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Introduction: The Doctor of Medicine (MD) and the Bachelor of Dental Science Honours (BDSc) degrees are challenging, with similar prerequisites regarding the scope of prior knowledge and academic performance. Studies have previously explored personality traits of students within each degree, but few have compared traits between the MD and BDSc cohorts. Methods: Successive first-year cohorts of MD and BDSc students (2015 to 2018) completed a survey including demographic questions and the Temperament and Character Inventory (TCI). Generalised estimating equations comparedTCI traits of students in the programs. Results: MD students comprised a higher proportion of students who were male, older and married/partnered compared to BDSc students. Profiles of temperament and character were similar. After adjusting for sex, age and marital status, the mean scores of harm avoidance were higher, and persistence, self-directedness and cooperativeness significantly lower inBDSc compared to MD students. Conclusions: Students pursuing medicine and dentistry demonstrate some differences in trait scores, however they are not meaningfully different when interpreting their profiles. Both groups have similar personalities, indicative of coping with their challenging degrees. A supportive learning environment is paramount to that coping success.

INTRODUCTION: Dental therapists, hygienists and oral health therapists constitute up to a third of the dental workforce in Australia and New Zealand. Personality is often explored in health professions to provide insights into traits that are conducive to workforce retention and to assist in planning and training. This study aimed to investigate the current demographic and personality characteristics of oral health students in Australia and New Zealand. MATERIALS AND METHODS: Students in years one to three of all eight undergraduate Bachelor of Oral Health programs in Australia and New Zealand were invited to complete an online survey. The survey measured activities prior to entering into oral health, career intentions and included a personality questionnaire, the Temperament and Character Inventory (TCI). RESULTS: Three quarters of participants (n = 336; 30% response rate; females = 90%) were single, from an urban area and 20-29 years of age. Oral health students overall portrayed high trait levels of Persistence and Cooperativeness. Cluster analysis of TCI traits identified three groups. Groups of students with high Persistence and Cooperativeness tended to be older, were working in non-dental and dental careers prior to their degree and were interested in working in regional areas after graduation. CONCLUSIONS: Students with high levels of persistence and cooperativeness were interested in working in regional areas after graduation, highlighting the importance of industriousness and persistence in overcoming barriers to practicing in regional areas. Further research is warranted to investigate barriers and enablers in recruitment and retention of males in a primarily female dominated profession.

The transactional model of stress is a framework describing the process for coping with stressful events as a relationship between the individual person and environment. This study aimed to investigate the associations between personality, learning environment and experiences of mental health for a cohort of Australian dentistry students.Students were invited in 2017 to complete an online questionnaire including the Depression, Anxiety and Stress Scale (DASS-21), The Dundee Ready Education Environment Measure (DREEM) and Cloninger's Temperament and Character Inventory (TCIR-140). Students were followed-up one year later, and generalised estimating equations were used.A total of 219 (response 73.5%) students participated in the study. Two personality profiles of dentistry students were identified. Group 1 were significantly higher in the traits persistence, self-directedness, cooperativeness and reward dependence, whereas Group 2 were significantly higher in harm avoidance. Students with Group 2 personality had a 3.12 (CI:1.72-5.65) increased odds of depression compared to Group 1 students. Compared to students with positive perceptions of the learning environment, students with negative perceptions had increased odds of stress (3.48, CI: 1.85-6.53), depression (2.71, CI: 1.57- 4.65) and anxiety (2.59, CI: 1.56-4.28).Students with personalities high in levels of self-directedness, cooperativeness and persistence and low in harm avoidance, as found in Group 1, demonstrate high levels of general well-being. Positive perceptions of the dentistry learning environment were found to be an important influence on students stress. This study highlighted a number of factors important to student well-being and provides direction for further investigation of interventions aimed at enhancing student well-being.

Background: An educational partnership between The University of Queensland (UQ) in Australia and Ochsner Health in the United States developed the UQ-Ochsner medical program that trains American citizens to practice medicine in the United States. This program provides the opportunity to explore and compare the personal characteristics of UQ-Ochsner students with their domestic (Australian citizen) and international classmates not enrolled in the Ochsner program. Findings may offer some insights into the types of students who choose to study medicine across multiple countries. Methods: We used a quantitative cross-sectional design for our study. A first-year cohort of domestic, international, and UQ-Ochsner students completed a survey comprising demographic questions and measures of temperament and character personality, resilience, and calling to medicine. Univariate statistics were used to compare groups for all variables. Results: The whole sample response rate was 72.1% (375/520). Domestic students represented the greatest proportion of students 0.3). Conclusion: UQ-Ochsner students have a personality profile similar to their classmates but with levels of certain traits—higher self-directedness and lower harm avoidance—that in combination contribute to higher resilience and a strong sense of calling to medicine. Being slightly older may allow for more development of self-directedness, but low harm avoidance suggests an innate degree of confidence in and acceptance of risk to achieving goals.

Medical students have personalities that are often shown to be perfectionistic. Perfectionism can manifest as maladaptive and lead to psychological distress. This study examined the mediating role of perfectionism on the association between personality trait profiles and levels of psychological distress.First-year medical students completed a questionnaire containing measures of personality, perfectionism (Concern over Mistakes: CoM), stress, anxiety and depression. Latent profile analysis classified students based on their personality traits and identified a profile vulnerable to psychological distress. Structural equation models examined the mediation effects of perfectionism on the relationship between the vulnerable personality profile and distress.The sample totalled 376 (84% response). The vulnerable personality profile was highest in Harm Avoidance, lowest in Self-Directedness, and significantly correlated with the highest Perfectionism-CoM. High Perfectionism-CoM was associated with the highest levels of stress, anxiety and depression. Perfectionism-CoM was a significant mediator for the relationship between personality and higher levels of psychological distress.Certain personality profiles are predisposed to psychological distress such as anxiety, stress and depression. Perfectionism, as a mediator between personality and psychological distress, may be a target strategy to help increase students' self-acceptance, and self-awareness of their perfectionistic tendencies and lower their vulnerability to poor mental health.

