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Background: Participation‐focused interventions are gaining momentum. The Pathways and Resources for Engagement and Participation (PREP) is one such intervention, and it was investigated in this study for its effectiveness in supporting participation in employment‐related activities for young adults with intellectual disabilities in Australia. Methods: The application of the PREP approach was adapted to accommodate COVID‐19 restrictions. Data were gathered from multiple sources in a triangulating manner following a case study design. Measures of performance, satisfaction, and a third measure of involvement were collected using the Canadian Occupational Performance Measure (COPM) in a multiple baseline format. The work questionnaire from the Assessment of Life Habits (Life‐H) was administered at three time points, and qualitative data were collected post‐intervention via a separate semi‐structured interview with four young adults with intellectual disabilities and the two occupational therapist facilitators. Findings: Performance, satisfaction and involvement scores had increased for 75% or more of employment‐related goals at follow‐up, although these changes were not statistically significant. Visual analysis indicated improved Life‐H accomplishment scores post‐intervention, but satisfaction with employment scores did not change. PREP was positively perceived, but the young adults reported needing more support from their participation teams. Conclusions: The PREP intervention shifts the focus from a skills‐based approach to a participation approach to practice and empowers young adults with intellectual disabilities to have greater independence over employment goals and related activities. COVID‐19 restrictions limited the application of the PREP approach, but the experience was still valued by the participants, although additional training and support for them and the PREP participation team working with them may have further enhanced their experience and participation outcomes. Accessible summary: New way to help with jobs: People are trying a new way to help young adults with intellectual disabilities find jobs. It's called the Pathways and Resources for Engagement and Participation (PREP).How they checked if it worked: They collected information from different places to see if PREP was helping. They asked young adults with intellectual disabilities and the occupational therapists to join and share their thoughts on PREP. They also used some tools to see if PREP was helping.Findings: Most people felt better about their job goals after using PREP, even though the changes weren't proven statistically. People liked using PREP, but they said they needed more help from their support teams.Conclusion: PREP is a good way to help young adults with intellectual disabilities be more independent with their job goals. COVID‐19 made it harder, but people still liked it. They think more training and support could make it even better. [ABSTRACT FROM AUTHOR]

A self-report instrument was created to measure stress, attitudes, and performance of domestic and family violence (DFV) first responders in an Australian state. DFV-related stress negatively impacted officers' attitudes and self-assessed performance. Higher DFV stress was predicted by the frequency and severity of DFV incidents, and the absence of lived experience. Negative attitudes were predicted by a shorter length of service and lower severity, and poorer performance by a longer length of service and lower perceived social support. Males reported higher stress and poorer performance than females. The findings reveal systemic issues that inhibit effective police response, emphasizing the need to address negative attitudes and "DV fatigue." [ABSTRACT FROM AUTHOR]

• A total-factor framework is developed for measuring safety performance. • A global DEA model is established. • The construction safety performance in Australia has been promoted by pure technical elements. • The scale factor is not an important force driving safety performance. • The safety performance improvement model is developed. Introduction: Safety is one of the critical and persistent challenges in the construction industry. Measuring safety performance could allow decision-makers to check safety production processes and enhance the health and safety environment. Method: This study developed a total-factor framework based on the global Data Envelopment Analysis (DEA) method to measure safety performance. The performance trend and influencing factors of pure technical efficiency and scale efficiency were separately investigated. The safety performance of construction employees in Australia was measured as a case study. Results: The results demonstrate that the safety performance in the Australian construction industry has been evidently enhanced, which is mainly promoted by the progress of pure technical elements. The scale factors did not play a positive and important role in driving the performance. Conclusions: The increasing regional differences in safety performance could be reduced by learning the practices from the benchmark construction industry, such as a young worker program, small business safety program, workplace mental health program, and advanced construction technologies. Practical Applications: The method can be utilized to measure safety performance and investigate the pathways to enhance performance without influencing production inputs and outcomes. The model and experiences of how to promote safety performance on the policymakers and employers were recognized. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic had a significant impact on community mental health globally and widened pre-existing health and social inequities. Tasmania, Australia has one of the highest rates of mental ill health and socioeconomic disadvantage in the country. Whilst Tasmania experienced a delayed and reduced physical presence of COVID-19 compared to other states and territories, mental health impacts remain. It is necessary to understand such impacts to inform policy, practice, and recommendations to enhance the mental health service sector and prevent future mental health burden. This qualitative study aimed to explore expert mental health stakeholders' perspectives of the impact of COVID-19 on: (1) the mental health of people living in Tasmania, and (2) mental health services. Method: Semi-structured interviews with 12 expert mental health stakeholders across Tasmania were conducted. This sample was well-positioned to comment on the impact of COVID-19 on community mental health and provide recommendations to enhance the sector. Interviews were thematically analysed. Results: Three subthemes exploring the COVID-19 impact on mental health were included: (1) anxiety, distress, and isolation; (2) varying presentations across age groups; and (3) increased complexity. Four key themes capturing the COVID-19 impact on mental health services were identified: (1) transition to telehealth; (2) increased service demand; (3) spotlight on service gaps; and (4) local workforce shortages. Conclusions: The pandemic has highlighted existing gaps across the community mental health service sector, and exacerbated existing psychosocial/structural stressors resulting in increased presentations and complexity of mental illness among the community, particularly for youth. Existing treatment gaps and inequities in service access, engagement, and mental health outcomes will persist if not addressed. Recommendations have been provided to inform community mental health service planning, policy, design, access, and provision, and improve wellbeing. The COVID-19 pandemic has widened pre-existing health and social inequities and adversely impacted community mental health. In Tasmania, Australia, COVID-19 has exacerbated existing psychosocial and contextual stressors that underpin or perpetuate mental ill health, and highlighted existing gaps in Tasmania's underdeveloped community mental health service sector, including limited service availability, accessibility, and capacity. These findings will inform the (re)design, resourcing, development, and implementation of community mental health services to address such inequities, reduce mental health burden, and enhance wellbeing. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to investigate allied health professionals' (AHPs') perspectives preand post-implementation of an electronic medical record (EMR) in a tertiary health service in Australia and examine factors influencing user acceptance. Methods. Data were collected preand post-EMR implementation via cross-sectional online surveys based on the Unified Theory of Acceptance and Usage of Technology (UTAUT). All AHPs at a large tertiary hospital were invited to complete the surveys. Data analysis included descriptive analysis, Mann--Whitney U tests for pre-post item- and construct-level comparison and content analysis of free-text responses. The theoretical model was empirically tested using partial least squares structural equation modelling. Results. AHPs had positive attitudes toward EMR use both pre- and post-implementation. Compared to pre-implementation, AHPs felt more positive post-implementation about system ease of use and demonstrated decreased anxiety and apprehension regarding EMR use. AHPs felt they had adequate resources and knowledge to use EMR and reported real-time data accessibility as a main advantage. Disadvantages of EMR included an unfriendly user interface, system outages and decreased efficiency. Conclusions. As AHPs increase EMR system familiarity, their positivity towards its use increases. An understanding of what influences AHPs when implementing new compulsory technology can inform change management strategies to improve adoption. [ABSTRACT FROM AUTHOR]

