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The objective of the study was to explore the experiences of primary health care (PHC) nurses advancing their careers in a remote location in Western Australia.The study was conducted in PHC organisations in one remote location in northern Western Australia.Six registered nurses working in four PHC organisations participated in the study. All were registered with the Nursing and Midwifery Board of Australia. Participants were all female, and five had child carer responsibilities. They had worked in the region for between 8 months and 10 years.The design was based on a qualitative, interpretative phenomenological analysis methodology involving in-depth, semi-structured, face-to-face interviews.Participants faced challenges advancing their careers given the limited employment opportunities and need to balance their professional ambitions with family needs. Participants had limited capacity to support each other's learning and felt poorly supported by employers to undertake professional development not directly related to their role. Participants were not well engaged with professional associations beyond undertaking online professional development activities provided with membership. Accessing professional development was difficult given a lack of time, limited access to local learning activities and a consequent need to travel, which was challenging. Despite the challenges they faced, most nurses remained passionate about their remote nursing roles and enjoyed the lifestyle.Remote PHC nurses face a range of challenges, some of which can be overcome by improved availability of local professional development and better support from employers and professional associations.

RORγt is the master transcription factor for the Th17 cells. Paradoxically, in the intestine, RORγt is coexpressed in peripherally induced regulatory T cells (pTregs) together with Foxp3, the master transcription factor for Tregs. Unexpectedly, by an unknown mechanism, colonic RORγt+ Tregs show an enhanced suppressor function and prevent intestinal inflammation more efficiently than RORγt-nonexpressing pTregs. Although studies have elucidated the function of RORγt in Th17 cells, how RORγt regulates pTreg function is not understood. In our attempt to understand the role of RORγt in controlling Treg function, we discovered a RORγt-driven pathway that modulates the regulatory (suppressor) function of colonic Tregs. We found that RORγt plays an essential role in maintaining Foxp3 expression. RORγt-deficient Tregs failed to sustain Foxp3 expression with concomitant upregulation of T-bet and IFN-γ expressions. During colitis induced by adoptive transfer of CD45RBhi cells in Rag1−/− mice, RORγt-deficient colonic Tregs transitioned to a Th1-like effector phenotype and lost their suppressor function, leading to severe colitis with significant mortality. Accordingly, Foxp3-expressing, RORγt-deficient Tregs showed impaired therapeutic efficacy in ameliorating colitis that is not due to their reduced survival. Moreover, using the Treg-specific RORγt and T-bet double-deficient gene knockout mouse, we demonstrate that deletion of T-bet from RORγt-deficient Tregs restored Foxp3 expression and suppression function as well as prevented onset of severe colitis. Mechanistically, our study suggests that RORγt-mediated repression of T-bet is critical to regulating the immunosuppressive function of colonic Tregs during the inflammatory condition.

BACKGROUND: The practice educator role is complex and becoming more so with changes in placement configurations since the COVID-19 pandemic. The role requires practitioners to manage clinical activities while providing learning opportunities and supervision for students. This can be time-consuming in often stretched clinical settings. This research investigated how experienced practice educators in occupational therapy tailored their approach to supporting student learning to make the most of limited supervision time. The results were developed into the Professional Learning through Useful Support (PLUS) Framework, which revealed how experienced practice educators focused their supervisory approach with students to maximise learning. METHODS: An Action Research methodology was used across four cycles. Semi-structured interviews and naturally occurring placement documentation were gathered to determine the critical features of practice educator supervision. Template analysis was used to explore the approaches employed by practice educators to support student learning. Key focal points were linked and situated within educational theory to create the PLUS Framework. FINDINGS: Three key focal points for practice educators were identified: (1) guiding learning, (2) making the theory-to-practice links explicit and (3) supportively challenging students. DISCUSSION: The PLUS Framework is an educational tool that describes a set of guidance strategies used by skilled practice educators, whilst acknowledging the critical influences of workplace and university contexts. The proposed key features could be useful target areas for busy practice educators to help make the most of limited supervision time. Future research will explore the PLUS Framework in different countries and professions' practice education environments.

