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Allied health clinical placements take place within an increasingly overstretched health care system where demand for services often exceeds availability of resources. Within this environment, student placements are often perceived as an additional burden to an already overwhelmed workforce. This study explored whether the quality of patient care was enhanced when services were re-designed using a collaborative partnership approach to more purposefully integrate students into delivery of care. Using an embedded multiple case study design, data were collected through focus groups and interviews, patient experience surveys, and secondary administrative data sources. Cases were across physiotherapy and occupational therapy in six different hospital settings. Perception of care provided by students was viewed positively by all stakeholders, including patients. Perceived health outcomes of faster improvement of health condition, improved mobility and function identified through our qualitative findings were supported by quantitative service delivery markers such as increased therapy sessions, more patients being discharged home instead of to other care facilities and reduced length of stay. Health care providers and students alike perceived improvements in service efficiencies whilst maintaining high quality care. This study has provided preliminary evidence towards improved patient care when a partnering approach is adopted whereby students are intentionally integrated into services that otherwise might not have been delivered. Furthermore, it has shifted the associated narrative from students as additional burden to students as benefit.

The importance of graduating ethical health professionals is indisputable. Yet evaluating the quality of ethics education programs remains problematic for educators. A divide between learning and integrating ethics in everyday professional practice lies at the heart of this issue. The Ethics in Professional Practice (EPP) project addresses health professions' students' self-efficacy for ethical practice. Students are cast as central characters in authentic vignettes and complete guided learning activities to facilitate their ethical reasoning skills. A design-based research approach was utilised to create EPP resources and this study focuses on the analysis phase of the design process. The aim was to investigate EPP learning outcomes by developing innovative measures based upon Kirkpatrick's (2006) evaluation model: namely, reaction, learning, behaviour and effects. Health professions students from Exercise and Sports Science, Rehabilitation Counselling and Speech Pathology (n = 58) participated in the EPP. Qualitative content analysis of reflective statements demonstrated their ethical sensitivity in four categories: Expectations and Empathy in Quality Care; Managing Overwhelming Demands; Informed, Engaged and Empowered; Access to Flexible Models of Service Delivery. Findings from the Rehabilitation Counselling cohort (n = 16) were explored in-depth using Semantic Differential Scales and demonstrated positive ethical reasoning outcomes. Participants also developed individual, ethical practice goals for professional practica. Qualitative content analysis of these goals demonstrated clear ethical reasoning learning effects. Participants integrated concepts of becoming an ethical professional with effective communication, collaboration, empowerment and quality care. Study outcome measures are critiqued and findings may inform redesign of future ethics education resources.

Supervising students in healthcare settings is complex and can be stressful for clinical educators. However, it is unclear how to design student placements without clinical educator stress. Using complexity theory as a lens, fuzzy set Qualitative Comparative Analysis (fsQCA) was used to explore factors associated with no increased stress for clinical educators during speech pathology (SP) placements. Factor selection was informed by the Demand- Control- Support model and existing literature. No single factor was necessary for clinical educators to experience no increased stress. Varied combinations of all factors were found in 10 paths to no increased stress. These combinations often had passing student(s); however, multiple paths included other factors that could be adjusted by clinical educators prior to placement. For example, having more than one workday per week without students was a factor in four paths to no increased stress despite other potential challenges such as a higher caseload throughput. More experienced educators, who had other supporting factors (e.g. lower caseload throughput or workplace engagement such as support from colleagues and managers), also perceived no increased stress in four paths. Student placements without increased stress for clinical educators require consideration of multiple interacting factors. Principles of complexity theory provide insight into how clinical educators uniquely respond to their individual circumstances, resulting in different experiences of student placement impact even within similar workplaces. FsQCA has highlighted practical ways clinical educators supervise students without increased stress. However, any changes for an individual clinical educator need to be considered in combination with other factors given the complexity of clinical education and healthcare settings.