Introduction: Specialty trainees often struggle to understand how well they are performing, and feedback is commonly seen as a solution to this problem. However, medical education tends to approach feedback as acontextual rather than located in a specialty‐specific cultural world. This study therefore compares how specialty trainees in surgery and intensive care medicine (ICM) make meaning about the quality of their performance and the role of feedback conversations in this process. Methods: We conducted a qualitative interview study in the constructivist grounded theory tradition. We interviewed 17 trainees from across Australia in 2020, eight from ICM and nine from surgery, and iterated between data collection and analytic discussions. We employed open, focused, axial and theoretical coding. Findings: There were significant divergences between specialties. Surgical trainees had more opportunity to work directly with supervisors, and there was a strong link between patient outcome and quality of care, with a focus on performance information about operative skills. ICM was a highly uncertain practice environment, where patient outcome could not be relied upon as a source of performance information; valued performance information was diffuse and included tacit emotional support. These different 'specialty feedback cultures' strongly influenced how trainees orchestrated opportunities for feedback, made meaning of their performance in their day‐to‐day patient care tasks and 'patched together' experiences and inputs into an evolving sense of overall progress. Discussion We identified two types of meaning‐making about performance: first, trainees' understanding of an immediate performance in a patient‐care task and, second, a 'patched together' sense of overall progress from incomplete performance information. This study suggests approaches to feedback should attend to both, but also take account of the cultural worlds of specialty practice, with their attendant complexities. In particular, feedback conversations could better acknowledge the variable quality of performance information and specialty specific levels of uncertainty. Does culture matter? Bearman et al. show how specialty feedback cultures impact trainee meaning making in divergent ways and suggest feedback conversations need tailoring to specific practice environments. @margaret_bea @r_ajjawi @CasDamian @charlotden @emolloy1 @chriswatling3 [ABSTRACT FROM AUTHOR]

Background: This study determined the prevalence of bothersome menstrual symptoms and their association with workability in naturally menstruating women not using hormonal contraception. Materials and Methods: A representative sample of community-dwelling Australian women aged 18–39 years selected from two large national electronic databases responded to a survey on general health. This study focuses on self-reported dysmenorrhea and menstrual bleeding and their association with workability and absenteeism in working women, assessed by the Workability Index. Results: Of 3,555 women, 1,573 (44.2% [95% CI: 42.6%–45.9%]) reported moderate to severe dysmenorrhea and 774 (21.8% [95% CI: 20.4%–23.2%]) reported heavy to very heavy bleeding. Women with dysmenorrhea were 50% more likely to report poorer work performance and twice as likely to report more days of sick leave in the past year (absenteeism) than other women. Conclusions: Despite the availability of safe and effective management options, Australian working women aged 18–39 years continue to experience bothersome dysmenorrhea and menstrual bleeding. Dysmenorrhea is associated with increased absenteeism and poorer workability. Therefore, awareness needs to be raised among women and health care providers of ways to manage dysmenorrhea and heavy bleeding and the unmet need for intervention in the community, respectively. [ABSTRACT FROM AUTHOR]

Introduction: The global nursing workforce is predominantly female, with a large proportion working in the 45–55 age group. Menopause is a transition for all women, and; therefore needs recognition as it can impact work performance and consequently staff turnover. Background: Women will go through the menopause, but not all women are affected. The menopause transition presents a range of signs and symptoms both physical and psychological which can impact the quality of life and individuals' work/life balance. The nursing workforce is predominantly women that will work through the menopause transition. Objectives: The study explored perspectives on digital health interventions as strategies to support menopausal women and to understand the requirements for designing health interventions for support in the workplace. Design: A qualitative explorative design. Settings: Nurses working in a range of clinical settings in England, Finland, Denmark, New Zealand, Australia and USA. Methods: Nurses (n = 48) participated in focus groups from six different countries from February 2020–June 2022 during the pandemic from a range of acute, primary care and education settings. Nurses were invited to participate to share their experiences. Thematic analysis was used. Results: All participants were able to describe the physical symptoms of menopause, with some cultural and possible hemisphere differences; more noticeable was the psychological burden of menopause and fatigue that is not always recognized. Four themes were identified: Managing symptoms in the workplace; Recognition in the workplace; Menopause interventions; and Expectation versus the invisible reality. These themes revealed information that can be translated for implementation into digital health interventions. Conclusions: Managers of nursing female staff in the menopausal age range need greater awareness, and menopause education should involve everyone. Finally, our results demonstrate design attributes suitable for inclusion in digital health strategies that are aligned with likely alleviation of some of the discomforts of menopause. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to explore healthcare managers' perceptions about older nurses' and midwives' and their contribution to the workplace. Design: A qualitative descriptive methodology. Method: Twenty healthcare managers working in Australia participated in semi‐structured interviews. Data were collected between April 2019 and April 2021. Interviews were recorded, transcribed and then analysed using thematic analysis. Results: All healthcare managers said older nurses and midwives contributed to the workplace through their experience and knowledge. Managers viewed them as a different type of worker and while there were some positive aspects to this, it was mostly negative. Although managers identified a broad age range for the older nurses or midwives, there was a common perception that if they were no longer able to perform their duties, they should leave the workforce. Conclusion: Healthcare managers' perceptions towards older nurses and midwives are mostly negative, and their understanding of older workers' contribution is contradictory and poor. These negative views co‐exist with the lack of agreement on who is the older worker, which explain the reluctance of healthcare organizations to invest in their older workforce. Future research is needed to better understand the unique contribution of older nurses and midwives in healthcare and how they can be supported at work. Impact The global ageing population will result in a rise in complex age‐related health issues and will require an experienced and knowledgeable workforce. Given the greater experience of older nurses and midwives they are an important part of the health workforce. Yet managers' perception of the contribution by older nurses and midwives were often negative. The findings of this study highlight the need for organizational change so that the contribution of older nurses and midwives is recognized and supported by managers. [ABSTRACT FROM AUTHOR]

To extend the authors' previous research by investigating the maintenance of work performance over time and the long-term experience of employment following traumatic brain injury (TBI). Semi-structured interviews were conducted with a sample of 72 individuals with predominantly severe TBI, up to 10-years post-injury. Thematic analysis of transcribed interviews was conducted. Four key themes were identified: brain injury influences on work performance and long-term employment; factors optimising long-term employment; and need for compromise and acceptance, which all impacted the final theme, quality of life outcome. While TBI-related difficulties such as fatigue, cognitive, and emotional difficulties still impacted work many years post-injury, work modifications and employer and vocational rehabilitation (VR) support were important factors optimising long-term employment. The timing of return to work (RTW) was also an important and potentially modifiable factor influencing work performance, which appeared to have long-term effects on the maintenance of employment. Support for acceptance of altered career goals is needed. Findings support the need for early VR to facilitate employer contact, to maximise adjustment and preparation time before RTW, to educate both employees and employers and to implement work modifications to support continuing employment after TBI. The maintenance of employment following TBI is of critical importance for financial independence, psychological and social well-being, and improved quality of life. Injury-related difficulties still impact work performance many years after injury requiring individuals with TBI to continue working in modified roles and for reduced hours over the long-term. Ongoing VR and employer support is needed to facilitate long-term work modifications and compensatory strategies to support work performance. Early VR involvement to facilitate employer contact and maximise adjustment and preparation time before returning to work is necessary to avoid the negative and potentially dire consequences of returning too early. Psychological support to facilitate acceptance of role changes and career compromises is also important. [ABSTRACT FROM AUTHOR]

Research shows utilizing pre-employment tests leads to improved job performance and satisfaction, and decreased turnover in hospitality industry. However, employers have been slow to embrace pre-employment testing due to concerns regarding validity, potential for discrimination, and heavy administration costs. Using focus groups, this study examined hospitality hiring managers' perceptions of pre-employment testing's value, barriers to adoption, and the relationship between testing, organizational commitment, and job performance in both the United States and Australia. Results showed opposing viewpoints between participants. Research results may enable hiring managers to justify the implementation of pre-employment testing, select which tests to use, and revise current assessment practices. [ABSTRACT FROM AUTHOR]