Producing enough doctors working in general practice or rural locations, or both, remains a key global policy focus. However, there is a lack of evidence about doctors’ emerging commitment to these decisions. This study aimed to explore changes in the level of certainty about career interest in working in general practice and working rurally, as doctors pass through various early career stages. The participants were 775 eligible respondents to a 2019 survey of medical graduates of The University of Queensland from 2002–2018. Certainty levels of specialty choice were similar between GPs and specialists up until the beginning of registrar training. At that point, 65% of GPs compared with 80% of other specialists had strong certainty of their specialty field. Consistently (and significantly) less of those working rurally had strong certainty of the location where they wanted to practice medicine at each career time point. At the start of registrar training, a similar gap remained (strong certainty: 51% rural versus 63% metropolitan). This study provides new evidence that career intent certainty is more delayed for the cohort choosing general practice and rural practice than the other options. The low level of certainty in early career highlights the importance of regular positive experiences that help to promote the uptake of general practice and rural practice.

Introduction: The success of rural longitudinal integrated clerkship (LIC) programs has contributed to our understanding of selecting and training students for rural practice. Studies have explored the personality traits of students who participate in rural LICs although few have compared them with classmates who have not. The purpose is to compare personalities of four successive cohorts of students in the LIC Rural Physician Associate Program (RPAP) with their non-RPAP classmates. Methods: In a longitudinal cross-sectional design, medical students RPAP and non-RPAP, from 2013 to 2017 completed identical questionnaires comprising measures of personality, perfectionism, ambiguity tolerance, and resilience. T-tests, ANOVA, and post-hoc tests compared groups. K-means cluster analysis identified profiles of traits. Results: Total sample 286; RPAP = 128; non-RPAP = 158. Gender and age proportions were not different between groups. RPAP students were significantly lower in levels of perfectionism and higher in cooperativeness compared to non-RPAP classmates. Similar proportions of both groups were distributed across three personality profiles detected. Conclusions: Lower perfectionism implies advantages for rural practice. Nevertheless, similarities between groups suggest that most students would be successful in rural practice. More encouragement to all students may improve uptake of rural LICs. Greater attention to issues that affect decisions to explore rural medical education, particularly for our next generation of students, is required.

Australia’s clinical research communities responded quickly to COVID-19. Similarly, research funding to address the pandemic was appropriately fast-tracked and knowledge promptly disseminated. This swift and purposeful research response is encouraging and reflects thorough and meticulous training of the academic workforce; in particular the clinician scientist. Clinician scientists have formal clinical and research qualifications (primarily PhD), and are at the forefront of translating knowledge into health care. Yet in reality, advances in medical research are not rapid. Scientific discovery results from the long-term accumulation of knowledge. The drivers of this knowledge are often PhD students who provide new lines of clinical inquiry coupled with the advanced training of early- and mid-career researchers who sustain discovery through a clinician scientist workforce. A crucial point during these COVID-19 times is that this initial investment in training must be nurtured and maintained. Without this investment, the loss of a future generation of potential discoveries and a vibrant scientific workforce to safeguard us from future global health threats is at risk. This risk includes the modest gains achieved by increasing female and minority representation in STEM and the clinician scientist workforce. COVID-19 has presented serious concerns to Australia’s health and economy. This perspective is central to these concerns and urges investment in the continuity of training and maintaining a sustainable clinician scientist workforce sufficient to address current and future pandemics, alongside continuing discoveries to improve the health of Australians.

Having 'good' doctors is important to everybody. How to select medical students better has been discussed repeatedly for more than seventy years, implying that prevailing methods could be improved. A significant body of research exists about selection methods and their application in medicine. Yet most medical schools world-wide continue to use prior academic performance and cognitive ability as their major criteria for selection, with minor or no consideration of personal qualities and interpersonal skills (possibly assuming they will develop naturally during training and practice). We describe the main methods available for assessing personal qualities of applicants to medical school and have attempted to identify some reasons and systemic disincentives working against their adoption.

BackgroundCertain personal attributes, such as perfectionism and tolerance of ambiguity, have been identified as influential in high achieving students. Medical students have been identified as high achievers and perfectionistic, and as such may be challenged by ambiguity. Medical students undertake a long and challenging degree. Personality has been shown to influence the well-being and coping and may equip some students to better cope with challenges. This paper examines the association between temperament and character personality profiles with measures of tolerance of ambiguity and with both adaptive and maladaptive constructs of perfectionism.MethodsA self-report questionnaire collected data on a sample of 808 Australian medical students in 2014 and 2015. Personality was measured using the Temperament and Character Inventory (TCIR-140) and classified traits as profiles using a latent class analysis. Two profiles were found. Profile 1 was characterized by low-average levels of Harm Avoidance, and high to very high levels of Persistence, Self-Directedness and Cooperativeness. Moderately-high levels of Harm Avoidance and high levels of Persistence, Self-Directedness and Cooperativeness characterized Profile 2. Moderation regression analyses were conducted to examine the association between the personality profiles with levels of Tolerance of Ambiguity (MSAT-II), Perfectionism-Concern over Mistakes and Perfectionism-High Standards (FMPS), considering demographic characteristics.ResultsStudents with Profile 1 were higher in levels of Tolerance of Ambiguity, and Perfectionism-High Standards, and lower levels of Perfectionism-Concern over Mistakes compared to Profile 2. These findings remained statistically significant after adjusting for age and gender. A significant personality by age interaction on Tolerance of Ambiguity was found. While higher levels of Tolerance of Ambiguity were associated with older age overall, it remained low across age for students with a personality Profile 2.ConclusionsA particular combination of personality traits was identified to be associated with low Tolerance of Ambiguity and high levels of maladaptive Perfectionism. An intolerance of ambiguity and over concern about mistakes may be maladaptive and underlie vulnerability to stress and poor coping. The psychobiological model of personality provides insight into traits that are stable and those that can be self-regulated through education and training. The interaction between biological mechanisms and socio-cultural learning is relevant to a sample of medical students because it accounts for interaction of the biological or innate aspects of their personal development within an intense and competitive learning environment of medical school.

