Discovering which experiences physiotherapy students identify as learning facilitators in practical laboratories: An action research project

Purpose: Students enrolled in courses that focus on patient contact participate in practical laboratories to learn clinical skills but this can be challenging in a pre-clinical environment. A simulated case based format using role play in small groups is commonly undertaken. Students may find it difficult to actively engage in learning and effective role playing without prior clinical experience. The aim of this study was to discover what type of experiences facilitated student learning in practical laboratory sessions. Method: Design: Action research study. Participants: Thirty two undergraduate second year physiotherapy students who were engaging in practical laboratories. Data collection and analysis: Teacher observations, minute papers and semi structured interviews were conducted over a nine week teaching period to gain the student perspective on what facilitated their learning. Data from these three sources were categorised and coded. A concept mapping technique was then used to represent the construct of learning facilitators identified, from which the final survey was developed. Results: Learning facilitators identified by students were categorised under three key units: those provided by the teacher, those initiated by the students themselves and material resources. Concept mapping revealed three emergent themes: provide multiple opportunities for learning that address all learning styles, formative learning support and resources to consolidate learning. Students rated timely feedback from the teacher while they practiced the required skills and behaviours as the highest valued learning facilitator (strongly agreed 78.6%, agreed 21.4%) followed by watching the teacher modelling the skill or behaviour required (strongly agreed 67.9%, agreed 25.0%). Students also reported that using a peer feedback checklist constructed by the teacher clarified their expectations of engaging in observation and feedback (strongly agreed 32.1%, agreed 50.0%) and guided their performance in the skills and behaviours expected (strongly agreed 35.7%, agreed 53.6%). Conclusions: Students at a pre-clinical level can identify which experiences facilitate their learning in practical laboratories, if given the opportunity. While these students place the highest value on teacher feedback they can actively engage in peer learning if given constructive guidance on the skills and behaviours required. Discovering what students identify as facilitating their learning in practical laboratories can guide successful evaluation of laboratory teaching plans to modify and create new learning opportunities and resources. This has the potential to improve student satisfaction and achievement of intended learning outcomes

Contingent Liabilities from Capital Transactions—Is Payment Capital or Ordinary Loss?

Contingent Liabilities from Capital Transactions—Is Payment Capital or Ordinary Loss

Contingent Liabilities from Capital Transactions—Is Payment Capital or Ordinary Loss?

Contingent Liabilities from Capital Transactions—Is Payment Capital or Ordinary Loss

Evaluating the impact of a falls prevention community of practice in a residential aged care organisation

Falls in the residential aged care (RAC) sector are a global concern with humanitarian and economic consequences. Reducing falls using a multifactorial approach involving multidisciplinary staff is recommended, but it is not clear how RAC organisations in Australia can achieve this in a resource constrained environment. One potential solution is to develop a sustainable means of addressing falls prevention from within an organisation, creating a forum for staff to share ideas, expertise and achieve goals in a community of practice (CoP). The purpose of this research was to evaluate the impact of a falls prevention CoP on falls outcomes in a RAC setting. A mixed methods design framed by a realist approach was undertaken, to better understand how CoP interventions were influenced by current conditions (contexts) in triggering (mechanisms) the observed outcomes. Diverse data sources including surveys, electronic CoP discussion transcripts, semi-structured interviews and organisational falls data were used to triangulate findings. The CoP was mapped across three phases. Phase 1 described how the CoP was developed, then evaluated its establishment and operation across 13 geographically diverse RAC sites. In Phase 2 the CoP identified gaps in falls prevention practice using evidence-based audit and feedback, determining the areas for priority intervention. Phase 3 comprehensively evaluated the impact of CoP activity at three levels; member, site and organisation. Overall the CoP had a positive impact; members gained new peer connections and falls prevention knowledge, the proportion of residents supplemented with vitamin D improved significantly and a falls prevention policy and risk assessment tool were developed and implemented across the organisation. Management recognition and support were key mechanisms in achieving successful outcomes. Falls rates pre CoP were 10.1/1000 occupied bed days (OBD) compared with 10.9 /1000 OBD post CoP operation [coefficient 0.7, 95% CI (-33.5, 34.9) p = .967]. This was potentially confounded by an increased use of beds for short stay transition care services and identified differences in defining falls between sites. A downward trend in the rate of injurious falls resulting in fractures was observed (pre CoP 0.2/1000 OBD compared with 0.1/1000 OBD post CoP; [coefficient -0.3, 95% CI (-1.1, 0.4) p = .423]. As the prioritised CoP interventions required design and development, implementation only occurred towards the end of the research period meaning the intervention effect on falls outcomes may require longer term follow up. The CoP remains operational and is ideally positioned to continue to lead evidence-based falls prevention practice change as determined by its membership

Can a web-based community of practice be established and operated to lead falls prevention activity in residential care?

