Structuring educational decisions using the multiple sorting task: An example focusing on international placements in nursing

Practical examples of the steps involved in the planning and execution of the multiple sorting task are frequently lacking in published reports. This article demonstrates how the multiple sorting task can be used to structure conversations with a group of health professionals planning an international placement for nursing students. Sixteen participants were drawn from diverse professional backgrounds, including academia, clinical practice, government policy, and placement administrators. Participants sorted 17 statements written on cards into categories of their choice and noted why they sorted the cards into these particular groups. Data were analysed using multidimensional scaling and qualitative perspectives. The analysis identified four key themes that detailed the participants’ views about international placements. These findings demonstrate how the multiple sorting task can be used to generate information that facilitates the examination of important facets of health care practice that universities could cover in preparing students for international placements

The simulated early learning of cervical spine manipulation technique utilising mannequins

Background Trivial pain or minor soreness commonly follows neck manipulation and has been estimated at one in three treatments. In addition, rare catastrophic events can occur. Some of these incidents have been ascribed to poor technique where the neck is rotated too far. The aims of this study were to design an instrument to measure competency of neck manipulation in beginning students when using a simulation mannequin, and then examine the suitability of using a simulation mannequin to teach the early psychomotor skills for neck chiropractic manipulative therapy. Methods We developed an initial set of questionnaire items and then used an expert panel to assess an instrument for neck manipulation competency among chiropractic students. The study sample comprised all 41 fourth year 2014 chiropractic students at Murdoch University. Students were randomly allocated into either a usual learning or mannequin group. All participants crossed over to undertake the alternative learning method after four weeks. A chi-square test was used to examine differences between groups in the proportion of students achieving an overall pass mark at baseline, four weeks, and eight weeks. Results This study was conducted between January and March 2014. We successfully developed an instrument of measurement to assess neck manipulation competency in chiropractic students. We then randomised 41 participants to first undertake either “usual learning” (n = 19) or “mannequin learning” (n = 22) for early neck manipulation training. There were no significant differences between groups in the overall pass rate at baseline (χ2 = 0.10, p = 0.75), four weeks (χ2 = 0.40, p = 0.53), and eight weeks (χ2 = 0.07, p = 0.79). Conclusions This study demonstrates that the use of a mannequin does not affect the manipulation competency grades of early learning students at short term follow up. Our findings have potentially important safety implications as the results indicate that students could initially gain competence in neck manipulation by using mannequins before proceeding to perform neck manipulation on each other

The influence of anatomy app use on chiropractic students’ learning outcomes: a randomised controlled trial

Background: Anatomy apps supplement traditional learning; however, it is unknown if their use can improve students' outcome. The present study examined whether the use of anatomy apps improved student performance on a neuroanatomy assessment. Methods: Second-year anatomy students, enrolled in a Bachelor of Science with Chiropractic Major program, were randomly allocated to experimental and control groups in July 2015. Students completed the Self-Directed Learning Readiness Scale (SDLRS). The experimental group had access to iPads with four anatomy apps for three weekly classes (1.5 h each). One week after the last class, students were assessed by an online 30-question neuroanatomy test. Linear regression was used to examine the association between test scores and app use, gender, previous anatomy unit score and SDLRS scores. Students' views on apps were collected by focus group discussion immediately after the test. Results: Completed questionnaires were obtained from n = 25 control and n = 25 experimental students. There was no association between app use and neuroanatomy assessment score (B = 1.75, 95 % CI: -0.340-3.840, p = 0.099). Only previous anatomy unit score (B = 0.348, 95 % CI: 0.214-0.483, p < 0.001) affected neuroanatomy assessment scores. Students favored apps with clinical images and features including identification pins, sliding bars and rotatable 3D images. Conclusions: App use did not enhance learning outcomes in a second-year anatomy unit