Clinician-scientists are a valuable resource and are crucial to ensuring that high-quality health and medical research is undertaken and translated to patients. Although the literature notes the global decline in clinician-scientists and infers the worldwide similarity in the challenges to reverse this decline, Australia continues to lag behind in establishing an infrastructure to address the dilemma.

Objective Despite increases in Commonwealth funded general practice (GP) Registrar training positions, workforce trends continue to show geographical maldistribution. This study aimed to identify Registrar attributes which describe a cohort choosing to work in rural practice. Design Cross-sectional self-report questionnaire for socio-demographics, prior training, current training pathway, measures of personality and resilience. Participants and Setting GP Registrars (N = 452) training in either the general or rural pathways of three Registered Training Providers in three states, or training through the Australian College of Rural and Remote Medicine's independent pathway. Main outcome measure Ordinal logistic regression tested the impact of key variables on the likelihood that Registrars would settle in rural practice. Univariate analysis explored differences between groups and effects of variables. Results A significantly increased interest in rural practice was to found to exist among registrars who were male, identified themselves as being rural, had a partner who identified as being rural, were enrolled in a rural training pathway and had high levels of Cooperativeness. Conclusion We present a discriminating model combining socio-demographics, prior training and personality variables which challenges Australia to rethink Registrar attributes when training for rural general practice. With significant changes about to occur to GP training in Australia, this paper highlights the need for a more holistic approach which considers personal attributes such as Cooperativeness, rural identity and provision of geographically focused rural training pipelines to encourage Registrars to bond to individual rural communities and further develop their personal connectedness to country life and rural medical practice.

The Queensland branch of the Royal Australasian College of Physicians (RACP) commissioned this study to update their workforce profile and examine rural practice. The present investigation aimed to describe characteristics of Queensland physicians and determine the influence of childhood and training locations on current rural practice. A cross-sectional online survey, conducted 4 July–4 November 2013, was administered to Fellows of The RACP, Queensland. Descriptive statistics report characteristics and logistic regression analyses identify associations and interactions. The outcome measure was current practice location using the Australian Standard Geographic Classification – Remoteness Area. Data were obtained for 633 physicians. Their average age was 49.5 years, a third was female and a quarter was in rural practice. Rural practice was associated with a rural childhood (odds ratio (OR) (95% confidence interval, CI) 1.89 (1.10, 3.27) P = 0.02) and any time spent as an intern (OR 4.07 (2.12, 7.82) P

Introduction: Dentistry students face a challenging academic and clinical curriculum that can result in depression and anxiety. While studies usually report sources of stress for dentistry students, there is less information on levels of stress. This study used the Depression, Anxiety and Stress Scale (DASS‐21), to report perceived levels of depression, anxiety and stress in a cohort of Australian undergraduate dentistry students. Methods: Students enrolled in years 1‐4 of the Bachelor of Dental Science (Honours) program at The University of Queensland were invited to complete the DASS‐21 using an online questionnaire. Students completed the same questionnaire 1 year later. Results: At baseline, the mean DASS‐21 scores for this cohort (n = 179; females = 56%) were in the normal range for depression (4.69, SD 3.87) and stress (5.50, SD 3.65), and mild range for anxiety (4.25, SD 3.21). Overall, 24% (n = 42), 44% (n = 78) and 11% (n = 20) of students had moderate or above levels of depression, anxiety and stress, respectively. At 1‐year follow‐up, DASS‐21 scores were not significantly different. Conclusions: Dental students have higher levels of depression, anxiety or stress than the general population, indicating they may be at risk for greater psychological distress. The information from this study should guide curriculum and learning environment design, as well as interventions to support students through this challenging degree.

Introduction Continuous evaluation and improvement of the learning environment are required to respond to the changing nature of dental practice and dental education. This study aimed to describe a cohort of undergraduate dentistry students' perceptions of their learning environment. Methods Students enrolled in years 1-4 of the Bachelor of Dental Science (Honours) programme at The University of Queensland were invited to complete an online survey which included demographics and the Dundee Ready Education Environment Measure (DREEM). This scale measures students' perception of the educational environment overall, and for five domains: Learning, Teaching, Academic self-perception, Atmosphere and Social self-perception. Data analysis was mostly descriptive, t tests and univariate statistics compared groups. Results Participants (N = 192; females = 57%) were generally positive about their learning environment, with a total DREEM score of 127 of 200. Overall, Academic and Social self-perception domain scores were ranked lower than others. Students in preclinical years of study and/or had dentistry as a first career preference were more positive across all domains, except Social self-perception. Conclusions Differences between the preclinical and clinical phases of the curriculum point to the structure of teaching and learning in health professional degrees. Further research should investigate how each environmental domain more specifically correlates with other aspects of the curriculum and student progression, including well-being. This could include logistical factors such as timetabling and its effect on physical well-being, to less tangible factors that may impact on mental well-being.

Background Clinician-scientist training represents the epitome of preparation for biomedical scientific discovery. The significance of, and need for, clinician-scientists is universally recognised as essential to progress medical research across what is regarded as the ‘translational gap’. Despite a rich history of cutting-edge biomedical research, Australia has no infrastructure or career pathway for training clinician-scientists. Discussion The Clinician-scientist Track (CST) was developed to address this concern at the University of Queensland. The CST concept began in 2010 with the Concurrent MD-Masters that allowed students to undertake a research Masters concurrently with their medical program. The rationale was to offer an attractive and realistic option to recruit our highest performing students into a research higher degree, with the underlying aim of encouraging those most capable, to transfer to the MD-PhD. The Concurrent MD-Masters was immediately popular and remains so. Over 8 years, enrolments rose seven-fold (60 MD-Masters, 36 MD-PhDs). The transfer rate from MD-Masters to MD-PhD is 28% supporting our original aim. Conclusions Many challenges remain for the future of the program. These challenges are underpinned by a culture that values clinician-scientists as crucial to ensuring that high quality health and medical research is undertaken and translated to patient care, but lags behind in establishing an infrastructure to develop and maintain a new generation of this vital workforce. A future challenge is to develop a coordinated approach to a supported Australian MD-PhD pathway for our most talented and committed students beginning in the undergraduate Bachelor’s degree into the medical degree and throughout specialty training. Shared responsibility is necessary between institutions and stakeholders to support and nurture newly trained MD-PhDs into the post-graduate years. Flexibility across this medical training continuum that allows integration of both degrees will help ensure students make the most meaningful connections between the research and the medicine. What is paramount will be acknowledging the career expectations of an emerging cohort of medical students, in particular females, wishing to pursue research. Without these considerations we risk losing our next generation of potential clinician-scientists.

