Australian Clinician’s Views on Interprofessional Education for Students in the Rural Clinical Setting

AbstractBackground: Collaboration between education providers and clinical agencies to develop models that facilitate cross-disciplinary clinical education for students is essential to produce work-ready graduates.Methods and Findings: This exploratory study investigated the perceptions of and opportunities for interprofessional education (IPE) from the perspectives of 57 clinical staff from three regional/rural health services across Victoria, Australia. Data were collected through a semi-structured questionnaire, interviews, and focus group discussions with staff from 15 disciplinary groups who were responsible for clinical education. Although different views emerged on what IPE entailed, it was perceived by most clinicians to be valuable for students in enhancing teamwork, improving the understanding of roles and functions of team members, and facilitating common goals for patient care. While benefits of IPE could be articulated by clinicians, student engagement with IPE in clinical areas appeared to be limited, largely ad hoc, and opportunistic. Barriers to IPE included: timing of students’ placements, planning and coordination of activities, resource availability, and current regulatory and education provider requirements.Conclusions: Without the necessary resources and careful planning and coordination, the integration of IPE as a part of students’ clinical placement experience will remain a largely untapped resource

Ruralization of students’ horizons: insights into Australian health professional students’ rural and remote placements

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).Introduction: Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students’ future rural practice intentions. Methods: Responses to open-ended survey questions from 3,204 students from multiple health professions and universities were analyzed using two independent methods applied concurrently: manual thematic analysis and computerized content analysis using Leximancer software. Results: The core concept identified from the thematic analysis was “ruralization of students’ horizons,” a construct representing the importance of preparing health professional students for practice in nonmetropolitan locations. Ruralization embodies three interrelated themes, “preparation and support,” “rural or remote health experience,” and “rural lifestyle and socialization,” each of which includes multiple subthemes. From the content analysis, factors that promoted students’ rural practice intentions were having a “positive” practice experience, interactions with “supportive staff,” and interactions with the “community” in general. It was apparent that “difficulties,” eg, with “accommodation,” “Internet” access, “transport,” and “financial” support, negatively impacted students’ placement experience and rural practice intentions. Conclusions: The study findings have policy and practice implications for continuing to support students undertaking regional, rural, and remote placements and preparing them for future practice in nonmetropolitan locations. This study may, therefore, further inform ongoing strategies for improving rural placement experiences and enhancing rural health workforce recruitment, retention, and capacity building

Q sample construction: a novel approach incorporating a Delphi technique to explore opinions about codeine dependence

Abstract Background Q methodology is an evidenced approach to researching subjectivity, involving a combination of qualitative and quantitative techniques. The methodology has been used successfully in healthcare research to explore the opinions of patients and healthcare providers about topics such as the illness experience, healthcare services, clinical practice and professional training. Q methodology studies require the generation of a Q sample, a set of opinion statements representing the phenomenon of interest. This paper describes a novel and rigorous approach to develop a Q sample for a study exploring misusers’ opinions about over-the-counter (OTC) codeine dependence and critically examines the associated methodological issues. Methods Development of the Q sample in this study involved three steps; (1) identification of opinion statements via a comprehensive literature search, (2) application of a theoretical framework, the Capability, Opportunity, Motivation - Behaviour (COM-B) model of behaviour, to group and then reduce the number of statements and (3) use of a Delphi technique to achieve expert consensus on the final selection of statements. The Delphi component involved a multidisciplinary panel of 15 addiction experts comprised of doctors, nurses, pharmacists, psychologists and researchers, who were recruited purposively. Experts rated each statement using a 5-point scale of perceived importance. Two Delphi rounds were undertaken and consensus for inclusion of a statement was set at a median score of ≥4 and an interquartile range of ≤1. Results A total of 842 statements representing codeine misusers’ opinions about OTC codeine dependence were identified from the literature. Statements were grouped thematically using the COM-B framework and representative statements were selected, reducing the number to 111. After two Delphi rounds, addiction experts achieved consensus on 46 statements which formed the final Q sample. Conclusions This paper describes a new and systematic approach to Q sample construction and explores associated methodological issues that could be useful for those considering Q methodology and for furthering the rigour of this research technique

The evidence for 'flipping out' : A systematic review of the flipped classroom in nursing education

Background The flipped classroom has generated interest in higher education providing a student-centred approach to learning. This has the potential to engage nursing students in ways that address the needs of today's students and the complexity of contemporary healthcare. Calls for educational reform, particularly in healthcare programs such as nursing, highlight the need for students to problem-solve, reason and apply theory into practice. The drivers towards student-based learning have manifested in team, problem and case-based learning models. Though there has been a shift towards the flipped classroom, comparatively little is known about how it is used in nursing curricula. Objectives The aims of this systematic review were to examine how the flipped classroom has been applied in nursing education and outcomes associated with this style of teaching. Data Sources Five databases were searched and resulted in the retrieval of 21 papers: PubMed, CINAHL, EMBASE, Scopus and ERIC. Review Methods After screening for inclusion/exclusion criteria, each paper was evaluated using a critical appraisal tool. Data extraction and analysis were completed on all included studies. Results This systematic review screened 21 titles and abstracts resulting in nine included studies. All authors critically appraised the quality of the included studies. Five studies were identified and themes identified were: academic performance outcomes, and student satisfaction implementing the flipped classroom. Conclusions Use of the flipped classroom in higher education nursing programmes yielded neutral or positive academic outcomes and mixed results for satisfaction. Engagement of students in the flipped classroom model was achieved when academics informed and rationalised the purpose of the flipped classroom model to students. However, no studies in this review identified the evaluation of the process of implementing the flipped classroom. Studies examining the process and ongoing evaluation and refinement of the flipped classroom in higher education nursing programmes are warranted