A scoping review of international literature was conducted to identify the various problems encountered by women with breast cancer associated with cognitive deficits, and the relationship to work roles and tasks. This scoping review was conducted using the structure recommended by Arksey & O'Malley in consideration of the PRISMA extension for Scoping Reviews checklist and reviewed for quality, inclusion criteria and key findings related to cognitive changes after breast and impact on work. Searches were conducted in five databases from January 2000 to December 2020. A total of 34 studies met the inclusion criteria. There were 20 quantitative studies, 11 qualitative studies, one mixed method and two case study reports. Findings related to the type of cognitive changes that impact work performance and participation, how these are measured in a work context and the types of interventions directed towards improving cognitive function at work after breast cancer. An absence of ecologically valid assessments and interventions with a coherent approach to early identification and management of cognitive changes after breast cancer was apparent. Breast cancer survivors can experience challenges in their employment due to cognitive deficits, which may lead to the loss of their employment. Health professionals need to explore breast cancer survivors work role and consider appropriate referrals to ensure women receive the necessary support and rehabilitation to address cognitive problems impacting work performance. Further research is needed to develop workplace-based cognitive assessments and interventions to improve the work performance and participation of women with breast cancer experiencing cognitive deficits. Work participation can be negatively impacted by unacknowledged cognitive changes that are not assessed and managed throughout the cancer survivorship journey. Health professionals in health care systems, particularly occupational therapists need to consider appropriate referrals to workplace rehabilitation providers to ensure necessary support and rehabilitation to address cognitive problems impacting on work performance. Occupational therapists performing workplace assessments for women with breast cancer, should assesses cognitive function in accordance with the cognitive demands of the job and work environment, and involve the employer and client in workplace based cognitive interventions. [ABSTRACT FROM AUTHOR]

General practice (GP) supervisors – the key resource for training the future GP workforce – are often described as 'occupying a role' or enacting a series of roles. However, as much of the discourse uses a lay understanding of role, or merely hints at theory, a significant body of theoretical literature is underutilised. We reasoned that a more rigorous application of role theory might provide a conceptually clearer account of the GP-supervisor's job. To this end, we describe the use of organisational role theory and job analysis to identify and define the roles of the Australian GP-supervisor. Our search of the academic literature identified 64 role titles, which we condensed to an initial iteration of core roles, using inclusion and exclusion criteria. We analysed GP training organisations' documents to map embedded supervisory tasks against our list of roles to verify their presence, review our role titles and definitions, and look for additional roles that we may have missed. We used subject matter experts iteratively, to authenticate a final list of ten roles and their accompanying definitions, which can be used to support Australian GP-supervisors to perform effectively. We encourage those who support GP-supervisors in other countries and those who educate other health professionals in primary care settings to review the roles to judge whether they are transferable to their contexts. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to determine the relationships between noncognitive traits (grit, resilience, and mindset-type), academic success, and clinical performance in physical therapist students. Methods This cross-sectional study using self-administered surveys was undertaken with final-year physical therapist students enrolled in 4 Australian universities. Participants completed validated questionnaires measuring grit, resilience, and mindset type. Academic transcripts were obtained to quantify academic success and clinical performance. A multiple regression analysis explored predictors of academic success and clinical performance in relation to sociodemographic factors, grit, resilience, and mindset type. Results A total of 266 students participated in the study (80% recruitment rate). Overall, 25% of students had low resilience, 20% had low grit, and 14% had a fixed mindset type. Grittiness was positively associated with academic success (r  = 0.24) and clinical performance (r  = 0.22) and negatively associated with failing a clinical placement (r  = ‐0.20). Grit was an independent predictor of overall academic success (β = 0.24, P ≤.01) and clinical performance (β = 0.15). Students with low grit were twice as likely to fail a clinical placement compared with students with moderate or high grit (risk ratio = 2.03, 95% CI = 1.06 to 3.89). Conclusion Grit was an independent predictor for overall academic success and clinical performance in final-year physical therapist students. Low grit may impact negatively on learning and students' ability to cope with challenges associated with university studies and clinical education. Further studies should investigate interventions that best develop grit in health professional students and the overlapping nature of grit, resilience, and a growth mindset. Impact This study helps universities and educators understand noncognitive factors predicting academic success and clinical performance in physical therapist students. Universities and clinical educators may consider screening and providing proactive strategies for students with low grit to improve success and general wellbeing. [ABSTRACT FROM AUTHOR]

Objectives: To identify outcome measures used to evaluate performance of healthcare professional role substitution against usual medical doctor or specialist medical doctor care to facilitate our understanding of the adequacy of these measures in assessing quality of healthcare delivery. Methods: Using a systematic approach, we searched Medline, Cochrane Central Register of Controlled Trials, Embase, CINAHL, and Web of Science from database inception until May 2020. Studies that presented original comparative data on at least one outcome measure were included following screening by two authors. Findings were synthesized, and outcome measures classified into six domains which included: effectiveness, safety, appropriateness, access, continuity of care, efficiency, and sustainability which were informed by the Institute of Medicine dimensions of healthcare quality, the Australian health performance framework, and Levesque and Sutherland's integrated performance measurement framework. Results: One thirty five articles met the inclusion criteria, describing 58 separate outcome measures. Safety of role substitution models of care was assessed in 80 studies, effectiveness (n = 60), appropriateness (n = 40), access (n = 36), continuity of care (n = 6), efficiency and productivity (n = 45). Two‐thirds of the studies that assessed productivity and efficiency performed an economic analysis (n = 27). The quality and rigour of evaluations varied substantially across studies, with two‐thirds of all studies measuring and reporting outcomes from only one or two of these domains. Conclusions: There are a growing number of studies measuring the performance of non‐medical healthcare professional substitution roles. Few have been subject to robust evaluations, and there is limited evidence on the scientific rigour and adequacy of outcomes measured. A systematic and coordinated approach is required to support healthcare settings in assessing the value of non‐medical role substitution healthcare delivery models. [ABSTRACT FROM AUTHOR]

Developing skills to critically evaluate and conduct research is central to psychology training programmes. The fundamental importance of scientific evidence to the practice and progression of psychology as a discipline is reflected in the "Scientist-Practitioner" model, to which psychologists adhere. However, to fully realise the potential benefits of the Scientist-Practitioner model for psychological practice and client outcomes, its implementation needs to occur in a bi-directional way. That is, psychologists need to be actively engaged in both a critical analysis of literature to inform clinical practice, as well as using their clinical expertise to develop, inform, and lead research activities to contribute to the evidence-base. Unfortunately, psychologists employed in public health settings are rarely able to utilise their research skills to contribute to the evidence-base. In this Commentary, we critically examine literature regarding barriers and facilitators to psychologists employed in clinical roles engaging in research activities. We argue that enabling more practising psychologists to lead research could facilitate significant benefits to individuals (both the psychologists and their clients) and organisations. We then describe the strategies developed and implemented by a local psychology research committee to drive improvements and address obstacles to psychology-led research in public health. [ABSTRACT FROM AUTHOR]

Personal trainers are well placed to provide basic nutrition care in line with national dietary guidelines. However, many personal trainers provide nutrition care beyond their scope of practice and this has been identified as a major industry risk due to a perceived lack of competence in nutrition. This paper explores the context in which personal trainers provide nutrition care, by understanding personal trainers' perceptions of nutrition care in relation to their role and scope of practice. Semistructured telephone interviews were conducted with 15 personal trainers working within Australia. Thematic analysis was used to identify key themes. All personal trainers reported to provide nutrition care and reported that nutrition care was an important component of their role. Despite this, many were unaware or uncertain of the scope of practice for personal trainers. Some personal trainers reported a gap between the nutrition knowledge they received in their formal education, and the knowledge they needed to optimally support their clients to adopt healthy dietary behaviors. Overall, the personal training context is likely to be conducive to providing nutrition care. Despite concerns about competence personal trainers have not modified their nutrition care practices. To ensure personal trainers provide nutrition care in a safe and effective manner, greater enforcement of the scope of practice is required as well as clear nutrition competencies or standards to be developed during training. [ABSTRACT FROM AUTHOR]

Workplace policies regarding women's reproductive and menopausal health are garnering global attention. The peri‐ and post‐menopause stages may be turbulent times for many women, with some experiencing debilitating symptoms and some none at all. While the symptoms of menopause should be recognised by employers due to their various impacts, the implementation of policies that pertain to all women can alienate older female workers by creating prejudice surrounding work capability. This piece identifies other avenues for the inclusion of menopausal symptoms through pre‐existing policy and highlights the issues facing menopausal women in this current age. [ABSTRACT FROM AUTHOR]