INTRODUCTION Dentistry is known to be a challenging degree and students are often under considerable academic pressure which may lead to stress and difficulties in coping. Personality influences coping ability, yet very little is known about the personality traits of dentistry students. This study aimed to describe the personality profiles of students enrolled in an Australian undergraduate dental degree. METHODS Students enrolled in year one and two of the undergraduate dental programme at The University of Queensland were invited to complete an online survey which included the Temperament and Character Inventory (TCI). Personality was measured by four dimensions of temperament: Novelty Seeking, Harm Avoidance, Reward Dependence and Persistence; and three-character traits: Self-Directedness, Cooperativeness and Self-Transcendence. Data analysis was mostly descriptive, and t tests and univariate statistics compared groups. RESULTS Participants (n = 134; 97% response rate; females = 51%) were generally single, spoke another language at home and lived in shared accommodation. The majority (55%) were 20-29 years old, and 40% were international students. The sample had average levels of all TCI traits, except for Cooperativeness which was high. CONCLUSIONS This sample of dentistry students portrayed a profile of temperament and character similar to profiles of other health profession students with the intellectual ability and drives to undertake a competitive and challenging degree. Longitudinal studies are needed to track changes in personality throughout the degree. This would provide insight into how and when to best support students.

The wrong acknowledgement and funding information were provided in the original publication.

AimPersonality traits refer to habitual patterns of behaviour, thoughts and emotions, and have been shown to influence health professionals' career pathways. The present study explored the associations between dietitians' personality profiles and the areas of dietetic practice they have previously worked.

This paper reports on a pilot study that incorporated discipline specific clinical skill development with intercultural and interprofessional education (IPE) experiences for eight health professions students on clinical placement in a Disability Program in Vietnam. The aim of this study was to examine students’ experiences of interprofessional work while in an intercultural learning environment. A mixed methods design explored student perceptions of their experiences and learning in an interprofessional and intercultural context using semi-structured interviews, the Readiness for Interprofessional Learning Scale (RIPLS) and the Cross-Cultural Adaptability Inventory (CCAI) pre- and post-placement. The quantitative measures were used as a means of individual feedback to student and to assist in the interpretation of the qualitative data. Interviews indicated that students agree on the importance of working interprofessionally but perceived adjustment to interprofessional supervision was more challenging than adjustment to the Vietnamese clinical culture. Students scored lowest on Professional Identity (RIPLS) and Personal Autonomy (CCAI). This study provides an adjunct approach to gaining insight into final year students’ perception of interprofessional work while in an intercultural learning environment. Our small sample size cannot imply student’s definitive attitudes toward IP and IP supervision. However it may suggest that more research combining interprofessional and intercultural learning may contribute to a better understanding of the notion of professions as distinct cultures and students’ perceptions of IPE ‘interculturally’. This may further develop best practice in interprofessional supervision that empowers student learning and reinforces their professional identity.

The individual Teamwork Observation and Feedback Tool (iTOFT) was devised by a consortium of seven universities in recognition of the need for a means of observing and giving feedback to individual learners undertaking an interprofessional teamwork task. It was developed through a literature review of the existing teamwork assessment tools, a discussion of accreditation standards for the health professions, Delphi consultation and field-testing with an emphasis on its feasibility and acceptability for formative assessment. There are two versions: the Basic tool is for use with students who have little clinical teamwork experience and lists 11 observable behaviours under two headings: 'shared decision making' and 'working in a team'. The Advanced version is for senior students and junior health professionals and has 10 observable behaviours under four headings: 'shared decision making', 'working in a team', 'leadership', and 'patient safety'. Both versions include a comprehensive scale and item descriptors. Further testing is required to focus on its validity and educational impact.

Background Clinician-scientists are in decline worldwide. They represent a unique niche in medicine by bridging the gap between scientific discovery and patient care. A national, integrated approach to training clinician-scientists, typically programs that comprise a comprehensive MD-PhD pathway, are customary. Such a pathway is lacking in Australia. The objective was to gather perceptions from Australian medical students on factors they perceive would influence their decision to pursue clinician-scientist training. Methods A cross-sectional mixed methods design used quantitative and qualitative questions in an online self-report survey with medical students from a four-year MD program. Quantitative measures comprised scaled response questions regarding prior experience and current involvement in research, and short- and long-term opinions about factors that influence their decisions to undertake a research higher degree (RHD) during medical school. Qualitative questions gathered broader perceptions of what a career pathway as a clinician-scientist would include and what factors are most conducive to a medical student’s commitment to MD-PhD training. Results Respondents (N = 418; 51% female) indicated Time, Funding and Pathway as the major themes arising from the qualitative data, highlighting negative perceptions rather than possible benefits to RHD training. The lack of an evident Pathway was inter-related to Time and Funding. Themes were supported by the quantitative data. Sixty percent of students have previous research experience of varying forms, and 90% report a current interest, mainly to improve their career prospects. Conclusions The data emphasise the need for an MD-PhD pathway in Australia. A model that provides an early, integrated, and exclusive approach to research training pathways across all stages of medical education is suggested as the best way to rejuvenate the clinician-scientist. A national pathway that addresses factors influencing career decision making throughout the medical education continuum should include an appropriate funding structure, and provide early and continuing advice and mentoring. It should be flexible, gender equitable, and include post-graduate training. The implications of implementing MD-PhD programs represent a substantial investment. However this should not be a deterrent to Australia’s commitment to an MD-PhD pathway, but rather a challenge to help ensure our future healthcare is guided by highly trained and competent clinician-scientists.

