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Purpose: Globally, countries with both developed and developing economies are struggling to secure sufficient participation in vocational education to generate the range and quantum of skills required for their communities and realising national social and economic goals. In an era of high aspiration, vocational education and the occupations it serves are increasingly seen as being a less than desirable outcome by young people and their parents. Hence, there is a need to identify means by which to inform and engage young people in considering vocational education and the occupations it serves. The case study discussed in this paper is contextualised within the Australian state of Queensland, which, like many other countries is struggling to have a workforce sufficient to meet communities' healthcare needs as its population both grows and ages. Methods: The study data were collected from 1) interviews with healthcare-related stakeholders including health industry representatives, teachers or practitioners, and healthcare providers, 2) focus groups with senior secondary students, and 3) surveys with these participant groups. It provides a descriptive analysis of efforts to secure greater participation by young people in allied health roles, and, in particular, young Australian Indigenous people. Findings: The study participants included those from regional and metropolitan centres and from state and independent schools, and in all of which the focus on engagement was central. Findings indicated that engagement was necessary to advise young people about these occupations, the effective preparation for them, and likely retention in the workforce. Conclusion: This study highlights the need for intentional strategies to engage young people, their parents/guardians and with those efforts likely needing to be organised and enacted at the local level. This requires collaboration and engagement from education, industry, and local communities. Essentially, a systemic approach is required, specifying roles for government, employers, educational systems, and teachers and parents who engage directly with young people. In all, engagement, advice and opportunities locally are all emphasised in the study reported here.

Sonography is a highly specialized diagnostic imaging profession facing significant workforce challenges due to increased service delivery demands and a shortage of clinical training opportunities. Developing sustainable solutions is crucial for workforce growth. Using examples from the Australian workforce and education context, this paper explores the current sonography training pathways available and the benefits and challenges of each, highlighting the importance of work-integrated learning (WIL) in facilitating the development of professional identity, clinical competence and the quality of sonographer education. Conclusions are drawn that WIL is integral to the future of the sonography profession to improve patient outcomes and address workforce shortages. However, effective implementation requires careful planning and consideration of many factors, including regulatory requirements, industry partnerships, student and supervisor/tutor support, and issues related to equitable access and participation in WIL. Key recommendations are provided to encourage ethical student learning, university-industry collaboration, effective resource allocation, and WIL-specific research. [ABSTRACT FROM AUTHOR]

Community health centres are a new development on the Australian health scene and current indications are that they may play a greater role in the delivery of primary health care of the future. Therefore, information about these centres, what they are doing and who they are affecting, must be forthcoming if more public funds are to be channelled their way. The study reported here and in subsequent papers attempts an in-depth examination of the Southern Memorial Hospital--Community Care Centre for the purpose of establishing a base line from which this centre can measure its progress and with which other centres providing health care can compare. This paper reports the methodology of the evaluation study and the results of a survey of the working patterns of allied health professionals.

This paper proposes social living labs for informed learning as an innovative approach to interprofessional and community education. It presents a new conceptual model and practice framework suited to rapidly changing, information-intensive work and social environments. The proposed approach is theoretically informed and evidence based. It integrates concepts from three complementary fields: Informed learning as information literacy pedagogy that enables using information critically and creatively to learn (information science); interprofessional education as a professional learning model with a cross-disciplinary and community reach (health sciences/medicine); and social living labs as informal learning context and problem-solving process (community development). After reviewing relevant literature, the paper introduces the concepts and research that underpin social living labs for informed learning. Then it presents a new conceptual model and a practice framework to guide their design and implementation. To illustrate the practical application of this approach, a hypothetical scenario envisages health practitioners, librarians and community members collaborating in a social living lab to address health and social challenges related to child obesity. The paper concludes by discussing anticipated benefits and limitations of the approach and possible wider application. As a contribution to theory, the paper uncovers a previously unrecognised synergy between the principles of informed learning, social living labs and interprofessional education. Supporting information literacy research and practice, the paper identifies a significant role for informed learning in community and professional education, and a novel strategy for health information literacy development. The paper is of interest to educators, researchers, and practitioners across information literacy, community development, healthcare, and other professional fields.

Background: There is emerging interest in person-centred care within a short-lived yet complex medical imaging encounter. This study explored this event from the viewpoint of patients referred for an imaging examination, with a focus on the person and their person-al space., Methods: We used convenience sampling to conduct semi-structured interviews with 21 patients in a private medical imaging practice in Australia. The first phase of data analysis was conducted deductively, using the six elements of the person-centred, patient-journey framework of the Australian Commission on Safety and Quality in Healthcare: transition in; engagement; decisions; well-being; experience; and transition out. This was followed by inductive content analysis to identify overarching themes that span a patient's journey into, through and out of an imaging encounter., Results: The transition-in phase began with an appointment and the first point of contact with the imaging department at reception. Engagement focused on patient-radiographer interactions and explanations to the patient on what was going to happen. Decisions related primarily to radiographers' decisions on how to conduct a particular examination and how to get patient cooperation. Participants' well-being related to their appreciation of gentle treatment; they also referred to past negative experiences that had made a lasting impression. Transitioning out of the imaging encounter included the sending of the results to the referring medical practitioner. Person-al vulnerabilities emerged as a cross-cutting theme. Patients' vulnerability, for which they needed reassurance, pertained to uncertainties about the investigation and the possible results. Healthcare professionals were vulnerable because of patient expectations of a certain demeanour and of pressure to perform optimal quality investigations. Lastly, patients' personal lives, concerns and pressures - their person-al 'baggage' - shaped their experience of the imaging encounter., Conclusion: To add value to the quality of the service they deliver, radiography practitioners should endeavour to create a person-al space for clients. Creating these spaces is complex as patients are not in a position to judge the procedures required by technical imaging protocols and the quality control of equipment. A reflective tool is proposed for radiographers to use in discussions with their team and its leaders on improving person-centred care and the quality of services in their practice., (© 2021. The Author(s).)

In Australia, paramedics are obliged to practice ethically. Graduates of baccalaureate degrees in paramedicine should therefore possess a common grounding in ethics to meet the professional capabilities expected of registered paramedics. However, there is a lack of clarity regarding ethics education for paramedicine students, including what is taught, how it is taught, and how it is assessed. This paper explores ethics education for paramedicine students in Australia, how it aligns with current professional expectations, and how it may be enhanced. Point-in-time data regarding ethics education was collected from websites of fifteen Australian universities offering undergraduate baccalaureate degrees in paramedicine. Data collection was supported by consultation with academics from several institutions. Content analysis was utilised to categorise and analyse data to explore similarities and differences in curricula. Similarities included approaches to learning and teaching and the use of case-based learning, with variability found across teaching staff profiles and content areas. Findings suggest it is time for collaboration to develop a model ethics curriculum for paramedicine students in Australia.