As Australia ages there are increasing opportunities for psychologists to contribute to the wellbeing of older adults. These clients have particular vulnerabilities that need to be considered when dealing with ethical issues. This study aimed to gain an in-depth understanding of how Australian psychologists manage ethical dilemmas when working with older adults. Eighteen psychologists participated in semi-structured interviews during which they provided 30 cases which were identified as suitable for analysis. Interviews were transcribed and analysed using interpretative content analysis. The 30 case studies included a range of residential situations and professional settings. The findings indicated that: (1) Ethical dilemmas presented by psychologists reflect the ethical principles of respect, dignity and propriety, (2) Many considerations are taken into account by psychologists when deciding how they manage ethical dilemmas, and (3) Elder abuse is a challenging and prevalent ethical issue for psychologists. This study demonstrates that psychologists use a sophisticated process of ethical decision making when working with older adults and provides a new resource for research and training psychologists in applied ethics. KEY POINTS What is already known about this topic: (1) Australia has an increasing older adult population. (2) Currently most psychologists have limited experience working with older adults. (3) Client's age impacts on psychologists' attitudes and behaviours. What this topic adds: (1) In this study psychologists provided cases from their clinical experience that highlight the complexity of working with older adults. (2) When managing ethical dilemmas psychologists are mindful of the tension that exists between respecting client autonomy and acting in the client's best interests. (3) Elder abuse is a challenging and prevalent issue for Australian psychologists. [ABSTRACT FROM AUTHOR]

Aim(s) To understand how nurse managers facilitate learning in clinical workplaces. Background: Meeting staff learning needs in the complex workplaces of contemporary health care is paramount to the delivery of safe patient care. Hospitals employ a range of strategies to address these needs. However, nurse managers' contribution to staff learning at the unit level is underexplored in contemporary literature. Method(s): A Gadamerian philosophical hermeneutic framework guided data collection and analysis. Thirteen nurse managers from two Australian hospitals each participated in two interviews and a period of observation. Findings Nurse managers' learning facilitation practices were enacted with staff individually, within teams, and through artefacts, and were shaped by their identities, perspectives on staff learning, knowledge of staff performance, and motivations. Power was revealed as a uniquely enacted driver of their learning facilitation practices. Conclusion(s): This paper illuminates an aspect of nurse managers' practice that has been poorly acknowledged in contemporary nursing literature. Nurse managers' learning facilitation practices were found to be complex, fluid, and embedded in their everyday work routines. Implications for Nursing Management: Given current concerns about safety and quality in health care, this research opens up possibilities for definition and enrichment of nurse managers' practice as facilitators of learning. [ABSTRACT FROM AUTHOR]

Medical testing promises to establish certainty by providing a definitive assessment of risk or diagnosis. But can those who rely on tests to offer advice or make clinical decisions be assured of this certainty? This article examines how Australian health professionals, namely clinicians, microbiologists, specialist physicians and health policymakers, delineate the boundary between certainty and uncertainty in their accounts of medical testing. Applying concepts from science and technology studies, and drawing on qualitative data from a sociological study of testing in Australian healthcare, we consider how professionals ascribe meaning to testing and test results. As we argue, for these health professionals, the 'evidence' that testing generates has ambiguous ontological significance: while it promises to provide diagnostic certainty and clear direction for advice or treatment, it also generates uncertainties that may lead to yet further tests. Our analysis leads us to question a key premise of testing, namely that it is possible to establish certainty in medical practice via the measurement of individual health risks and disease markers. Against this dominant view, the responses of the health professionals in our study suggest that uncertainty is intrinsic to testing due to the constantly changing, unstable character of 'evidence'. We conclude by considering the implications of our analysis in light of healthcare's increasing reliance on sophisticated technologies of 'personalised' testing using genetic information and data analytics. [ABSTRACT FROM AUTHOR]

Introduction: Driving is a valued occupation given the independence and freedom it provides. Safe driving performance can be impacted by medical conditions, change in functional status and ageing processes. Occupational therapy driver assessors (OTDAs) provide invaluable driving recommendations; however, this requires specialist training for the therapist and is costly for clients. The number of OTDAs is not expected to meet the growing demand for expert services in this area, and little is known about the practices that non‐ OTDAs use to assist clients with returning to driving. The aims of this study were to investigate the practices of non‐OTDAs in a community‐based rehabilitation setting in Australia with respect to knowledge, confidence and skills in assessments, recommendations and outcomes for clients as part of the return to driving process. Methods: A descriptive study including medical record audits between April and September 2019 and staff surveys were completed at a large metropolitan community‐based rehabilitation facility. Descriptive statistics and thematic analysis were used to summarise data. Results: A total of 102 client medical records were audited, and 13 clinician surveys were completed. Medical record audits identified that return to driving was not consistently addressed by occupational therapists. Clinician surveys outlined a lack of knowledge and confidence of return to driving processes and available assessment tools to guide this process. Conclusion: All occupational therapists have an ethical obligation to address driving as an activity of daily living; however, non‐OTDAs report that they are not equipped for this role. This may negatively impact on driver safety, independence and overall health and well‐being of clients in community‐based rehabilitation. Further research is indicated to develop evidence‐based driving resources to support best practice of non‐OTDAs. [ABSTRACT FROM AUTHOR]

Police officers gave accounts of how their perceptions toward Domestic and Family Violence have changed over repeated exposure to these types of incidents as first responders. Interviews were conducted with 16 police officers in an Australian state. Officers expressed a desire to help people and reported personal growth through increased interpersonal skills and open-mindedness but many also became disillusioned. Officers highlighted futility, paperwork, and scrutiny of their actions as factors that inhibited their ability to cope. The findings imply that although officers' competence may increase, their well-being and capacity to do their job effectively and compassionately may become impaired. [ABSTRACT FROM AUTHOR]

Aims: To examine the perceptions of leadership by leaders within residential aged care and to identify the crucial requirements for successful leadership in this complex industry. Background: As an industry capitalizing on the concept of 'care', one of the critical attributes this research has found to be absent in many aged care leadership approaches is compassion. Methods: A qualitative methodology using thematic analysis was used to explore the construction of leadership attributes needed within residential aged care, as perceived by leaders in these organisations. Results: Senior staff in the aged care industry believe that compassion is both a key component and a gap in the skill set of aged care leadership and leaders. While most studies define good leadership and care in relation to clinical 'safety' and 'efficiency', this research demonstrates that compassionate caring is central to high‐quality care in residential aged care. Conclusions: The aged care industry needs to enhance and encourage compassionate leadership as a cornerstone of humane and dignified care. Implications for Nursing: When developing theoretical explanations for the role of leadership in aged care, researchers should contemplate compassion as a key attribute required in residential aged care leaders. Education and training in this industry must incorporate the attributes associated with compassion, including emotional intelligence and person‐centred leadership. [ABSTRACT FROM AUTHOR]

Evaluate the utility of brief online training for facilitating mental health professionals' perceived knowledge, confidence, and comfort in working with non-binary clients, and building positive attitudes. Baseline participants were 79 Australian registered mental health professionals, of whom 38 completed online training and a one-week follow-up assessment. Participants completed an assessment of attitudes, comfort, confidence, and perceived knowledge pertaining to non-binary people before and after completing online training. The training (30-minute average completion time) provided information on non-binary people's lives using text, images, embedded video, and links to optional resources. Follow-up measures completed one-week post-intervention indicated engagement in the training may lead to increased perceived knowledge, confidence and comfort. Attitudes were positive at baseline and were not significantly different at follow-up. Providing brief online training for working with non-binary people in mental health might improve practitioner perceived knowledge, confidence and competence at low cost and with easy access. Future research is required to account for limitations and build on current outcomes. Key Points What is already known on this topic: Little is known about the effects of brief online training regarding non-binary genders on mental health practitioner's attitudes, confidence, comfort, and perceived knowledge. Previous research has shown that brief training can increase positive attitudes for, knowledge of, behavioural intent, and cultural competence for working with sexual and gender minorities, though has not specifically focused on non-binary people. Previous literature has highlighted positive associations between practitioner knowledge and the well-being of non-binary people accessing health services. What this paper adds: This paper adds to the ongoing genesis of options for training mental health practitioners about non-binary people and relevant issues. Findings suggest beneficial outcomes from both prior professional training in this area and the brief training used in the study. The brief online training used in the study was associated with higher perceived knowledge, confidence, and comfort for working with non-binary clients, but further research is needed to understand reasons for change in these variables. [ABSTRACT FROM AUTHOR]