IntroductionPlacements are considered vital in promoting theory-to-practice learning. With role-emerging placements increasingly being offered, the learning processes experienced by students warran...

One of the key challenges with implementing and sustaining interprofessional education initiatives is the lack of governance structures and processes to guide them. This case study presents a process evaluation of an intersectoral advisory group that facilitated a novel interprofessional clinical education model in rural health settings in the state of Queensland, Australia. The group consisted of health and academic partners to guide the implementation and promote sustainability of this new model. The advisory group process was evaluated mid-way and at conclusion of the group functions, using focus group discussions. The focus group audio recordings were transcribed verbatim and subjected to inductive content analysis. Categories were developed for reporting. Three broad categories were identified: Characteristics of the group, functions of the group and multifaceted communication within the group and between sectors. By identifying and mapping the processes used by a strategic, high-level intersectoral advisory group consisting of members from the health and academic fields, key recommendations have been formulated to guide similar work in the future.

Background Rates of family and gender-based violence (FV) are high, particularly in rural and remote areas in Australia. The City of Greater Geraldton, a local government area in the Midwest region of Western Australia, has developed a FV primary prevention strategic action plan. Local data are needed to measure the impact of community based prevention efforts. Our research aim was to develop a tool to measure community attitudes and experiences of FV in order to assess the effectiveness of efforts to change attitudes and reduce violence over time. Methods A working group developed the Local Community Attitudes and Exposure to Violence Survey (LCAEVS), based primarily upon the National Community Attitudes Survey (NCAS), which is periodically undertaken by Australia’s National Research Organisation for Women’s Safety (ANROWS). Questions from all relevant domains in the NCAS were included, with prioritisation of items likely to be sensitive to change over time. The survey was shortened to reduce respondent burden. Results Geraldton respondents showed misunderstandings about the key drivers and the gendered pattern of FV, while some local attitudes were less supportive of gender equality than those documented in the national survey. Conclusions Approaches adopted to distribute the survey, the response rate and demographics of the population who completed it, and comparison of responses of Geraldton residents with those in the NCAS will be discussed. Learning Outcomes It is feasible to administer a shorter survey based on the NCAS, to measure particular attitudes on which to focus violence prevention education for a regional population.

AIMS To offer a rough guide to a quality rural/remote interprofessional educational activity. CONTEXT Australian remote and rural interprofessional undergraduate placements offered in Modified Monash Model 3-6 locations. APPROACH Biggs' triple P framework from the interprofessional educational literature and Allport's contact hypothesis are used to describe map, and explore the educational dimensions and positive elements, of a quality rural/remote interprofessional educational activity. CONCLUSION Delivery of a quality interprofessional educational activity requires attention to all dimensions of the activity with acknowledgement of the value of the remote or rural contexts. Interprofessional learning requires constructive alignment and positive contact conditions to ensure a quality and sustained experience.

The increase in cyber-attacks forced public institutions to design computer security mechanisms to prevent damage to equipment or loss of information, for private use. The objective is to present a security prototype that allows determining critical information and improves the management of a public organization. The deductive method and exploratory research were used. The result was a mixed information control model, a mixed security architecture with mechanisms that comprehensively protect the information, verifying the identity and correlating the risks produced with the application of Blockchain technology, the Magerit and Octave methodology, it was also It is possible to correlate the risks of the links and the data, applying an analysis to give an immediate response. It was concluded that the hybrid architecture allowed to verify the identity and correlate the risks, Blockchain provided control against malicious attacks, together with Magerit that made use of safeguards and Octave analyzed the threats to the security of the assets, used in public management.

