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Objective: Family violence causes brain injury and trauma for many victim survivors. Neuropsychologists play a central role in helping with these issues. We aimed to evaluate rates of family violence training, knowledge and clinical skills in Australian neuropsychologists. Method: An online, brief, self-report survey of psychologists practicing clinically in the area of neuropsychology Australia wide. The survey assessed prior training, knowledge and confidence together with awareness of specific family violence clinical skills, and barriers to competent practice. Results: Responses were received from every state and territory and represented more than 10% of the total registered endorsed clinical neuropsychology workforce (N = 92). Over 90% of respondents had undertaken family violence training, however 57% reported having little or no knowledge and 67% little or no confidence working clinically in the area. Knowledge of specific family violence skills was reduced, with only 20% indicating that they knew how to respond, when clients disclosed experiencing family violence. Conclusions: Further work is needed to improve the ability of the Australian neuropsychology workforce to respond to this important health issue. Response of neuropsychologists may be sub-optimal, particularly in regard to the provision of psychological support following disclosures a central tenant of World Health Organization guidelines. KEY POINTS What is already known about this topic: Family violence is a significant public health issue in Australia. Family violence can cause both brain injuries and psychological trauma and attenuated cognitive functioning has been associated with both of these conditions. Clinical neuropsychologists commonly work with clients who experience cognitive attenuation. What this paper adds: This paper is the first, to our knowledge, to survey training, knowledge, confidence levels and specific family violence clinical skills in Australian neuropsychologists. Over 10% of the endorsed clinical neuropsychology Australian workforce participated in this self-report online survey. Results indicated that most had received some family violence training, however, self-rated knowledge, confidence and awareness of specific family violence skills were relatively low and further training and professional development in this area is required. [ABSTRACT FROM AUTHOR]

The large number of international medical graduates (IMGs) working in Australia, and many other countries around the world, has received significant attention from the media, governments and academia. These institutions utilise a number of classificatory schemes in order to categorise IMGs. Such classification is often stigmatising, yet goes largely unquestioned. In this paper I show that the 'official naming' of IMGs in Australia, as well as the naming of IMGs by staff in hospitals, is historically, politically and socially produced. Following Bourdieu's call to also study how the classified classify, the paper goes on to examine ways in which IMGs name and categorise each other, drawing on ethnographic research. I argue that IMGs use classification themselves, strategically, in order to modify their marginalised position within the 'social space' of the hospital. The article questions taken-for-granted assumptions about classified groups such as IMGs and leaves an opening for change. [ABSTRACT FROM AUTHOR]

Aims: Life expectancy for both sexes in Australia exceeds 80 years, with individuals with intellectual disability also increasingly living into older age. This research aimed to comparatively examine perceptions of staff supporting either older adults or age peers with lifelong intellectual disability. Methods: This project asked 420 medical, health, and support workers about training adequacy, health services access, and trigger points for premature institutionalisation. This paper is based on a subsample of 196 respondents who provided quantitative and qualitative responses. Results: There was considerable variation in confidence in supporting ageing individuals, while only 23.7% of doctors reported their training was adequate to support adults ageing with intellectual disability. A lack of services and poor carer health were identified as triggers for premature institutionalisation. Conclusions: The study revealed key differences in staff perceptions of support provision and training adequacy when comparing ageing individuals with intellectual disability to the general ageing population. [ABSTRACT FROM AUTHOR]

Background: Success in summative general practice (GP) training assessments is one indicator of competence for practice. Early-training factors predictive of outcomes would facilitate targeted interventions aimed at preventing candidate failures. Methods: We undertook a retrospective cohort study of Australian GP trainees in two training organizations over five years. Associations of pre-training and early-training predictors with summative examination scores in an Applied Knowledge Test (AKT), Key Features Paper (KFP), and Objective Structured Clinical Examination (OSCE), plus failure on any one of these, were tested via univariate and multivariable regression. Predictors were program-entry selection-score decile, pre-training-commencement multiple choice assessment (MCQA), direct observation of practice performance, and clinical supervisor reports. Results: On univariate analyses, selection decile and MCQA were associated with all outcomes except AKT. There were no associations of other predictors with any outcomes. On multivariable analysis, selection decile and MCQA performance were predictive of OSCE performance. MCQA performance was also predictive of KFP performance. On multivariable analysis, no predictors were associated with AKT performance or failing any examination. Conclusions: Selection decile and pre-commencement MCQA performance were predictive of performance in some summative assessments. These findings could inform selection policies and targeted early interventions for trainees at most risk for exam failure. [ABSTRACT FROM AUTHOR]

This paper describes a mixed method survey that was administered to a group of Australian palliative care social workers (n = 27). Specifically, it aimed to investigate the ways that social workers understood and worked with clients who were estranged from family at the end of life. Respondents suggested that estrangement potentially impacted clients emotionally, practically, and existentially. They were challenged to make clear assessments, provide emotional support, encourage news ways of thinking about estrangement, to manage practical issues, work with the client’s family, and monitor their own professional role. Theories and models of intervention and levels of training are also discussed. [ABSTRACT FROM AUTHOR]

The author comments on the paper "Physiotherapists in occupational health: The Australian experience," by R. Boucaut and B. McPhee. Topics covered include the recognition of occupational health as a specialist practice area for physiotherapists, standards development for occupational health physiotherapists (OHP), and the strong commitment to education and professional development. Also mentioned is the significance of occupational health to physiotherapists.