Self-management is a contemporary model of chronic condition care that places expectations on, and roles for, both patients and health professionals. Health professionals are expected to form partnerships with their patients, and patients are expected to be active participants in their own care. In these new roles, control and responsibility for self-management are shared between people with chronic conditions and their health professionals. We still have limited knowledge about how these new roles are enacted in self-management support. In this article, we examine how health professionals perceive the roles of patients and professionals in chronic condition self-management, drawing on Bourdieu's concepts of field, doxa and capital. In this qualitative study, 32 in-depth interviews were conducted with 11 health professionals in Sydney, Australia. Data were analysed thematically. Three themes were derived. First, there was incongruence between how participants characterised and enacted their roles. Second, participants compartmentalised clinical and non-clinical aspects of self-management support. Finally, the roles of health professionals entwined with emotions and judgements of patienthood revealed that the provision of self-management support was linked to a fit between individuals' cultural health capital and the expectations governing the field. We argue that 'taken for granted' assumptions about self-management and self-management support must be challenged to mitigate negative social representations and unrealistic expectations placed on patients and health professionals, particularly those patients with less capital, who are more marginalised within clinical interactions. [ABSTRACT FROM AUTHOR]

Australia has approximately 26,000 registered exercise professionals (REP), in comparison with 3,379 accredited practicing dietitians (APD). The REP workforce has the potential to reach more than 10% of the Australian population but there is limited data on their educational background and professional behaviors with regards to nutritional counseling of clients. The purpose of this research was to determine if REPs are working within their scope of practice and if their qualifications align with their practice, specifically as it relates to nutrition advice. Using a cross sectional descriptive study design, a self-administered online survey of REPs was conducted over 5 months. REPs were recruited through electronic and social media using a snowballing technique. The study focused on education, nutrition advice, and sources of information. A total of 286 respondents completed the survey, including 13 with tertiary dietetic qualifications i.e., APDs. The nationally recognized industry Certificate III/IV in Fitness was the most common qualification. The majority of REPs responding (88%) were working outside of their professional scope of practice, offering individual nutrition advice to clients across fitness and medical issues. This was despite 40% of REPs undertaking no further training in nutrition since graduating, and primarily basing advice on use of readily accessible sources of nutrition information. It is recommended the nutrition advice provided to REPs during training be limited to general nonmedical nutrition information in accordance with nationally endorsed evidence based guidelines and that issues pertaining to scope of practice be addressed with onward referral to other health professionals be advocated. [ABSTRACT FROM AUTHOR]

Objective: Family violence causes brain injury and trauma for many victim survivors. Neuropsychologists play a central role in helping with these issues. We aimed to evaluate rates of family violence training, knowledge and clinical skills in Australian neuropsychologists. Method: An online, brief, self-report survey of psychologists practicing clinically in the area of neuropsychology Australia wide. The survey assessed prior training, knowledge and confidence together with awareness of specific family violence clinical skills, and barriers to competent practice. Results: Responses were received from every state and territory and represented more than 10% of the total registered endorsed clinical neuropsychology workforce (N = 92). Over 90% of respondents had undertaken family violence training, however 57% reported having little or no knowledge and 67% little or no confidence working clinically in the area. Knowledge of specific family violence skills was reduced, with only 20% indicating that they knew how to respond, when clients disclosed experiencing family violence. Conclusions: Further work is needed to improve the ability of the Australian neuropsychology workforce to respond to this important health issue. Response of neuropsychologists may be sub-optimal, particularly in regard to the provision of psychological support following disclosures a central tenant of World Health Organization guidelines. KEY POINTS What is already known about this topic: Family violence is a significant public health issue in Australia. Family violence can cause both brain injuries and psychological trauma and attenuated cognitive functioning has been associated with both of these conditions. Clinical neuropsychologists commonly work with clients who experience cognitive attenuation. What this paper adds: This paper is the first, to our knowledge, to survey training, knowledge, confidence levels and specific family violence clinical skills in Australian neuropsychologists. Over 10% of the endorsed clinical neuropsychology Australian workforce participated in this self-report online survey. Results indicated that most had received some family violence training, however, self-rated knowledge, confidence and awareness of specific family violence skills were relatively low and further training and professional development in this area is required. [ABSTRACT FROM AUTHOR]

Self‐harm is a significant health issue, a leading cause of serious injury and is an indicator of psychological distress. Nurses play an important role in providing therapeutic care to people who self‐harm. The aim of this study was to explore mental health nurses' (MHNs) experience of working with people who self‐harm. Data were collected using semi‐structured interviews and transcribed verbatim from 14 MHNs across Australia. Elo and Kyngäs' inductive content analysis was used to extract meaning from the data which is reported in accordance with the consolidated criteria for qualitative research guidelines (COREQ). Two categories were identified which captured the MHNs' experiences of working with people who self‐harm: (i) Nurses' level of preparedness to work with people who self‐harm; and (ii) The healthcare system. Several sub‐categories were identified. Attitudes, knowledge, skills, and support from others influenced their experience of working with people who self‐harm. Clinical and life experience, undergraduate programme preparation and ongoing education all contributed towards developing therapeutic care with this group of patients. Nurses are vital in the care of people who self‐harm and an accurate understanding of the functions of self‐harm focuses therapeutic interactions to manage psychological distress and reduce further self‐harm and lessen the risk of suicide. [ABSTRACT FROM AUTHOR]

Purpose: To explore the views and opinions of nonconsumer researchers to the concept of an Expert Consumer Researcher Group. Design and Methods: Qualitative exploratory involving individual interviews with nonconsumer mental health researchers experienced in working collaboratively with consumer researchers. Data were analyzed thematically. Findings: Participants viewed the concept positively, albeit with caution. Perceived advantages included: greater visibility and enhanced access; collegiality; sharing and creating expertise; broader acceptance; making it mandatory; and structure and location. Participants were concerned about potential tokenism and implementation barriers. Practice Implications: Consumer involvement enhances the quality and relevance of research, potentially impacting clinical practice. [ABSTRACT FROM AUTHOR]