The increase in interprofessional models of collaborative practice and identification of health services as interprofessional organisations, sits somewhat awkwardly with traditional governance systems for both health services and educational institutions. Whereas health services have a primary focus on assuring competence and safety for health care practice, educational institutions have a primary focus on assuring academic standards within specific qualifications. Bridging the gap between these two systems with a workable option has proven challenging, especially in relation to interprofessional education (IPE).Given the need to ensure 'work ready' graduates within a more interprofessional and collaborative workforce, it is important to review the quality assurance governance models that are in place and to consider which of these existing governance systems, if either, is the more appropriate model for enabling and supporting IPE.This paper describes current issues in relation to governance for quality assurance, summarises the current state of research in the field and discusses potential governance options moving forward.Given that existing governance models are not meeting the challenges of IPE, there is a need to achieve greater alignment between the academic and health service governing systems.

"This ground-breaking text provides a comprehensive guide to occupational therapy in Australia, from its role in the healthcare system to the scope and nature of its practice. The authors begin with an overview of the history of occupational therapy in Australia, the ethical and legal aspects of its practice and its role in population health and health promotion. The values and philosophy of occupational therapy are considered next, together with the roles and responsibilities of practitioners and specific practice features, including client- centred practice, evidence-based practice, research in occupational therapy and clinical reasoning. Key issues, including occupational analysis, the development of occupations across the lifespan, occupational therapy assessment, Indigenous issues, practice in rural and remote areas and advocacy, leadership and entrepreneurship, are also examined in detail...The first text specifically written for Australian entry-to-practice students by Australian authors, this book is destined to become an essential reference for both students and professionals in the field..." -- Back cover.

The World Health Organization International Classification of Functioning, Disability and Health has the power to shape professional behaviour and positively influence all aspects of health and social care practice. The visual depiction of the ICF framework belies the complexity of this multifaceted classification and coding system which students and practitioners can find challenging to grasp. This guide offers twelve integrated practical tips to help health and social care educators embed the ICF throughout the curriculum with a view to supporting student learning and ultimately interprofessional and inclusive practice.

Introduction: Very little is known about the long term workforce outcomes, or factors relating to these outcomes, for nursing and allied health rural placement programs. The positive evidence that does exist is based on short term (1-3 year) evaluations, which suggest that undergraduate rural placements are associated with substantial immediate rural practice of 25-30% graduates practising rurally. These positive data suggest the value of examining long term practice outcomes, since such data are necessary to providing an evidence base for future workforce strategies. The objective was to measure long term (15-17 year) rural practice outcomes for nursing and allied health graduates who had completed an undergraduate rural placement of 2-18 weeks through a university department of rural health (UDRH). Methods: This was a longitudinal cohort study, with measures taken at the end of the placement, at one year and at 15-17 years post-graduation. Participants were all nursing and allied health students who had taken part in a UDRH rural placement, who consented to be followed up, and whose practice location was able to be identified. The main outcome measure was factors associated with location of practice as being either urban (RA 1) or rural (RA 2-5). Results: Of 776 graduates initially surveyed, 474 (61%) were able to be contacted in the year after their graduation, and 244 (31%) were identified through the Australian Health Practitioner Regulation Agency, 15-17 years later. In univariate analysis at the first graduate year, previously lived rural, weeks in placement, discipline and considering future rural practice all had significant relationships with initial rural practice. In multivariate analysis, only rural background retained significance (odds ratio (OR) 3.19, confidence interval (CI) 1.71-5.60). In univariate analysis 15-17 years later, previously lived rural and first job being rural were significantly related to current rural practice. In multivariate analysis, only first job being rural retained significance (OR 11.57, CI 2.77-48.97). Conclusion: The most significant long term practice factor identified in this study was initial rural practice. This suggests that funding to facilitate a rural pathway to not just train but also support careers in rural nursing and allied health rural training, similar to that already established for pharmacy and medicine, is likely to have beneficial long term workforce outcomes. This result adds to the evidence base of strategies that could be implemented for the successful development of a long term rural health workforce.