Written tests for selection into medicine have demonstrated reliability and there is accumulating evidence regarding their validity, but we know little about the broader impacts or consequences of medical school selection tests from the perspectives of key stakeholders. In this first Australian study of its kind, we use consequential validity as a theoretical lens to examine how medical school students and applicants view and experience the Graduate Medical Schools Admission Test (GAMSAT), and the consequences of testing. Participants (n = 447) were recruited from five graduate-entry medical schools across Australia and a publicly available online test preparation forum. An online survey was used to gather demographic information, and quantitative and qualitative data. Quantitative data were analysed via descriptive statistics and qualitative data were thematically analysed. The findings showed there was a considerable financial burden associated with preparing for and sitting the GAMSAT and moderate agreement regarding the GAMSAT as a fair selection method. The main unintended consequences of using the GAMSAT as a selection tool included barriers related to test affordability and language, and socialisation into the hidden curriculum of medicine. Selection tools such as the GAMSAT have some limitations when the goals are to support equitable participation in medicine and professional identity development. Our study highlights the value interpretive and theoretically-informed research in contributing to the evidence base on medical school selection.

Resilience, coping with uncertainty and learning from mistakes are vital characteristics for all medical disciplines - particularly rural practice. Levels of coping constructs were examined in medical students with and without a rural background or an interest in rural practice.Cross-sectional surveys identified two personality profiles, and their association with levels of Tolerance of Ambiguity, Resilience, Perfectionism-High Standards and Concern over mistakes as constructs indicative of coping. Medical students (N = 797) were stratified by rural background and degree of rural interest. Mediation analysis tested the effect of personality profile on levels of the coping constructs.More (72%) rural background students had Profile 1 which was associated with higher levels of Tolerance of Ambiguity, High standards, and Resilience, but lower Concern over mistakes. Non-rural background students reporting a strong rural interest also had Profile 1 (64%) and similar levels of coping constructs. Personality profile mediated the association between rural interest and levels of coping constructs regardless of background.Having a rural background or strong rural interest are associated with a personality profile that indicates a better capacity for coping. Personality may play a part in an individual's interest in rural practice. Rural workforce initiatives through education should encourage and nurture students with a genuine interest in rural practice - regardless of background.

Trigger warnings are proposed as a strategy to keep university students safe from potentially distressing material. While used internationally for several years, they have begun to be formally implemented in some Australian universities. This paper provides a critical review of the underlying theoretical premises of trigger warnings and the personal and professional impact of such warnings for students in health professions. As with most short-term avoidance strategies, trigger warnings are likely to have a negative impact on student mental health, rather than improve it. The warnings undermine the autonomy and self-management skills of students as independent, adult learners. If these warnings become more widespread, they have significant implications for the resilience of students. For students in health professions, who need skills to manage a wide-range of often unpleasant topics and provide responsive and competent treatment for their patients, they have the potential to result in adverse outcomes in patient care. The development of coping skills to flexibly self-manage and self-regulate emotions and behaviour is an important graduate attribute and provides an alternative to counterproductive trigger warnings. Refereed/Peer-reviewed

Background: The continuing decline in clinician scientists is a global concern. This paper reports on a two-fold rationale to address this decline by increasing the number of students on a formal pathway to an academic research career, and building a ‘teaching-research nexus’ using the research intensive environment at our University. Methods: The University of Queensland has implemented a research intensive program, the Clinician Scientist Track (CST), for a select cohort of students to pursue a part time research Masters degree alongside their full time medical degree. To this end, the support of clinical academics and the research community was vital to achieve a ‘teaching-research-clinical nexus’ – most appropriate for nurturing future Clinician Scientists. Results: In three years, the CST has 42 enrolled research Masters’ students with the majority (90%) upgrading to a PhD. Research represents 33 different areas and over 25 research groups/centres across this University and internationally. Conclusions: Other research intensive institutions may similarly build their ‘teaching-research nexus’ by purposeful engagement between their medical school and research community. The CST offers a feasible opportunity for outstanding students to build their own ‘field of dreams’ through an early start to their research career while achieving a common goal of rejuvenating the ethos of the clinician scientist.

Objective: To report, and determine reasons for, a change in the gender ratio observed among enrolled medical students after removal of the interview from the selection process.

To perform a gap analysis of rehabilitation medicine learning objectives (RMLOs) coverage within school of medicine (SOM) curriculum and educational resources as a basis for development of educational resources to fill any identified gaps.Following ethics approval, interviews were carried out with SOM academics and clinicians to assess the relevance of a set of RMLOs and the extent to which RMLOs were addressed in SOM resources. Interviewee opinion was quantified via Likert scales and additional free comments were subjected to thematic analysis.Most RMLOs were perceived as relevant by more than half of the 18 participants. There was evidence of relevant material relating to each RMLO in SOM resources. Thematic analysis suggested that rehabilitation medicine was addressed at the SOM in less detail than outlined in the RMLOs, and that additional rehabilitation content could be included in SOM resources across a number of courses and year levels.Rehabilitation medicine is considered relevant by clinicians and academics at the SOM. The most effective way of filling identified gaps in coverage of rehabilitation medicine at the SOM will be via engagement across a number of medical and surgical disciplines. Implications for Rehabilitation Rehabilitation-related knowledge and skills are relevant to medical education. Many of these issues are already partially addressed in existing educational resources. The design and delivery of medical school curricula should include a trans-disciplinary and inter-year approach to the inclusion of rehabilitation concepts and aptitudes. This could be done by introducing relevant concepts early, making resources available online, and embedding rehabilitation items across different disciplines, courses and assessments.

ObjectiveTo describe the personality (temperament and character traits) of remote Australian allied health professionals (AHPs). Recent research shows that health professionals can be differentiated by personality traits but little is known about the personality traits of AHPs.