Severe drug hypersensitivity reactions (DHRs) are often encountered by health care professionals (HCPs). We evaluated knowledge of doctors and pharmacists in the assessment and management of severe DHRs using a structured questionnaire. A cross‐sectional study was conducted in 4 metropolitan hospital networks in Melbourne, Australia. A 13‐question, scenario‐based multiple‐choice questionnaire to assess specific knowledge domains in drug hypersensitivity syndrome recognition, causality attribution, cross‐reactivity patterns, appropriate diagnostic tests, and therapy was administered to HCPs of various vocation and specialty groups. Data were analyzed according to profession, self‐reported experience, and preparedness in managing severe DHRs. Two hundred thirty‐eight participants (45.0% senior doctors, 24.4% junior doctors, and 30.7% pharmacists) across a range of subspecialties achieved an overall median score of 7 (IQR, 5‐8)—overall 55.6% correct responses to all questions—with senior doctors outperforming junior doctors and pharmacists (P <.001). The best performance by all participants was in DHR syndrome recognition (60.9%), and the poorest was in diagnostics/therapy (52.0%). HCP group and experience level were significantly associated with better performance in the knowledge domains of cross‐reactivity and diagnostics/therapy (P =.003 and <.001, respectively), but not in the domains of syndrome recognition and causality attribution (P >.05). Levels of self‐reported preparedness in DHR management were not associated with performance rates in any of the knowledge domains. This study demonstrated significant knowledge gaps in the recognition and management of severe drug hypersensitivity reactions. Targeted multidisciplinary education of staff caring for these patients is needed to improve knowledge gaps. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives: Urinary tract infection (UTI) is a common presentation to general practitioners (GPs). There is increasing antimicrobial resistance in urinary pathogens in many healthcare systems. Adherence to principles of antimicrobial stewardship is important to combat this problem. Our aim was to describe the prevalence of presentations of clinically diagnosed new UTI to early‐career GPs, to describe management choices made, and to identify associations of prescribing antibiotics at the index consultation for UTI. Method: This is a cross‐sectional analysis of the Registrar Clinical Encounters in Training cohort study. Early‐career GPs from five Australian states (urban to very remote practices) collected data on 60 consecutive patient encounters during each of three 6‐month training terms. Proportions of problems being new UTIs, antibiotics prescribed, urine microscopy and culture ordered were calculated. Univariate and multivariable logistic regressions established associations of patient, registrar, and practice factors with prescribing antibiotics for a new UTI. Results: One thousand three hundred thirty‐three early‐career GPs diagnosed 2850 new UTIs from 189 736 consultations (1.5%; 95% CI, 1.4‐1.6). Antibiotics were prescribed at 86% (95% CI, 84.7‐87.2) of these index consultations. Antibiotic choice followed Australian therapeutic guideline recommendations. Urine microscopy and culture were requested at the index consultation less than recommended by guidelines in men, 69.2% (95% CI, 62.6‐75.1), and children, 80.8% (95% CI, 76.4‐84.6). Adults were significantly more likely to be treated with antibiotics at the index consultation than children under 16. Conclusions: A new UTI is a common presentation to Australian early‐career GPs. There is general adherence to guidelines for antibiotic choice in UTIs. Further research is needed, however, to understand some decisions made when managing UTI in children and men. This may reflect diagnostic uncertainty with consequent attention to antibiotic stewardship by deferring antibiotic prescription. [ABSTRACT FROM AUTHOR]

The article offers information on Standard of practice in oncology and haematology for pharmacy services. Topics include the Standard may overlap with others and depending on the area of specialty practice it may be advisable to refer to additional Standards of Practice, and the oncology pharmacists should be familiar with the National Safety and Quality Health Service Standards User Guide for Medication Management in Cancer Care and Clinical Oncology Society of Australia Guidelines.

Aims: The aim of this study was to examine professional identity through the group performances of nurses within a specific work environment. Background: Professional identity and social identity are closely linked. Nurses undertake clinical practice usually within a social group environment. The literature is limited on the development of professional identity within the context of nurses' daily work. Design An integrated ethnographic case context design was adopted, consisting of two clinical wards in one acute health‐care facility in Australia. The application of the social identity theory (SIT) was used to study two specific professional activities to describe the group performance of nurses within this organizational cultural context and how this influenced nurses' professional identity. Method: The research was undertaken between 2012 and 2014. Data collection included observation, interviews and fieldnotes of a convenience sample of nurses and allied health‐care professionals who undertook two professional activities in their normal work environment. Findings The development of group efficacy contributed to the development of the professional identity in the homogenous handover activity. Self‐efficacy was demonstrated in the heterogenous multidisciplinary activity. Conclusion: The results indicated the importance of recognizing core identity‐building activities and understanding the value of these activities to professional identity development. SUMMARY STATEMENT: What is already known about this topic? Outside health care, it is well researched that social identity theory and group performance are important to group development within organizations.Professional identity during the training of undergraduate nurses is well researched.It is known, but under studied, that work contexts are significant arenas where nurses' professional identity is refined and expressed. What this paper adds? Social processes in the work environment sustain the construction of nurses' professional identities.Group efficacy during nurse‐to‐nurse activities contribute to the development of professional identity.Self‐efficacy during multidisciplinary interactions offers insights into the performance of professional identity. The implications of this paper: The findings have implications for informing the development of core identity‐building activities to purposefully enhance professional identity within nursing work contexts.The findings have implications for understanding how nurses self‐categorize their professional identity and how this is expressed differently in a homogenous nursing group from a multidisciplinary group.The findings are relevant to professional leadership, education and service development in the nursing profession and generate important possibilities for further research in other nursing work environments. [ABSTRACT FROM AUTHOR]

Objective. Mental health nurses (MHNs) have a long, under-recognised, history of engaging in psychotherapeutic practice across the spectrum of mental illness and mental health problems. There is a need for a psychotherapeutic response for people with complex or serious mental health problems within the stepped care model and in response to increased need for psychotherapeutic responses to COVID-19 and natural disasters. This project sought to identify the educational preparation and self-reported competency of MHNs to clinically undertake psychotherapy across the continuum of care. Methods. Situated within a larger mixed-methods study exploring how MHNs practice psychotherapy, adapt it to routine care and envisage the future, this paper reports the findings from a survey of MHNs regarding their educational preparation, experience and competence in modalities of psychotherapy and the application of psychotherapy with specific clinical groups. Results. In all, 153 MHNs responded to a request to participate in the study. In this cohort, 86% of nurses had postgraduate qualifications specific to psychotherapy and 95% had worked for over 10 years in the mental health field and had hundreds of hours of training in psychotherapy. There was a high level of self-reported competence in working with people with serious mental health problems and at-risk or vulnerable groups. Conclusions. Currently, MHNs are not recognised in federal funding arrangements to procure psychotherapeutic intervention for members of the Australian population who require it. MHNs ought to be recognised as independent providers based on both the psychotherapeutic skills they possess and their specialist clinical skills of working with people across the spectrum of mental health problems. Appropriately qualified MHNs need to be funded to use their skills in psychotherapy via access to appropriate funding arrangements, such as Better Access and the National Disability Insurance Scheme. [ABSTRACT FROM AUTHOR]

Background: Emergency medicine is a well-established specialty in Australia and New Zealand. The Australian Defence Force (ADF) has progressively identified the value of this discipline across a range of domestic and deployed activities, with EM trainees and fellows deploying on a range of ADF exercises and operations since 1991. In 2017, Operation OKRA (Iraq) saw the first ADF deployment of specialist emergency physicians (EPs) in a dedicated EP position as the Senior Medical Officer and lead clinician of a deployed health facility. Purpose: This narrative review seeks to highlight the skills and abilities EPs bring to the ADF, as well as opportunities for the future. Conclusion: ADF EPs are increasingly providing key clinical capabilities within Role 1, 2 and 2E facilities on exercises and overseas deployments, and have established the requirement for EP inclusion in the manning of future deployed facilities. Involvement of EPs in ADF technical and clinical governance at all levels will enable these specialists to provide advice to commanders as well as clinicians, and influence policy and future ADF health capability development [ABSTRACT FROM AUTHOR]

Objective: Drawing upon extant Australian and International literature we sought to identify the skills and knowledge psychologists require to competently evaluate Australian young offenders for sentencing. We also sought to identify the key ethical and methodological issues that Australian psychologists should be aware of before commencing a forensic evaluation of a young offender. Method: Using search terms "expert witness, pre‐sentence report, pre‐sentence report, forensic mental health assessment, Forensic Mental Health Assessment, forensic assessment, methodology, forensic model, and sentencing juveniles" we searched for peer reviewed articles published between the years 2000–2018 on the PsycARTICLES, PsycINFO, and ProQuest data bases. Results: Drawing upon available literature we identified the knowledge and skills required for evaluations and the ethical standards available to help guide the evaluation. Due to the lack of Australian research in this area, we had to rely on international literature regarding recommended evaluation methods. There is no clear statement on what the psychology profession in Australia believes is an appropriate evaluation methodology and what content is required in a pre‐sentence report. There is no specific data clarifying what Australian judicial officers find helpful in pre‐sentence reports. Conclusions: Our article highlights the need for further research into Australian evaluation methodology for pre‐sentence reports, and the need for professional standards and guidelines specific to Australian jurisdictions. [ABSTRACT FROM AUTHOR]

