Rethinking attitudes to student clinical supervision and patient care: a change management success story

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background The aim of this project was to explore the process of change in a busy community dental clinic following a team development intervention designed to improve the management of student supervision during clinical placements. Methods An action research model was used. Seven members of a community dental clinic team (three dentists, two dental therapists, one dental assistant and the clinic manager), together with the university clinical placement supervisor participated in the team development intervention. The intervention consisted of two profiling activities and associated workshops spread six months apart. These activities focused on individual work preferences and overall team performance with the aim of improving the functioning of the clinic as a learning environment for dental students. Evaluation data consisted of 20 participant interviews, fourteen hours of workplace observation and six sets of field notes. Following initial thematic analysis, project outcomes were re-analysed using activity theory and expansive learning as a theoretical framework. Results At project commencement students were not well integrated into the day-to-day clinic functioning. Staff expressed a general view that greater attention to student supervision would compromise patient care. Following the intervention greater clinical team cohesion and workflow changes delivered efficiencies in practice, enhanced relationships among team members, and more positive attitudes towards students. The physical layout of the clinic and clinical workloads were changed to achieve greater involvement of all team members in supporting student learning. Unexpectedly, these changes also improved clinic functioning and increased the number of student placements available. Conclusions In navigating the sequential stages of the expansive learning cycle, the clinical team ultimately redefined the ‘object’ of their activity and crossed previously impervious boundaries between healthcare delivery and student supervision with benefits to all parties

An evaluation of pharmacology curricula in Australian science and health-related degree programs

Background: Pharmacology is a biomedical discipline taught in basic science and professional degree programs. In order to provide information that would facilitate pharmacology curricula to be refined and developed, and approaches to teaching to be updated, a national survey was undertaken in Australia that investigated pharmacology course content, teaching and summative assessment methods. Methods: Twenty-two institutions participated in a purpose-built online questionnaire, which enabled an evaluation of 147 courses taught in 10 different degrees. To enable comparison, degrees were grouped into four major degree programs, namely science, pharmacy, medicine and nursing. The pharmacology content was then classified into 16 lecture themes, with 2-21 lecture topics identified per theme. The resultant data were analysed for similarities and differences in pharmacology curricula across the degree programs. Results: While all lecture themes were taught across degree programs, curriculum content differed with respect to the breadth and hours of coverage. Overall, lecture themes were taught most broadly in medicine and with greatest coverage in pharmacy. Reflecting a more traditional approach, lectures were a dominant teaching method (at least 90% of courses). Sixty-three percent of science courses provided practical classes but such sessions occurred much less frequently in other degree programs, while tutorials were much more common in pharmacy degree programs (70%). Notably, problem-based learning was common across medical programs. Considerable diversity was found in the types of summative assessment tasks employed. In science courses the most common form of in-semester assessment was practical reports, whereas in other programs pen-and-paper quizzes predominated. End-of-semester assessment contributed 50-80% to overall assessment across degree programs. Conclusion: The similarity in lecture themes taught across the four different degree programs shows that common knowledge- and competency-based learning outcomes can be defined for pharmacology. The authors contend that it is the differences in breadth and coverage of material for each lecture theme, and the differing teaching modes and assessment that characterise particular degree programs. Adoption of pharmacology knowledge-based learning outcomes that could be tailored to suit individual degree programs would better facilitate the sharing of expertise and teaching practice than the current model where pharmacology curricula are degree-specific.Hilary Lloyd, Tina Hinton, Shane Bullock, Anna-Marie Babey, Elizabeth Davis, Lynette Fernandes, Joanne Hart, Ian Musgrave and James Zioga

Kualitas Hidup Pasien Diabetes Melitus Tipe 2 di Puskesmas Se Kota Kupang

Diabetes Mellitus is well known as a chronic disease which can lead to a decrease in quality of life in all domains. The study aims to explore the diabetic type 2 patient\u27s quality of life and find out the factors affecting in type 2 diabetic mellitus patients. The cross-sectional study design is used that included 65 patient with type 2 diabetes mellitus, in 11 public health centers of Kupang City. Data were collected by using Short Form Survey (SF-36) that assessed 8-scale health profile. Independent sample t-test is used to analyze the correlation between the factors affecting and the quality of life. the study showed that the QoL of DM patients decreased in all 8- health profile including physical functioning, social functioning, mental health, general health, pain, change in the role due to physical problems and emotional problems. The Study also showed there was a relationship between gender, duration of suffering from Diabetes mellitus, and complications to the quality of life. Male perceived a better quality of life than female