In most developed countries, competent patients have the legal right to refuse any medical treatment; Advance Care Planning mechanisms extend this right to non-competent patients. However, some groups, including lesbian, gay, bisexual, transgender and intersex (LGBTI) people, risk their wishes not being respected if they lose capacity, more than others. Little is known about medical practitioners' knowledge of, or attitudes to, the law in this area, especially in relation to LGBTI people, or how the law influences their decision-making. An Australian postal survey explored knowledge and attitudes of medical specialists to legal issues relating to withdrawing/ withholding life-sustaining treatment from adults without capacity. One scenario (the focus of this paper) asked which of four plausible substitute decision-makers, including a same-sex partner, had the legal authority to make such decisions. The overall response rate was 32% (867/2702). Less than one-third of respondents correctly identified the same-sex partner as the legally authorised decision-maker. LGBTI people face multiple obstacles to having their end-of-life wishes respected. Where healthcare providers are also ignorant of the partner's legal right to make such decisions, the problem is compounded. Improved legal education for clinicians and promotion of educational resources for members of the LGBTI community is needed. [ABSTRACT FROM AUTHOR]

Context: Health practitioner registration boards require health professionals to evaluate and maintain “fitness to practice” (FTP). This encompasses the professional behavior, clinical competence, and freedom from impairment required for safe and effective service provision. We developed and implemented policies to promote student self-assessment and support of FTP that were pre-emptive and designed to be helpful and sought clinician feedback on this initiative.Method: An innovative student-centered FTP approach was devised with consideration of defensible ethico-legal practice. A survey explored clinical educators’ perceptions of the FTP policy and the associated education and support. Closed and open survey questions were analyzed using descriptive statistics, qualitative evaluation, and thematic analysis.Results: Seventy-nine physiotherapy clinical educators from 34 sites across eight Australian health services returned surveys. Educators had positive perceptions of policy components, particularly incorporating professionalism as a hurdle requirement and the attendance and incident reporting policies.Conclusions: The benefits of a student-centered FTP approach included clarity and consistency in managing FTP issues and facilitation of student awareness through active engagement in maintaining their FTP. To our knowledge, this paper is the first to report a comprehensive approach to the range of FTP issues incorporating student self-declaration of issues that may affect desirable progression through clinical placements. The policy and program of education and support are likely to be generalizable to health professional training programs that utilize workplace training. [ABSTRACT FROM PUBLISHER]

Recent changes to clinical psychology training and supervision in Australia have been driven by a deliberate endeavour by regulatory authorities and professional bodies to align education and training with competency-based models of training, a development that is apparent internationally across health disciplines. A critical question is: how do reforms in Clinical Psychology training standards match international benchmarks for competency-based pedagogies? Objective: To outline key principles of competency-based pedagogies and to critically examine whether Australia's new standards and guidelines for accreditation of coursework, practicum requirements, and supervision are consistent with competency principles, and match similar guidelines proposed in the U.K. and the U.S.A. Method: Following a critical analysis of the extant literature, the authors highlight progress achieved, discuss major gaps and challenges, and examine the extent to which current accreditation changes constitute a reliable blueprint for the development of a competent psychology workforce for the country. Results and Conclusions: The current review indicates that in an overall sense, practitioner training in Australia is tracking well in comparison to international developments. Specifically, the decreased emphasis on the regulation of inputs (e.g., nature and type of coursework and practicum) is pedagogically sound and has the potential to promote training innovation and efficiencies. However, a revision of the current competency framework is required to underpin future progress. Also, the lack of reliable and valid competence instruments in combination with less than rigorous adherence to systematic, timely, and ecologically valid assessments constitute a major challenge and a serious threat to ensuring safe and competent psychology practice. What is already known about this topic: (1) Competency-based education and clinical training play important coordinated roles in ensuring the competence of clinical psychologists, consistent with the accreditation standards and registration requirements of the Psychology Board of Australia. (2) The Australian Psychology Accreditation Council (APAC, 2019) have recently published new accreditation standards for psychology programs that are based on competency principles. (3) The shift to the new paradigm is both exciting and challenging. It is exciting because it provides opportunities for innovation; it is challenging because it demands systemic change. What this topic adds: (1) The current paper compares and contrasts current standards and guidelines for accreditation in Australia with their counterparts in the U.K. and the U.S.A. (2) Although significant progress has been made in Australia, additional implementation efforts should be taken to establish a comprehensive and authoritative competency framework, incorporating empirically-supported means of assessment. Such a framework should be fit-for-purpose providing a grid that maps shared and unique aspects of competencies across registration levels and specialised endorsements. (3) The progressive relaxing of input criteria has the potential to seriously compromise the commitment to safe and competent psychological practice if training institutions do not adopt a re-designed system of ecologically valid assessments both during training and at the point of entry to the profession. (4) The need to ensure competence is maintained throughout a psychologist's career will remain a major challenge, given the ongoing and rapid advance of science. A commitment to the competency-based approach provides the necessary scaffolding for ongoing professional development. [ABSTRACT FROM AUTHOR]