Participation in mental healthcare: A qualitative meta-synthesis

Background: Facilitation of service user participation in the co-production of mental healthcare planning and service delivery is an integral component of contemporary mental health policy and clinical guidelines. However, many service users continue to experience exclusion from the planning of their care. This review synthesizes qualitative research about participation in mental healthcare and articulates essential processes that enable service user participation in mental health care. Methods: Electronic databases were systematically searched. Studies were included if they were peer reviewed qualitative studies, published between 2000 and 2015, examining participation in mental health care. The Critical Appraisal Skills Program checklist was used to assess the quality of each included study. Constant comparison was used to identify similar constructs across several studies, which were then abstracted into thematic constructs. Results: The synthesis resulted in the identification of six principal themes, which articulate key processes that facilitate service user participation in mental healthcare. These themes included: exercising influence; tokenism; sharing knowledge; lacking capacity; respect; and empathy. Conclusions: This meta-synthesis demonstrates that service user participation in mental healthcare remains a policy aspiration, which generally has not been translated into clinical practice. The continued lack of impact on policy on the delivery of mental healthcare suggests that change may have to be community driven. Systemic service user advocacy groups could contribute critically to promoting authentic service user participation in the co-production of mental health services

Australian mental health caregiver burden: A smallest space analysis

Objectives To explore Australian mental health carers’ prioritisation of key elements of caregiving and establish the extent to which particular issues contribute to carer burden. Design Cross-sectional survey. Setting All Australian States and Territories. Participants Responses were received from 231 Australian mental health caregivers. Main outcome measures The Involvement Evaluation Questionnaire was used to assess caregiver burden. Results Smallest space analysis identified three distinct regions, which we conceptualise as: 1) promoting the safety and health of mental health consumers; 2) impact of caring on caregivers’ personal lives and 3) enabling daily living functional recovery of mental health consumers. The analysis demonstrates that carers are most concerned with enabling daily living functional recovery, for which the mean value was considerably higher than the personal impact and promoting safety and health regions. In terms of the individual questionnaire items, the issues of most importance are assisting with self-care, worrying about consumers’ future, finances and general health, encouraging consumer involvement in activities and concerns over the treatment consumers are receiving. Conclusion Caregiving often came at significant personal cost. The burden that results from caring for mental health consumers could perhaps be alleviated through the expansion of psychiatric disability services, increasing government financial support and providing tailored psychosocial interventions that meet the needs of families

A health and education needs analysis of Gumala Aboriginal Corporation members

On the first of February 2011 Murdoch University commenced a research project to identify gaps and needs in health and education of Gumala Aboriginal Corporation (GAC) members and to provide practical solutions to reduce these gaps and needs. All Gumala members were invited to participate but special emphasis was placed on members in the Pilbara region of Western Australia. Our findings are contained On the first of February 2011 Murdoch University commenced a research project to identify gaps and needs in health and education of Gumala Aboriginal Corporation (GAC) members and to provide practical solutions to reduce these gaps and needs. All Gumala members were invited to participate but special emphasis was placed on members in the Pilbara region of Western Australia. Our findings are contained within this report. In addition our methodologies allow cautious generalisation of many of the findings to other Aboriginal language groups in the Pilbara. The research project was co-sponsored by Gumala Aboriginal Corporation and Rio Tinto. The project team consisted of: Dr. Bruce Walker, Project Director (Health), Dr Anne Price, Project team member (Education), Ms Elizabeth Jackson-Barrett, Project team member (Education), Ms Ellen Seymour, Project Officer (Health) (deceased) and Dr Norman Stomski, Project Officer (Health). We commend the report to all who read it and particularly the recommendations which we believe will enhance the health and educational status of Gumala members, their children and generations to come

Carers' perspectives on mental health consumers' use of antipsychotic medication: A multidimensional scalogram analysis