An ethnographic study of schizophrenia in Zimbabwe: the role of culture, faith, and religion

This ethnographic study explored the experiences of eighteen Shona speakers living with schizophrenia in Zimbabwe. Data were collected using semistructured interviews, observations and field notes. Almost three in four participants reported having a strong religious affiliation and believed mental illnesses are caused by spirits (zvirwere zvemweya) or witchcraft (zvirwere zvevaroyi). Cultural and religious beliefs influenced the perceived causes of schizophrenia, symptom explanations, and help-seeking behavior. Schizophrenia compounded social disadvantage, often leading to family disruption, isolation, homelessness, and wandering. Faith and religious belonging provided participants access to support and fostered hope, resilience, a sense of self-worth and greater quality of life

The benefits and challenges of academic writing retreats : An integrative review

The immediate drivers to increase publication outputs in higher education are government and research funding, organisational status, performance expectations and personal career aspirations. Writing retreats are one of a range of strategies used by universities to boost publication output. The aims of this integrative review were to synthesise the available evidence, identify the attributes, benefits and challenges of academic writing retreats and examine the components that facilitate publication output. The review was based on a systematic search of six electronic databases. Of the 296 articles identified, 11 primary research papers met the inclusion criteria. Thematic analysis of the data highlighted a raft of personal, professional and organisational benefits of writing retreats. The five key elements of writing retreats conducive to increasing publication output were protected time and space; community of practice; development of academic writing competence; intra-personal benefits and organisational investment. Participants involved achieved greater publication outputs, particularly when provided ongoing support. Further research is required to examine more substantively the feasibility of writing retreats, their cost-effectiveness and the features that increase publication outcomes

Preparing student nurses for healthcare reform

This research aimed to determine how clinical agencies and universities can best prepare student nurses to develop the capability to contribute to healthcare reform. A list of desirable reform capabilities (graduate attributes) was developed and validated. A case study approach was used and interviews conducted with personnel at six clinical agencies in Victoria and South Australia to assess the extent to which student nurses achieved or were likely to achieve these capabilities and to identify strategies that would assist their development. As a significant component of the healthcare workforce, nurses are positioned to play a critical role in healthcare reform. A major challenge facing the profession is how best to prepare nurses and equip them with the skills and attributes necessary to contribute to the reform agenda. Nine reform capabilities were identified. Some were more likely to be achieved than others during undergraduate preparation. Strategies were identified to assist the development of each capability though a number of challenges were also identified by participants. These related to: university–agency relationships, the clinical learning environment, student–graduate transition, curriculum and organisational culture. The research concluded that graduate nurses are unlikely to demonstrate all nine capabilities on initial entry into the workforce. If these are regarded as desirable attributes for beginning practitioners, universities and clinical agencies need to develop and implement more effective strategies to support their development during undergraduate preparation. [Author abstract

Ethnographic insights into the quality of life and experiences of people living with schizophrenia in Harare, Zimbabwe

Schizophrenia is a complex and severe mental disorder affecting more than 20 million people worldwide. This study used focused ethnography to explore the everyday lives of 18 people living with schizophrenia in Zimbabwe and its impact on their quality of life (QOL). Data were collected using semi-structured interviews, observational fieldwork, and the short form of the World Health Organization QOL-BREF questionnaire. Those aged 20–40 years experienced poorer QOL than older people. Family dislocation, living with stigma and discrimination, cost of medications and limited and variable access to treatment and support disrupted participants’ ability to enjoy life and function socially

An ethnographic study of schizophrenia in Zimbabwe: The role of culture, faith, and religion

This ethnographic study explored the experiences of eighteen Shona speakers living with schizophrenia in Zimbabwe. Data were collected using semistructured interviews, observations and field notes. Almost three in four participants reported having a strong religious affiliation and believed mental illnesses are caused by spirits (zvirwere zvemweya) or witchcraft (zvirwere zvevaroyi). Cultural and religious beliefs influenced the perceived causes of schizophrenia, symptom explanations, and help-seeking behavior. Schizophrenia compounded social disadvantage, often leading to family disruption, isolation, homelessness, and wandering. Faith and religious belonging provided participants access to support and fostered hope, resilience, a sense of self-worth and greater quality of life

Research collaborations: Like minds, diversity and safe spaces

Researchers, stakeholders and research funders are realising the benefits of building multidisciplinary research teams; pooling experts from varied fields with differing methodological approaches, methods and perspectives, to answer research questions. This diverse ‘meeting of the minds’ creates layers of opportunity for exploring social phenomena with new richness and clarity. Additionally, collaborations offer new prospects and synergies, new insights and awareness, and opportunities for self-growth. Multidisciplinary alliances are critical to the work of nurses, as practitioners, academics and researchers