Background: Enrolled nurses (ENs) across Australia precept nursing students in the clinical field. Yet learning about the preceptoring role is not widely available to ENs. Educational innovation: EN's in this study participated in a professional development project that utilised the material of an online learning resource, originally designed to inspire clinical registered nurses (RNs), and RN teachers, to develop teaching innovations in their role. Aim: The aim of this paper is to report the results of a pre-post-test questionnaire designed to evaluate the impact of the professional development intervention. Results: The analysis showed high scoring means with many items in the questionnaire statistically significant (p < .05, CI 95%). Conclusion: Results indicated positive differences in a number of teaching capabilities between pre- and post-test scores. This suggests ENs appreciate education that extends beyond clinical skills and that professional development should include the nursing education role. [ABSTRACT FROM AUTHOR]

Internationally Australia is considered one of the safest countries in the world for women to birth in. However, Aboriginal women in Australia have a much higher incidence of perinatal mortality and morbidity. One strategy to address this higher mortality and morbidity is to increase the numbers of Indigenous people working in healthcare. This paper discusses cultural competence in healthcare programs and higher education, including a reflection on midwifery education from the perspective of an Indigenous undergraduate midwife. [ABSTRACT FROM AUTHOR]

Significant changes to the scope of practice for enrolled nurses have occurred in Australia over the past decade. These changes, which are largely a consequence of staff shortages and economic pressure, have resulted in increased role confusion and overlap between enrolled and registered nurses in Australia. This paper presents a brief history of the enrolled nurse in Australia followed by an overview of the current situation and emerging trends in the education and employment of these nurses. Definitions and approaches to scope of practice are described and emerging issues within Australia raised and discussed. A review of the literature found the number of enrolled nurses and the roles they perform have changed significantly in Australia following the introduction of the enhanced scope of practice. Further research is required to better define and delineate between the different nursing roles and to explore broader frameworks to analyze, describe and define these roles. [ABSTRACT FROM AUTHOR]

The nursing profession has experienced significant change over the last 100 years. Consequently, the work-force of the 21st century is a diverse entity that is edging toward the specialization of nurses in a specific clinical setting. In such an environment, a common knowledge base is demanded of nurses - a factor that has affected the development of second level, or enrolled nurses (ENs). The forces at play raise questions about nursing roles and scopes of practice. The establishment of education pathways that promote career development has been the stimulus for conversations about the effectiveness of the transition of EN to registered nurse (RN). This paper presents a review of the literature that identifies and explores common emerging themes (making the move from EN; adapting to Bachelor of Nursing; transitioning to RN) associated with this transition through the process of undertaking baccalaureate studies in nursing. [ABSTRACT FROM AUTHOR]

Introduction: Student nurses in Australia are regularly placed in acute clinical areas providing them with clinical experience to link theory with real patient situations. Specialist clinical areas such as day oncology and renal dialysis often exclude students on the basis that their clinical area may not be able to meet normal clinical expectations, including holistic care of four to six patients with minimal direction from the registered nurse. However, specialist clinical areas provide students with unique learning experiences. This paper reports on an evaluation of speciality clinical placements for student nurses with an aim to increase our understanding of this type of placement. Methods: Semi-structured audiotaped interviews were undertaken with 7 third year final semester students and 13 registered nurses working with the third year students. All interviews were transcribed and a thematic analysis conducted. Findings: Key themes from the students and registered nurses were knowledge and preparedness for specialist placement, team work and being included and customising learning needs. Conclusion: Speciality placements provide a valuable experience for the undergraduate nurse including opportunities to see excellence in team work, communication and assessment as well as identifying future intention to become an oncology or renal specialist nurse. [ABSTRACT FROM AUTHOR]

The creation of a curriculum blueprint appropriate to the development of a professional nurse who is practice-ready for the current and future context of health service delivery must take account of the extant context as well as an unpredictable and sometimes ambiguous future. The curriculum renewal process itself ought to challenge existing long held ideals, practices, and sacred cows within the health and higher education sectors. There is much to consider and importantly curriculum developers need to be mindful of reform within the health sector and health workforce education, as well as the concomitant vision and requirements of the nursing profession. Curriculum must develop more than discipline knowledge and skills: it must provide an infrastructure for generic abilities both social and intellectual in order to better prepare students for the registered nurse role. This paper discusses a number of forces that are essential to consider in curriculum development in undergraduate nursing education. [ABSTRACT FROM AUTHOR]