Reconciling the professional and student identities of clinical psychology trainees

The study explored the ways in which qualified and trainee clinical psychologists perceived professional behaviour, as illustrated in a series of short vignettes, in student and clinical practice contexts. Comparisons were made to identify the extent to which ideas of professionalism differed across different learning contexts and between qualified and unqualified staff, with the aim of adding to the literature on which factors influence the development of professional identity in health professionals. An online questionnaire depicting a range of potentially unprofessional behaviours was completed by 265 clinical psychology trainees and 106 qualified clinical psychologists. The data were analysed using a general linear model with simultaneous entry in which rater (trainee vs qualified clinical psychologist), setting (student vs placement) and their interaction predicted acceptability ratings. We found that, in general, trainees and qualified staff agreed on those behaviours that were potentially unprofessional, although where significant differences were found, these were due to trainees rating the same behaviours as more professionally acceptable than qualified clinical psychologists. Despite trainees identifying a range of behaviours as professionally unacceptable, some percentage reported having engaged in a similar behaviour in the past. Irrespective of the status of the rater, the same behaviours tended to be viewed as more professionally unacceptable when in a placement (clinical) setting than in a student (university) setting. Generally, no support was found for a rater by setting interaction. The study suggests that trainee clinical psychologists are generally successful at identifying professional norms, although they do not always act in accordance with these. Conflicting student and professional norms may result in trainees viewing some potentially unprofessional behaviour as less severe than qualified staff. Health professional educators should be aware of this fact and take steps to shape trainee norms to be consistent with that of the professional group

Sustaining the future through virtual worlds

Virtual worlds (VWs) continue to be used extensively in Australia and New Zealand higher education institutions although the tendency towards making unrealistic claims of efficacy and popularity appears to be over. Some educators at higher education institutions continue to use VWs in the same way as they have done in the past; others are exploring a range of different VWs or using them in new ways; whilst some are opting out altogether. This paper presents an overview of how 46 educators from some 26 institutions see VWs as an opportunity to sustain higher education. The positives and negatives of using VWs are discussed

How are Australian higher education institutions contributing to change through innovative teaching and learning in virtual worlds?

Over the past decade, teaching and learning in virtual worlds has been at the forefront of many higher education institutions around the world. The DEHub Virtual Worlds Working Group (VWWG) consisting of Australian and New Zealand higher education academics was formed in 2009. These educators are investigating the role that virtual worlds play in the future of education and actively changing the direction of their own teaching practice and curricula. 47 academics reporting on 28 Australian higher education institutions present an overview of how they have changed directions through the effective use of virtual worlds for diverse teaching and learning activities such as business scenarios and virtual excursions, role-play simulations, experimentation and language development. The case studies offer insights into the ways in which institutions are continuing to change directions in their teaching to meet changing demands for innovative teaching, learning and research in virtual worlds. This paper highlights the ways in which the authors are using virtual worlds to create opportunities for rich, immersive and authentic activities that would be difficult or not possible to achieve through more traditional approaches. © 2011 Brent Gregory, Sue Gregory, Denise Wood, Yvonne Masters, Mathew Hillier, Frederick Stokes-Thompson, Anton Bogdanovych, Des Butler, Lyn Hay, Jay Jay Jegathesan, Kim Flintoff, Stefan Schutt,Dale Linegar, Robyn Alderton, Andrew Cram, Ieva Stupans, Lindy McKeown Orwin, Grant Meredith, Debbie McCormick, Francesca Collins, Jenny Grenfell, Jason Zagami, Allan Ellis, Lisa Jacka, Angela Thomas, Helen Farley, Nona Muldoon, Ali Abbas, Suku Sinnappan, Katrina Neville, Ian Burnett, Ashley Aitken, Simeon Simoff, Sheila Scutter, Xiangyu Wang, Kay Souter, David Ellis, Mandy Salomon, Greg Wadley, Michael Jacobson, Anne Newstead, Gary Hayes, Scott Grant, Alyona Yusupova

How do we connect and engage students, learning in a distance mode, to develop verbal communication skills?