Australia is a country and a continent. Whilst health standards are ranked amongst the best in the world, its immense size and distributed population creates unique challenges for the delivery of integrated health and social care services.

Regional, rural and remote Australia is diverse, not only in terms of the landscape, but also in ways that influence cultural, spiritual and operational aspects of health service delivery. Dotted across the landscape there are 16 Australian Government funded University Departments of Rural Health (UDRHs). These UDRHs support health professional students to undertake real world, rural focussed practice-based educational experiences, facilitated by interprofessional academic teams. As such, UDRHs can lay claim to considerable expertise in the delivery of interprofessional education, as well in the development and implementation of new models of interprofessioanl team-based care. This chapter describes the features of rural health services and the numerous intersections with interprofessional education and team-based health care.

People with disability experience multidimensional inequalities, which heighten their vulnerability to climate change. An understanding of the vulnerability and adaptive capacity of people with disability can be gained through considering how they have fared during the types of events associated with climate change, such as droughts, floods, heat waves, hurricanes, and wildfires. A systematic review was conducted to identify factors associated with climate change vulnerability and adaptive capacity of people with disability. Papers were sourced from 12 electronic databases, the Google search engine, the websites of 21 organizations, and the reference lists of included papers; 34 papers (relating to 28 studies) met the selection criteria. Most studies were located in the United States, and almost half were focused on hurricane events. Factors contributing to vulnerability included personal factors (e.g., female gender, uncoupled or living alone, nonwhite ethnicity, and low income), environmental factors (commonly, limited practical support from government agencies and disability organizations), bodily impairments (cognitive impairments, hearing impairments, progression of impairments, relapse/exacerbation of symptoms, and thermoregulation difficulties), and activity limitations and participation restrictions (limited preparedness, difficulties with evacuation, and difficulties reassembling individual accommodations and repairing or replacing adaptive equipment). Factors relating to their adaptive capacity included personal factors (e.g., formal education), environmental factors (practical support from mainstream organizations, disability organizations, family, and friends), and activities and participation (emergency planning, keeping an emergency pack, and seeking information). People with disability are vulnerable to climate change largely due to inequalities and their exclusion from adaptation and mitigation efforts.

La presente investigacion tiene el objetivo de evaluar la eficiencia de la biorremediacion mediante la aplicacion de los microorganismos eficaces (EM) en cuatro tipos de usos de suelo contaminados con Diesel B5, de origen agricola, costero, urbano y ribereno. La metodologia utilizada consistio, primero en activar los Microorganismo EM durante nueve dias para luego aplicarlo al suelo contaminado. Se aplico por aspersion un litro por semana de Microorganismos EM activados sobre el area afectada durante 28 dias en los cuatro tipos de usos de suelo. Los resultados permitieron determinar la eficiencia de la biorremediacion en los cuatro tipos de usos de suelo; obteniendo para el suelo de uso urbano una eficiencia del 41.60 % con una disminucion de 51 221 mg/kg a 29 911 mg/kg de HTP; para el suelo de uso agricola, una eficiencia de biorremediacion del 40.06 % con una disminucion de 35 674 mg/kg a 21 383 mg/kg de HTP; para el suelo de uso ribereno una eficiencia de 35.05 % con una disminucion de 7 604 mg/kg a 4 939 mg/kg de HTP y finalmente el suelo de uso costero una eficiencia de 15.29 % con una disminucion de 12 973 mg/kg a 10 989 mg/kg de HTP. Asimismo, se determino los coeficientes de correlacion entre el porcentaje de materia organica (M.O) y la densidad aparente (D.A) del suelo con los resulta- dos de la eficiencia de biorremediacion, obteniendo un valor de 0.9984 y 0.9496, respectivamente; observando una relacion directa e indirecta entre las variables.