Injury is the leading cause of hospitalisation of children in Australia and can cause ongoing physical and psychological morbidity. Hospital staff provide excellent physical care to injured children, but there is a need for models of care that improve psychosocial care. To address this gap, a trauma support social work service was trialled at an Australian paediatric trauma hospital, to guide families of injured children through the healthcare system from the day of the child's injury to 6 months following discharge. A mixed methods approach was used to evaluate the service and used a range of data sources—trauma registry records, the Trauma Support Coordinator (TSC) journal, staff surveys, and interviews. Findings from this small study suggest the TSC was able to improve the coordination of care, provide information, and meet the emotional needs of families of injured children. Ways to improve the effectiveness and acceptance of the TSC role were also identified. IMPLICATIONS Injured children should be allocated a dedicated TSC for their entire stay in hospital to provide continuity of care for the child and their family. Situating the TSC role in the Emergency Department will allow for early contact with families when support is most crucial. Incorporation of the TSC role into the social work roster will reduce "doubling up" of psychosocial services offered to families. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate a mentoring programme embedded in a work‐based personal resilience enhancement intervention for forensic nurses. This qualitative study formed part of a wider mixed‐methods study that aimed to implement and evaluate the intervention. Twenty‐four semistructured interviews were carried out with forensic nurse mentees and senior nurse mentors; these explored their experiences of the mentoring programme and any benefits and challenges involved in constructing and maintaining a mentor–mentee relationship. Qualitative data were analysed thematically using the Framework Method. Four key themes relating to the initiation and maintenance of mentor–mentee relationships were identified: finding time and space to arrange mentoring sessions; building rapport and developing the relationship; setting expectations of the mentoring relationship and the commitment required; and the impact of the mentoring relationship for both mentees and mentors. Study findings highlight the benefits of senior nurses mentoring junior staff and provide evidence to support the integration of mentoring programmes within wider work‐based resilience enhancement interventions. Effective mentoring can lead to the expansion of professional networks, career development opportunities, increased confidence and competence at problem‐solving, and higher levels of resilience, well‐being, and self‐confidence. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the skills, knowledge, and experiences differentiating expert and competent strength and conditioning (S&C) coaches. Method: The participants were 87 elite-level head S&C coaches with an average of over 18 years of coaching experience. These coaches were employed by teams from the MLB, NBA, NFL, NHL, NCAA Division 1 FBS "Power Five" Conferences, United States National Teams, and the Australian Football League. This study used both a qualitative and quantitative research design through the use of the Delphi method, which incorporated three rounds of surveys. The first-round survey asked the participants to identify at least one important skill, knowledge area, and experience that should be possessed by an expert and competent S&C coach respectively. The characteristics generated from the first round were placed on a second-round survey and rated on their level of importance using a five-point Likert scale. If a characteristic received a suggestion for rephrasing, and did not reach a level of consensus, or an entirely new characteristic was suggested, then it was placed on the final-round survey to be rated again. Characteristics that reached a level of consensus were placed on the final list of characteristics. Results: A total of 46 characteristics reached a level of consensus and were placed on the final list of characteristics. Conclusion: There now exists an empirically validated list of characteristics differentiating expert and competent S&C coaches. This list can aid in the selection, evaluation, and development of S&C coaches. [ABSTRACT FROM AUTHOR]

When the Royal Australasian College of Physicians incorporated in 1938, the names of 232 Foundation Fellows entered the first fellows' register. In histories of the College, there is no mention that five of these pioneers were women. The achievements of these extraordinary women appear to have been overlooked or ignored. This is a brief account of what they achieved and the times in which they lived. [ABSTRACT FROM AUTHOR]

Health coaching is a service provided to patients by healthcare professionals for the purposes of disease management and health risk prevention. Internationally, pharmacist health coaching services provided to patients with chronic health conditions have produced beneficial health outcomes. Despite this, the service is not currently provided within Australian community pharmacies. This study evaluates the knowledge, opinions and attitudes of leaders within the pharmacy profession about the concept of health coaching as a service in community pharmacy. Semi‐structured interviews with leaders in the pharmacy profession were carried out. Pharmacy leaders were interviewed until data saturation was reached; 10 pharmacists were interviewed. The interviews were transcribed verbatim and analysed thematically; extracts from the transcripts were compared and categorised to establish themes and subcategories. Analysis of the transcripts indicated the emergence of two main themes and 10 subcategories. The main themes were as follows: 'positive view of health coaching in Australian community pharmacy' and 'barriers to integrating health coaching into Australian community pharmacy'. There was an overall perception that health coaching within community pharmacies would be valued by the Australian community. Interviewees held differing perceptions of pharmacists' capability to effectively coach pharmacy clients and suggested that the main impediments to its introduction related to remuneration for the service. The findings indicated that there is a potential for pharmacists to provide a health coaching service in community pharmacies, but that remuneration is a fundamental barrier. The research also indicated the need to clearly identify the knowledge, skills and attitudes needed to health coach and to identify whether potential gaps in the competencies of Australian community pharmacists exist. [ABSTRACT FROM AUTHOR]

Background: A clinical swallow examination (CSE) provides integral information that informs the diagnostic decision‐making process within dysphagia management. However, multiple studies have highlighted a high degree of reported variability within the CSE process. It has been hypothesized that such variability may be the result of the clinical reasoning process rather than poor practices. Aims: To elucidate the nature of expert, speech–language therapists' (SLTs) clinical reasoning during an initial bedside assessment of patients referred for suspected dysphagia in the acute care environment. Methods & Procedures: An exploratory 'observation of practice' qualitative methodology was used to achieve the aim. Four expert SLTs, from two clinical services, completed CSEs with 10 new referrals for suspected dysphagia. All assessments were video‐recorded, and within 30 min of completing the CSE, a video‐stimulated 'think aloud' semi‐structured interview was conducted in which the SLT was prompted to articulate their clinical reasoning at each stage of the CSE. Three types of concept maps were generated based on this video and interview content: a descriptive concept map, a reasoning map and a hypothesis map. Patterns that consistently characterized the assessment process were identified, including the overall structure; types of reasoning (inductive versus deductive), facts (i.e., clinical information) drawn upon; and outcomes of the process (diagnosis and recommendations). Interview content was examined to identify types of expert reasoning strategies using during the CSE. Outcomes & Results: SLTs' approach to clinical assessment followed a consistent structure, with data gathered pre‐bedside, during the patient interview and direct assessment before a management recommendation was made. Within this structure, SLTs engaged in an iterative approach with inductive hypothesis‐generating and deductive hypothesis‐testing, with each decision‐making pathway individually tailored and informed by patient‐specific facts collected during the assessment. Clinical assessment was primarily geared towards management of an initial acute presentation with less focus on formulating a diagnostic statement. Conclusions & Implications: Variability in reported dysphagia practice is likely the result of a patient‐centred assessment process characterized by iterative cycles of fact‐gathering in order to generate and test clinical hypotheses. This has implications for the development of novel assessment tools, as well as professional development and education of novice SLTs. What this paper addsWhat is already known on the subjectCSE practices are reportedly variable, which has led to calls for more stringent, standardized assessment tools. Emerging evidence suggests that this variation is non‐random, but may arise from clinical reasoning processes.What this paper adds to existing knowledgeWe directly observed expert SLTs conducting CSEs and identified patterns in practice that were consistent across all CSEs evaluated. These patterns were consistent in structure, whereas the content of the assessment items varied and was tailored to individual patient presentation. Overall, expert SLTs engaged in balanced cycles of inductive hypothesis generation and deductive hypothesis‐testing, a hallmark of good clinical assessment and practice.What are the potential or actual clinical implications of this work?Ensuring quality CSE requires a more nuanced approach that considers the role of clinical reasoning in SLTs' decision‐making and the potential unintended negative consequences of standardized assessment tools. [ABSTRACT FROM AUTHOR]

