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Background Clinical supervision in general practice is critical for enabling registrars (GP trainees) to provide safe medical care, develop skills and enjoy primary care careers. However, this largely depends on the quality of supervision provided. There has been limited research describing what encompasses quality within GP clinical supervision, making it difficult to promote best practice. This study aimed to explore the attributes of high-quality clinical supervision for GP registrars. Methods In 2019–20, 22 semi-structured interviews were conducted with GP supervisors who were peer-nominated as best practice supervisors, by Regional GP Training Organisations and GP Colleges in Australia. Purposeful sampling sought respondents with diverse characteristics including gender and career stage, practice size, state/territory and rurality. Interviews were conducted by video-consultation and recorded. De-identified transcripts were independently coded using iterative, inductive thematic analyses to derive themes that reflected quality in GP supervision. Results Seven themes emerged. Participants understood the meaning of quality supervision based on their experience of being supervised when they were a registrar, and from reflecting and learning from other supervisors and their own supervision experiences. Quality was reflected by actively structuring GP placements to optimise all possible learning opportunities, building a secure and caring relationship with registrars as the basis for handling challenging situations such as registrar mistakes. Quality also encompassed sustaining and enhancing registrar learning by drawing on the input of the whole practice team who had different skills and supervision approaches. Strong learner-centred approaches were used, where supervisors adjusted support and intervention in real-time, as registrar competence emerged in different areas. Quality also involved building the registrar’s professional identity and capabilities for safe and independent decision-making and encouraging registrars to reflect on situations before giving quality feedback, to drive learning. Conclusions This study, although exploratory, provides a foundation for understanding the quality of clinical supervision in general practice, from the perspective of peer-recognised GP supervisors. Understanding and adopting quality within GP supervision may be improved by GPs sharing exemplars of best practice and having opportunities for professional reflection. The findings could be used as a point of reference for devising GP supervisor curriculum, resources and professional development activities.

Background and objective Characterising the general practice response to the COVID-19 pandemic is important for ongoing policy planning The objective of this study was to explore challenges, responses and effects of COVID-19 in Australian general practice in the early stages of the pandemic, and to consider variance by geographic location Methods A national cross-sectional online survey of Australian general practitioners was conducted in April and May 2020, with 572 respondents Results The COVID-19 pandemic in Australia has resulted in major changes to general practice business models Most practices have experienced increased workload and reduced income Discussion Australian general practices have undertaken major innovation and realignment to respond to staff safety and patient care challenges during the COVID-19 pandemic Increased administration, reduced billable time, managing staffing and pivoting to telehealth service provision have negatively affected practice viability Major sources of information for general practice are primary care-specific, but many practices turn to colleagues for support and resources

Clinical education/training is increasingly being expanded to community general practice settings (primary care clinics led by doctors). This plays an important role in developing a skilled “primary-care ready” workforce. However, there is limited information to guide the implementation of high-quality learning environments suitable for the range of general practices and clinical learners they oversee. We aimed to develop a consensus-based framework to address this. A co-design participatory action research method involved working with stakeholders to agree a project plan, collect and interpret data and endorse a final framework. As a starting point, an initial draft framework was adapted from an existing framework, the Best Practice Clinical Learning Environment (BPCLE) Framework. We gathered feedback about this from a national GP Supervisor Liaison Officer Network (SLON) (experienced GP clinical supervisors) during a 90-minute face-to-face focus group. They rated their agreement with the relevance of objectives and elements, advising on clear terminology and rationale for including/excluding various components. The resulting framework was refined and re-tested with the SLON and wider GP educational stakeholders until a final graphically designed version was endorsed. The resulting “GP Clinical Learning Environment” (GPCLE) Framework is applicable for planning and benchmarking best practice learning environments in general practice.

People use reflection and reflective practice for many different reasons, including for self-care and to make sense of their experiences. In this study, social workers spoke about how they learned to be reflective, with many participants describing activities in their childhood that developed their reflective capacity. The aim of this article is to apply these ideas and examine the factors that enhance reflective capacity in children and young people. This research was part of a PhD study that involved interviews with 35 social workers in USA, Canada, UK and Australia. This exploratory study found that activities like story reading and asking children to reflect on their behaviour are early steps in the process of becoming reflective, but this needs to be followed up with conversations that deconstruct assumptions to make sense of experiences and explore multiple perspectives. This research is important for health and human service workers and others who want to develop reflective capacity in children and young people, particularly for children subject to disadvantage who need to overcome trauma and adversities.

