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Over the past two decades, there have been important changes to interprofessional education in Australia and New Zealand. Interprofessional education has slowly shifted from peripheral, small-scale education activities attended by volunteer students to become an expectation of many health professional courses to meet accreditation requirements and community expectations of a collaborative healthcare system. In Australia, interprofessional education curricula have been facilitated by increased accreditation expectations and a series of national large-scale funded projects. However, despite declarations of intent and direction, strategic implementation of nationwide recommendations has not been achieved. In New Zealand, large-scale funding has not been available to facilitate the implementation of interprofessional education in the professional courses. Instead, interprofessional education initiatives have been driven by a small group of champions. Furthermore, efforts to achieve the World Health Organization's (2010) vision of interprofessional education across the education spectrum--to ensure the future and current health workforce have the competencies for interprofessional collaboration--have been hampered in our region by the focus on interprofessional education within tertiary education. This paper outlines the transnational status of interprofessional education and the role of the Australian and New Zealand Association for Health Professional Educators (ANZAHPE) and the Australasian Interprofessional Practice and Education Network (AIPPEN) in progress to date. We conclude with several suggestions for future interprofessional education across our two countries. [ABSTRACT FROM AUTHOR]

In this paper, we argue that Australian & New Zealand Association for Health Professional Educators (ANZAHPE) is a nurturing organisation and envision what cultivating this means for its future. We use communities of practice and social learning to examine ANZAHPE's evolution as a nurturing association. We describe two ANZAHPE innovations, the unique conference presentation format called the "personally arranged learning session", or "PeArLS", and a new professional development program called "ANZAHPE Online". We then reflect on how these function as nurturing structures in which members embody ANZAHPE's philosophy of community learning. From these examples, we draw out future directions for the association. [ABSTRACT FROM AUTHOR]

This article, titled "Strategy: The secret to writing a conference abstract in health professional education," provides guidance for educators, researchers, and students on how to write effective conference abstracts. The authors emphasize the importance of understanding the reader's expectations and following conference guidelines and reviewer expectations. They offer suggestions for organizing abstracts according to five common elements: introduction/background, methods, results, discussion/conclusion, and title. The article also highlights the significance of crafting clear, specific, and succinct abstracts that engage readers. [Extracted from the article]

Objective: Intra-articular injection of local anaesthetic provides safe and effective analgesia for patients with shoulder dislocation. We designed a three-dimensional-printed ultrasound model of the shoulder to educate ED clinicians on use of this technique. We aimed to evaluate the impact of a 1-h training session using this model on participants' knowledge, skills and clinical practice., Methods: This was a prospective study of the clinicians working at two EDs in New Zealand. Participants (n = 20) took part in a 1-h educational session. We tested participants' performance before the session, afterwards and at 3 months using a 10-point objective structured clinical examination. We reviewed clinical records to determine whether there was increased utilisation of this technique among ED patients before and after the training., Results: There was improvement in participants' OCSE performance (median pre-training score = 4.00, median 3-month post-training score = 7.00, P = 0.044) and self-reported competence and knowledge, which were sustained to the end of the study. There was increased use of intra-articular injection among ED patients with shoulder dislocation: 2 of 68 patients (3%) before and 11 of 76 patients (14.5%) after the study. Notably, most were performed by clinicians who did not take part in the study (n = 9)., Conclusion: A 1-h training session using a three-dimensional-printed model improved participants objective structured clinical examination performance in ultrasound-guided injection of the shoulder joint. Although there was minimal change in the practice of participating clinicians, overall use of the procedure increased., (© 2024 Australasian College for Emergency Medicine.)