AbstractBackgroundMethodsResultsConclusionsA service-focussed placement model involves an innovative partnership between service and education providers to a) address service delivery needs and b) facilitate students’ competency development. Services are collaboratively redesigned such that students are positioned as collaborators in service delivery with their learning supported through evidence-informed educational design. This model was implemented in the hospital setting and was found to promote positive patient outcomes. Our study explored whether this model supports student learning.Students’ perception of learning was explored using a multiple-case study design with data collected from 22 semi-structured focus groups and interviews with 64 senior year allied health students (physiotherapy n = 55; occupational therapy n = 9) across six placement settings. Inductive thematic analysis identified aspects of this placement model that facilitated and challenged students’ learning.A service-focussed placement model provides a quality student learning experience. Students identified the need to be prepared for independent learning. This placement model promoted their professional development and sense of autonomy through engaging them in early, active learning within a safe learning environment.Students perceived that a service-focussed placement model equipped them for the ever-changing complexities and challenges of hospital services. [ABSTRACT FROM AUTHOR]

Simulation for success (SIM-S) was designed by work-integrated learning (WIL) academics and external clinical educators as an interprofessional, intensive remediation program for underperforming allied health students. Students engaged in authentic work-focused experiences in preparation for future clinical placements. A designbased research approach with mixed-methods was adopted to explore learning outcomes from perspectives of simulation facilitators and students. Learning outcomes were measured through descriptive analysis of students’ goal attainment scaling, readiness for placement evaluation, and standardized national clinical assessment tools for subsequent placements. Framework Analysis was used to deductively code student learning goals. Students (n=23) built on their learner behavior, communication skills and information gathering skills. After participating in the SIM-S program, 19 students achieved a satisfactory outcome in their subsequent placement. Findings from this study may inform the design of future remediation programs that engage students in translating theory to practice, developing complex skills, and achieving professional competence. [ABSTRACT FROM AUTHOR]

Background: Development of the Australian Fire Danger Rating System began in 2017 with a project aimed at demonstrating the feasibility of a new fire danger rating system through a Research Prototype (AFDRSRP) that accounted for variability in Australian vegetation types, was nationally applicable, modular and open to continuous improvement. Aims: In this manuscript, we identify and define transition points and categories for the AFDRSRP. We discuss user responses to the categorisation during a live trial evaluation of the AFDRSRP and reflect on limitations and potential improvements. Methods: A review of available literature, broad consultation with stakeholders and reanalysis of fire impact data were used to determine suitable thresholds for categorising fire danger within the AFDRSRP. Key results: Fire danger categories within the AFDRSRP reflect transitions in fire behaviour that result in application of different fire management strategies or are associated with variation in serious consequences and impacts. Conclusions: The AFDRSRP incorporated the best available science, supported by a well-defined framework for categorising and defining fire danger making it suitable for application across Australian fire jurisdictions and range of fuel types. Implications: The framework allows fire managers to assess the accuracy and appropriateness of forecasted fire danger. We identify and present defined categories and thresholds for the Australian Fire Danger Rating System: Research Prototype based on reflecting transitions in fire behaviour that result in application of different fire management strategies or associated with variation in potential for serious consequences and impacts. This article belongs to the Collection Australian Fire Danger Rating System. [ABSTRACT FROM AUTHOR]

Background: Fire danger rating systems are used daily across Australia to support fire management operations and communications to the general public regarding potential fire danger. Aims: In this paper, we introduce the Australian Fire Danger Rating System (AFDRS), providing a short historical account of fire danger rating in Australia as well as the requirements for an improved forecast system. Methods: The AFDRS combines nationally consistent, spatially explicit fuel information with forecast weather and advanced fire behaviour models and knowledge to produce locally relevant ratings of fire behaviour potential. Key results: A well-defined framework is essential for categorising and defining fire danger based on operational response, the potential for impact and observable characteristics of fire incidents. The AFDRS is modular, supporting continuous and incremental improvements and allowing upgrades to components in response to new science. Conclusions: The AFDRS provides a new method to estimate fire danger based on the best available fire behaviour models, leading to potentially significant improvements in the way fire danger is calculated, forecast and interpreted. Implications: The Australian Fire Danger Rating System was implemented in 2022, the most significant change to fire danger forecasting in Australia in more than 50 years. We introduce the Australian Fire Danger Rating System (AFDRS), providing a history of fire danger rating in Australia and requirement for advancements. We describe development, design principles and the supporting framework of the AFDRS as an introduction to subsequent papers in this series. This article belongs to the Collection Australian Fire Danger Rating System. [ABSTRACT FROM AUTHOR]