As part of a regional School of Nursing and Midwifery's commitment to addressing recruitment and retention issues, approximately 90% of second year undergraduate student nurses undertake clinical placements at: multipurpose centres; regional or district hospitals; aged care; or community centres based in rural and remote regions within the State. The remaining 10% undertake professional experience placement in urban areas only. This placement of a large cohort of students, in low numbers in a variety of clinical settings, initiated the need to provide consistent support to both students and staff at these facilities. Subsequently the development of an audio teleconferencing model of clinical facilitation to guide student teaching and learning and to provide support to registered nurse preceptors in clinical practice was developed. This paper draws on Weimer's 'Personal Accounts of Change' approach to describe, discuss and evaluate the modifications that have occurred since the inception of this audio teleconferencing model (Weimer, 2006). [ABSTRACT FROM AUTHOR]

Like other countries, Australia is looking to reforms in the primary health care sector to meet the growing demand for care. Expansion of the role of practice nurses (PNs) is one way in which this demand may be met. To date the Federal Australian government has played a significant role in encouraging growth in the PN workforce. If PNs tend to be GP directed, with little autonomy, care must be taken to consider whether to expand existing scopes of practice. In contrast, if PNs rely on their own independent clinical judgment and skill, this would support potential expansions to the scope of the PN role. Understanding these issues is important to inform the development of future workforce policy. This paper examines the structural policy dimensions within which these changes are occurring, and makes recommendations for future research on PNs. [ABSTRACT FROM AUTHOR]

Background: Over the last decade several innovative approaches to enhance students' transition to graduate nurse year have been implemented or piloted. This paper describes a study that investigated how the social practices of clinical partnership placement model underpin workplace learning for undergraduate students as they transitioned to graduate. Methods: A mixed method approach was utilized comprising individual interviews with students, observation of clinical workplaces across six different areas of nursing practice, student surveys of the clinical learning environment and participant workshops. Results: Three themes were identified that influenced participants' preparedness for work and enhanced the transition into the workplace: 'organizational familiarity', 'continuity' and 'social participation'. Conclusion: A clinical partnership model offers a degree of work readiness for novices when commencing their professional practice role. It enables individuals to participate and engage in workplace activities which are a central component of their learning. [ABSTRACT FROM AUTHOR]

It is claimed that an interprofessional approach to health care aims to provide optimal client care, reduce duplication of services, address gaps in service delivery and prevent adverse consequences to patients. Hence there is widespread international interest in interprofessional education in undergraduate programs. However, after employment in the Australian health care workforce, there is limited opportunity for this. The continued education and training of health professionals and other care workers frequently occurs in a climate where professional development is dominated by the existence of professional demarcations. In order to enhance interprofessional collaboration in health care practice and education, mechanisms to guide individual performance within a multi-professional health team are required. This paper presents both the process and outcomes of a consultancy undertaken in order to determine core competencies for collaborative interprofessional practice in a community and aged care service. [ABSTRACT FROM AUTHOR]

Sessional teachers are taking an increasing role in classroom teaching in Schools of Nursing. However, there is a paucity of literature reporting the experiences of, and impact on, career academics working with or alongside the burgeoning numbers of sessional teachers. Therefore, the purpose of this paper is to explore the experiences of continuing academics working with sessional teachers. This qualitative study used purposive sampling to recruit nurse academics and collect narrative data related to their experiences of working with sessional teachers. Four major themes emerged from the data, namely: They have got real credibility -- perceptions of clinical currency, We've got people who are very good clinically, but don't know how to teach - lacking skills and confidence, No allegiance to the school or the students -- perceived lack of commitment and accountability, and A terrible burden -- workload implications for continuing academics. The development and implementation of standards for the recruitment and employment of sessional teachers would benefit both continuing academics and sessional teachers, and assist in the delivery of quality teaching and learning to nursing students. [ABSTRACT FROM AUTHOR]

Self-reflection is integral to effective clinical practice and yet is a skill that many intelligent students struggle to develop. This paper reports on the findings of a pilot study where students shared both positive and challenging experiences with each other and co-wrote songs that captured their experiences. Four students attending clinical practicum engaged in collaborative songwriting experiences with peers from both the same and different universities in the US and Australia. These experiences utilized both face to face and online environments utilizing Skype communication software. Lyrics were reviewed by the researchers and were compared with themes and categories about music therapy clinical training found in the literature. Findings suggest that collaborative songwriting provides opportunities for students to engage in experiences of reflection with other peers. [ABSTRACT FROM AUTHOR]