This paper describes the evaluation of the use of an ePortfolio which was embedded across a speech pathology program and designed to enhance employability. Personal development planning (PDP) is a key part of employability and includes learning, reflection, goal setting and understanding the wider context. Students' perceptions of their engagement in this process were evaluated using a mixed methods approach. Qualitative data was collected through student focus groups and individual staff interviews, while quantitative data was collected via a student questionnaire (reported in Lewis & Strampel, 2014). Qualitative data was analysed using NVivo following the six phases of thematic analysis described by Braun and Clarke (2006). This paper reports the themes which emerged from the focus group data. A key finding of the study was that the platform used was not ideal for the ePortfolio purpose causing frustration and negative reactions from students and colouring their engagement with, and enthusiasm for, the ePortfolio activities. Students achieved some of the objectives of personal development planning, especially goal-setting, but it was not until students were in their final year that they saw the links with their future career and employment. Further embedding of key tasks would enhance employability aspects, including for example involving industry from the first year and modelling the PDP process with students.

Work-integrated learning (WIL) for students studying medical laboratory science (MLS) provides hands-on experience that prepares graduates for entry into the pathology workforce. This study explored the student perceptions of studying MLS, before and after WIL placement in a pathology service, and the associated employment opportunities in a pathology laboratory. The WIL pathology technician model enabled students to gain experience across regional and metropolitan locations within the state of Queensland, Australia. With nearly two thirds of graduates employed in the profession and a quarter continuing further education in this field, this program was regarded as a success and helps meet the needs of a growing population with an expectancy of high quality health care. Discussed in this paper is the unique role of the pathology industry working with a regional university to develop successful graduates for a career in pathology, with a focus on the impact of WIL.

Australia's National Disability Insurance Scheme (NDIS) is associated with disability sector growth. A skilled and competent disability professional workforce is needed. Developmental Educators (DEs) are university qualified disability specialists; however, the profession (est.1983) has been under recognised. Due to the multi-skilled nature and broad scope of this profession, there is little evidence associated with the exact roles of DEs once they complete their degree and enter the disability workforce. This paper presents a mixed methods self-assessment investigation of DEs' current job roles and responsibilities, and DEs' perceptions of the understanding of their profession. Data were gathered from DEs (N = 121) using an online survey. Data were analysed using descriptive statistics and thematic analysis. DEs reported working with people with disabilities across the lifespan in various settings including: employment, accommodation, recreation, education, positive behaviour support, and skill development. Though there were widespread perceptions from DEs that their profession was under recognised, many DEs reported being employed prior to or immediately after graduation from their degree. The next step for this research is to investigate the views and perceptions of people with disabilities and their family members who receive service and support from DEs.

Purpose: The COVID-19 pandemic has led to "forced innovation" in the health education industry. High-quality training of the future rural health workforce is crucial to ensure a pipeline of rural health practitioners to meet the needs of rural communities. This paper describes the implementation of an online multidisciplinary teaching program focusing on integrated care and the needs of rural communities. Design/methodology/approach: A multidisciplinary teaching program was adapted to allow students from various disciplines and universities to learn together during the COVID-19 pandemic. Contemporary issues such as the National Aged Care Advocacy Program for Residential Aged Care COVID-19 Project were explored during the program. Findings: This case study describes how the program was adopted, how learning needs were met, practical examples (e.g. the Hand Hygiene Advocacy within a Rural School Setting Project), the challenges faced and solutions developed to address these challenges. Guidelines are proposed for remote multidisciplinary learning among health professional students, including those in medical, nursing, pharmacy, dentistry, and allied health disciplines. Originality/value: The originality of this program centers around students from multiple universities and disciplines and various year levels learning together in a rural area over an extended period of time. Collaboration among universities assists educators in rural areas to achieve critical mass to teach students. In addition it provides experiences and guidance for the work integrated learning sector, rural health workforce practitioners, rural clinical schools, universities, policy makers, and educators who wish to expand rural online multidisciplinary learning.

Purpose: Education, training and continuing professional development are amongst the evidence-based initiatives for attracting and retaining rural and remote health professionals. With rapidly increasing access to and use of digital technology worldwide, there are new opportunities to leverage training and support for those who are working in rural and remote areas. In this paper we determine the key elements associated with the utility of digital technologies to provide education, training, professional learning and support for rural health workforce outside the University and tertiary sector. Design/methodology/approach: A scoping review of peer-reviewed literature from Australia, Canada, US and New Zealand was conducted in four bibliographic databases -- Medline complete, CINAHL, Academic Search complete and Education Complete. Relevant studies published between January 2010 and September 2020 were identified. The Levac "et al." (2010) enhanced methodology of the Arksey and O'Malley (2005) framework was used to analyse the literature. Findings: The literature suggests there is mounting evidence demonstrating the potential for online platforms to address the challenges of rural health professional practice and the tyranny of distance. After analysing 22 publications, seven main themes were found -- Knowledge and skills (n = 13), access (n = 10), information technology (n = 7), translation of knowledge into practice (n = 6), empowerment and confidence (n = 5), engagement (n = 5) and the need for support (n = 5). Ongoing evaluation will be critical to explore new opportunities for digital technology to demonstrate enhanced capability and retention of rural health professionals. Originality/value: To date there has been limited examination of research that addresses the value of digital platforms on continuing professional development, education and support for rural health professionals outside the university and tertiary training sectors.

This paper presents findings from a qualitative study of ePortfolio experiences among health professions students at a major Australasian research-intensive university. This exploratory study of the scholarship of teaching and learning (SoTL) aims to understand the experiences and perspectives of students introduced to program-level ePortfolios across multiple curricula in the health sciences. Six key themes emerged from the data: benefits of an ePortfolio at the curriculum level, ePortfolios as an enabling technology, the value of reflection, the role of user support, the speed and quality of feedback, and mitigating distance and isolation. These data show that a program-level strategy that embeds ePortfolios across a curriculum, including delivering assessable tasks in the ePortfolio platform, is beneficial to students when a scaffolded, structured approach is taken.