Regulatory frameworks around the world mandate that health and social care professional education programs graduate practitioners who have the competence and capability to practice effectively in interprofessional collaborative teams. Academic institutions are responding by offering interprofessional education (IPE); however, there is as yet no consensus regarding optimal strategies for the assessment of interprofessional learning (IPL). The Program Committee for the 17th Ottawa Conference in Perth, Australia in March, 2016, invited IPE champions to debate and discuss the current status of the assessment of IPL. A draft statement from this workshop was further discussed at the global All Together Better Health VIII conference in Oxford, UK in September, 2016. The outcomes of these deliberations and a final round of electronic consultation informed the work of a core group of international IPE leaders to develop this document. The consensus statement we present here is the result of the synthesized views of experts and global colleagues. It outlines the challenges and difficulties but endorses a set of desired learning outcome categories and methods of assessment that can be adapted to individual contexts and resources. The points of consensus focus on pre-qualification (pre-licensure) health professional students but may be transferable into post-qualification arenas.

Introduction During role-emerging placements students require different support as occupational therapy specific supervision is provided periodically and they cannot model their practice on experienced occupational therapists. This paper describes the development and evaluation of a workbook designed to reinforce the integration of theory with practice and provide an additional resource to support students when a supervisor was not present. Method A social constructionist perspective and action research methodology were used. Participants were 14 final year occupational therapy students and three off-site occupational therapy supervisors. All participants were involved in role-emerging placements in school settings in England. In-depth, semi-structured interviews across four action research cycles informed the development and evaluation of the workbook. Findings While the workbook originally focused on supplementing students’ knowledge of occupational therapy theory, during the action research cycles the focus shifted to consider how educational theory informed workbook design and content. Key features and critical aspects which supported students’ learning were identified. Conclusion The workbook was received positively by students and supervisors. Aspects which were particularly valued included the provision of examples and scenarios which contextualised theory within the placement setting. The workbook was proposed to have scope for use in placements beyond school-based practice.

Interprofessional education (IPE) to improve and increase interprofessional collaborative practice (IPC) has been documented for over 50 years in Canada, but it is within the last 15 years that it has gained attention in research, education and practice contexts. IPE is defined as two or more professions that learn with from and about each other to improve collaboration and the quality of care (CAIPE 2002). Early drivers for a renewed interest in IPE and IPC derive from an emerging interest in new health service delivery models such as integrated care clinics and primary health care and IPE and IPC have taken the center stage nationally and globally...

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.

This article was migrated. The article was marked as recommended. The purpose of this paper is to clarify what work-based IPE is, challenge some common misconceptions about its values in clinical settings and highlight tools that will assist with its implementation in such settings.

Objective This paper examines the implementation and implications of four development and research initiatives, collectively titled the Curriculum Renewal Studies program (CRS), occurring over a 6-year period ending in 2015 and focusing on interprofessional education (IPE) within Australian pre-registration health professional education. Methods The CRS was developed as an action-focused and participatory program of studies. This research and development program used a mixed-methods approach. Structured survey, interviews and extensive documentary analyses were supplemented by semi-structured interviews, focus groups, large group consultations and consensus building methods. Narrative accounts of participants’ experiences and an approach to the future development of Australian IPE were developed. Results Detailed accounts of existing Australian IPE curricula and educational activity were developed. These accounts were published and used in several settings to support curriculum and national workforce development. Reflective activities engaging with the findings facilitated the development of a national approach to the future development of Australian IPE – a national approach focused on coordinated and collective governance and development. Conclusion This paper outlines the design of an innovative approach to national IPE governance and development. It explores how ideas drawn from sociocultural theories were used to guide the choice of methods and to enrich data analysis. Finally, the paper reflects on the implications of CRS findings for health professional education, workforce development and the future of Australian IPE. What is known about the topic? IPE to enable the achievement of interprofessional and collaborative practice capabilities is widely accepted and promoted. However, many problems exist in embedding and sustaining IPE as a system-wide element of health professional education. How these implementation problems can be successfully addressed is a health service and education development priority. What does this paper add? The paper presents a summary of how Australian IPE was conceptualised, developed and delivered across 26 universities during the period of the four CRS studies. It points to strengths and limitations of existing IPE. An innovative approach to the future development of Australian IPE is presented. The importance of sociocultural factors in the development of practitioner identity and practice development is identified. What are the implications for practitioners? The findings of the CRS program present a challenging view of current Australian IPE activity and what will be required to meet industry and health workforce expectations related to the development of an Australian interprofessional- and collaborative-practice-capable workforce. Although the directions identified pose considerable challenges for the higher education and health sectors, they also provide a consensus-based approach to the future development of Australian IPE. As such they can be used as a blueprint for national development.