Clinical supervision cuts to the heart of professional psychology training. It is the most expensive single investment of staff time in the training of the psychology practitioner, and it appears to be the single most important contributor to training effectiveness, repaying that investment. Now there are changes afoot internationally which may change its pivotal role. For example, the Psychology Board of Australia has recently proposed that supervisors undergo approved supervisor training; in the USA, a competence-based emphasis is gaining ground; while in the UK, supervisors within the Improving Access to Psychological Therapies initiative are receiving unprecedented training and support. It is therefore timely to clarify the need for such training and to consider promising options for its effective delivery. Following a summary of the changes within Australia, we next address these emergent problems and promising solutions by examining the available scientific evidence and by considering professional consensus statements. [ABSTRACT FROM AUTHOR]

Background: International Medical Graduates (IMGs) are a diverse group of doctors who provide essential health services in many western countries, and hospitals are increasingly relying upon IMGs to fill vacancies in all staff grades. Clinical skills and experience vary greatly between doctors, and orientation and clinical skills training is a way of addressing any identified deficiencies. Work done: This paper relates the experiences of establishing a training program and support services for IMGs working in the public hospital system in Tasmania, Australia, and offers advice for other agencies contemplating establishing similar programs. Conclusions: A 'hub and spoke' model is a useful model to adopt: a central coordinating office designs and implements programs informed by best available evidence, and clinical educators on site at healthcare facilities implement programs and provide direct assistance and orientation. Broad-based programs attending to orientation, doctor's families' needs, communication skills and clinical skills training are required. Support from health administrators is essential. Practice points Understand the practices and certification requirements of your jurisdiction. Involve IMGs with the planning and implementation of programs. Consider the needs of spouses and families. Orientation to health systems is of paramount importance. [ABSTRACT FROM AUTHOR]

Occupational therapy competency standards provide an evidence-base to inform clinical best practice, however it is not known whether education about competency standards will increase occupational therapists' adherence to their use. To investigate if education about the 'Australian Competency Standards for Occupational Therapy Driver Assessors' leads to increased adherence to the competency standards in the clinical practice of occupational therapy driver assessors. A mixed methods multiple case study design was used to evaluate 5 occupational therapy driver assessors' adherence to the competency standards. An audit of 25 client files and interviews were conducted to evaluate practice against the competency standards prior to an education session, followed by an audit of a further 25 files, interview and feedback after education. Qualitative and quantitative analyses suggest that education about the 'Australian Competency Standards for Occupational Therapy Driver Assessors' was associated with increased adherence to the competency standards in clinical practice. The results also support the use of competency standards in clinical practice. Competency standards can be used to inform and guide clinical practice, and individualised education and feedback of practice against the competency standards can increase occupational therapists' adherence to these standards. [ABSTRACT FROM AUTHOR]

There is building evidence that oesophageal screening (OS) should be considered a critical component of videofluoroscopic swallow studies (VFSS). This study surveyed Australian speech-language pathologists (SLPs) regarding current practices and perceptions of OS in VFSS. A 16–24 item online survey was distributed to Australian SLPs via relevant email forums. One response per site was requested. Survey questions explored experience and training in VFSS, skill and confidence with OS, OS protocol use, and pathways following OS. One hundred and one SLPs across all Australian states and territories responded, with 70% (n = 69/99) from metropolitan hospitals and 74% (n = 75/101) having more than five years' VFSS experience. While 69% (n = 70/101) of SLPs conducted OS, only half (n = 35/70) conducted OS routinely, and only 4% (n = 3/70) always used published OS protocols. Barriers to OS, for some participants, were concerns about scope of practice and confidence. This study confirms higher levels of OS in Australia compared to similar international surveys and provides rich data on the Australian context. Prescriptive clinical guidelines for OS, consensus regarding a preferred OS protocol, and specific OS training may clarify SLP scope of practice and improve SLP confidence and standardisation in OS. [ABSTRACT FROM AUTHOR]

Social workers play a pivotal role in addressing equity and diversity within Australia using both culturally responsiveness skills and knowledge. This article describes a research project that resulted in the development of the Continuous Improvement Cultural Responsive Tools that can be used by social workers in their practice. This was a large project conducted over three years, which involved engagement and consultation with Aboriginal and Torres Strait Islander community social workers. The community engagement and consultation process included the provision of cultural governance and participation in interviews. The tools developed are linked to seven key domains (Ngurras) that aim to increase the skills, knowledge, and overall confidence of social work practitioners in their culturally responsive practice. This article discusses the tools that provide a clear structure to guide social workers' critical engagement in becoming more culturally responsive social workers and individuals when working with Aboriginal and Torres Strait Islander Peoples. IMPLICATIONS Social work practices need to address the social injustices faced by Aboriginal Peoples by becoming more culturall responsive. The tools were developed to support social workers in their practice to self-assess their transformation in becoming culturally responsive social workers. Continuous improvement in collaborative and culturally responsive social work will improve services for Aboriginal and Torres Strait Islander Peoples. [ABSTRACT FROM AUTHOR]