The aims of this study were to evaluate establishing and operating a web-based community of practice (CoP) to lead falls prevention in a residential aged care (RAC) setting. A mixed methods evaluation was conducted in two phases using a survey and transcripts from interactive electronic sources. Nurses and allied health staff (n = 20) with an interest in falls prevention representing 13 sites of an RAC organization participated. In Phase 1, the CoP was developed, and the establishment of its structure and composition was evaluated using determinants of success reported in the literature. In Phase 2, all participants interacted using the web, but frequency of engagement by any participant was low. Participatory barriers, including competing demands from other tasks and low levels of knowledge about information communication technology (ICT) applications, were identified by CoP members. A web-based CoP can be established and operated across multiple RAC sites if RAC management support dedicated time for web-based participation and staff are given web-based training

The effect of complex falls prevention interventions on falls in residential aged care settings: A systematic review protocol

The objective of this review is to synthesize the best available evidence on the effectiveness of complex falls prevention interventions on fall reductions in the residential aged care population, implemented at two or more of the following levels: organization, facility or resident. Specifically the review question is: What is the effect of complex falls prevention interventions on falls in residential aged care settings

Assessing knowledge, motivation and perceptions about falls prevention among care staff in a residential aged care setting

Falls are a serious problem in residential aged care settings. The aims of the study were to determine the feasibility of surveying care staff regarding falls prevention, and describe care staff levels of knowledge and awareness of residents\u27 risk of falls, knowledge about falls prevention, motivation and confidence to implement falls prevention strategies. A custom designed questionnaire was administered to care staff at one site of a large residential aged care organization in Australia. The survey response was 58.8%. Feedback from staff was used to inform the administration of the survey to the wider organization. Seven (29.2%) care staff reported they were unsure or thought residents were at low risk of falls. Only five (20.8%) care staff were able to suggest more than three preventive strategies. These preliminary findings suggest that education to change care staff behavior regarding falls prevention should target improving care staff knowledge and awareness of falls

Undergraduate reflective journaling in work integrated learning: Is it relevant to professional practice?

This paper presents the research findings from a study reviewing graduates’ opinions on completing online reflective journaling tasks during work integrated learning as an undergraduate. The study was divided into two parts with an initial focus group conducted with six physiotherapy graduates seven months following graduation. Findings from the focus group guided the development of a questionnaire sent to graduates nine months after course completion. Results from both the focus group and questionnaire (n = 25) highlighted the benefits of online, structured, assessed reflective writing tasks. Graduates provided specific examples of their personal and professional development and perceived benefits from undertaking reflective journaling during work integrated learning. These findings may have application across a wide variety of tertiary courses of study with work integrated learning incorporated into curriculum

Designing and evaluating falls prevention education with residents and staff in aged care homes: A feasibility study

Purpose: The purpose of this study was to co-design a falls prevention education programme with aged care home residents and staff and evaluate its feasibility. The intention of providing the education programme was to assist residents to stay safe and mobile whilst reducing their risk of falling. Design/methodology/approach: A two-phase mixed methods participatory design using a resident (n = 6) and care staff (n = 5) consumer engagement panel, pre- and post-programme resident (n = 35) survey and semi-structured care staff interviews (n = 8) was undertaken in two countries. Findings: A poster, brochure, video and staff education guide featuring 12 safety messages depicting fall prevention behaviours were co-designed. Residents, supported by staff, perceived the falls prevention education programme as enjoyable and informative, but there were no significant differences in capability, opportunity or motivation. However, several residents were observed enacting fall prevention behaviours such as “If I feel unwell, I\u27ll ring the bell” and waiting for staff assistance. Challenges to programme demand, acceptability and implementation which may have impacted residents\u27 exposure and engagement with the programme were identified, along with recommendations to improve feasibility. Practical implications: When developing falls prevention education programmes partnering with residents and staff, providing choices to meet personal and aesthetic preferences along with frequent, shorter duration learning opportunities are important for translating education messages into actions. Originality/value: The use of bespoke resources, novel rhymes, positive messages emphasising safety and co-designing with residents themselves was a welcomed point of programme difference

Using a community of practice to evaluate falls prevention activity in a residential aged care organisation: a clinical audit

Objective This study evaluates whether a community of practice (CoP) could conduct a falls prevention clinical audit and identify gaps in falls prevention practice requiring action. Methods Cross-sectional falls prevention clinical audits were conducted in 13 residential aged care (RAC) sites of a not-for-profit organisation providing care to a total of 779 residents. The audits were led by an operationalised CoP assisted by site clinical staff. A CoP is a group of people with a shared interest who get together to innovate for change. The CoP was made up of self-nominated staff representing all RAC sites and comprised of staff from various disciplines with a shared interest in falls prevention. Results All 13 (100%) sites completed the audit. CoP conduct of the audit met identified criteria for an effective clinical audit. The priorities for improvement were identified as increasing the proportion of residents receiving vitamin D supplementation (mean 41.5%, s.d. 23.7) and development of mandatory falls prevention education for staff and a falls prevention policy, as neither was in place at any site. CoP actions undertaken included a letter to visiting GPs requesting support for vitamin D prescription, surveys of care staff and residents to inform falls education development, defining falls and writing a falls prevention policy. Conclusion A CoP was able to effectively conduct an evidence-based falls prevention activity audit and identify gaps in practice. CoP members were well positioned, as site staff, to overcome barriers and facilitate action in falls prevention practice