Educating students to become evidence-based practitioners remains a significant challenge in health professional education. Clinical placements form a significant element of curriculum, and the impact of students' work integrated learning experiences on their ability and desire to practice in an evidence-based manner remains largely unexplored. This study used focus groups to explore students' experiences of evidence-based practice (EBP) during clinical placements, the impact of these experiences on their education, and their future EBP tendencies within the profession. Reflexive thematic analysis was utilized to analyze data and three main overarching themes were identified. These themes are education, culture and responsibility and hopes, fears and barriers and they were explored in detail. Improving the teaching of EBP skills within health professional education, which includes the strengthening of the integration of these skills across work-integrated learning curricula, has the potential to enhance the translation of knowledge into practice as these graduates become qualified clinicians within the profession. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas. Method: Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes. Results: Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace. Conclusions: The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.

Background: Speech pathologists are confronted by ethical issues when they need to make decisions about client care, address team conflict, and fulfil the range of duties and responsibilities required of health professionals. However, there has been little research into the specific nature of ethical dilemmas experienced by speech pathologists and whether the nature of ethical conflict changes as they acquire experience in the professional workforce. Speech pathologists' perceptions of ethical issues provide insight into factors impacting upon quality of care in contemporary healthcare settings. Aims: To describe, compare, and contrast the nature of ethical dilemmas identified by new graduate and experienced speech pathologists. Methods & Procedures: A narrative methodology was used to explore the ethical dilemmas that participants experienced in the professional work place. Primary data were collected through in-depth interviews with ten new graduate and ten experienced speech pathologists in their work settings. During these interviews, participants were asked to "tell the story" of ethical dilemmas they identified at work. Outcomes & Results: An ethical story was constructed for each participant based upon keywords and concepts from interview transcripts. These keywords and concepts were coded into group themes that reflected the nature of ethical dilemmas experienced by new graduate versus experienced speech pathologists. Comparing the results of thematic analysis for both groups of participant revealed similarities and differences in ethical dilemmas identified by new graduate and experienced health professionals. Conclusions & Implications: Participants identified ethical dilemmas in the professional practice areas of client management, professional relationships, service delivery, and personal/professional identity. Themes from new graduates' ethical dilemmas included: making safe choices; avoiding conflict, following service delivery rules, and building professional identity. Experienced speech pathologists' themes included: life choices, adapting policies, and professional status. Supporting client autonomy, managing risk taking, adopting fair service delivery policies, and supporting health professionals' ethical practice are part of ethical quality care. The results support the need for an increased focus on ethical practice in the workplace and further support for speech pathologists experiencing ethical conflict in response to service delivery policies. (Contains 3 tables and 1 note.)

Background: Ethics of care provides a framework for health care professionals to manage ethical dilemmas and moral resilience may mitigate stress associated with the process and outcomes of ethical reasoning. This review addresses the empirical study of ethics of care and moral resilience, published in the health care literature, and identifies potential research gaps. Methods and procedure: Arksey O'Malley's framework was adopted to conduct this scoping review. A literature search was conducted across six databases: CINAHL Plus with full text, PubMed, PsycINFO, EMBASE, Scopus and MEDLINE. We collected and synthesised information on the nature of studies including study design, methods and key findings. Results: While there is an abundance of literature describing the potential strengths of an ethics of care approach to ethical reasoning and growing interest in the role of moral resilience in protecting against moral distress, both concepts have received little empirical attention. A total of six relevant publications were selected for review. No studies explored the relationship between ethics of care and moral resilience. However, studies focused upon ethics of care approach as a facilitator of patient-practitioner professional relationships and effective ethical decision making in health care practice. Current evidence explores key characteristics consistent with moral resilience in health care professionals. Conclusion: This review identified a dearth of research in ethics of care and moral resilience in healthcare practice. Further empirical investigation may provide a deeper understanding of the translation of ethics of care and moral resilience to health care practice to facilitate workplace culture. [ABSTRACT FROM AUTHOR]