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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]

The life expectancy of persons with intellectual disability is increasing, and this is often occurring concurrently with the aging of their long‐term parental carers. Research in both Australia and around the world indicates that proactive post‐parental care planning is not widely implemented, and transitions primarily happen suddenly following a personal crisis for the primary caregiver. Little focus in Australia has been placed on identifying the barriers that inhibit post‐parental care planning in rural areas, specifically in the context of the newly implemented National Disability Insurance Scheme. This paper examines the factors that limit disability services and their staff in supporting successful post‐parental care planning for individuals with intellectual disability and their aging carers in rural South Australia. Small focus groups were conducted with three groups of rural disability support workers using online technologies to assist with the participants' geographic disparity. A semi‐structured interview guide was developed prior to commencement and was used to initiate discussions on key points. A thematic analysis methodological approach was used for data analysis. There were three themes identified through the analysis; Recruitment; Provision of Care; and Retention. The key findings relating to these themes are presented and supported with exemplar quotes. This research proposes three recommendations for policy or practice change: developing a national advertising campaign for new disability staff that positively emphasizes the high‐level skillset need for proactive planning; supporting rural disability providers to collaborate to establish shared teams of staff with expertise in post‐parental care planning; and, using incentive payments to retain staff with these invaluable skillsets in the disability sector. [ABSTRACT FROM AUTHOR]

This paper reports an Australian project designed to simultaneously explore and capacity build professional practice when working at the intersection of parental mental health and/or problematic substance use and domestic violence (DV). Data from this paper are derived from two main sources: observations and ethnographic notes obtained during 28 Community of Practice (CoP) meetings and semi‐structured interviews with 28 CoP participants. Participants were front‐line workers from a range of government and non‐government organizations providing services to families experiencing DV across three Australian states who participated in The STACY Project: Safe and Together Addressing ComplexitY. Thematic analysis was employed to examine the research questions: How do professionals and organizations understand and respond to families experiencing DV, parental mental health difficulties and problematic substance use issues? How did practitioners report participation in the STACY Project reorienting professional practice with families experiencing DV, parental mental health difficulties, and substance misuse issues? This paper reports workers' exploration of practice implications. The research found that 'domestic violence blind' practice has become entrenched at the intersections of child protection, substance misuse and mental health problems, but a shared framework could bring practitioners from diverse sectors together to generate new ways of working with these complex problems. [ABSTRACT FROM AUTHOR]

Background: Communicating about medications across transitions of care is important in older patients who frequently move between health care settings. While there is increasing interest in understanding patient communication across transitions of care, little is known about older patients' involvement in formal and informal modes of communication regarding managing medications. Objective: The aim of this paper was to explore how older patients participated in managing their medications across transitions of care through formal and informal modes of communication. Methods: The study was conducted across two metropolitan hospitals: an acute hospital and a geriatric rehabilitation hospital in metropolitan Melbourne, Australia. A focused ethnographic design was used involving semi‐structured interviews (n = 50), observations (203 h) and individual interviews or focus groups (n = 25). Following thematic analysis, data were analysed using Fairclough's Critical Discourse Analysis. Results: Data analysis revealed two major discursive practices, which comprised of an interplay between formal and informal communication and environmental influences on formal and informal communication. Self‐created patient notes were used by older patients to initiate informal discussion with health professionals about medication decisions, which challenged traditional unequal power relations between health professionals and patients. Formal prompts on electronic medication administration records facilitated the continuous information discourse about patients' medications across transitions of care and encouraged health professionals to seek out older patients' preferences through informal bedside interactions. Environmental influences on communication comprised health professionals' physical movements across private and public spaces in the ward, their distance from older patients at the bedside and utilization of the computer systems during patient encounters. Conclusion: Older patients' self‐created medication notes enabled them to take on a more active role in formal and informal medication communication across transitions of care. Older patients and family members did not have continuous access to information about medication changes during their hospital stay and systems often failed to address older patients' key concerns about their medications, which hindered their active involvement in formal and informal communication. Patient or Public Contribution: Older adults, family members and health professionals volunteered to be interviewed and observed. [ABSTRACT FROM AUTHOR]

The majority of children and young people removed from the care of their parents by the state of Victoria, Australia, reside in foster or kinship care. These children have experienced a broad range of adverse conditions and are up to 4 times more likely to experience problems with mental health than their mainstream peers. This paper draws on the perspectives of foster and kinship carers, describing the disconnection between their role as mental health advocates and their interest in early intervention in a field which is dominated by crisis and the historic marginalisation of foster and kinship carers. Thirty‐one foster and kinship carers across greater metropolitan Melbourne, Australia, contributed to this study through interviews and focus groups. Participants demonstrated a practical understanding of mental health and an ability to identify a range of conditions that have an adverse impact on the mental health of children and young people in their care. The paper concludes that there is a lack of systemic support and even a range of barriers that affect the capacity of foster and kinship carers to promote the mental health and well‐being of the children and young people in their care. [ABSTRACT FROM AUTHOR]