Purpose Medical schools worldwide have developed rural primary care immersive experiences to nurture students' interest in future rural careers and address workforce shortages. Few studies have looked at the students who participate in these programs. This study explores personality traits in US and Australian students who undertake rural-focused medical training. Methods A cross-sectional cohort design used the Temperament and Character Inventory to identify levels of the 7 basic dimensions of personality. Data were collected in successive cohorts over 2007-2011. Multivariate analysis compared trait levels between groups and by demographic variables. Findings The majority of the 302 students (US-167; Australia-135) were female, aged 20-29 years and single. A greater proportion of US students reported being partnered, living longest in a small rural/remote community and having a rural background. Significant differences between groups were detected in several traits but effect sizes were small. The personality pattern of the combined sample indicates students with a mature and stable personality high in Self-Directedness, Persistence, and Cooperativeness. Rural background and marital status enhanced this pattern. Conclusions Despite coming from different educational and societal backgrounds, similar personality patterns are evident in US and Australian students who pursue rural medical education. Data provide support for a pattern of traits associated with a rural background and its predictive influence on interest in rural practice. Considering the international expansion of rural longitudinal integrated clerkships, understanding student attributes may assist in identifying strategies to enhance the rural workforce that are relevant across cultures and continents.

OBJECTIVE: Recent efforts to redress the deficit of rural medical practitioners have considered the problem of recruitment and retention of rural doctors as one of influencing individuals' career choices. Exposure to rural medical environments during basic medical training is one long-standing example of an initiative aimed in this direction and there is some evidence that it is effective. This study sought to determine whether or not various domains of personality are related to medical students' attitude to practising as rural doctors after graduation. DESIGN: The sample comprised 914 students commencing medical studies in Australian universities. They were recruited as part of the Medical Schools Outcomes Database project and indicated intended location of future medical practice. SETTING: Seven Australian basic medical training programs. MAIN OUTCOME MEASURES: All students completed the NEO five-factor index (NEO-FFI) and Adjective Checklist (ACL) personality instruments. RESULTS: A preference for a rural practice location was associated with a combination of six domains of personality. The probability of rural preference was greater with higher scores on openness to experience, agreeableness and self-confidence but lower with higher scores on extraversion, autonomy and intraception. Taken together these six domains of personality provide useful although imperfect discrimination between students with a rural versus urban location preference. After controlling for student age the associations with extraversion and agreeableness failed to reach statistical significance. CONCLUSIONS: While personality does not fully explain medical students' attitude towards practicing as a rural doctor, the data suggest it is an important factor and that some individuals may be better suited to a rural medical career than others. Considering personality along with other characteristics of the individual might allow targeted 'marketing' of rural practice.

This was the first Australian study investigating the acceptability, feasibility and sustainability of a nurse-led model of chronic disease management in general practice. A concurrent mixed-methods design was used within a 12-month intervention of nurse-led care in three general practices. Adult patients with type 2 diabetes, hypertension and/or stable ischaemic heart disease were randomized into nurse-led or standard care. Semi-structured interviews explored perceptions of key stakeholders towards this model including patients in the nurse-led arm, and all practice staff pre- and posttrial. The data were thematically analysed and the emergent themes were: importance of time; collaborative relationships; nurse job satisfaction, confidence and competence; patient self-management and choice. Our findings showed that nurses provided chronic disease management that was acceptable, feasible and sustainable. The collaborative involvement of doctors was intrinsic to patient acceptability of nurse-led care that facilitated job satisfaction, and therefore retention and growth within this nursing speciality.

Evidence suggests that current models of chronic disease management within general practice are not effective in meeting the needs of the community.The objective of this article is to examine patients' perceptions of a nurse-led collaborative model of care trialled in three general practices in Australia.This article reports on the second phase of a mixed-methods study in which semi-structured interviews with purposively selected patients were conducted to elicit information about their perceptions of nurse-led care.Three themes emerged from the data - time, ambiance and dimensions of the nurse role.The results suggest that general practice nurses had a positive impact on patients' ability to manage their chronic disease. This infers that there is scope for general practice nurses to expand their role in chronic disease management to assist patients to better self-manage their chronic diseases.

Purpose There is a high prevalence of stress, depression, and burn-out in medical students. Medical students differ widely in personality traits, self-perceptions, and values that may have an impact on their well-being. This study aimed to investigate variability in their personality profiles in relation to their potential for well-being and resilience. Method Participants were 808 medical students from The University of Queensland. An online questionnaire collected socio-demographics and the Temperament and Character Inventory to assess personality traits. Latent profile analyses identified students’ trait profiles. Results Two distinct personality profiles were identified. Profile 1 (“Resilient”) characterized 60% of the sample and was distinguished by low Harm Avoidance combined with very high Persistence, Self-Directedness and Cooperativeness compared to Profile 2 ("Conscientious"). Both Profiles had average levels of Reward Dependence and Novelty Seeking and low levels of Self-Transcendence. Profiles did not differ by age, gender, or country of birth, but rural background students were more likely to have Profile 1. While both Profiles indicate mature and healthy personalities, the combination of traits in Profile 1 is more strongly indicative of well-being and resilience. Conclusions Finding two distinct profiles of personality highlights the importance of considering combinations of traits and how they may interact with medical students’ potential for well-being. Although both profiles of students show healthy personalities, many may lack the resilience to maintain well-being over years of medical training. Programs that develop character and personality self-awareness would enhance their well-being and prepare them to promote the health of their patients.

Purpose Rural physicians wrestle with professional boundary issues routinely in everyday interactions, and their situation differs from the experience of their urban colleagues. Medical students receive limited exposure to professional boundary management in preclinical training. Increasingly, schools are implementing rural longitudinal clinical clerkships which expose students to rural boundary setting. This qualitative study explored the management of professional boundaries integral to rural practice and how this management may differ from their urban colleagues.

This article is a report of a mixed method study of the association between personality traits of nurses and their reasons for entering nursing. Background. The worldwide nursing shortage prompts research into better understanding of why individuals enter nursing and may assist in exploring ways to increase their recruitment and long term retention. Design. A mixed method sequential explanatory design employed semi-structured interviews and a validated personality inventory measuring temperament and character traits. Methods. Registered Nurses (n = 12) and nursing students (n = 11) working and studying in a regional area of Queensland Australia were purposively sampled for the interviews in 2010 from their participation in the survey in 2009 investigating their personality traits. Qualitative data collection stopped at saturation. A thematic content analysis of the qualitative data using the framework approach was interpreted alongside their personality trait profiles. Results. Two dominant themes were identified from the participant interviews about reasons for entering nursing; opportunity for caring and my vocation in life. These themes were congruent with key temperament and character traits measured in the participants. All nurses and students were very high in traits that exude empathy and altruistic ideals regardless of other characteristics which included highly pragmatic and self-serving principles. Conclusions. Qualitative and quantitative findings suggest that a caring nature is a principal quality of the nursing personality. Recruitment and retention strategies whilst promoting multiple benefits for the profession should not forget that the prime impetus for entering nursing is the opportunity to care for others.