Purpose: The purpose of this paper is to review the literature on the response and adaption to change of allied health professionals. Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health-care environments are characterised by frequent and rapid change, often with unrealistic and challenging time frames. Individuals operate independently, but also as members of teams, professions and organisations. Therefore, having a sound understanding of individual response to change is important for change leaders. In the Australian context, allied health professionals represent a quarter of the health-care workforce. There is a significant gap in understanding how allied health professionals respond and adapt to change., Design/methodology/approach: A scoping review was designed to report on the nature and extent of the literature on the response and adaption to change in the context of allied health professionals. Change leaders in the health-care environment face a number of complex challenges when attempting to facilitate change. While this scoping review did not identify any specific literature on the response and adaption to change of allied health professionals, it did however provide information on change models and factors to take into consideration when implementing a change process., Findings: The results of this scoping review identified findings in two main areas with regard to response and adaptation of allied health to change: a review of change management literature at the organisation level and change management for allied health. Most of the literature described organisational level change management without providing a structural framework for change. At the professional individual level, the literature focused on specific clinical interventions, rather than on the response and adaption to change for allied health. Minimal literature was identified in regard to the response and adaption to change of allied health professionals. In an environment characterised by continuous change and policy reform, a greater understanding of the response and adaption to change by allied health is a priority for research, policy and practice., Research Limitations/implications: This scoping review was undertaken to explore the response and adaption to change of allied health. It sought to identify the factors that may explain why certain disciplines within the allied health professional group responded to change differently. Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers. However, this scoping review provides a clear indication of the nature and extent of the literature in allied health., Social Implications: This scoping review will assist change leaders to gain a better understanding of theoretical frameworks of individual, team and organisational change processes and the impacts these have individually and collectively on change processes., Originality/value: To the best of the authors' knowledge, this scoping review is the first of its kind to identify the minimal literature available on the way allied health professionals respond and adapt to change., (© Emerald Publishing Limited.)

There has been a gradual shift towards vocational type courses in tertiary education, and subsequently an increasing trend in the employment of those experienced in their profession into academic positions. This paper will focus on the case study of allied health professionals employed under the assumption that people with clinical skills and experience will be able to transfer into academia. Yet the skills required in academia are different from clinical practice. Despite there being a paucity of research exploring this phenomenon, that which does exist suggests that academics transitioning from clinical practice may feel stressed, confused and disillusioned. They can also take many years to establish their academic career. A greater understanding of the transition process is needed, and support strategies for developing academics must be prioritised. These strategies need to be implemented at a systemic level in tertiary education institutions, but also at the individual level by the academics themselves.

The ePortfolio presents itself as potentially a highly useful assessment tool for students, encouraging self-reflection and the development of both clinical skills and theoretical knowledge by students identifying strengths and gaps in knowledge. A survey of students after the completion the inaugural Emergency Health ePortfolio program revealed several strengths and weaknesses of the ePortfolio as an assessment tool of paramedicine students. The ePortfolio format was perceived by many students to encourage reflection and help them recognise areas where improvement was required. Certain students struggled to accurately identify the volume of information and concepts that should be covered while collating the ePortfolio which caused a degree of stress for some. The online format was another point of contention for students, with some enjoying the freedom of online education while others struggled to integrate multimedia components into their ePortfolios. The overarching student response was favourable and encouraged further implementation of the ePortfolio tool into the education of paramedicine students. This paper concludes that the ePortfolio has the potential to be a powerful assessment and more importantly education tool if development of the concept is continued into the future.

Background: The involvement of speech and language therapists (SLTs) within paediatric palliative care (PPC) settings has been recognized within the extant literature. However, there is little understanding of SLT's specific roles and practices when working with this vulnerable cohort of children and their families. As part of a larger body of work to develop consensus-based recommendations for SLTs working in PPC, it is important to investigate demographic and caseload characteristics. Aims: This exploratory study aimed to gather previously undocumented international demographic data pertaining to SLT service provision, caseload and training in PPC. Additionally, it sought to ascertain the current treatment and assessment approaches of SLTs, and if variations exist in beliefs and practices. Methods & Procedures: An anonymous cross-sectional survey was designed and reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). The online survey consisted of 40 items spanning four domains: (1) demographic information; (2) caseload information; (3) service provision; and (4) training and education. SLTs from Australia, Canada, New Zealand, the UK, Ireland and the United States were recruited using a purposive snowball sampling approach. Descriptive analysis of closed-ended survey responses and content analysis of open-ended responses are presented. Outcomes & Results: A total of 52 respondents completed the survey. SLTs worked in a variety of PPC settings, with patients of varying age and disease groups. Over 50% of participants reported working in PPC for [less than or equal to] 4 years. Genetic disorders (34%), oncology (27%) and neurological conditions (21%) made up a significant portion of respondents' caseloads. Reported treatments and assessment approaches used by SLTs are not unique to a PPC population. Barriers and enablers for practice were identified. A portion of participants did not feel trained and prepared to assess (19.2%) or treat (15.4%) PPC clients. Conclusions & Implications: This study confirms that SLTs internationally have a role in the management of communication and swallowing impairments in a PPC context. However, whether current training and resources adequately support SLTs in this role remains questionable. This paper helps to provide SLTs, administrators, professional associations and tertiary institutions with foundational data to help inform workforce planning, advocacy efforts and training priorities.

Ear infection or otitis media (OM) occurs in many Aboriginal and Torres Strait Islander children at a young age and tends to persist over a long period of time. Chronic OM is associated with conductive hearing loss that reduces a child's access to sounds. This can have a negative impact on development of listening and communication skills. Primary health and early childhood workers are best positioned to detect children with hearing and listening problems. However, they lack appropriate tools to screen and triage young children for early referral. By using a co-design approach with Aboriginal primary health workers and early childhood teachers, we have developed the Parents' Evaluation of Listening and Understanding Measure (PLUM) listening skills questionnaire. The PLUM provides a systematic framework for front-line workers to explore a parent's observations of their child's listening behaviour in everyday situations to detect hearing and listening problems in young Aboriginal children. This paper reports the development of the scale. PLUM scores for 438 children from urban, regional and remote communities in Australia were collected. The internal consistency reliability was 0.87. Normative data from 235 children with normal hearing (hearing thresholds averaged between 0.5 and 4 kHz in the better ear to be no greater than 20 dB HL) were used to define the relationship between PLUM scores and age. The functions allow performance of individual children to be related to their normal-hearing peers.

Health indicators for rural populations in Australia continue to lag behind those of urban populations and particularly for Indigenous populations who make up a large proportion of people living in rural and remote Australia. Preparation of health practitioners who are adequately prepared to face the "messy swamps" of rural health practice is a growing challenge. This paper examines the process of learning among health science students from several health disciplines from five Western Australian universities during "Country Week": a one-week intensive experiential interprofessional education program in rural Western Australia. The paper weaves together strands of transformative theory of learning with findings from staff and student reflections from Country Week to explore how facilitated learning in situ can work to produce practitioners better prepared for rural health practice.