Objective: To assess the image quality and common technical limitations seen on cardiac point-of-care ultrasound (POCUS) performed and archived in a single New Zealand ED., Methods: A retrospective cohort study of clinically indicated cardiac POCUS, archived from 1 October 2019 to 20 May 2020. Archived examinations were retrospectively reviewed by an ED POCUS expert, and an expert cardiac sonographer to determine diagnostic image quality, technical limitations present and opportunities for image quality improvement. Image quality of credentialed examinations was compared to uncredentialed examinations and examinations that were undocumented in the medical record., Results: A total of 211 cardiac POCUS examinations were included. The impact of image quality on diagnostic interpretation was only documented in <2% of examinations. There was no difference in median global image quality scores for uncredentialed and credentialed examinations (8.5 vs 9, P = 0.55) and median score for undocumented examinations (5.5) was lower than credentialed examinations (P < 0.01). Common technical limitations identified were off-axis imaging and artefacts limiting image quality., Conclusion: In the present study of clinically indicated cardiac POCUS, low image quality was common but the impact of image quality on diagnostic interpretation was very rarely documented in the medical record. Local quality assurance and training should be directed at credentialed and uncredentialed clinicians including strategies to improve off-axis imaging and managing artefacts where possible. Standardised documentation of image quality that may impact diagnostic accuracy should be encouraged., (© 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Phenomenon : Navigating uncertainty is a core skill when practicing medicine. Increasingly, the need to better prepare medical students for uncertainty has been recognized. Our current understanding of medical students' perspectives on uncertainty is primarily based on quantitative studies with limited qualitative research having been performed to date. We need to know from where and how sources of uncertainty can arise so that educators can better support medical students learning to respond to uncertainty. This research's aim was to describe the sources of uncertainty that medical students identify in their education. Approach : Informed by our previously published framework of clinical uncertainty, we designed and distributed a survey to second, fourth-, and sixth-year medical students at the University of Otago, Aotearoa New Zealand. Between February and May 2019, 716 medical students were invited to identify sources of uncertainty encountered in their education to date. We used reflexive thematic analysis to analyze responses. Findings : Four-hundred-sixty-five participants completed the survey (65% response rate). We identified three major sources of uncertainty: insecurities, role confusion, and navigating learning environments. Insecurities related to students' doubts about knowledge and capabilities, which were magnified by comparing themselves to peers. Role confusion impacted upon students' ability to learn, meet the expectations of others, and contribute to patient care. Navigating the educational, social, and cultural features of clinical and non-clinical learning environments resulted in uncertainty as students faced new environments, hierarchies, and identified challenges with speaking up. Insights : This study provides an in-depth understanding of the wide range of sources of medical students' uncertainties, encompassing how they see themselves, their roles, and their interactions with their learning environments. These results enhance our theoretical understanding of the complexity of uncertainty in medical education. Insights from this research can be applied by educators to better support students develop the skills to respond to a core element of medical practice.