Research has indicated that students perform at least as well in distance courses as in faceto-face courses across a number of measures including critical thinking, sharing of personal perspective, and task-focused interaction. To date, there has be

Assessing students' professionalism: considering professionalism's diverging definitions

Context: Although most health education programs assess students' professionalism, there is little clarity within the health education literature on the definition of professionalism. This makes assessment of students' professionalism a potentially flawed activity.\ud This literature review clarifies professionalism by bringing together diverging definitions from across a number of health disciplines and discusses the complexities and limitations of these definitions. \ud \ud Methods: A search was conducted within the medical and health science education literature to identify articles that discussed professionalism and its assessment. Theoretical, qualitative and empirical research were included in the review.\ud \ud Findings: The literature variably defines professionalism as upholding professional values, as demonstrating professional attitudes or demonstrating professional behaviours. Each of these perspectives influences how professionalism is to be assessed, with each perspective having its own limitations. The behavioural perspective is simple to assess, but it has been criticised for being too superficial. The values perspective has the potential to develop professionals who are motivated by philanthropic values, but values can be difficult to identify and assess. Attitudes are complex in their structure, but they are less superficial than behaviours and can be assessed with attitudinal scales.\ud \ud Conclusion: Health professions educators should ideally assess all three perspectives of professionalism, however, this may not be realistic given the already laden curricula and the demands on educators. Educators may decide to only assess one perspective and given its advantages, the attitudes perspective may be a useful starting point

Learning and teaching of patient-centred communication skills in allied healthcare manual therapy students: A systematic review

Objective: Analogous to medical professionals, allied healthcare manual therapies such as osteopathy, chiropractic and physical therapy/physiotherapy rely on patient centred communication skills to optimise positive outcomes of clinical encounters. The objective of this review is to identify how communication skills are taught and learned within these specific professions. Methods: CINAHL, AMED, PubMED, ERIC and PsychINFO were searched in April 2018 (search years: inception-2018). Papers were independently selected by two researchers. A narrative synthesis of results was formulated. Results: Six papers on how patient centred communication skills are being developed in the undergraduate manual therapy healthcare professions were identified. All excluding one paper reported interventions used in undergraduate physical therapy/physiotherapy. The additional paper provided a summary of teaching methods used in undergraduate physical therapy/physiotherapy university programmes across the United Kingdom. Training programmes employed a combination of instruction, modelling and problem-based learning. Only one paper measured the effectiveness of their training to identify if the changes in the students patient centred communication skills were observable. Conclusion: There is little evidence to indicate communication skills training is being provided to chiropractic and osteopathy students. However, communication skills training is being provided to physical therapists/physiotherapists and is varied in the types of teaching techniques used, the duration of teaching and the timing of teaching around clinical placements

The academic developmental learning journey in using a competency graduated descriptors tool for student self-assessment and feedback

Aim: Academic skill building is a significant issue for lecturers involved in preparatory health programs. This study examines various university academics from pharmacy schools and their approaches to introducing a generic competency tool for student self-assessment and feedback within experiential placement processes. Background: Competency standards used in determining that entrants to professions have the required skills, knowledge and attributes are essentially focused on 'end points' and assessment processes which indicate a competent/non-competent categorisation. An Australian Learning and Teaching Council pharmacy project developed a graduated descriptors tool for competencies relevant to student self-assessment and feedback which acknowledged the progressive development of skills by students. The tool was progressively amended in response to feedback by students. Method: Academics at two pharmacy schools implemented a graduated descriptors competency tool which they had amended in varying ways, including providing students with online access to some preparatory materials and using small tutorial groups to revisit competencies. Student surveys, trial school academic reflective writing and student and academic interviews were used to gather data about the tool's usefulness and the effectiveness of various implementation approaches. Manual collation and analysis were used. Results: A generally positive response was indicated to the amended tool for self-assessment, improving feedback and student learning. Academic reflective writing and interviews indicated the importance of appropriately contextualising the tool, including appropriate scaffolding in pre-placement approaches as relevant to the particular pharmacy program context. Discussion: While wider scale trialling is required, the research highlights the value of student feedback in developing and implementing new materials, with reflection by academics supporting their learning journey.13 page(s