist assist with prescribing improved patient safety by reducing prescribing errors and admission charting delays, and assisted with patient flow by reducing delays in discharging patients. Participants felt that pharmacist‐assisted prescribing reduced their workload. They noted a drawback was the potential to de‐skill HMOs, but felt this was outweighed by the benefits. Conclusions: Hospital medical officers and nurses reported that pharmacist‐assisted prescribing had benefits on patient safety, patient flow and workload and that these outweigh the potential drawbacks of potentially de‐skilling junior HMOs. [ABSTRACT FROM AUTHOR]

Objective: To explore the design of deployable articles that can turn subacute hospital rooms into palliative care rooms to provide better patient‐centred care and to meet the shortage of dedicated palliative care spaces in Australia. Methods: Clinicians and a design researcher collaborated to review the literature, obtain clinical/practitioner feedback on needs and use design research methods to produce design concepts and prototypes for use in the subacute care hospital setting. Results: A design solution that included: (a) A guest‐bed module for improved family togetherness and room personalisation; and (b) A digital connectivity module designed to provide family togetherness virtually. Conclusions: Informed design solutions for palliative care spaces were derived from clinical feedback and literature evidence. Clinicians expressed great interest and support for further development and implementation in Victorian hospitals. This exploratory concept also provides insights for future research and innovation in the design of palliative care environments. [ABSTRACT FROM AUTHOR]

The organisational, physical and social environment within residential aged care settings greatly influence its residents' sense of autonomy, choice and control and their ability to engage in meaningful occupations. Identifying to what extent these environmental contexts are supportive and well‐coordinated could assist with promoting meaningful engagement of residents. The Residential Environment Impact Scale (REIS) was developed to measure the impact of the physical and social environment on residents. This study examined the benefits and barriers to implementing the REIS in four Australian Residential Aged Care Facilities (RACFs) and factors to consider during implementation. Method: A multisite sequential mixed‐methods study was conducted. Research participants included occupational therapists conducting the REIS and leadership staff examining the REIS reports in four facilities. Data consisted of formal observations of the REIS assessment process, an online survey of all participants and two research consensus groups. Qualitative findings were generated from field notes, open‐ended survey questions and group discussions. Close‐ended survey questions provided quantitative data. Findings The REIS was considered a useful audit tool, generating a holistic overview of the RACF. It highlighted the quality of person‐centred care and the potential role of occupational therapists to promote opportunities for meaningful occupational engagement. Barriers included administration time, personal characteristics of residents and limited resources to action recommendations. Conclusion: The REIS has potential to be an audit tool for a whole‐environment approach to facility assessment of residents' sense of autonomy, occupational choice and meaningful engagement. As such, it provides occupational therapists with scope to support RACFs meeting national quality standards. [ABSTRACT FROM AUTHOR]

Introduction: Inaccessibility of mental health services in rural Australia is widely reported. Community co‐produced mental health and well‐being initiatives could fill gaps and complement other services. Objective: This scoping review summarises findings from peer‐reviewed articles to identify the key features of co‐produced Australian rural mental health initiatives that engage communities in their design, delivery or evaluation processes. Design: Between 2009 and 2019 inclusive, 14 articles met inclusion criteria and were reviewed using Arksey and O'Malley's review methodology. Findings: Communities co‐produced initiatives through informing, collaborating and instigating them. Some initiatives operated in specific places, for example an art gallery, while others operated across regions. Only two initiatives involved community members in multiple activities targeting prevention, early intervention, education and service accessibility; other initiatives were more focused, for example designing a new service. Over half of initiatives found were targeted at Aboriginal and Torres Strait Islander Peoples. Most articles discussed evaluation approaches, though methods were diverse. Discussion: Published peer‐reviewed evidence about Australian rural community co‐produced mental health initiatives appears scant. Evidence found suggests they generate a range of supports that could complement or mitigate for lack of, public health services. The overall lack of evidence, diversity of initiatives and inconsistent evaluation makes it difficult to assess effectiveness and which activities might be scaled‐up for wider benefit. Conclusion: Rural communities have limited resources, and evidence of what constitutes best practice in co‐producing mental health services would help to avoid 'reinventing the wheel.' Greater efforts in evaluating and publishing about initiatives would be helpful. [ABSTRACT FROM AUTHOR]

The article informs about Pharmacy Forecast Australia 2021, a strategic thought leadership piece on emerging trends and phenomena projected to impact pharmacy practice and the health of Australian patients to 2026, developed by Society of Hospital Pharmacists of Australia (SHPA) utilizing ‘wisdom of crowds' methodology. It mentions that Developed by the Pharmacy Forecast Advisory Committee, Pharmacy Forecast Australia 2021 is designed to help hospital pharmacy departments.

Background: In many jurisdictions worldwide, individuals with a mental illness may be forced to receive care and treatment in the community. In Australia, legislation states that such care should be driven by a care plan that is recovery‐focussed. Key components in the care planning process include engagement and decision‐making about a person's support needs and care options, with trust being an essential component of care planning relationships. Objective: This study examines how these components were enacted during service care contacts for individuals on community treatment orders. Methods: The study was located at two community mental health teams in South Australia. Ethnographic observations of care planning discussions between consumers, their carers and clinicians, and interviews with individuals from these groups, were conducted over 18 months. Carspecken's critical ethnography provided a rigorous means for examining the data to identify underlying cultural themes that were informing day‐to‐day care interactions. Results: Care planning was not occurring as it was intended, with service culture and structures impeding the development of trusting relationships. Clinicians striving to work collaboratively with consumers had to navigate a service bias and culture that emphasized a hierarchy of 'knowing', with consumers assumed to have less knowledge than clinicians. Conclusions: Services and clinicians can challenge prejudicial ethical injustice and counter this through testimonial justice and implementation of tools and approaches that support genuine shared decision‐making. Patient or Public Contribution: This study included individuals with lived experience of mental illness, their carers and clinicians as participants and researchers. [ABSTRACT FROM AUTHOR]