Research examining the relationship at the interface of personality, values, moral foundations and its impact on employees' subjective well‐being, resilience, job performance and satisfaction is almost non‐existent. This study addresses this Special Issue's call focusing on the key antecedents and consequences of resilience on individual and/or organisational level outcomes. It does so by analysing data from two different, though comparative cross‐national studies in Australia and India. Employing a quantitative survey method, we collected data from 195 respondents in Australia and 257 respondents from India. Employing the core theory of moral foundations in association with its relationships with individual personality, values, well‐being and resilience, our findings suggest a significant relationship between personality traits and individual moral foundations, and psychological well‐being via values. The study offers distinctive contributions to the literatures on well‐being, resilience and moral foundations theory. Specifically, the personality trait of extroversion influences power and achievement or self‐enhancement values through individualised moral foundations. Second, the study found that values of benevolence and universalism, or compassionate values, form the basis for biological mechanisms of resilience through individual moral foundations of fairness/harm care. The paper concludes with implications for theory and practice. [ABSTRACT FROM AUTHOR]

Considerable evidence demonstrates the importance of both job demands and job resources in the prediction of employee health and motivational outcomes. However, scant empirical evidence explains how broader organisational factors can also have an impact on these outcomes. Utilising the job demands‐resources (JD‐R) model as a theoretical explanation of occupational stress, we examined the impact of employees' alignment with their organisation's strategic objectives (strategic alignment) in predicting long‐term occupational health outcomes. The sample consisted of 1,601 police officers employed in one Australian police service, who completed two self‐report surveys over 12 months. Results of the study indicated that strategic alignment was the only resource to reduce psychological strain, and to increase work engagement over time. Job demands were not found to be significantly associated with either psychological strain or work engagement over time. There was also no evidence of the moderating effects of job resources on health and motivational outcomes. The theoretical and practical implications of the inclusion of strategic alignment as an organisational resource are discussed. [ABSTRACT FROM AUTHOR]

Objective: Ensuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual and organisational performance, there have been few studies exploring these concepts in the public healthcare sector. This study addresses this gap by exploring the perceived differences in demonstration of core competencies between average and higher-performing managers in public sector healthcare organisations. Methods: Mixed methods were used to define and measure a set of competencies for health service managers. In addition, supervisors of managers were asked to identify the differences in competence between the average and high-performing managers reporting to them. Results: Supervisors could clearly distinguish between average and higher-performing managers and identified related competencies. Conclusions: The consistent pattern of competence among community health and hospital public sector managers demonstrated by this study could be used to develop a strategic approach to talent management for the public healthcare sector in Australia. What is known about this topic?: Although there are validated competency frameworks for health service managers, they are rarely used in practice in Australia. What does this paper add?: This paper illustrates the perceived differences in competencies between top and average health services managers using a validated framework. What are the implications for practitioners?: The public health sector could work together to provide a more effective and efficient approach to talent management for public hospitals and community health services. [ABSTRACT FROM AUTHOR]

Medication order accuracy checking is an integral and time-consuming component of the current Australian pharmacist's role. However, the pharmacy profession internationally has moved towards separating the checking task into two parts: a clinical check performed by the registered pharmacist and a technical accuracy check delegated to an appropriately trained pharmacy technician. This case study demonstrates that in an Australian hospital pharmacy context, appropriately trained pharmacy technicians have the potential to be more proficient and time efficient than pharmacists when undertaking accuracy checking of dispensed medications. What is known about the topic?: International data have shown that appropriately trained pharmacy technicians can be more precise than pharmacists when performing accuracy checking. What does this paper add?: This paper reports the findings of an Australian case study reallocating the accuracy checking task to trained pharmacy technicians and evaluating the time efficiency data, which has not previously been reported. What are the implications for practitioners?: These findings provide support for the potential to safely delegate checking tasks to an appropriately trained accuracy checking pharmacy technician. [ABSTRACT FROM AUTHOR]

Background: Employability, employment destinations and utilisation of knowledge–skill domains of new graduate health information managers (HIMs) have not been explored. Objectives: To capture the timing from course completion to employment and employment locations of a 5-year cohort of health information management graduates of La Trobe University, Australia, in 2017–2018; identify professional knowledge and skills used by the graduates in executing their roles; and map these to four domains of the health information management curriculum. Method: A mixed-methods descriptive study utilising a survey investigated early career pathways of new graduates of health information management courses from 2012 to 2016. Demographic data included age, year of graduation, lead time from course completion to employment, position title, number of positions held post-graduation and knowledge–skills used in the workplace. Results: Eighty percent (n = 167) of graduates working in Australia with known contact details responded to the survey. Of these, 96.4% (n = 161) worked in at least one "health information management-related" position since graduation. Forty-five percent (n = 72) of graduates obtained a position before course completion, and over 94% (n = 150) were employed in the profession within 6 months of completion. Sixty percent (n = 97) of graduates had worked in two or more positions from 2012 to 2016. The large majority of new graduate HIMs (82.4%) were employed in the public healthcare sector in "health information management" (44%), or "health classification" (28.1%) roles. Most graduates (61%) had utilised at least three or four domains of professional knowledge–skills in the workplace. Whereas 16% (n = 26) of graduates used, solely, their health classification knowledge–skill set, almost 74% (n = 117) undertook some health classification-related activities. Only 16% (n = 26) of graduates were over 40 years of age, and there were no statistically significant differences between Bachelor and Master (Combined Degree Programs) graduates and Graduate-entry Master degree graduates in terms of lead time to employment, number of positions held, type of employing agency and professional knowledge–skills utilised in the workplace. Conclusion: Graduate HIMs have very high employability, demonstrate job mobility consistent with the national trends, are largely represented in the public sector but have presence throughout the healthcare system and utilise most or all of the specialised domains of professional knowledge and skills studied at university. [ABSTRACT FROM AUTHOR]

Background: To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency.Methods: A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n = 498) from three categories of hospital in Jinan, Shandong Province, China.Results: The survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate. The core competencies identified in the Australia context were applicable to the management roles in Chinese hospitals. In addition, the senior executives had low levels of confidence in their management competence. Furthermore, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence.Conclusions: The study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the nature of knowledge exchange on a multi‐disciplinary Australasian intensive care virtual community of practice, "ICUConnect." Background: Current organisational structures and cultures constrain the social networks of healthcare professionals, limiting access to contemporary best practice knowledge. While virtual communities can facilitate knowledge and clinical expertise exchange in professional networks, their effectiveness has not been established. Design: A sequential mixed‐methods design with a quantitative core and qualitative supplementary component was used to explore the content of discussions from an intensive care virtual community. SRQR has been used to report this study. Methods: Email archives of an intensive care listserv (2003–2013) were mined using a two‐stage sampling technique to identify discussion threads (with >2 posts) concerning ventilator or airway practices (cluster) and two sets of 20 threads (stratified across years). Summative content analysis was used to examine both manifest and latent content. Results: Forty threads containing 326 emails posted by 133 individuals from 80 organisations were analysed. Nurses contributed 68% (55% were in clinical leadership roles) and physicians 27%. Three subject areas were identified: clinical practices (71%); equipment (23%); and clinical governance (6%). "Knowledge‐requested" and "knowledge‐supplied" posts were categorised as follows: experiential and explicit (33% and 16%, respectively); experiential (27% and 35%); or explicit (40% and 17%). Knowledge supplied was also categorised as "know‐how" (20%); "know‐why" (5%) or "no knowledge" exchanged (6%). The central construct of virtual community work was identified with six elements that facilitated participation and knowledge exchange including: (a) the discussion thread; (b) sharing of artefacts; (c) community; (d) cordiality; (e) maven work; and (f) promotion of the VC. Members asked questions to benchmark their practice, while those who answered were focused on ensuring that best practices were delivered. Conclusions: ICUConnect reflected characteristics of a virtual community of practice, enabling key benefits for members and the broader Australasian intensive care community, especially access to best practice knowledge from clinical experts. Relevance to clinical practice: This study demonstrated that a practice‐based VC can function effectively as a VCoP to establish an effective professional network where members have access to up‐to‐date best practice knowledge. Healthcare organisations could leverage VCs to support the professional development of HCPs and ensure that local clinical practices are based on contemporaneous knowledge. Participation by nurses in these communities facilitates individual professional development and access to important clinical knowledge and expertise, and ultimately reinforcing the unique position of nursing in delivering effective, consistent high‐quality patient care. [ABSTRACT FROM AUTHOR]