There are diverse perceptions about the primary purpose of evaluation. In interprofessional education (IPE), there has been a perceived focus on evaluating against the outcome of improved collaborative practice and quality of care. This paper presents an exploration of the nature and purpose of evaluation methods commonly utilized in the IPE literature with its focus on outcomes-based evaluation and particularly the Kirkpatrick framework. It categorises recent evaluations of pre-qualification (pre-certification) IPE interventions. Of the 90 studies included, most evaluated soon after the educational intervention, only five specifically referred to an evaluation framework and the most frequently used tool was the RIPLS. There was a noteworthy reliance on students' self-rated perceptions of their attitudes towards collaborative practice collected through surveys, focus groups and interviews. There appears to be a need to reconsider the type of evaluation required. In conclusion, this paper offers recommendations for evaluation practice that is moving towards realist approaches; describes the longer term effects of interventions on attitudes and behaviour; develops and validates data collection tools including direct observation of practice and more comprehensively engages with all stakeholders to ensure that evaluation activities are not only focused on improving IPE but also on enhancing our understanding of interprofessional practice.

Interprofessional education (IPE) programs aim to improve collaboration between health- and social-care professionals and to optimize clinical outcomes. Such programs are complex to design, and evaluation of effectiveness is difficult. Combining qualitative and quantitative data may provide greater understanding of how a program affects participants and what aspects are influential on attitudes and behavior. This qualitative study used semi-structured interviews and interpretative phenomenological analysis to explore undergraduate student perspectives on what attributes of a 4-week IPE program they considered contributed to a successful learning experience. Due to the fact that the students were not formally assessed, the realistic context of the activities and the quality of the facilitators created an environment where the students felt empowered to interact freely without fear of reproach. Learning the roles of other professions and their contribution to a healthcare team broadened the students' perspectives on healthcare and increased their sense of self-worth and pride in their professions. In addition, being able to identify the relevance of the learning experience to their future practice motivated the students. This information can be used to create optimal learning environments for facilitating the development of successful future healthcare teams.

Supervision of occupational therapy students on placements is a challenging, but rewarding experience. There is a growing body of literature related to role emerging placements but the experiences of the occupational therapists who undertake the role of off-site supervisors are underrepresented. These placements are based in settings where there is no defined occupational therapy role and the professional supervisor is not based at the placement site.Drawing from research in two European countries with off-site supervisors the enablers and barriers of this role are presented. Supervising students with innovative occupational therapy interventions positively influenced the off-site supervisors’ professional practice. Practical guidance for those interested in this role is shared to encourage occupational therapists to pursue this rewarding role including the need for peer support while undertaking this valuable role. Financial support by the Health Research Board (HRB) PhD Fellowship, Ireland, (2012–13)