This study aimed to examine the experiences of graduates of online interdisciplinary postgraduate mental health programmes in Australia. The program was delivered in 6-week terms. Seven graduates from diverse backgrounds were interviewed about their experiences with the course and its impact on their practice, confidence, professional identity, views on mental health service users, and their motivation for additional learning. The interviews were recorded and transcribed and underwent thematic content analysis. The graduates reported an increase in confidence and knowledge after completing the course, which led to a change in their views and attitudes towards service users. They appreciated the examination of psychotherapies and motivational interviewing, and applied their newly acquired skills and knowledge in their practice. The course was found to have improved their clinical practice. This study highlights a departure from traditional pedagogical approaches in mental health skill acquisition, as the entire program was delivered online. There is a need for further research to determine who might benefit most from this mode of delivery and to verify the competencies acquired by graduates in real-world situations. Online mental health courses are a feasible option and have been positively received by graduates. To enable graduates to participate in transforming mental health services, systemic change and recognition of their capabilities, particularly those from non-traditional backgrounds, is required. The results of this study suggest the potential for online postgraduate programs to play a significant role in transforming mental health services. [ABSTRACT FROM AUTHOR]

The authors discuss the impact of unemployment of newly graduated nurses on the quality of healthcare and the nursing profession in Sydney, New South Wales. The authors mention that the failure of new nurse graduates to get employment is detrimental not only to individuals and the communities where they live but also on the nursing profession. Moreover, they state the need for the sector to find ways to support new nursing graduates who failed to obtain jobs immediately.

Purpose: The role of allied health practitioners providing physical rehabilitation of central facial palsy (CFP) is minimally reported in the literature. This study explores current practice and the roles, attitudes and perceptions of allied health professionals (AHPs) working with people with CFP. Method: An electronic survey was distributed to speech-language pathologists (SLPs), occupational therapists and physiotherapists. Responses (n = 78) were analysed using qualitative and quantitative methods. Result: SLPs often lead management of CFP; however, their role is not clearly defined nor well recognised. Several barriers were identified which prevent AHPs from providing consistent specialist rehabilitation to people with CFP. These included a lack of training, no clear delegation of role, limited evidence and lack of resources. Conclusion: Survey respondents viewed CFP to be within SLP scope of practice; although, ownership of management varies between countries and professions. Most SLPs recognise the negative impact of CFP and feel a sense of responsibility to provide assessment and treatment of this impairment, but many barriers to doing so have been identified. Suggestions to improve access to rehabilitation for people with CFP included increased access to training for SLPs, more evidence, clinical practice guidelines and more clinical resources. Further research is required to ensure people suffering from CFP can access services that provide skilled management of their impairment. [ABSTRACT FROM AUTHOR]

Although clinical guidelines recommend Cognitive Behavioural Therapy for insomnia (CBTi) as the first-line treatment for insomnia, many people with insomnia do not have access to CBTi and are prescribed sedative-hypnotic medicines by medical health professionals. Psychologists have training in CBT and may be well placed to deliver behavioural therapy for insomnia. However, the current treatment of insomnia, amount of sleep-specific training and knowledge of CBTi among Australian psychologists remains unknown. This qualitative study conducted semi-structured interviews with Australian psychologists. Interviews included case study scenarios to provide an in-depth exploration of psychologists' knowledge and skills in the management of insomnia. Interview transcripts were analysed using thematic analysis to identify themes. Twenty-six psychologists participated in this study. Four themes were identified in the data: 1) Sleep is important but rarely a treatment priority; 2) Confusion about funding pathways discourages treatment of insomnia; 3) A variety of approaches are used in the management of insomnia; 4) Psychologists with experience in CBTi are rare. Most Australian psychologists are not well equipped to manage insomnia effectively with CBTi. Along with other primary health care professionals, psychologists need training in the delivery of evidence-based insomnia treatment. What is already known about this topic: The recommended treatment for insomnia is Cognitive Behavioural Therapy for insomnia (CBTi) but most people with insomnia do not receive this treatment The most common treatments for insomnia are sedative hypnotic medications and sleep hygiene education Most people with insomnia are not referred to a psychologist. What this topic adds: Most psychologists and other primary care professionals lack specific knowledge and training in insomnia and CBTi Insomnia is often regarded as a secondary problem and clients are not usually referred to psychologists for treatment of insomnia Psychologists use a range of treatments for insomnia, most common are sleep hygiene and relaxation. [ABSTRACT FROM AUTHOR]

