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Purpose: This paper aims to provide an account of learning and change in the redesign of a primary health-care initiative in a large metropolitan city in Australia. Design/Methodology/ Approach: The paper is based on research exploring the place and role of learning in the re-making of health professional practices in a major New South Wales Government health reform called HealthOne. The analysis and findings presented here make reference to data drawn from a longitudinal ethnographic study (2011-2014) conducted by an inter-disciplinary team of researchers from the University of Technology Sydney. Socio-material and practice-based approaches for understanding learning are used in working with the data. Findings: There were substantial changes in professional practice, especially in the role of the General Practice Liaison Nurse. Changes, and the learning connected to the changes, were dynamically influenced by the macro-context. HealthOne was a reform initiative with a strong focus on achieving health service redesign and a consistent focus on staff developing new ways of thinking and operating. Although learning was often discussed, it was, for the most part, expressed in general terms, and there was a lack of a formal and well-developed approach to learning collectively and individually. Originality/Value: This research paper will inform future attempts at service redesign in community and primary health contexts and provides a site-specific examination of workplace learning in a context of rapid change.

This paper reports on a small exploratory study that investigates the place and role of reciprocal learning within a partnership-based home visiting program for mothers experiencing depression. The study is one important example of an increased focus on reciprocal learning within practice that has significant implications for the development of professional education and, more generally, for workplace learning and ongoing professional development. The study addresses two major gaps in the research literature: a lack of detailed accounts of how partnership based approaches are taken up and developed in Australian health care; and a lack of attention to learning as a focus and outcome of partnership-based practice. Using information from in-depth interviews with nurses and mothers we describe and analyse the experience of participants, their learning and knowledge development, the techniques used to facilitate learning, and the development of a relationship between mother and nurse, and mother and child. We identify a fundamental repositioning in practice that was being enacted and learned by all nurses, and a shift in practice strategy from expert assessment and knowledge provision, to practice as a process of shared inquiry and learning. We identify key relational strategies developed by the nurses and commented on by the mothers. We identify a shift in how the mothers experienced the locus of knowing and decision making in relation to their child/children and their parenting. Nurses enhanced their ability to formulate effective interventions for mothers, to build a deeper understanding of mothers' experience, and to challenge or reinforce their own existing beliefs and knowledge. We suggest much of what was described by both the nurses and mothers within this study can usefully be described in terms of reciprocal learning, or as pedagogy. Such findings, we argue, have significant implications for the conceptualisation of health professional practice, the identification of the capabilities required to deliver partnership forms of practice, and, critically, for the redesign of curriculum in the area of health professional education.

Following a history of the Australian health system and funding models, we outline workforce issues, in particular, the lack of health professionals in regional locations. The role of the Australian government health departments in workforce planning is discussed. We describe research funded by the Commonwealth government focussing on the development of interprofessional education (IPE) for collaborative practice. New models of interprofessional care have been introduced to help tackle the population needs: in the Australian Capital Territory (ACT); HealthOne in New South Wales; health-care homes nationally; and partnerships between pharmacists and general practitioners in Victoria. Changes in care delivery necessitate innovations in health education, however how IPE is embedded in Australian health professional education still varies. There is a growing sense of an IPE community complemented by an interest in IPE from peak policy and workforce bodies. There are changes underway in health professional registration and accreditation that are likely to regulate shared and common learning to enable the continuous development of a flexible, responsive and sustainable health workforce. We conclude that there are significant opportunities for further development of IPE and collaborative practice as key strategies for adding to the ability of health systems to address individual needs in conjunction with aiming for optimal and universal health coverage. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports on three interrelated Australian studies that provide a nationally coherent and evidence-informed approach to interprofessional education (IPE). Based on findings from previous studies that IPE tends to be marginalized in mainstream health curriculum, the three studies aspired to produce a range of resources that would guide the sustainable implementation of IPE across the Australian higher education sector. Method: Nine national universities, two peak industry bodies and a non-government organization constituted the study team. Data were gathered via a mixture of stakeholder consultations, surveys and interviews and analyzed using quantitative and qualitative methods. Results & Conclusion: An important outcome was a curriculum renewal framework which has been used to explore the implications of the study's findings on Australian nursing. While the findings are pertinent to all health professions, nursing is well placed to take a leading role in establishing IPE as a central element of health professional education. [ABSTRACT FROM AUTHOR]