Bioscience is a foundational unit (subject) of undergraduate allied health degree programs, providing students the scientific basis underpinning their clinical practice. However, despite its significance, bioscience is a difficult academic hurdle for many students to master. The introduction of active learning strategies, including small team-based guided-inquiry learning approaches, has been shown to significantly reduce this hurdle and improve assessment outcomes for the learner. Guided team-based activities can aid in this approach by also building broader skills and capabilities, like teamwork and communication, as well as subject-specific knowledge and skills, thereby positively influencing student assessment outcomes. This paper details the redesign and evaluation of two first-year Bioscience for Paramedics units with the introduction of guided-inquiry learning, as well as other active learning strategies, and assesses their impact on student performance. Results indicate that active learning used within a classroom and in the large lecture theater setting improved students' grades with positive student perception of their learning experience.

Aims: Life expectancy for both sexes in Australia exceeds 80 years, with individuals with intellectual disability also increasingly living into older age. This research aimed to comparatively examine perceptions of staff supporting either older adults or age peers with lifelong intellectual disability. Methods: This project asked 420 medical, health, and support workers about training adequacy, health services access, and trigger points for premature institutionalisation. This paper is based on a subsample of 196 respondents who provided quantitative and qualitative responses. Results: There was considerable variation in confidence in supporting ageing individuals, while only 23.7% of doctors reported their training was adequate to support adults ageing with intellectual disability. A lack of services and poor carer health were identified as triggers for premature institutionalisation. Conclusions: The study revealed key differences in staff perceptions of support provision and training adequacy when comparing ageing individuals with intellectual disability to the general ageing population.

This paper reports a cross-sector reflection on a current, simulation-based program for maternity emergency management in an Australian healthcare site. It aims to develop our understandings of how learning can be enhanced through simulation and debriefing practices. It discovers how the healthcare and aviation sectors, which have seen increasing collaboration in areas of human factors and non-technical skills in the last decade, can continue to evolve beyond these areas and considers what each sector can learn from the other. A cross-sector research team observed a one-day course on maternity emergencies. The observers took reflective notes progressively throughout the day and held a post-course discussion about their observations and reflections. Thematic analyses of their cross-sector reflections -- observation notes and a transcribed team discussion -- identified vague understandings of occupational competence embedded in current simulation-based practices. Possible avenues to improve practices were identified, taking into consideration the differing views among researchers from different sectors.

Purpose: The purpose of this paper is to explore the experiences of students and teachers who had participated in a postgraduate work-based praxis course within a Master of mental health practice qualification. Design/methodology/approach: This qualitative study used an interpretative phenomenological approach to understand the lived experience of students and course convenors participating in a work-based praxis course. Seven students and two convenors were recruited. Interview and reflective portfolio data were analysed thematically. Findings: The main themes identified were the importance of planning, the value of partnerships, the significance of learning in the workplace and how the facilitation of work-based learning differs from coursework. Originality/value: Work-based learning within postgraduate coursework qualifications can support higher-level learning, knowledge and skills has received limited attention in the literature. This study supported the value of providing postgraduate students with work-based learning opportunities, resulting in the application of new or advanced skills, within their existing work roles. This study is important, because it provides insights into the student experience of postgraduate work-based learning and the impact of this learning on professional practice.

Background: Discharging clients with long-term aphasia from therapy services constitutes a challenging dilemma for practising clinicians for a multitude of reasons. Although discharge was raised and discussed as a contentious issue in the field of aphasiology ten years ago, it remains an aspect of practice which is complex and underexplored. We are only a little more enlightened now than then on how to address this issue in relation to professional education and practice. Aims: This paper draws on a single case study of a man with aphasia, his wife, and treating clinician, taken from a substantial research study, to highlight awareness of how communication, choice and differing perceptions of goals of therapy influence the experience of the discharge process. The case serves as the context for addressing a gap in the university curriculum around teaching about discharge practice in the context of long-term aphasia. Methods & Procedures: This paper describes how university and practice educators could include discharge issues in students' learning by teaching discharge in context, addressing it in formal university lessons as well as through work-based learning opportunities in clinical placements, and by scaffolding learning using graduated learning outcomes over the different stages of the students' programme. Main contribution: This paper provides practical suggestions to guide the inclusion of discharge in teaching about communication disorders generally, and specifically in relation to long-term aphasia. Discharge needs to be appreciated within the context of the entire intervention process, with good practice modelled in both university and workplace settings. We propose that it is learned in association with stages of decision-making, duty of care, documentation, goal setting, continuous therapy evaluation, clinical reasoning, professional communication with clients, ethical behaviour, and evidence-based practice. Conclusions & Implications: Bringing discharge practice from the realm of implicit knowledge to one that can be examined and discussed in an explicit manner should help reduce anxieties about discharge for new clinicians, help to clarify and improve the discharge approaches used by clinicians and lead to better discharge experiences for clients. (Contains 1 note.)

Background: Workplace-based learning is a critical component of professional preparation in speech pathology. A validated assessment of this learning is seen to be "the gold standard", but it is difficult to develop because of design and validation issues. These issues include the role and nature of judgement in assessment, challenges in measuring quality, and the relationship between assessment and learning. Valid assessment of workplace-based performance needs to capture the development of competence over time and account for both occupation specific and generic competencies. Aims: This paper reviews important conceptual issues in the design of valid and reliable workplace-based assessments of competence including assessment content, process, impact on learning, measurement issues, and validation strategies. It then goes on to share what has been learned about quality assessment and validation of a workplace-based performance assessment using competency-based ratings. The outcomes of a four-year national development and validation of an assessment tool are described. Methods & Procedures: A literature review of issues in conceptualizing, designing, and validating workplace-based assessments was conducted. Key factors to consider in the design of a new tool were identified and built into the cycle of design, trialling, and data analysis in the validation stages of the development process. Outcomes & Results: This paper provides an accessible overview of factors to consider in the design and validation of workplace-based assessment tools. It presents strategies used in the development and national validation of a tool COMPASS[R], used in an every speech pathology programme in Australia, New Zealand, and Singapore. The paper also describes Rasch analysis, a model-based statistical approach which is useful for establishing validity and reliability of assessment tools. Conclusions & Implications: Through careful attention to conceptual and design issues in the development and trialling of workplace-based assessments, it has been possible to develop the world's first valid and reliable national assessment tool for the assessment of performance in speech pathology. (Contains 4 tables and 1 figure.)