Objectives: Responding well to clinical uncertainty is a crucial skill for any doctor. To better understand how medical students develop this skill, Social Cognitive Theory can be used to explore students' perceived capability to respond to situations of uncertainty. This study aimed to construct a self-efficacy questionnaire and use it to measure medical students' responses to clinical uncertainty., Design: A 29-item questionnaire was constructed. For each item, participants rated their confidence in responding to uncertain situations using a scale of 0-100. Data were analysed with descriptive and inferential statistics., Setting: Aotearoa New Zealand., Participants: The questionnaire was distributed to 716 of 852 medical students in second, fourth and sixth year, at the three campuses of the Otago Medical School., Results: The Self-Efficacy to Respond to Clinical Uncertainty (SERCU) questionnaire was completed by 495 participants (69% response rate) and found to be highly reliable (α=0.93). Exploratory factor analysis confirmed a unidimensional scale. A multiple linear regression model predicted self-efficacy scores from year of study, age, mode of entry, gender and ethnicity, F(11,470) = 4.252, p<0.001 adj. R²=0.069. Male students and those admitted to the programme 3 years postdegree or with significant allied health experience were predicted to have significantly higher self-efficacy scores. Year of study was not a significant predictor of average efficacy scores., Conclusions: Our research contributes a novel, highly reliable questionnaire that uses self-efficacy to measure medical student responses to uncertainty. The questionnaire revealed that students' confidence in responding to uncertainty may be more related to their background and life experience than to progression through the curriculum. Medical educators and researchers can use the SERCU questionnaire to obtain a new perspective on how their students respond to uncertainty, inform future research and tailor teaching about uncertainty., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Medical imaging is integrated across all years in the medical programs at the Medical School, in our country. Little is known about this pedagogical approach from the perspective of those who participate in it. This study investigated how students and educators experience an integrated medical imaging curriculum., Methods: One-on-one interviews were conducted with nine educators and three undergraduate medical students and analyzed using a reflexive thematic approach. Educators included radiologists, non-radiologists clinicians, and scientists and health professionals from the medical program., Results: The integrated medical imaging curriculum appears to be incoherently experienced by educators and students as learning opportunities that were 'everywhere and nowhere'. Teaching events were 'repetitive and patchy' and featured a transmission-oriented pedagogy emphasizing 'exposure and absorption'. Educators expressed paradoxical views of their responsibility for teaching medical imaging reflected in this sentiment: 'I don't teach medical imaging… (but I do)'., Discussion: When medical imaging is integrated into learning resources and course work across the undergraduate program, it may lose its visibility and importance as a distinct learning area despite its crucial role in medical practice. An integrated curriculum may inadvertently separate knowing about medical imaging from learning to apply medical imaging knowledge in clinical practice., Conclusions: Further work is required to construct an integrated medical imaging curriculum that explicitly emphasizes medical imaging learning outcomes, so they are experienced coherently and consistently by medical students and those who prepare them for practice as doctors., (Copyright © 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Practical advice is offered for a positive and productive supervisory relationship. Tips to get started include suggestions to consider about possible reasons, assumptions, and expectations for engaging in education research. Once a relationship is established, we emphasise the importance of constructing appropriate research questions, understanding the use of theory, and developing time management strategies. We consider the practicalities of initiating a research project and the reflexivity required to maintain shared expectations. We address potential challenges which may disrupt the research process. Finally, we present a set of reflective prompts for supervisors and students to consider before starting a project together., (© The Author(s) under exclusive licence to International Association of Medical Science Educators 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Rationale, Aims, and Objectives: Uncertainty is a complex and constant phenomenon in clinical practice. How medical students recognize and respond to uncertainty impacts on their well-being, career choices, and attitudes towards patients. It has been suggested that curricula should do more to prepare medical students for an uncertain world. In order to teach medical students about uncertainty, we need to understand how uncertainty has been conceptualized in the literature to date. The aim of this article is to explore existing models of uncertainty and to develop a framework of clinical uncertainty to aid medical education., Method: A scoping literature review was performed to identify conceptual models of uncertainty in healthcare. Content and inductive analyses were performed to explore three dimensions of clinical uncertainty: sources of uncertainty, subjective influencers and responses to uncertainty., Results: Nine hundred one references were identified using our search strategy, of which, 24 met our inclusion criteria. It was possible to classify these conceptual models using one or more of three dimensions of uncertainty; sources, subjective influencers, and responses. Exploration and further classification of these dimensions led to the development of a framework of uncertainty for medical education., Conclusion: The developed framework of clinical uncertainty highlights sources, subjective influencers, responses to uncertainty, and the dynamic relationship among these elements. Our framework illustrates the different aspects of knowledge as a source of uncertainty and how to distinguish between those aspects. Our framework highlights the complexity of sources of uncertainty, especially when including uncertainty arising from relationships and systems. These sources can occur in combination. Our framework is also novel in how it describes the impact of influencers such as personal characteristics, experience, and affect on perceptions of and responses to uncertainty. This framework can be used by educators and curricula developers to help understand and teach about clinical uncertainty., (© 2020 John Wiley & Sons Ltd.)

