A Model for Large-Scale, Interprofessional, Compulsory Cross-Cultural Education with an Indigenous Focus

Cultural competency training for health professionals is now a recognised strategy to address health disparities between minority and white populations in Western nations. In Australia, urgent action is required to "Close the Gap" between the health outcomes of Indigenous Australians and the dominant European population, and significantly, cultural competency development for health professionals has been identified as an important element to providing culturally safe care. This paper describes a compulsory interprofessional first-year unit in a large health sciences faculty in Australia, which aims to begin students on their journey to becoming culturally competent health professionals. Reporting primarily on qualitative student feedback from the unit's first year of implementation as well as the structure, learning objects, assessment, and approach to coordinating the unit, this paper provides a model for implementing quality wide-scale, interprofessional cultural competence education within a postcolonial context. Critical factors for the unit's implementation and ongoing success are also discussed

Understanding and working with different worldviews to co-design cultural security in clinical mental health settings to engage with Aboriginal and Torres Strait Islander clients

Background: Creating the conditions for meaningful relationships is essential to understanding Aboriginal worldviews and co-designing ways of working to achieve better health outcomes. Non-Aboriginal health professionals struggle to recognise the importance of social relationships to Aboriginal peoples and tensions emerge due to these different worldviews informed by different ontologies and epistemologies. This is more so in clinical settings where training and models of care are often inadequate for working with Aboriginal people. The impact of different understandings of relationships on the provision of health services to Aboriginal peoples remains under-researched. There is a critical need to reassess the way clinicians are supported by their organisations to engage with Aboriginal clients in competent and meaningfully ways. Methods: The paper provides key insights into an Aboriginal-led participatory action research project and the work of Aboriginal Elder co-researchers with non-Aboriginal mainstream service staff to better understand the importance of social relationships from an Aboriginal worldview. The paper critically engages literature on clinical service provision for Aboriginal peoples, along with an examination of the Australian Psychological Society Code of Conduct, to explore the tensions between professional training and the need to build relationships with Aboriginal clients. Findings: Through the Elders, non-Aboriginal service staff have expanded their understanding of Aboriginal culture, kinship and the importance of country to Aboriginal wellbeing. The Elders mentored staff to unpack the tensions between worldviews in clinical settings. The research resulted in a co-designed culturally safe framework for non-Aboriginal practitioners, which is building confidence, capacity and competence to work in partnership with Aboriginal peoples. The framework emphasis the need for culturally safe models of care. The Elders have supported non-Aboriginal staff to sit between the two worldviews to develop ways to work with Aboriginal clients and shift mainstream models of mental health care to improve the wellbeing of Aboriginal people

Empowering academics to be adaptive with eLearning technologies: An exploratory case study

© 2019. This paper describes an exploratory case study investigating the capacity of a multidisciplinary approach to academic development, to empower adaptive responses to ongoing technological change impacting on teaching practice. A quasi-experimental design with an intervention group (n = 22) and a comparative control group (n = 7) was adopted. Pre and post online questionnaires were administered to participants in both groups to evaluate attitudes and experiences relating to technology use in teaching and learning. The questionnaires were adapted from the Technology Acceptance Model. Qualitative measurement of the intervention group's experiences following the professional development was captured using semi-structured interviews, followed by two focus groups to confirm the interview findings. Results indicate that the professional development impacted positively on participants through significantly increased levels of confidence and perceived ease of use. Qualitative data indicated participants experienced cognitive, emotional, and/or practical changes during and/or following the professional development

Interprofessional team-based placements: The importance of space, place, and facilitation.