This paper is targeted primarily at doctoral students and others considering hermeneutics as a research strategy. Research using hermeneutics was carried out with occupational therapy educators and clinicians in Australia, New Zealand, Canada, and the UK. A total of 53 participants engaged in focus groups and individual interviews over a one-year. The paper explores hermeneutics as a credible, rigorous and creative strategy to address aspects of professional practice that similarly need to be flexible, adaptable to particular needs, and justifiable in the contexts of evidence-based as well as client-centred practice. The hermeneutic study produced A Model of Professional Practice Judgment Artistry (Paterson, 2003) which is briefly described and the connections. (Contains 2 tables, 2 figures, and 1 footnote.)

Knowledge translation resources that summarise and disseminate systematic review findings can support evidence into policy and practice. Since 2007, we have produced Evidence Bulletins; brief, web-based summaries of Cochrane Reviews published by Cochrane Consumers and Communication. Evidence Bulletins are designed for health decision makers employed by or in representational roles within policy and practice settings, that is, policy makers, health professionals and consumer and carer representatives. In this paper, we describe the evolution of our Evidence Bulletins, including revisions made to ensure they reflect the latest research-based guidance on evidence summaries, the results of a subsequent evaluation, and how we incorporated the evaluation findings by making further revisions to the Evidence Bulletin development process and format. The main initial revision to the Evidence Bulletins was the addition of a new section, in which we explicitly considered the relevance of the evidence to the healthcare context in Victoria, Australia. To evaluate the Bulletins, we conducted structured feedback sessions at five Australian health services involving 14 staff and eight consumer representatives. Participants were invited to share their perceptions about the usefulness of the Bulletins and how they might use them for decision making. Although the Evidence Bulletin format, and the new Relevance section were broadly endorsed by both stakeholder groups, a number of suggestions for improvement were identified. As preferences varied somewhat between the two groups; specifically identifying the intended audience for each Bulletin and seeking the input of the nominated stakeholder group in the development may improve usefulness.

Universities face increasing pressure not only to embed interprofessional education within health education curricula but also to prepare graduates as catalysts of change for interprofessional, team-based approaches to health care delivery. Currently, few leadership programmes exist that support the expansion of interprofessional education. This paper describes the development, implementation and evaluation of a leadership programme aimed to build faculty and health practitioners' capacity to become change agents for interprofessional education and practice. The programme was delivered by two Australian universities, each in partnership with a local health care provider. A mixed method approach was adopted to measure participants' pre- and post- knowledge, reactions to the programme, planned and reported behavioural changes, and organizational outcomes. The programme was positively evaluated and reported to increase participants' understanding of interprofessional education and practice. Follow up with participants suggested the programme had facilitated the implementation of interprofessional education and practice in both academic and practice contexts.

The development of clinical skills and judgment is a key area of learning for undergraduate paramedic students but they typically find translating theory to practice a daunting prospect not least because they practice their developing clinical skills in front of others. This paper documents the rationale and outcomes of a peer mentoring program in which selected third year paramedic students took on the role of mentors within a second year clinical practice subject. The second year students reported that the program had resulted in positive changes, including an improvement in their clinical skills. Mentors reported benefits such as forming effective relationships with their mentees, enhanced positive relationship with the staff and support from their fellow mentors. Comments from staff and future directions are discussed.

Introduction: This paper reports results of an investigation into the needs of persons with disabilities wanting to participate in the use of virtual communities. The aim was to investigate "how virtual communities for persons with long-term, severe physical disabilities can best be facilitated"? Method: A Grounded Theory approach was adopted to inform the investigation. In- depth interviews were conducted with twelve persons with paraplegia, quadriplegia or other severe, long-term physical or mobility disabilities and six health care professionals, service providers, information personnel and policy advisers who were involved in their well-being. Analysis: Rich explanations were derived about the information and communication technology (ICT) usage and the technologies' contributions towards restoration of sense of control over their lives. Results: The primary outcome of the investigation is a theory regarding the character of virtual communities for the disabled. The theory is represented as a Virtual Community Model. The model identifies: the need for "a sense of control" as the foundation element of virtual communities for the disabled; the key domains in which disabled people participate in virtual communities; and the barriers and enablers to their participation. Conclusion: The model provides a framework which can be used by interest groups and other organizations to facilitate the development of virtual communities for persons with severe physical disabilities. The six key types of community need to be represented in such virtual communities if a full "sense of control" is to be achieved by disabled persons.

Introduction: Allied health has a valuable role in providing services to people living in residential aged care. The recent Royal Commission into Aged Care Quality and Safety included several important recommendations relating to the nursing, personal care, and allied health workforce and the care that they provide. The purpose of this paper is to review these recommendations and the Australian Government's policy responses and explore the emerging changes in allied health service provision in residential aged care., Methods: Data from the four available Quarterly Financial Reports from the 2022-2023 financial year were extracted and analysed in relation to staff costs and time per person per day across personal care, nursing, and allied health workers. Supplementary data sources including the 2020 Aged Care Workforce Census were accessed to provide contextual data relating to individual allied health professions, including occupational therapy., Results: The analysis shows a modest increase in median registered nurse minutes per person per day, and cost per person per day, from the first to second quarter, and again in the third and fourth. By contrast, median time and cost for allied health declined. From 5.6 minutes per person per day in the first quarter, reported allied health minutes fell to 4.6 minutes per person per day in the second quarter, an 18% decrease, and by the fourth quarter was 4.3 minutes per person per day. This is just over half the Australian average of 8 minutes reported to the RCACQS in 2019., Conclusion: Under recent residential aged care reforms, aged care providers have regulatory incentives to concentrate their financial resources on meeting the mandated care hours for registered nurses, enrolled nurses, personal care workers, and assistants in nursing. These same reforms do not mandate minutes of allied health services. Although providers of residential aged care in Australia continue to employ and value allied health, we argue that mandating care minutes for personal and nursing care without mandating the provision of allied health creates a perverse incentive whereby access to allied health services is unintentionally reduced., (© 2024 The Authors. Australian Occupational Therapy Journal published by John Wiley & Sons Australia, Ltd on behalf of Occupational Therapy Australia.)

The implementation of action learning workshops in three nursing homes in rural Victoria, Australia has been critical in the re-visioning of how care can be enhanced for residents. The workshops were designed with the intent of improving quality of care for residents by providing health care staff with opportunities to learn together and effect cultural change. Valuing what was accomplished well in these nursing homes was the starting point. The project was funded by a Commonwealth Government Rural Education Grant and was based on "My Home Life" a popular programme that promotes quality of life and delivers positive change in care homes for older people across the United Kingdom. This paper provides an account of the project including key components of the action learning workshops and subsequent evaluation of the programme conducted in Australia. The lessons learnt throughout this project have provided the impetus to continue using appreciative inquiry and action learning to involve participants in reflecting on their practice, valuing what they do well while identifying areas that require change. Working together in a safe and respectful space provides participants with opportunity to harness their own collective wisdom and as the health professionals in this project experienced, also learn valuable skills that support progressive action that makes a difference to older people's lives.