This article explores the process of combining narrative inquiry and critical reflection as research methodology. Qualitative researchers use narrative approaches to explore the stories of participants and to understand the ways these stories were constructed and positioned. Critical reflection provides a framework for deconstructing the stories and exploring assumptions about knowledge, power and reflexivity. In this PhD research, the narrative approach was underpinned by, and combined with, a critically reflective research approach. As these approaches were amalgamated, the critical narrativist emerged. Principles of critical reflection and narrative scholarship can be intertwined; however, the separate threads may be conceptually and practically separated. This article describes how these modes of inquiry came together and discusses the implicit and explicit nature of the methodological positions. Finally, the author considers the opportunities for being more explicit about combining critical reflection with other research methodological approaches.

Summary Objective To determine the elements of quality clinical and field placements through the eyes of paramedic instructors. Design Qualitative study. Settings Two large paramedic services in two countries where the entry to practice qualification for paramedics has been set at the Bachelors degree level. Participants Fifteen purposively selected paramedic instructors were invited to voluntarily participate. The criterion for inclusion was that they had supervised at least one university paramedicine student on a field placement. Recruitment ceased when saturation was reached. Methods Face to face semi-structured interviews were conducted with participants who were asked their views and expectations of paramedicine student clinical and field placements. Inductive thematic analysis of the transcripts was completed using Nvivo software. Results The elements of quality clinical and field placements from the perspective of paramedic instructors were identified. With no agreed clinical and field placement paramedicine standards in the countries studied there is variation in the focus of placements, preferred settings, and expectations. Vocationally trained paramedics favoured paramedic service placements, whilst university educated paramedics see benefits in placements in more diverse settings. Conclusions Paramedic services and universities need to collaboratively address the variation in paramedicine university student clinical and field placements. Standards need to be developed that address the purpose of placements, expectations of students and instructors, and be scaffolded across the education spectrum from undergraduate student to graduate paramedic to instructor.

Community conversations are structured, inclusive conversations that bring together a group of people to engage in meaningful conversation, share knowledge and ideas, and discuss solutions to complex problems. This article focuses on the methodological aspects of using community conversations as a research approach. Participants included paramedics, ambulance service managers, paramedicine students and paramedicine educators, who gathered at La Trobe University in Bendigo in February 2013 to attend a conference titled ‘Paramedic Education and Leadership. Conversations took place over three days, with participants spending around five hours discussing the key issues related to paramedicine student clinical placements. Three stages of community conversations are described, along with the participants’ evaluation of the process, leading to the conclusion that community conversations are a valuable and effective way to bring together groups of people to discuss ideas and solutions to complex social problems.

Objectives This paper examines the issues that affect the quality of paramedic student clinical placements. Participants included paramedics, paramedic educators, paramedic students and ambulance service managers who had gathered for an Australian conference in Bendigo in central Victoria. The aim of this paper is to highlight issues identified by the participants and to start a conversation about the importance of clinical placement for paramedic students. Methods This was a qualitative study utilising ‘Community conversations’ as a research methodology. ‘Community conversations’ is an action research approach. This study had 53 participants, who spent around 5 hours in conversation throughout a 3-day conference. The conversation initiated was to discuss and raise issues that related to paramedic student clinical placements, and identify creative and innovative solutions. Results In this paper, we focus on three themes that emerged from the conversations: planning and preparation of the placement; continuity of placement experience; and diversity of placements. We argue that better communication is required between the university, the ambulance service, the paramedic educator/clinical instructor and the student. Conclusions Clinical education is an essential element of student learning and skill development, yet in Australia there are no mandatory requirements in relation to duration, content or measurement of quality in student clinical placements. We strongly recommend that continuity is an essential element of a quality clinical placement and argue that students should be allocated to work in one location for 1–2 week blocks.

Following the devastating Victorian bushfires in February 2009, social workers engaged with people affected by this event in a variety of roles, including bushfire case manager, counsellor, and community development worker. This paper explores the experiences of social workers who worked with bushfire-affected families to understand their role and the context in which they practised. It describes the personal impact of disaster recovery work. Secondly, by drawing on the knowledge and experiences of these social workers, this investigation identified skills and personal qualities that can be used to inform the preparation and support of social workers responding in future disaster events or emergency recovery situations. The research design featured a mixed methodology that included an anonymous online survey completed by 22 participants and personal interviews with 6 social workers. Narrative data analysis was performed to identify themes. A key finding of the study was that, while social workers ...

Social workers are increasingly using social media for networking, peer support, reflection, and fun. Social media presents exciting opportunities for social work practice; however, social workers and employers of social workers need to understand the challenges and conflicts that can occur. This study explored the experiences of social workers who used an online blog for reflection, describing different levels of engagement with reflection and the development of an online community of practice to support isolated social workers. This study is significant because although there are many studies that describe the experiences of students using a blog for reflection, the author has been unable to identify another study that focuses on the ways social workers engaged with a blog for reflection.