In Australia, a national approach to accreditation of programs and regulation of health professions was adopted a decade ago. Accreditation standards and regulatory frameworks can drive change and provide support for interprofessional education and collaborative practice. There is a commonly held belief among Australian academics involved in health professional education, that accreditation and practice standards provide system-level support for interprofessional education and interprofessional collaborative practice. Using a purpose-designed analysis framework and scoring scheme, we analyzed standards of accreditation and practice for 29 regulated, self-regulated and member health professions in Australia to determine the extent and accountability of statements related to interprofessional education and interprofessional collaborative practice. Currently, in Australia, there is a fragmented and inconsistent approach to interprofessional education and interprofessional collaboration evident in accreditation and practice standards and, in general, there are more explicit requirements in standards of the regulated health professions. However, overall the concepts of interprofessional education and interprofessional practice are ill-defined and statements lack accountability and/or outcome measures. Our analysis provides a foundation for reform of Australian standards and an approach for analysis of accreditation and practice standards which may be useful in other jurisdictions. [ABSTRACT FROM AUTHOR]

Appropriately skilled staff are required to meet the health and care needs of aging populations yet, shared competencies for the workforce are lacking. This study aimed to develop multidisciplinary core competencies for health and aged care workers in Australia through a scoping review and Delphi survey. The scoping review identified 28 records which were synthesized through thematic analysis into draft domains and measurable competencies. Consensus was sought from experts over two Delphi rounds (n = 111 invited; n = 59 round one; n = 42 round two). Ten domains with 66 core competencies, to be interpreted and applied according to the worker's scope of practice were finalized. Consensus on multidisciplinary core competencies which are inclusive of a broad range of registered health professionals and unregistered aged care workers was achieved. Shared knowledge, attitudes, and skills across the workforce may improve the standard and coordination of person-centered, integrated care for older Australians from diverse backgrounds. [ABSTRACT FROM AUTHOR]

There is considerable literature outlining the high levels of occupational stress nurse academics experience, and the potential effect of workplace pressure on mental health and wellbeing. To support the notion that to succeed in an academic environment, academics are more successful when working in a team, two academics conducted a Participation Action Research study. The PAR study was developed in line with a Clinical Skill Project to better understand the experiences of nurse academics working in a team. The Clinical Skills Project involved the write up of 40 nursing skills for publication. Twenty-seven academics were recruited into the project and allocated skills to write, in teams of 2–3, according to clinical expertise and interest. The Participatory Action Research (PAR) approach formed the framework for the project, as well as, provided an opportunity for the nurse academics to 'come together' at fortnightly team meetings to discuss the project and talk about their experience working in a team. Using the PAR cyclical process of observing, reflecting, planning, and acting there was ongoing opportunity for the academic nurses to discuss, question and share knowledge about academic practices. These Interactive reflections were recorded in a team reflective diary during the meetings. Participants were also asked to reflect on their individual experience of working in the team, before, during and after the project. At the completion of the project all reflective comments were transcribed to form a combined narrative. Thematic and content analysis was then undertaken to identify any similarities and or differences in academic staff experience. The analysis revealed the following key themes. Working in a team creates better staff relationships, Working in a team can change workplace culture and Working in a team can Improve staff health and well-being. [ABSTRACT FROM AUTHOR]

Copyright of Australian Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Purpose: High demand for speech-language pathology services is reflected in long waiting lists. Waiting can be active or passive and has implications for stakeholders, including consumers, professionals, and organisations. The present study explored experiences and perspectives regarding waiting for speech-language pathology services through analysis of stakeholders' written submissions to an Australian Government Senate Inquiry. Method: Written submissions (n = 337) were screened for terms related to waiting. Included submissions (n = 133) were written by organisations (36.8%), speech-language pathologists (29.3%), parents (27.8%), individuals with communication and/or swallowing difficulties (5.3%), and others. Result: Inductive thematic analysis identified three themes. (1) Duration. Consistently described as long. (2) Consequences. Consumers' consequences included: burden on physical health, finances, time, emotional wellbeing, and relationships, reduced continuity of care, and increased intervention needs. Professional consequences included: stress and burnout impacting job satisfaction, and reduced effectiveness. Societal consequences included: social and ethical burden, and a drain on health and legal systems. (3) Actions. Consumers advocated and sought alternatives (e.g. threats to harm their child, relocation to a capital city), professionals implemented service delivery and policy actions, and organisations lacked effective system-wide strategies. Conclusion: Existing services did not appear to meet stakeholders' needs. Action is needed to improve speech-language pathology waiting lists and access to services, and minimise possible consequences for stakeholders. [ABSTRACT FROM AUTHOR]

The broadening of access to HIV pre-exposure prophylaxis (PrEP) in Australia has rekindled debates about which types of clinicians are best suited to deliver HIV prevention innovations: specialist HIV services or primary care physicians and general practitioners (GPs). We conducted 21 semi-structured qualitative interviews in 2017 with Australian HIV sector experts working across policy, advocacy, clinical service provision, research, and health promotion. These interviews took place before a national policy commitment to subsidising access to PrEP was achieved. We explored how participants conceptualised PrEP, patients and GPs at this key turning point in the history of HIV prevention. Participants expressed varied views regarding GPs' anticipated ability to successfully navigate the potential complexities associated with PrEP roll-out. While participants were supportive of greater patient access to PrEP, they expressed concerns about non-specialist GPs' cultural competence and expertise regarding sexuality and clinical practice, and the potential for patients to experience discrimination and homophobia from non-expert GPs. This study has broad implications for thinking about experts and expertise, the implementation of previously specialised medicine into mainstream settings, and the anticipated challenges of LGBTIQ+ inclusive healthcare. [ABSTRACT FROM AUTHOR]

