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Problem: Implementation of woman-centred care in evidence-based maternity practice requires clinicians to be skilled in shared decision-making, yet there is limited training or research into such interventions. Background: Shared decision-making enables women to make informed decisions in partnership with clinicians where there are varied clinical options in relation to indications for and timing of planned birth. Aim: We aimed to develop a shared decision-making training intervention and evaluate its feasibility and acceptability to midwives and obstetricians. Methods: The intervention was co-designed by midwifery and medical clinician-researchers, and a consumer representative. Online training and demonstration videos were distributed to midwives and obstetricians in three Sydney hospitals, followed by two online workshops in 2021 and 2022 where participants practised shared decision-making in roleplaying scenarios tailored to timing of birth. Training was evaluated using post-workshop and post-training surveys and semi-structured qualitative interviews. Findings: The training workshop format, duration and content were well received. Barriers to the uptake of shared decision-making were time, paternalistic practices and fear of repercussions of centring women in the decision-making process. Discussion: The intervention enabled midwifery and medical colleagues to learn communication repertoires from each other in woman-centred discussions around timing of birth. Roleplay scenarios enabled participants to observe and provide feedback on their colleagues’ shared decision-making practices, while providing a space for collective reflection on ways to promote, and mitigate barriers to, its implementation in practice. Conclusion: Shared decision-making training supports maternity clinicians in developing skills that implement woman-centred care in the timing of planned birth.

Lack of training for school clinicians in evidence-based practices (EBPs) contributes to underutilization of such services for youth with attention-deficit/hyperactivity disorder (ADHD). Advances in web-based technology and videoconferencing have allowed for expanded access to and optimization of training. We describe the development and outcomes of a novel web-based platform for training school clinicians to gain skills in EBPs for school-age youth with ADHD. The training platform is adapted from an empirically supported, in-person training for a school-home behavioral intervention (Collaborative Life Skills program) and includes skill modules for working with teachers, parents, and students. Training methods include web-accessed manuals/handouts, skill example video clips, automated progress monitoring tools, and consultation/in-session coaching via videoconferencing. We gathered stakeholder qualitative and quantitative feedback during discovery and design phases of the iterative development. We then evaluated the usability, acceptability, fidelity and clinician and student outcomes of the remote training program. Focus group themes and qualitative feedback identified clinician preferences for remote training features (e.g., interactive, brief, role-plays/coaching methods), video tools (recorded samples of skills and therapy sessions), and progress monitoring tools (e.g., clear, easy to use). Clinician usability ratings of the platform were high with most components rated as moderately to very useful/easy to use. Clinician ratings of usability, fidelity implementing the treatment, and their EBP knowledge and confidence following training were favorable. Student's outcomes were similar to those achieved in prior studies of clinician in-person training. Results support the promise of remote, web-based clinician training for the dissemination of evidence-based practices.

This paper describes the development and evaluation of a new instrument - the Clinician Suicide Risk Assessment Checklist (CSRAC). The instrument assesses the clinician's competency in three areas: clinical interviewing, assessment of specific suicide risk factors, and formulating a management plan. A draft checklist was constructed by integrating information from 1) literature review 2) expert clinician focus group and 3) consultation with experts. It was utilised in a simulated clinical scenario with clinician trainees and a trained actor in order to test for inter-rater agreement. Agreement was calculated and the checklist was re-drafted with the aim of maximising agreement. A second phase of simulated clinical scenarios was then conducted and inter-rater agreement was calculated for the revised checklist. In the first phase of the study, 18 of 35 items had inadequate inter-rater agreement (60%>), while in the second phase, using the revised version, only 3 of 39 items failed to achieve adequate inter-rater agreement. Further evidence of reliability and validity are required. Continued development of the CSRAC will be necessary before it can be utilised to assess the effectiveness of risk assessment training programs.

ABSTRACT This dissertation explores mental health clinicians’ experiences and self-identified confidence to identify and treat post-traumatic stress disorder (PTSD) and Complex PTSD. PTSD is a highly prevalent mental health condition that impacts an estimated 24.4 million individuals in the United States (PTSD United, 2019). Complex PTSD has just emerged for the first time with official diagnostic criteria in the publication of the ICD-11 in 2019 for use beginning in January 2022 (WHO, 2019). There is very little existing research that considers the experience or confidence of clinicians who work with clients who have PTSD and Complex PTSD, which is troubling given the prevalence rates of these disorders. Nor does research exist that speaks to what it will mean for clinicians to incorporate the new taxonomy for Complex PTSD or the ways in which Complex PTSD differs in identification or treatment approach in comparison to PTSD. Through the analysis of three principal factors, primary clinical focus on trauma, years of experience, and highest level of training, a foundational understanding of the ways these factors influence clinician confidence is presented in this Volume I report of the Meier’s Therapists’ Experiences Survey (M-TES). This exploratory survey research utilizes descriptive statistics, crosstab calculations, and several post hoc tests to begin to unpack the aggregated responses of 217 outpatient mental health clinicians who participated in the first distribution of the M-TES. This study provides an introductory look at factors associated with clinician confidence to identify PTSD and Complex PTSD and differentiate their treatment approach between the two. Recommendations are suggested for follow-up studies that would enhance knowledge specific to improving clinician confidence in identifying and treating PTSD and Complex PTSD. This research identifies needed areas of support for clinicians to identify PTSD and Complex PTSD and differe