There is growing evidence that the use of simulation in teaching is a key means of improving learning, skills, and outcomes, particularly for practical skills. In the health sciences, the use of high-fidelity task trainers has been shown to be ideal for reducing cognitive load and leading to enhanced learning outcomes. However, how do we make these task trainers available to students studying at a distance? To answer this question, this paper presents results from the implementation and sustained testing of a mobile mixed reality intervention in an Australian distance paramedic science classroom. The context of this mobile mixed reality simulation study, provided through a user-supplied mobile phone incorporating 3D printing, virtual reality, and augmented reality, is skills acquisition in airways management, focusing on direct laryngoscopy with foreign body removal. The intervention aims to assist distance education learners in practising skills prior to attending mandatory residential schools, building a baseline equality between those students who study face to face and those at a distance. Outcomes from the study showed statistically significant improvements in the use of the simulation across several key performance indicators in the distance learners, but also demonstrated problems to overcome in the pedagogical method.

In Australia, over 900,000 children attend some type of early childhood education and care service. Many of these children have learning difficulties and early childhood teachers play a significant role in identifying children's needs and working with other professionals to instigate and/or implement appropriate interventions. When educators and allied health professionals work collaboratively in interprofessional ways, they are in a better position to support children and their families. Drawing on findings from a sustained body of research, this short paper shares our reflections on some of the benefits and challenges of two different approaches to working in interprofessionally in Australian early childhood education settings, and provides some suggestions for supporting this work.

Introduction: Rapid increases in the utility of vascular ultrasound combined with increasing expectations from reporting physicians have required a shift to a more defined professional role for the vascular sonographer in Australia. This has created increasing pressure on newly qualified sonographers to be more job-ready and better able to navigate the challenges of the clinical workplace early in their career. Topic Description: There is a distinct lack of structured strategies that newly qualified sonographers can utilise to assist their transition from student to employee. In our paper, we aimed to answer the question of 'What makes a sonographer a Professional?' with the view to extending understanding of how a structured framework can assist the development of a professional identity and can encourage participating in Continuing Professional Development by the newly qualified sonographer. Discussion: The authors reviewed their own clinical experiences and the current literature to source tangible and practical strategies that can be easily enacted by newly qualified sonographers to motivate their continuing growth. Through this review, the 'Domains of Professionalism in the role of the sonographer' framework was developed. In this framework, we describe the various domains of professionalism and their associated dimensions, making it specific to the discipline of sonography and to the point of view of a newly qualified sonographer. Conclusion: Our paper contributes to the discussion on Continuing Professional Development using a purposeful and targeted approach to support newly qualified sonographers across all discipline areas of ultrasound specialisation to navigate the often challenging pathway to becoming a professional. [ABSTRACT FROM AUTHOR]

General practice registrars in Australia undertake most of their vocational training in accredited general practices. They typically see patients alone from the start of their community-based training and are expected to seek timely ad hoc support from their supervisor. Such ad hoc encounters are a mechanism for ensuring patient safety, but also provide an opportunity for learning and teaching. Wenger's (Communities of practice: learning, meaning, and identity. Cambridge University Press, New York, 1998) social theory of learning ("communities of practice") guided a secondary analysis of audio-recordings of ad hoc encounters. Data from one encounter is re-presented as an extended sequence to maintain congruence with the theoretical perspective and enhance vicariousness. An interpretive commentary communicates key features of Wenger's theory and highlights the researchers' interpretations. We argue that one encounter can reveal universal understandings of clinical supervision and that the process of naturalistic generalisation allows readers to transfer others' experiences to their own contexts. The paper raises significant analytic, interpretive, and representational issues. We highlight that report writing is an important, but infrequently discussed, part of research design. We discuss the challenges of supporting the learning and teaching that arises from adopting a socio-cultural lens and argue that such a perspective importantly captures the complex range of issues that work-based practitioners have to grapple with. This offers a challenge to how we research and seek to influence work-based learning and teaching in health care settings.

Background: Many people with intellectual disability have limited sexual knowledge. Several assessment tools have been developed to assess the sexual knowledge of people with intellectual disability. This paper examines how clinicians' are using these tools. Method: This research uses a constructivist grounded theory approach. Semistructured qualitative interviews were conducted with clinicians who use sexual knowledge assessment tools. Findings and Discussion: Assessment of sexual knowledge is not routine in disability service provision. Sexual knowledge is typically only assessed when there has been an incident of problematic sexualised behaviour. This reactive approach perpetuates a pathological sexual health discourse. Conclusions: Clinicians using assessment tools said that they need the tools to support work they do in relation to sexual health of people with intellectual disability. However, they also reported that the tools have gaps and are not fully meeting their needs or the needs of people with intellectual disability.

Objective: Consumer-centred care is fundamental to high-quality health care, with allied health professionals playing a pivotal role in hospital settings. Allied health typically operates within standard weekday working-hours. Consumer preferences for receiving allied health services are largely unexplored but could inform whether weekend and/or out-of-hours services are required. This study aims to understand consumer preferences for hospital-based inpatient and outpatient allied health services. Methods: Using a cross-sectional survey and convenience sampling approach, consumers of a public health service in Melbourne, Australia were surveyed about preferences for allied health service delivery. Electronic health record reviews compared the accuracy of self-reported service delivery times. Descriptive statistics, concordance and predictive values were calculated. Responses to free-text survey items were analysed using content analysis. Results: Of 120 participants (79% response rate), most (69%) received allied health services, however, almost half of inpatient responders (44%) were unsure of the specific allied health professional involved. Audit results found moderate–high concordance overall (range, 77–96%) between self-reported and audit-identified allied health services by profession. Most inpatient responders had no strong day of week preference, equally selecting weekdays and weekend days, with most preferring services between 8 am and 4 pm. Outpatient responders (81%) preferred a weekday appointment between 8 am and 12 pm or before 8 am (29%) to complete scheduled activities early in the day. Conclusion: While provision of allied health services during standard working-hours was preferred by most consumers, some inpatient and outpatient consumers are receptive to receiving weekend and out-of-hours services, respectively. Decisions about offering these services should consider operational capacity and research evidence. What is known about the topic? Research on consumer acceptance of out-of-hours or weekend allied health services is lacking, with an assumption of consumer willingness and demand for these service models. What does this paper add? Hospital inpatients are generally indifferent to the day of allied health services, preferring weekday or weekend day equally, typically between 8 am and 4 pm, while outpatients favour weekday mornings. Although consumers reported that their needs were met by allied health services, there was a lack of awareness about the specific services they received. What are the implications for practitioners? Results highlight the importance of not only aligning service delivery with consumer preferences for timing, but also enhancing awareness and understanding of the available allied health services for consumers. [ABSTRACT FROM AUTHOR]