Mental health caregivers commonly have detailed insight about consumers’ lives, and therefore often have developed an understanding of the manner in which antipsychotic medication affects consumers. This study explored caregivers’ perspectives of key factors that influence mental health consumers’ use of antipsychotic medications. The analysis was based on transcripts of interviews which were conducted with caregivers of mental health consumers. Each transcript was categorically coded across 12 variables to generate a series of data profiles. The data set was then analysed using multidimensional scalogram analysis to identify associations between subsets of variables. The findings demonstrated that mental health consumers tended to adhere to prescribed antipsychotic medications despite experiencing troubling side effects. Such adherence occurred when caregivers participated in discussions about medications, and health professionals monitored side effects vigilantly and altered medications to reduce side effects. Also, caregivers were generally unsettled about the impact of medication side effects on consumers’ lives, but conceded that benefits of medications typically outweighed the adverse effects. Further studies are warranted to strengthen the findings of this study

Carers' involvement in decision making about antipsychotic medication: A qualitative study

Background: Current Australian mental health policy recommends that carers should be involved in the provision of mental health services. Carers often provide intensive support to mental health consumers and gain detailed insight into their lives. As such, carers could make valuable contributions to well-informed decisions about mental health consumers' use of antipsychotic medication. Objectives: The aim of this study was to explore carers' participation in antipsychotic medication decision making. Methods: Snowball sampling was used to enrol 29 carers in this study. Of these carers, 19 participated in semi-structured interviews, and ten participated in a focus group. Data were analysed thematically. Results: Four main themes emerged from the analysis. The findings highlighted that carers typically received little or no information about antipsychotic medication. Carers commonly addressed the shortfall in information by obtaining additional information through online sources or distributing among carer networks material that they had developed themselves. Almost all carers emphasized that they should be involved in decisions about antipsychotic medication, but noted that they were typically excluded. The lack of involvement in medication decisions was a source of frustration, as carers could contribute saliently through sharing detailed knowledge about mental health consumers' lives, address communication gaps that resulted from disjointed care and improve communication between health professionals and mental health consumers. Conclusion: Health professionals could consider improving the extent to which they collaborate with carers in medication decisions

Predictors of burden in Australian mental health caregivers: A cross-sectional survey

Background: The shift towards providing mental healthcare in the community has resulted in caregivers becoming more involved in the delivery of these services. Supporting mental health consumers can be burdensome which, in conjunction with the anguish that may result from observing their relative develop a mental illness, can lead to carers experiencing significant levels of distress. Aims: This study aimed to quantify the extent to which specific aspects of caregiving contribute to mental health burden in Australia. Methods: Participants were included if they were Australian mental health caregivers. An online questionnaire was distributed via email. Multivariate logistic regression was used to identify predictors of burden in mental health caregivers. Results: Completed questionnaires were collected from 231 respondents. The logistic regression analysis yielded five factors that contributed significantly to mental health caregiver burden. Of these factors, a strained atmosphere and regularly carrying out tasks for consumers were the two strongest predictors of burden. Conclusion: Community health professionals could focus on interpersonal relationships between family members, access to disability and financial support services, and carers’ views about the quality of healthcare provided to consumers. Addressing these issues may decrease carer burden and improve the quality of life for all family members

Embracing participation in mental health research: Conducting authentic interviews

Purpose – Successful interviews are underpinned by several important processes that researchers must take account of. These include: understanding the meaning of participation in research, acquiring informed consent, establishing rapport, managing boundaries between research and helping, and embracing consumer participation in research. These processes have been addressed individually in articles, but have not been collectively appraised yet they are all critical determinants of successful interviewing. The purpose of this paper is to bridge the gap in the literature by synthesizing the available information that shapes the practice of interviewing people with a mental health problems in a research project. Design/methodology/approach – This paper involves a review of the literature. Findings – Numerous interactional processes need to be addressed to facilitate the full engagement of both researchers and informants in research interviews. Engaging authentically in research interviews is challenging at many levels, and strategies are presented that researchers and informants can use to manage the difficulties that they may encounter. Originality/value – This paper draws on the notion of participation to highlight how certain aspects of interactions between researchers and informants with mental health problems contribute to authentic narratives