Background: Interprofessional education initiatives can be used as effective means to influence students' perceptions of their own and others' roles and interactions as health professionals. There is a need to better understand how interprofessional education learning outcomes are appreciated by students., Aim: The aims of this study were to describe and compare evaluation feedback from students in undergraduate nursing and medicine programmes about the learning outcomes of an interprofessional education initiative., Methods: A mixed methods pre-post-study design was used to collect data using evaluation questions about the initiative and two interprofessional learning outcomes: communication and teamwork. Ratings were analysed with a two-way repeated measures analysis of variance or a t-test. Written responses were analysed using a general inductive approach., Results: Data from 30 nursing students and 12 medical students were analysed. A noteworthy finding was a significantly higher average rating for nursing students than medicine students before and after the session for the statement about valuing interprofessional learning. Three themes represented comments from both groups: positive experiences, relevance to practice, and learning design issues., Discussion: Findings were interpreted to indicate that students from both programmes valued the learning outcomes session and was greater at the end of the session. Notably, the perceived value of interprofessional learning was higher for nursing students than medical students before and after the session. This finding may be related to the familiarity nursing students may have with the teaching methods used in the initiative. Further exploration of this finding is needed so educators can better understand how they can provide optimal learning experiences for all students who participate in interprofessional education., Conclusion: Nursing and medicine students appear to value the interprofessional learning outcomes in an undergraduate health professional initiative. However, differences between these two groups of students are an area for further exploration., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

This article was migrated. The article was marked as recommended. Introduction: Online resources are available to enhance emergency medicine training programmes. The aim of this study was to evaluate the feasibility of using online case-based resources created in the United States in a New Zealand emergency medicine training programme. Methods: Evaluation data were collected from junior doctors and educators after they participated in the programme. Data sources included research notes and questionnaire responses. The data were analysed qualitatively using a general inductive approach. Results: Evaluation feedback from 19 junior doctors and 14 educators was interpreted to suggest that the online resource, with minor adaptations, was feasible to use in a New Zealand emergency medicine training programme. Findings indicated that educators were able to modify the materials to modify to meet local requirements, however, the opportunity to include a cultural component was missed. Participants appreciated the case-based format and felt that they established a safe and encouraging learning environment with each other. Participants were able to develop a systematic approach to emergency situations and identify red flags related to deteriorating patients. Discussion and Conclusion: Evaluation findings indicate that adapting an online-sourced curriculum is feasible to educators and acceptable to junior doctors and educators participating in a single New Zealand based Emergency Medicine training program. Educators in other international training settings may find the lessons learned helpful when adapting online resources to address the learning needs of their junior doctors. Next steps are to evaluate the impact of this resource on the knowledge and skills learned by junior doctors and any changes in their care for patients in emergency medicine situations., (Copyright: © 2021 Beck S et al.)

This article was migrated. The article was marked as recommended. Background. This article uses a case study approach to describe and analyse how a peer-led committee was used to develop leadership skills among junior doctors. Junior doctors are a potentially powerful group of leaders within the healthcare sector, yet more senior staff members may encounter difficulty engaging with this group. Leadership and engagement are essential for optimal functioning of an organisation. Alternatives. Typical methods used to develop leadership skills and promote engagement with leadership activities include higher degrees, short courses, coaching, and experiential learning activities. One alternative can be to use experiential learning that has be informed by situated learning theory and the concept of communities of practice. Solution. A peer-led committee of junior doctors was established using to develop leadership skills and promote engagement with leadership activities. The committee was designed to address five features of a community of practice: mutual engagement, joint enterprise, shared repertoire, learning, and community. This peer-led committee included elected roles and met regularly out of hours over two sites within the Southern District Health Board, New Zealand. Recommendations. This intervention was well-received by junior doctors and has been sustained in the Southern District Health Board. A peer-led committee structured with the features of a community of practice may be useful method for others to use when they seek to promote and support the development leadership skills of junior doctors., (Copyright: © 2021 Hehir L et al.)