This study compared temperament and character traits of Australian registered nurses and general practitioners. A cross-sectional quantitative design used the Temperament and Character Inventory. Total sample size was 426. Only main effects were detected. Nurses were higher in the temperament traits of Novelty Seeking and Reward Dependence, lower in the character traits of Self-Directedness and Cooperativeness but higher in Self-Transcendence compared with the sample of doctors. Differences in personality profiles between registered nurses and general practitioners might challenge existing stereotypes between these professions. Further exploration of traits exclusive to and shared among health professions would supplement a broad conceptualization of specialities and support the enhancement of appropriate training and career counselling. Awareness of one's temperament and character can lead to a clearer understanding of how they function in the workplace and might encourage reflection on and insight into the implications of their personality and career plans.

Aims and objectives. To describe individual temperament and character trait profiles associated with nurses and nursing students in a large regional health district and university in Australia. Background. Identification of personality characteristics have been undertaken in most professions; however there is little extant literature on nurses which looks at specific aspects of temperament and character. Design. A cross-sectional quantitative study of nurses and nursing students in a large regional health service district and university in South East Queensland, Australia. Method. An online survey to nurses and nursing students included a demographic questionnaire and the temperament and character inventory (TCI) to identify levels of the seven basic dimensions of temperament and character. Univariate analysis made multiple and covariate comparisons between TCI scores, nurses, students, working status and age. Results. The target number of responses was exceeded and totalled 451. Results are reported for females who comprised 90% of respondents; 53·5% students and 46·5% nurses. Significant main effects for age and student status were detected in several temperament and character inventory dimensions. Working students had significantly different temperament and character profiles compared to non-working students. Conclusions. Overall, this sample displays levels of temperament and character traits congruent with a profession requiring high levels of persistence, self-directedness, cooperativeness and reward dependence. Our findings prompt further investigation of whether individuals with the requisite temperament traits are attracted to nursing, or do individuals develop certain character traits as a product of their professional experiences/training. Relevance to clinical practice. The identification of distinct profiles of temperament and character traits among different nursing roles may provide insight into what traits are conducive to retention of nurses in these roles. The predictive potential of the temperament traits plus the modifiable component of character traits may provide scope for nursing educators and policy-makers to assist in recruitment and retention of nurses in the workforce

Objectives: This study uses data from a prospective randomized controlled trial to estimate predictors of pharmaceutical expenditure in diabetes (DM) or cardiovascular disease (CVD) patients. Identifying drivers of pharmaceutical use and the extent to which they are modifiable may inform cost-effective policy-making. Methods: The trial followed 260 patients aged >18 years (mean 68) from three general practices for 12 months. Patients had type 2 diabetes (90 patients) or cardiovascular disease (170 patients). Costs for pharmaceuticals prescribed on the Pharmaceutical Benefits Scheme (PBS) were obtained retrospectively at 12 months. Sociodemographic data and health-related quality-of-life (QoL) were recorded from questionnaires. Clinical measures (including body mass index (BMI), blood pressure, high and low density lipoprotein (LDL), and HbA1c) were also collected. Results: Mean pharmaceutical costs for DM patients (AU$4119) was greater than CVD patients (AU$2424). The largest contributor to costs in both groups was pharmaceuticals used for management of conditions other than CVD or DM. QoL (EQ5D) and BMI were significant predictors of costs in both groups. A history of cardiac events, HbA1c, age, and unemployment were significant predictors of costs in the DM group. A diagnosis of heart failure, frequency of hospital admissions, and LDL levels were significant predictors of costs in the CVD group. Roughly one third of total variation of costs can be explained by the regressors in both models. Limitations: Generalizability will be limited as data was derived from a trial and the study was not powered for this post-hoc analysis. Missing data imputation and self-reporting bias may also impact on results. Conclusions: Factors such as QoL BMI, HbA1c levels, and a history of cardiac events are significant predictors of costs. The results suggest there may be a place for interventions that improve quality-of-life and concurrently reduce pharmaceutical costs in patients with CVD or DM.

In recent years, there has been growing concern for the wellbeing of people affected by mental illness and the recipients of mental health care in Australia. Despite significant positive change there is always room for improvement and one means of introducing and monitoring improvement is through the use of service provision standards. National and international reviews of mental health care highlight the need for responsive service delivery that meets the needs of all people affected by mental illness regardless of their place in the systems of care. The development of documents such as the National Standards for Mental Health Services by the Commonwealth Department of Health and Ageing (Australian Health Minister's Advisory Council 1996) maintained the impetus towards the development of quality measurement tools for mental health service provision. Given the magnitude of change in the area of mental health care over the past decade and the major role that mental health nurses play in the delivery of mental health care it is considered a priority to ensure that this professional group is supported by relevant and appropriate standards for practice.

Introduction: This longitudinal tracking project by the University of Queensland Rural Clinical School (UQRCS) provides data on the early career pathways of alumni since its inception in 2002. Specifically we report on; (1) perceptions of the UQRCS regarding its influence on current career choice, (2) current speciality choices, and (3) factors that influenced these choices. Methods: A retrospective web-based survey of all graduates who undertook clinical Year 3, Year 4 or Years 3 & 4 at UQRCS from 2002 to 2006. Associations with demographics, Year(s) at UQRCS, current workplace and speciality choice were assessed. Results: Response rate was 69%, (N ¼ 180). Alumni who spent two years (Years 3 & 4) at UQRCS reported significantly higher degrees of encouragement to pursue a rural career. Alumni currently working in a non-urban location had spent two years at UQRCS and were significantly higher in desire to remain rural. ‘Time spent at the UQRCS’ contributed most to interest in a rural career. General practice and emergency medicine were most preferred specialities. Conclusions: Findings confirm that a longer rural clinical experience is more effective in eventual choice of workplace location and future interest in a rural career. This corroborates the positive impact of Australian rural clinical schools toward rural medical workforce improvement.