Introduction: Globally there is an increased emphasis on the provision of high quality healthcare and improved productivity under mounting financial constraints. Interprofessional collaboration and practice are considered crucial in promoting teamwork and optimising patient outcomes. However, there is a lack of structured, evaluated interprofessional learning opportunities for graduates in regional and rural health services in Australia. This pilot study reports on a novel interprofessional new graduate learning program that was developed and implemented to address the lack of structured post-qualification interprofessional learning opportunities in the Central Queensland Hospital and Health Service. Methods: Twenty-one participants enrolled in the six-month program, which consisted of six ninety-minute sessions. A mixed method exploratory design was used to collect data using the Interprofessional Socialization and Valuing Scale before and after the program, and a reflective summary at program completion. Results: Results indicated that participation in the program had a positive effect on participants’ attitudes, beliefs and behaviours regarding interprofessional practice as measured on the Interprofessional Socialization and Valuing Scale. Various themes about the usefulness of the program to participants were elicited from the reflective summary data. These included enhanced understanding of interprofessional practice, increased confidence in own professional role, improved understanding of the roles of other professions, increased collaboration with others, improved patient outcomes and improved networking with colleagues. Conclusions: It was concluded that the new graduate interprofessional learning program was a feasible and effective way to facilitate interprofessional learning among health graduates in a regional health service.

Virtually all educational programmes for health professionals involve work-based or practice-based learning experiences, often referred to as clinical or professional practice placements. In Australia, professional accrediting bodies mandate either that a minimum number of practice based hours must be completed prior to graduation or that students must attain a range of clinical/professional competencies that can only be achieved by prolonged exposure to practice-based learning environments.

Modern health services are amongst the most complex systems in the world and this complexity places huge demands on those identified as leaders. The image of the individual trailblazing leader, much valued in the business world, has also been pervasive within healthcare environments in Australia and beyond (Fulop and Day, 2010). This model focuses on the capacity-building of individuals as leaders so that they take on a mantle of heroic characteristics and traits, managing teams, juggling budgets and driving development of service policies and proce-dures. The emphasis is on one individual to manage the organizational challenges of an entire service or team, the hero-leader, the one person at the top of a hierarchy who works alone to take his/her followers to new heights (Dickson and Tholl, 2014).

The occupational therapy profession has always concerned itself with the complexities of peoples’ lives, with a focus on holistic practice that promotes maintenance of life roles and client autonomy. For this reason occupational therapy education is a complex matrix moving far beyond the traditional pedagogical talk-and-chalk techniques. Occupational therapy educators aim to provide a learning experience that meets professional needs within a number of challenging contexts. These contexts include the evolving nature of the profession itself on both theoretical and practical levels, influences from national and international organisations and institutions driving the health care agenda, and of course societal trends.

This is the author's accepted manuscript. The final published article is available from the link below. © 2013 Occupational Therapy Australia. Background/aim - Occupational therapy educators are challenged to provide students with practical experiences which prepare them for ever changing health-care contexts on graduation. Role-emerging placements have been widely used internationally to help meet this challenge, but research into the learning experiences of students during these innovative placements is limited. This research investigated the enablers and barriers to learning from the perspectives of students on such placements from two European universities. Methods - Two separate qualitative studies tracked 10 final year students. Interviews explored their learning experiences prior to, during and after an eight- or 10-week role-emerging placement in a range of settings. Results - Four themes emerged, which were (1) adapting to less doing, more thinking and planning; (2) understanding the complexity of collaboration and making it work; (3) emotional extremes; and (4) realising and using the occupational therapy perspective. Conclusions - These placements presented a ‘roller coaster’ of authentic learning experiences which created the opportunity for students to use occupation in practice and develop skills for collaborative working in an interprofessional environment. Whereas students viewed their role-emerging placement experiences positively, challenges included the emotional responses of students and placement pace. Findings suggest the need for supportive student placement experiences in both established and role-emerging areas to prepare students for a range of opportunities in an uncertain future. Health Research Board Ireland

This paper uses (and perhaps abuses) deconstruction to revisit the meanings of collaboration and practice. We start with a description of deconstruction itself, as espoused by Jacques Derrida, and then move onto challenging the notion that words, such as collaboration, can have fixed meanings. And, in the spirit of Derrida, "I can foresee the impatience of the bad reader: this is the way I name or accuse the fearful reader, the reader in a hurry to be determined, decided upon deciding (in order to annul, in other words to bring back to oneself, one has to wish to know in advance what to expect...)" (Derrida, 1987, p. 4-original italics), we move straight into the text. © 2013 Informa UK, Ltd.