Objective. To conduct a survey of practicing pharmacists in which best-worst choice methodology was used to prioritize pharmacy practice skills for inclusion in a pharmacy curriculum in New Zealand. Methods. A literature search and review of pharmacy curricula were conducted, and the findings were used to develop a best-worst choice survey instrument regarding inclusion of pharmacy practice skills in the pharmacy curriculum. The survey was sent to registered pharmacists and intern pharmacists in New Zealand. Participants were asked to prioritize 16 skills in terms of their importance and relevance to pharmacy practice. Results. Of the 3836 pharmacists invited to participate in the survey, 388 completed the questionnaire. Comprehensive chronic disease management, specialty medications, and medicines use review were the top three prioritized skills. Injections, independent prescribing, and specialty compounding were the skills ranked as having the lowest priority. The pharmacists' gender, age, practice setting, and ethnicity all influenced their skill prioritization. The pharmacists emphasized skills required in their current practice but deemphasized some skills that were emerging professional responsibilities. Conclusion. If curricular reform is to include new skills that are largely unfamiliar to or deemed unimportant by practicing pharmacists, quality assurance of students' experiential education will be needed. Furthermore, preceptor education about changing expectations for pharmacy graduates' skill sets must be adequately developed and implemented to ensure that preceptors provide students with opportunities to practice the full range of skills they will need in practice and provide them with accurate assessment and helpful feedback., (© 2020 American Association of Colleges of Pharmacy.)

This article was migrated. The article was marked as recommended. Introduction . In the health professional education literature, there is a need for information about the teaching and learning of medical laboratory sciences for clinical practice. The goal of this reflection-on-practice is to describe how an orofacial pathology interprofessional education (IPE) initiative was designed and implemented. Innovation . The designers of this initiative were teachers from dentistry, oral health, and medical laboratory science. The designers used six interprofessional competencies (patient-centred care, role clarification, team functioning, collaborative leadership, communication, and cultural practice) to guide their construction of teaching and learning resources. The initiative required students to work collaboratively with a given patient case to develop a differential diagnosis, prepare a treatment plan, present their case to classmates and staff members, and describe how they worked together to address the orofacial pathology in their case. Evaluation . The designers collected and considered evaluation information including the learning resources used, logistical arrangements for the initiative, and evaluation data from students via an anonymous 10-item questionnaire. Students rated statements that addressed the six interprofessional competencies and provided written comments about the initiative. Outcomes . In general, the 18 students agreed strongly with all statements except for cultural practice. Written comments about the initiative were positive and indicated that students appreciated learning about their own discipline and that of other professionals in the context of providing oral healthcare involving orofacial pathology. What next? Given the acceptability of this initiative to the designers, facilitators, and students, the next step is to consider the feasibility of scaling-up this small voluntary IPE initiative into a permanent component of the dentistry, oral health, and medical laboratory science programmes. Aspects to consider include staffing, scheduling, assessment, and cultural perspectives., (Copyright: © 2020 Olson H et al.)

Phenomenon: Professionalism can be characterized by a particular set of attributes that clinicians demonstrate in practice. Although much has been described on those attributes that define acceptable professionalism, the characteristics that define distinction in professionalism have not yet been well defined. Approach: In this exploratory project, qualitative methods were used to triangulate three sources of data collected from three campuses of one medical school: student assessment summaries, teacher interviews, and an institutional policy. Findings: One hundred-thirty student assessment summaries, eight teacher interviews, and one institutional policy were analyzed. Three characteristics emerged that define distinction in professionalism: improvement of oneself, helping others learn, and teamwork. These characteristics are in addition to students demonstrating a clear minimum standard in all other aspects of professionalism. Insights: Findings from this project offer a first step toward a definition of distinction in professionalism for assessing student performance. The characteristics can be demonstrated by students to varying degrees of proficiency and are potentially achievable by all students. Finally, the characteristics would be required in addition to demonstrating a clear minimum standard of performance in all other aspects of professionalism and cannot be inferred by the absence of negative or unprofessional behaviors. Recognizing that conceptions of professionalism have contextual and cultural influences, the characteristics of distinction identified by this project expand the language available for teachers and learners to discuss professionalism. Teachers may use these characteristics to help inform their teaching, learning, and feedback practices. Students will gain clarity about the expectations regarding their professional behavior.