In this paper, I explore reflective practice literature and the elements of critical reflection, and I reflect on my experiences of learning and using a critical reflection approach to better understand a significant incident. This reflective paper is written from my personal perspective as a social worker using Fook and Gardner’s model of critical reflection to provide a framework to reflect, explore and learn from my own experiences. The Fook and Gardner approach to critical reflection encourages deconstruction and analysis of a personal or professional experience to understand the different assumptions, relationships and influences embedded within it and how it affects our practice. As new understandings emerge, the individual is able to reconstruct this incident and develop new techniques to deal with a similar incident in the future.

Introduction : Popularity of paramedicine undergraduate programs continues to rise in Australia and New Zealand. While this is important in the professionalisation of paramedicine, it has also raised a number of issues, particularly those surrounding the issue of national clinical placement standards and consistency between university providers. Therefore the purpose of this cross-sectional study was to investigate paramedicine student perceptions of the learning environment during their university studies. Methods : The Dundee Ready Education Environment Measure (DREEM) is a validated questionnaire that measures students’ perceptions of the educational environment. Convenience sampling was used to recruit 682 undergraduate paramedicine students enrolled at five universities in Australia and New Zealand. Results : This study has investigated the education environment as perceived by paramedicine students and found that generally, students were satisfied with the education environment at their institution. There were 630 student participants from Australia and 52 from New Zealand. Conclusions: The DREEM questionnaire has highlighted significant differences between universities, which is not surprising considering the various ways that universities structure their paramedicine programs. These findings can be used to inform universities and ambulance services about these differences and to guide strategic planning to ensure that there is a more consistent approach to paramedicine education in Australia and New Zealand.

Background Clinical placement is an essential element of paramedicine education and training as the profession completes the transition from vocational training to a pre-employment, university based model. The objective of this study was to survey pre-employment paramedicine students at Universities in Victoria, Australia and Auckland, New Zealand to measure their self-assessed preparedness for clinical placement. Methods This was a cross-sectional study involving paper-based questionnaires employing a convenience sample of 682 undergraduate paramedicine students (years 1–4) who had completed at least one clinical placement. Student perceptions of preparedness for clinical placement were measured using an adaptation of the ‘Preparedness for Hospital Practice’ questionnaire. Results There are significant differences in students’ perception of preparedness for clinical placement, which reflects the differences between universities in relation to structure of their paramedicine programs, the timing of clinical education and the number of hours of clinical placement. Discussion There needs to be clinical placement agreements between the ambulance services and universities that clearly describe the standards and expected elements of a quality clinical placement. Conclusions In order to improve the preparedness for placement for paramedicine students, a united approach is required by all stakeholders, including ambulance services, students and universities.

Chapter 1. Critical Reflection in Context: Contemporary Perspectives and Issues Jan Fook Section 1: Critical Reflection in Professional Practice Chapter 2. Kathleen McLoughlin and Sinead McGilloway Chapter 3. Integrating Spirituality and Critical Reflection: Toward Critical Spirituality Fiona Gardner Chapter 4. Not Beating Around the Bush - Critical Reflection in a Rural Community Health Service Gavan Thomson Chapter 5. Learning Critical Reflection for Professional Practice Helen Hickson Chapter 6. Using Critical Reflection to Research Practice in a Mental Health Setting Fiona Gardner Section 2: Critical Reflection in Supervision and Management Chapter 7. Critical Reflection in Statutory Work Yolande Ferguson Chapter 8. Critical Reflection and Supervision - An Interdisciplinary Experience Fiona Gardner and Eddie Taalman Chapter 9. Thinking Critically About Student Supervision Lynne Allan Chapter 10. Cringe-ical Reflection? Notes on Critical Reflection and Team Supervision in a Statutory Setting Jeffrey Gordon Baker Chapter 11. Learning to Play Hide and Seek with Pink Elephants Belinda Hearne Section 3: Critical Reflection in Research Chapter 12. The Challenges of Using Critical Reflection to Develop Contextually Appropriate Social Work Gurid Aga Askeland Chapter 13. Using Critical Reflection to Research Spirituality in Clinical Practice Janet Allen Chapter 14. Some Methodological and Ethical Tensions in Using Critical Reflection as a Research Methodology Christine Morley Section 4: Critical Reflection in Education Chapter 15. Critical Reflection Training to Social Workers in a Large, Non-Elective University Class Riki Savaya Chapter 16. Critical Reflection: Multiple Applications within Physiotherapy and Medicine Clare Delaney and Deborah Watkin Chapter 17. Critical Reflection in Social Work Education Roslyn Giles and Rosalie Pockett Chapter 18. An On-Line Critical Reflection Dialogue Group Gail Baikie, Carolyn Campbell, Jackie Thornhill and Jodi Butler Conclusion Chapter 19. Implementing Critical Reflection in Health and Social Care Settings Jan Fook