In order to evaluate the effectiveness of a rehabilitation programme for patients with chronic back pain, data on the subjective outcomes of perceived pain intensity (as measured by the Visual Analogue Scale Horizontal) and perceived level of disability (as measured by the Oswestry Low Back Pain Disability Questionnaire), and the objective outcome of functional capacity (as measured by the West Standardised Evaluation), were collected on 51 subjects prior to entry into a back pain rehabilitation programme and at discharge.The results at discharge showed a significant reduction in the perceived level of disability and a significant Increase in the functional capacity. The perceived pain intensity did not change significantly. The discussion focuses on the importance of directing therapeutic interventions towards increasing physical function rather than concentrating on the reduction or elimination of pain.

Background During clinical placements, clinical educators facilitate student learning. Previous research has defined the skills, attitudes and practices that pertain to an ideal clinical educator. However, less attention has been paid to the role of student readiness in terms of foundational knowledge and attitudes at the commencement of practice education. Therefore, the aim of this study was to ascertain clinical educators’ views on the characteristics that they perceive demonstrate that a student is well prepared for clinical learning. Methods A two round on-line Delphi study was conducted. The first questionnaire was emailed to a total of 636 expert clinical educators from the disciplines of occupational therapy, physiotherapy and speech pathology. Expert clinical educators were asked to describe the key characteristics that indicate a student is prepared for a clinical placement and ready to learn. Open-ended responses received from the first round were subject to a thematic analysis and resulted in six themes with 62 characteristics. In the second round, participants were asked to rate each characteristic on a 7 point Likert Scale. Results A total of 258 (40.56%) responded to the first round of the Delphi survey while 161 clinical educators completed the second (62.40% retention rate). Consensus was reached on 57 characteristics (six themes) using a cut off of greater than 70% positive respondents and an interquartile deviation IQD of equal or less than 1. Conclusions This study identified 57 characteristics (six themes) perceived by clinical educators as indicators of a student who is prepared and ready for clinical learning. A list of characteristics relating to behaviours has been compiled and could be provided to students to aid their preparation for clinical learning and to universities to incorporate within curricula. In addition, the list provides a platform for discussions by professional bodies about the role of placement education.

Changes in health service delivery and issues of quality of care and safety are driving interprofessional practice, and interprofessional learning (IPL) is now a requirement for medical school accreditation. There is international agreement that learning outcomes frameworks are required for the objectives of IPL to be fully realised, but there is debate about the most appropriate terminology. Interprofessional skills can be gained in several ways - from formal educational frameworks, at pre- and post-registration levels to work-based training. Research activity suggests that many consider that IPL delivers much-needed skills to health professionals, but some systematic reviews show that evidence of a link to patient outcomes is lacking. Australian efforts to develop an evidence base to support IPL have progressed, with new research drawing on recommendations of experts in the area. The focus has now shifted to curriculum development. The extent to which IPL is rolled out in Australian universities will depend on engagement and endorsement from curriculum managers and the broader faculty.

Successful transition of students to competent work-ready health professionals requires an ability to work in health care teams. Poor communication and teamwork practice has been implicated as a contributing source of error affecting patient safety. Traditional university curriculum structures severely limit the time that students from different professions can spend together, learning about and from each other (interprofessional education [IPE]). IPE initiatives need to focus on whole-of-system impacts and organisational sustainability. The Health Care Team Challenge (HCTC) is a high-profile leadership strategy that engages students, academic staff, practising professionals, policymakers and industry in a whole-of-system approach to IPE and interprofessional practice. Interprofessional student teams compete at a live public event for a cash prize for the best management plan centred on a complex clinical case study. National and international HCTCs are planned for future years.

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 theestablishment 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.