This study explored temperament and character traits in medical students to identify the possible predictive value of these traits to students with varying levels of intention to pursue rural medicine. This work is the precursor to a better understanding of personality traits associated with medical disciplines within specific environments such as rural medicine.The long term aim is to increase the recruitment of students who are best suited, and choose to practice in rural locations.Medical students (272) completed a demographic survey and the Temperament and Character Inventory (TCI-R 140) to identify levels of the seven basic dimensions of temperament and character. Multivariate statistics explored differences between students' TCI levels based on gender, rural origin and level of intention to pursue rural medicine.Analysis showed only main effects and confirmed significant differences in certain TCI dimensions between students with a high compared to a low or medium intention to practice rural medicine and between males and females.Preliminary findings suggest that certain temperament and character traits may be related to interest in rural medicine however the efficacy of assessing personality traits as an adjunct to medical school training and career counselling remains uncertain.

Context: Australia shares many dilemmas with North America regarding shortages of doctors in rural and remote locations. This preliminary study contributes to the establishment of a psychobiological profile for rural doctors by comparing temperament and character traits with an urban cohort. Purpose: The aim was to compare the individual levels and combinations of temperament (mildly heritable and stable) and character (developmental and modifiable) traits of rural and urban general practitioners (GPs). Methods: Rural (n = 120) and urban (n = 94) GPs completed a demographic questionnaire and the TCI-R 140 to identify levels of the 7 basic dimensions of temperament and character. These are Novelty Seeking (NS), Harm Avoidance (HA), Reward Dependence (RD), Persistence (PS), Self-Directedness (SD), Cooperativeness (CO), and Self-Transcendence (ST). Findings: Preliminary results show rural GPs were higher in the temperament traits of NS and lower in HA compared with the urban sample. All female GPs were higher in RD and CO compared with all males, and all older GPs (over 55 years) were lower in RD compared with all younger GPs. Conclusions: This preliminary work may be the precursor to a new approach for the recruitment and retention of rural doctors through a greater awareness of personality traits conducive to the rural workforce. Further work may help inform appropriate policies to attract and retain this workforce and be a useful adjunct to the counseling of students interested in rural medicine by providing a better understanding of "what it takes" to be a rural doctor.

[Extract] Despite a number of initiatives aimed at increasing the rural doctor numbers, the continuing reality of the rural doctor shortage in Australia is that most rural doctors leave after a few months or years. Hays explored the reasons why long-term general practitioners (GPs) stay in rural practice and found that personal and professional support and a strong attachment to the community were associated with decisions to remain in rural practice for long periods, while overwork and children's education concerns contributed most to leaving. 1 Since 2001, numerous initiatives are underway to recruit new graduates and doctors to the bush and as such, their reasons for entering rural practice might be associated with these positive initiatives. This paper builds on previous literature 1 and looks at an established cohort of rural GPs and reports what originally attracted them to rural practice and why they would consider leaving rural practice.

The expanding role of the mental health nurse brings new challenges and rewards. To support this, nationally adopted, formalized standards of practice are required. Currently, the Standards of Practice for Mental Health Nurses in Australia published by the Australian and New Zealand College of Mental Health Nurses in 1995 provide a guide for mental health nurses working in Australia. While these standards have played a role in supporting mental health nurses, they have not been widely adopted. This report reviews the current literature on standards for practice and describes an evidence-based rationale as to why a review and renewal of these is required and why it is important, not just for mental health nurses but to the field of mental health in general.

Objective: This exploratory study serves as a starting point to establish a psychobiological profile for rural GPs. The overall aim is to describe how individual levels and combinations of temperament (mildly heritable) and character (influenced by sociocultural learning) traits allow GPs to flourish or fail in rural medicine. Design: In a mixed-method study, 13 rural GPs (rural and remote metropolitan areas 5–7, minimum 7 years of experience) from Central/Southern Queensland, Australia completed the Temperament and Character Inventory-R140 to identify the intensity of the seven basic dimensions of temperament and character. These are novelty seeking, harm avoidance, reward dependence, persistence, self-directedness, cooperativenes and self-transcendence. Semistructured interviews provided in-depth information on what brought them to and kept them in rural practice. Results: Preliminary results show that our sample of rural GPs are highly self directed, caring, cooperative, objective and persistent. Individual variations occur in the temperament dimensions of harm avoidance, novelty seeking and reward dependence. In particular, GPs who intended to leave rural practice due to dissatisfaction had significantly higher harm avoidance (F = 23.74; P < 0.01) than those GPs intent on staying. Conclusion: Although preliminary, triangulation of the data sources provides insight into individual GP profiles regarding which particular combination of traits is most conducive to maintaining a rural career, and might provide a greater understanding of rural doctors. This information could provide a basis for counselling of students with an interest in rural medicine and for informing policy on appropriate initiatives for rural GPs and the communities they serve.

Objective: A needs analysis was undertaken to determine the quality and effectiveness of mental health services to Indigenous consumers within a health district of Southern Queensland. The study focussed on identifying gaps in the service provision for Indigenous consumers. Tools and methodologies were developed to achieve this. Method: Data were collected through the distribution of questionnaires to the target populations: district health service staff and Indigenous consumers. Questionnaires were developed through consultation with the community and the Steering Committee in order to achieve culturally appropriate wording. Of prime importance was the adaptation of questionnaire language so it would be fully understood by Indigenous consumers. Both questionnaires were designed to provide a balanced perspective of current mental health service needs for Indigenous people within the mental health service. Results: Results suggest that existing mental health services do not adequately meet the needs of Indigenous people. Conclusions: Recommendations arising from this study indicate a need for better communication and genuine partnerships between the mental health service and Indigenous people that reflect respect of cultural heritage and recognises the importance of including Indigenous people in the design and management of mental health services. Attention to the recommendations from this study will help ensure a culturally appropriate and effective mental health service for Indigenous consumers.