Trauma Informed Care is an approach to the delivery of mental health care that requires sensitivity to the prevalence and effects of trauma in the lives of people accessing services. While TIC is increasingly emphasized in mental health policy and frameworks in Australia, people working in mental health settings have reportedly struggled to translate the values and principles into their everyday practice. This qualitative study used an experience‐based co‐design methodology to explore the potential for implementation of Trauma Informed Care into mental health services in Australia. The experiences of consumers, carers, clinicians, and managers were gathered. This paper presents the perspectives of clinicians (n = 64) and senior managers (n = 9) from across three Local Health Districts in New South Wales in Australia. All data were analysed thematically to address the research question: What is needed for Trauma Informed Mental Health Services in Australia? To be trauma‐informed, managers required: leadership at all levels, access to resource, relevant and accessible training, support for staff, resolution of wider systems issues, and clarification of the concept and actions of TIC. Clinicians identified that to be trauma‐informed they required services to: be aware of staff well‐being, support different ways of working, address workplace cultures and provide increased resources. The findings have implications for any service, team or individual seeking to implement TIC within mental health settings. [ABSTRACT FROM AUTHOR]

As international migration increases, the Australian socio‐cultural and political context in which sub‐Saharan African migrant families are settling is causing tension between traditional sub‐Saharan African migrant definitions of child and childhood experiences and host nation definitions particularly when compared with the child protection system. This paper seeks to explore and highlight the fundamental values and differences that determine perceptions and treatment of children within traditional sub‐Saharan African communities. Using a qualitative design, this study was influenced by acculturation theory. Four major themes emerged from the analysis: (a) culture and the sub‐Saharan African child, (b) moulding good children, (c) family functioning and relationships, and (d) host context: perceptions of Australian mainstream parenting. The study found that in order to successfully make decisions that are in the best interest of sub‐Saharan African migrant children that come to the attention of the child protection system, discussions about children rights can only yield good outcomes when the child's socio‐cultural environment is considered. [ABSTRACT FROM AUTHOR]

Objective: The need for more Remote Area Nurses in the Northern Territory is clear. This paper investigates the perspectives of Remote Area Nurse workforce issues among multiple stakeholders. The aim is to identify how Remote Area Nurse staffing issues are perceived by clinic managers, Remote Area Nurses themselves, Aboriginal colleagues and community members in seven remote communities in the Northern Territory. Design: This is a qualitative study that uses interviews and focus groups to identify key messages of local stakeholders about Remote Area Nurse workforce issues. A content analysis was used for data analysis. Setting: Seven diverse remote Aboriginal communities in the Northern Territory with government‐run health clinics were visited. Participants: Non‐random sampling techniques were used to target staff at the clinics at the time of field work. Staff and community members, who agreed to participate, were interviewed either individually or in groups. Interviews were conducted with 5 Managers, 29 Remote Area Nurses, 12 Aboriginal staff (some clinics did not have Aboriginal staff) and 56 community residents. Twelve focus groups were conducted with community members. Results: Content analysis revealed that participants thought having the "right" nurse was more important than having more nurses. Participants highlighted the need for Remote Area Nurses to have advanced clinical and cultural skills. While managers and, to a lesser extent, Remote Area Nurses prioritised clinical skills, Aboriginal staff and community residents prioritised cultural skills. Conclusions: Participants identified the importance of clinical and cultural skills and reiterated that getting the "right" Remote Area Nurse was more important than simply recruiting more nurses. Thus, retention strategies need to be more targeted and cultural skills prioritised in recruitment. [ABSTRACT FROM AUTHOR]

Promoting community participation for people with intellectual disability through encounter with strangers is an integral part of the mission of disability support workers. This paper offers detailed micro-level analysis of the practices of support workers when they accompany a person with intellectual disability outside their home and explores the subtle differences which make some staff practices more effective than others in promoting more convivial encounters with strangers. Based on 160 h of observations of twenty-six adults with intellectual disability in a variety of public places, and interviews and focus groups with their support workers, the paper points to some of the critical judgements support workers need to make when considering whether, when and how to initiate or intervene in such encounters. [ABSTRACT FROM AUTHOR]

Background In Australia, Aboriginal children experience significantly poorer health outcomes compared with non-Aboriginal children. Health policies aimed at improving Aboriginal health outcomes include interventions in the early childhood period. There is a need for government health services to work in partnership with Aboriginal people and other services to achieve the highest level of health possible for Aboriginal children, who often require a range of services to meet complex needs. Aim This paper describes the views of service providers on how paediatric outreach services work in partnership with other services, Aboriginal families and the community and how those partnerships could be improved to maximize health outcomes for children. Methods In-depth, semi-structured interviews and focus groups were conducted with managers and service providers over a 6-week period in 2010. The views and suggestions of participants were documented and a thematic analysis was undertaken. Results and Discussion Analysis of two focus groups with seven service providers and five individual interviews with service managers resulted in the identification of four themes: (i) using informal and formal ways of working; (ii) cultivating effective relationships; (iii) demonstrating cultural sensitivity; and (iv) forging strong leadership. Use of formal and informal approaches facilitated effective relationships between service providers and Aboriginal families and communities. Partnerships with the community were founded on a culturally appropriate model of care that recognized a holistic approach to health and wellness. Leadership emerged as an essential component of effective partnerships, cultivating the ethos of the workplace and creating an environment where collaboration is supported. Conclusion Culturally appropriate child health services, which utilize effective relationships and employ a range of informal and formal collaboration with other services and community members, are well positioned to implement health policy and improve access to services for Aboriginal children with better health outcomes as a result. [ABSTRACT FROM AUTHOR]