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

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

This article addresses the question of the implications for professional education of economic, social and political changes that are transforming the boundaries, accountabilities and governance of professional practice. We argue that approaches to professional education that are uni-disciplinary and focused on the individual, cannot prepare students for practising a profession in circumstances requiring transformative change. We pose a conceptual alternative, drawing on practice theory, which, we argue, engages more effectively with the nature of practice in changing circumstances. Our particular concern is to find better ways to understand how learning is situated and embodied in practices and complexly implicated in change and innovation. In developing these new understandings, we draw on material from a case study of practice change in the area of health, to theorise learning as relational and embedded in the practices of an organisation in an intense state of change and becoming.

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-8500.2008.00608.x Byline: Roger Dunston (*), Alison Lee (*), David Boud (*), Pat Brodie (*), Mary Chiarella (*) Keywords: co-production; health services reform; professional learning Abstract: There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of post-neoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required. Author Affiliation: (*)University of Technology, Sydney

Background: Over the past two years health educators in Australia have benefited from funding made available from national organizations such as the Office of Learning and Teaching (OLT) and Health Workforce Australia (HWA). Funded research has been conducted into educational activities across the country that aim to promote integrated and sustainable interprofessional learning. Methods and Findings: A collaboration between multiple stakeholders led to the establishment of a consortium of nine universities and interprofessional organizations. This collaboration resulted in a series of research studies and the development of a conceptual framework to guide the planning and review of interprofessional health curricula. A case study of the development of a suite of health education programs at a regional university in Australia is used to demonstrate how the framework can be used to guide curricular reflection and to plan for the future. Shedding a light on interprofessional health education activities across multiple sites provides a rich picture of current practices and future trends. Commonalities, gaps, and challenges become much more obvious and allow for the development of shared opportunities and solutions. Conclusions: The production of a shared conceptual framework to facilitate interprofessional curriculum development provides valuable strategies for curricular reflection, review, and forward planning. [ABSTRACT FROM AUTHOR]