Access to allied health services offers significant benefits for people living with dementia, yet access is currently fragmented and inconsistent. The 2023–2024 budget allocated AU$445 million to further enable general practice-led, multidisciplinary teams, with integrated care located within practices, including employment of allied health professionals. Such team care models are recognised by The Royal Australian College of General Practitioners as vital to delivery of high-quality care for older adults. They are especially relevant for over 250,000 Australians who live with dementia in the community. However, not all allied health professionals are currently based within general practices. Future, sustainable general practice-led models of multidisciplinary care that connect patients with external allied health providers could be considered for a comprehensive and collaborative approach to care. Our focus is on people living with dementia, who are at greater risk of preventable vision impairment. Poor vision and/or ocular health can be detected and managed through regular eye examinations, which are predominantly delivered by community-based optometrists in Australia, in a primary care capacity. However, people living with dementia are also less likely to have regular eye examinations. In this paper, we highlight the value of ensuring access to primary eye care services as part of post-diagnosis dementia care. We illustrate the important role of primary care practitioners in building and sustaining connections with allied health professions, like optometry, through effective referral and interprofessional communication systems. This can help break down access barriers to dementia-friendly eye care, through promoting the importance of regular eye tests for people living with dementia. Access to allied health services offers significant benefits for people living with dementia, yet access is currently fragmented and inconsistent. People living with dementia are at greater risk of experiencing vision impairment, preventable through regular eye examinations usually provided by community-based optometrists in a primary care capacity. We encourage all primary care practitioners to 'think vision' when consulting with people living with dementia, and advocate for a schedule of regular eye tests post-diagnosis. This article belongs to the Collection Access to Primary Health Care. [ABSTRACT FROM AUTHOR]

Objective: This case study describes the development and outcomes of a new integrated and multidisciplinary care pathway. Spearheaded by allied health, the 'COVID community navigator team', applied established principles of reverse triage to create additional surge capacity. Methods: A retrospective cohort study examined workflow patterns using electronic medical records of patients who received navigator input at the Royal Melbourne Hospital between 20 September 2021 and 20 December 2021. Results: There were 437 eligible patient encounters identified. On average patients stayed 4.15 h in the emergency departments (ED) (s.d. = 4.31) and 9.5 h (s.d. = 10.9) in the short stay unit. Most patients were discharged into a 'low risk pathway' with community general practitioner follow up. Of discharged patients, only 38 re-presented to the ED with symptoms related to their initial COVID-19 diagnosis (34.9% of total re-admissions). Of these re-admissions, more than half did not require admission to a ward. Conclusion: The findings presented here provide support for the clinical utility of a multidisciplinary reverse triage approach in surge planning for anticipated presentation peaks. What is known about the topic? Reverse triage offers the potential to rapidly assess, treat and discharge patients from the emergency department. No known studies have explored this in response to the coronavirus 2019 (COVID-19) pandemic. What does this paper add? This paper supports a reverse triage approach to surge planning during the COVID-19 pandemic. We outline a multidisciplinary initiative to support discharge pathways. What are the implications for practitioners? Spearheaded by allied health, the reverse triage model described could provide a solution for surge planning during health crises. [ABSTRACT FROM AUTHOR]

Background: Sexual health remains one of the most overlooked areas of life for people with intellectual disability. In recent years there has been an increasing expectation that this issue will be addressed by disability service providers. In this paper we examine the barriers to sexual health provision of people with intellectual disability as experienced by disability service providers and clinicians. Method: This research uses a constructionist grounded theory approach. It was conducted in 2 phases using semistructured qualitative interviews to collect data from disability service managers and clinicians working with people with intellectual disability in New South Wales, Australia. Findings and Discussion: Key themes within the interviews -- including funding shortages and a lack of policy guidelines -- were identified as significant administrative barriers to sexual health provision. Myths about the sexual health of people with intellectual disability, family attitudes, and lack of staff training were also identified as barriers.

The Consolidated Framework for Implementation Research (CFIR) is a well-established framework for systematically identifying key factors influencing the implementation of programs. To enhance the classification of existing CFIR definitions, as well as its +2/-2 scoring system, this study incorporated the views of relevant experts to: i) improve how themes are scored; and ii) utilise more information regarding the frequency with which themes are identified. This structured, frequency-based approach to the CFIR's scoring process has been trialled as the CFIR-frequency (CFIR-f). Researchers thematically analysed semi-structured interview data from four groups of policy and program experts (N = 24) delivering two family-based therapies in New South Wales (NSW), Australia. Themes identified by less than 50% were excluded from further analysis. Themes identified by 50% or more of expert participants in the four groups were classified as enablers or barriers using clearly defined criteria. Each theme was allocated a score according to how many experts identified it as an enabler or barrier, and then mapped back onto the latest adaptation of the CFIR comprising 67 constructs. The CFIR-f successfully determined three enablers of, and six barriers to, implementation. Enablers included the family-based therapy programs, therapist training and participant monitoring systems. Barriers included referral, data collection and staffing difficulties, NSW adaptation issues and the suitability and safety of the programs for Aboriginal families. The same enablers and barriers were identified using both the CFIR-f and the original scoring approach, and the identified themes were successfully mapped to almost all CFIR constructs (65/67). This paper proposes a more frequency-based approach to CFIR's scoring process (the CFIR-f). By specifically utilising the frequency with which these barriers and enablers are identified, the CFIR-f engenders a list of ranked themes that service providers and policymakers can use to inform their decisions about program modification and implementation., Competing Interests: All authors have approved the manuscript for submission. One co-author, Anthony Shakeshaft, was the lead investigator on a competitive tender (FACS.17.266) awarded by the NSW Government Department of Family and Community Services (now Department of Communities and Justice) to evaluate the Functional Family Therapy – Child Welfare [FFT-CW®] and Multisystemic Therapy for Child Abuse and Neglect [MST-CAN®] programs in New South Wales, Australia (2018-2020). The lead author, George Economidis, was employed part-time at the National Drug and Alcohol Research Centre as a Project Coordinator for the FFT-CW® and MST-CAN program evaluation from May 2018 to August 2020. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Economidis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Telepractice service delivery of allied health interventions to people with disability can potentially reduce access barriers and improve service equity. However, questions remain regarding telepractice functionality for people with disability. This study addressed questions related to how allied health clinicians and managers perceive telepractice as functioning in the provision of therapy services to people with disability. Methods: Thirteen interviews of allied health clinicians and managers from across Australia were conducted between 21 November and 22 February via MS teams. Qualitative methodology and critical realist theoretical paradigm underpin the study. Data analysis was completed using a reflective thematic analysis method and five themes were generated and described utilising an analytic metaphor. Results: The study themes were described in relation to a shopping for shoes analytic metaphor and the five themes included (1) a shoe for every foot, (2) planned purchases, (3) shoe on the other foot, (4) you need both shoes and (5) help choosing their shoes. In summary, the function of telepractice fits differently for each individual, similar to pairs of shoes. Conclusions: Telepractice has its own strengths and weaknesses and isn't a direct substitute for in‐person sessions, much like left and right shoes are similar but not the same. The results support participant perceptions that telepractice functions best as an adjunct to in‐person sessions through a flexible hybrid delivery model in the provision of therapy services to people with a disability. A strategy for improving perceived usefulness may involve positioning telepractice as unique with strengths and weaknesses, not replacing in‐person care. Patient or Public Contribution: The paper forms part of a larger codesign process which included customer and carer participants throughout the design and planning of the project, inclusion of a peer researcher, and the selection of the analytic metaphor including in the findings of this article production. [ABSTRACT FROM AUTHOR]