Interprofessional education in practice settings typically requires greater resource investment than in the classroom or online. Increased interest in return on investment means research on the outcomes of practice-based interprofessional education is needed. In this article, we report findings from a qualitative study involving a series of focus groups with health sciences' students during their interprofessional placements in three community health settings in Western Australia. An exploratory case study approach was adopted to determine students' perceptions of the placement and their learning. The presage-process-product (3P) model of learning and teaching was employed to illuminate to the nature of this interprofessional education experience. Verbatim transcripts were analysed by two researchers using an inductive approach to derive key themes. Findings illuminate a number of factors that strongly influenced student perceptions of their learning in interprofessional practice-based placements including a dedicated space to collaborate and learn; exposure to a wide range of professions in practice settings; the approach of the facilitators; and students' previous clinical experience, year level and the timing of the placement. Students reported that the placement enhanced their knowledge, professional communication, leadership, understanding of other health professions and collaboration. This study provides contemporary insight into key factors that influence student learning during practice-based interprofessional placements

Transfer of training in an academic leadership development program for program coordinators

The higher education sector has increasingly begun to pay more attention to academic leadership. This qualitative study explores how such an investment in a 20-week leadership development program influenced the behaviour of 10 academic staff in the role of program coordinator 6 to 12 months following participation in the program. Otherwise known as program directors or department chairs, academic staff in this role are responsible for coordinating and leading degree courses or programs. Leadership learning and changes in the behaviour of program coordinators was evident, particularly in regard to building influence, communicating more effectively and managing upwards. Improved confidence in their ability to perform the role was a lasting outcome and the use of peer learning and coaching was an important part of the success of the intervention. However, workload factors, succession planning and orientation were seen to be factors that impact on leadership development in this role. The findings suggest that participation in well designed academic leadership programs can result in a lasting transfer of training for program coordinators

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Writing-between: Australian and Canadian ficto-criticism

The current cultural climate, theoretical developments, the changing state of the tertiary institution, and the increasing presence of voices from the margin have contributed to the critical re-evaluation of academic writing as a way of knowing and representing the world. At the same time, hybrid forms of writing, those that exist in the interstices of established generic codes, are experiencing increased critical attention. Yet, despite the fact that genre has become an inadequate notion to describe boundary-crossing writing, little appears to have shifted in the way these forms are understood. Dominant methodologies tend to render what is between less visible or valid, and they define this space only in terms of its relation to set borders. Located at the boundaries of what is familiar and unfamiliar, 'writing-between' is a contentious space where elements are combined without clear rules to aid identification. In this thesis the term 'ficto-criticism' is used broadly to describe generically transgressive writing that blurs the defining lines between creative and critical texts. The thesis explores the political and theoretical implications of writing-between through a discussion of Australian and Canadian work in English (or English translation), which display the characteristics of the ficto-critical form. This thesis argues for a critical understanding of ficto-criticism that conceptualises it as a highly political strategy of literary intervention, rather than as a mere trend toward cross-genre writing. Indeed, rather than understanding it as surface play, the thesis argues that ficto-critical practice is deeply troubled by the oppressive role of academic writing and that, significantly, its emergence was highly influenced by postcolonial and feminist theory. Thus, ficto-critical practice interrogates the violence of representation and explores what is left out and or misrepresented through that process. The thesis applies Deleuze and Guattari's concept-tools to articulate a methodology by virtue of which desire and ficto-criticism are understood as productive forms that are liberated from an equation of lack. The tension between ficto-criticism as an open practice and the tradition of scholarly writing, which requires a clear fixed proposition and outcomes, mirrors the project of ficto-criticism, which seeks to unlearn one's authority and privilege as the beginning of a process towards developing an ethical relationship with the other

Facilitating collaborative capabilities for future work: What can be learnt from interprofessional fieldwork in health

There is growing pressure in higher education to develop graduates with the capabilities to work effectively in collaborative, interdisciplinary teams to solve the key issues facing humankind. For many years, health has been pioneering interprofessional education as the means to deliver professionals with capacity to work together to deliver high quality, cost-effective, client-centered care. This paper reports on an explorative case study where interviews were undertaken with ten students from different professions who had experienced interprofessional education at three different community sites. The learning was informed by an adapted version of contact hypothesis for use in interprofessional education combined with adult learning principles. Four interrelated metathemes were identified: space and time, informality and independence, which resulted in a more holistic approach to practice. Results suggest that the contact hypothesis, with consideration of contact variables, has the potential to improve the quality of interdisciplinary group interaction