Background: Students find learning clinical reasoning skills challenging. Viewing how students learn clinical reasoning skills from a sociocultural perspective, however, may allow helpful and unhelpful descriptions to be interpreted as experiences that promote or inhibit their participation in and opportunities to co-construct their clinical reasoning skills., Methods: This interview study was conducted with 25 Year-6 undergraduate medical students. Interview data were first analysed thematically, and then the findings were analysed with the concepts of participation and co-construction., Results: The themes identified were: (1) practising with undifferentiated patients; (2) teachers who were willing to make thinking explicit; (3) a lack of independence and involvement; (4) a lack of communication and feedback; and (5) confusion from different sources of information. When further analysed, the themes could be represented as points along a continuum of participating in, and co-constructing, clinical reasoning skills., Discussion: Clinical educators will find the themes identified from students' experiences learning in a workplace environment helpful for understanding why some students may struggle to develop their clinical reasoning skills. An interpretation of findings from a sociocultural perspective offers a different approach for understanding students' difficulties when learning clinical reasoning: one where students are able to increase their participation in, and co-construction of, clinical reasoning in the context of working collaboratively to provide patient care. Students find learning clinical reasoning skills challenging., (© 2019 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

Background: Threshold skills are defined as new ways of thinking about and performing in a discipline. They represent transformed ways of thinking and doing that are pivotal to learners' progress. Our aim was to establish whether clinical reasoning exhibited features of a threshold skill. Methods: Twenty-five final-year medical students were interviewed with a five-question protocol about how they were learning clinical reasoning. Students' responses were analyzed using a deductive method to identify features of threshold skills. Results: Students' descriptions of learning clinical reasoning exhibited five features: transformation, troublesomeness, integration, association with practice, and issues with transferability. Conclusions: Viewing clinical reasoning as a threshold skill is a novel interpretation of its nature and has implications for learning, teaching, and research. Students can be reassured that, although initially troublesome, with practice, they will not only learn the skill but also how to use it more effectively. Teachers can help students to understand that clinical reasoning is difficult to learn and will require time and repeated practice under supervision to develop.

Background: There is increasing evidence that students at different levels of training may benefit from different methods of learning clinical reasoning. Two of the common methods of teaching are the "whole - case" format and the "serial cue" approach. There is little empirical evidence to guide teachers as to which method to use and when to introduce them., Methods: We observed 23 students from different stages of training to examine how they were taking a history and how they were thinking whilst doing this. Each student interviewed a simulated patient who presented with a straightforward and a complex presentation. We inferred how students were reasoning from how they took a history and how they described their thinking while doing this., Results: Early in their training students can only take a generic history. Only later in training are they able to take a focused history, remember the information they have gathered, use it to seek further specific information, compare and contrast possibilities and analyze their data as they are collecting it., Conclusions: Early in their training students are unable to analyze data during history taking. When they have started developing illness scripts, they are able to benefit from the "serial cue" approach of teaching clinical reasoning.

This article was migrated. The article was marked as recommended. Introduction : Dual process theory and script theory have been used to understand and explain how students learn clinical reasoning. This study used these tools to interpret how experienced teachers described their definitions of clinical reasoning, their own history learning about clinical reasoning, and their methods of teaching clinical reasoning. Methods : Interview data from 14 senior clinicians were investigated thematically using a general inductive approach then interpreted using principles and concepts associated with dual process theory and script theory, including the concept of deliberate practice and script consciousness. Results and Discussion : Senior clinicians' definitions of clinical reasoning were consistent with the literature. Few of them recalled being explicitly taught clinical reasoning. They identified teaching as a way to further develop their own clinical reasoning. They taught it opportunistically using an apprenticeship and role-modelling approach in clinical contexts. Their teaching techniques included supervised practice, reflection, think aloud, focused data collection guided by the clinical presentation, and iterative reasoning. Conclusion : Dual process theory, script theory, and the concepts of mindful practice and deliberate practice were found to be useful tools to understand how senior clinicians taught and learned clinical reasoning. These findings are guiding our clinical reasoning curriculum and faculty development programme., (Copyright: © 2017 Gee W et al.)