Therapy service delivery models to non-Indigenous and Indigenous people living in outer regional, remote, and very remote areas of Australia have typically involved irregular outreach from larger regional towns and capital cities. New South Wales (NSW) is the most populous Australian state with 7.23 million people of whom 4.58 million live in the capital city, Sydney. With the state of NSW covering 801,600 square kilometres, the experience of NSW residents with a disability provides a useful overview of the challenges involved in accessing therapy services in rural and remote areas of Australia. NSW government policy advocates for early intervention and person-centred therapy services (New South Wales Government, 2002, 2006, 2007). While in keeping with best-practice principles, these policy goals must be translated on the ground in rural and remote areas. Innovation is required, and collaboration between rural and remote therapists, people with a disability and their carers, and researchers could provide opportunities to develop, implement, and evaluate collaborative new service delivery models that meet local needs across the disability sector. (Contains 1 note.)

The professional identity of counsellors and guidance practitioners in Aotearoa New Zealand is currently under review as a result of the passing of legislation regulating health professionals and the proposed introduction of national registration of counsellors. In this paper I explore this debate, and examine the professional identities claimed by counsellors, counselling psychologists and psychotherapists. The current discussion in this country is both informed by and provides an illuminating lens on professional identity issues in Australia, the UK and the US. An alternative construction of professional identities that are localised and dynamic, yet distinctly of Aotearoa New Zealand, is proposed. (Contains 1 note.)

Computers and computer-assisted instruction are being used with increasing frequency in the area of undergraduate paramedic education. Paramedic students' attitudes towards the use of e-learning technology and computer-assisted instruction have received limited attention in the empirical literature to date. The objective of this study was to determine paramedic students' attitudes towards e-learning. A cross-sectional methodology was used in the form of a paper-based survey to elicit students' attitudes to e-learning using three standardised scales. Convenience sampling was used to sample a cross-section of paramedic students at five universities during semester 1 of 2009. The scales used were: the Computer Attitude Survey (CAS), the Online Learning Environment Survey (OLES), and the Attitude Toward CAI Semantic Differential Scale (ATCAISDS). There were 339 students who participated. Approximately one-half (57.7%) were female and most (76.0%) were under 24 years of age. Moderate results were noted for the CAS general and education subscales. The CAS results were broadly corroborated by the OLES, although a statistically significant difference between participants preferred and actual results on the OLES Computer Usage subscale identified that participants would prefer to use computers less than they actually do. Similarly, the ATCAISDS found participants were largely ambivalent towards computers. As paramedic degree programs continue to emerge and develop, careful consideration should be given to the usability and utility of various e-learning approaches. (Contains 6 tables.)

A crucial aspect of the teaching of professionalism relates to the provision of learning experiences that will promote the achievement of this affective learning domain. The development and trial of a learning opportunity to scaffold learning concepts of professionalism is described in this paper. Peer reviewed literature was used to construct a survey, administered to students (n = 79). The scenarios for which there was student disagreement, or for which there was disagreement with literature provided a basis for tutorial discussions. Students attended a short clinical placement; subsequent post placement survey completion (n = 35) focused tutorial discussions on compilation of students' own understandings of professional behaviours. The scenarios developed could be used for other health sciences students; the approach is a model for affective domain learning in all professions. (Contains 2 tables.)

Placements are an integral component of the medical, nursing, and allied health curriculum. Literature on problem-based learning indicates that curriculum change can impact student experience. However, outside of the nursing literature, there is little research on the impact of education reform on students' experiences of placements. This paper reports on medical, midwifery and paramedic students' perception of the impact of education reform they experienced in the clinical setting. A qualitative study using a semi-structured schedule was conducted. Data was collected using focus groups (17), individual interviews (48) and written responses (2) from undergraduate students (103) and graduates (27) from a tertiary institution in Victoria, Australia. Recorded interviews were analysed, coded and categorised into themes. Whilst students indicated they were prepared for the impact of educational reform on their placement experience, they perceived that clinical educators responsible for teaching them were less prepared. Three themes were identified from the data: clinical educator's lack of familiarity with new curriculum, clinical educator's negative attitudes to curricular change and looking to the future. Our study advances the understanding of the implications of education reform during the clinical placement of medical, midwifery, and paramedic students. Whilst important lessons can be learned from the medical and nursing literature this study highlights that staff responsible for curriculum change need to action change management process to ensure that the clinical educators are able to deliver the revised program.

Family-centred practice positions families as the key decision-makers, central to and experts in the wants and needs of their child. This paper discusses how families interviewed for a Western Australian study describe their relationships with a range of allied health professionals in the paediatric disability sector. The allied health professionals, in turn, describe how they characterize the role of families caring for children with disabilities. We argue that the successful implementation of family-centred principles in service delivery need to move beyond the individualizing of responsibility and acknowledge the structural and systemic limits to family-centred practice, as well as the social complexity within which diverse families live. (Contains 1 note.)

There are numerous aspects to becoming an effective, culturally competent health practitioner, among these is the need to "become knowledgeable about the historical and sociopolitical backgrounds of clients" (Bemak et al., 2003, p. 26). It has been established that culturally sensitive empathy has the potential to contribute greatly to the healing process when working across cultures. It is therefore essential for an effective and productive client-healer relationship. Indeed it is said that "empathy bridges the gap" between practitioner and client (David & Erickson, 1990). This paper explores a model to develop cultural competence within health related courses. (Contains 5 tables.)