Background: Junior physiotherapists require satisfactory clinical skills to work effectively within the acute hospital setting for service quality and consistency. Objective: To investigate the effects of stream-specific clinical training on junior physiotherapist self-efficacy, self-rated confidence, and self-rated ability to work independently during weekend shifts. Design: Prospective cohort study. Participants: Eighteen junior physiotherapists. Methods: Physiotherapists undertook 8 h of stream-specific education in: pediatrics, women's health, neuro-medical, musculoskeletal, cardiorespiratory, and critical care over 8 weeks. Learning objectives were evaluated using a self-efficacy (0–100) scale and self-rated confidence was measured with a 4-point Likert scale (not confident to independent). Self-rated ability to independently work weekend shifts was measured dichotomously (yes/no). Results: Participants completed an average of three stream-specific programs in the study period. Post-training, mean improvement in self-efficacy across objectives ranged from 2.9 (95% CI −8.7 to 14.5) to 43.3 (95% CI 4.8–81.8) points, p < 0.05 for 80% of objectives. Self-rated confidence scores improved for 45.6% of stream-specific learning objectives; 52.8% were unchanged and 1.7% reported a decrease in confidence. Self-rated ability to work stream-specific weekend shifts increased from 56–70%, but no stream achieved a significant increase in staff able to independently work weekend shifts (p range 0.10 to 1.0). Conclusions: A stream-specific education program increased junior physiotherapists' self-efficacy and self-rated confidence but not perceived ability to work independently on weekends. Results were non-randomized and actual practice change was not assessed. Future studies could investigate different educational structures in a blinded, randomized manner on clinical practice change. [ABSTRACT FROM AUTHOR]

Background: Socially-accountable health professional education (SAHPE) is committed to achieving health equity through training health-workers to meet local health needs and serve disadvantaged populations. This research assesses the biomedical and socially-accountable competencies and work-readiness of first year graduates from socially-accountable medical schools in Australia, the United States and Sudan. Method: A self-administered survey to hospital and community health facility staff closely associated with the training and/or supervision of first year medical graduates from three SAHPE medical schools. Main outcome measure: Likert scale ratings of key competencies of SAHPE graduates (as a group) employed as first-year doctors, compared to first year doctors from other medical schools in that country (as a group). Findings: Supervisors rated medical graduates from the 3 SAHPE schools highly for socially-accountable competencies ('communication skills', 'teamwork', 'professionalism', 'work-readiness', 'commitment to practise in rural communities', 'commitment to practise with underserved ethnic and cultural populations'), as well as 'overall performance' and 'overall clinical skills'. Interpretation: These findings suggest SAHPE medical graduates are well regarded by their immediate hospital supervisors, and SAHPE can produce a medical workforce as competent as from more traditional medical schools, but with greater commitment to health equity, working with underserved populations, and addressing local health needs. [ABSTRACT FROM AUTHOR]

Background/problem: Stigma and stigmatization are important concepts in the area of mental health and illness. Nursing and nurse education are continuously examining ways to understand and address the stigma toward people with a lived experience of mental illness. While the negative influence of stigma is understood, the variables that influence these behaviors are emerging. An area may provide insight into aspects that influence stigmatization of pre-registration nurses is motivation. Previous research has illustrated that individual motivation can significantly predict and influence work-related behaviors and actions across a range of work settings. Therefore, the purpose of this study was to examine the predictive influence that the motivational needs, as espoused by Self-Determination Theory, play in the stigmatization of pre-registration nurse toward people with a lived experience of mental illness. Approach: A total of 168 pre-registration nurses completed two surveys that measured support for their psychological needs and their stigmatization of people with a lived experience of mental illness. Outcomes/conclusions: Using a regression analysis, some psychological needs significantly influenced the stigmatization of pre-registration nurses. Results illustrate the potential importance of psychological needs in the training of the future nursing workforce. [ABSTRACT FROM AUTHOR]

Objective: The objective of this collaborative study was to compare current practices of conducting high-stake, exit-level Objective Structured Clinical Examinations (OSCEs) at all Australian medical schools. We aimed to document similarities and differences between schools, and compare existing practice against available gold standard, evidence-based practice. We also aimed to identify areas where gold standards do not currently exist, and could be developed in the future. Methods: A 72-item semi-structured questionnaire was sent to all 19 Australian medical schools with graduating students. Results: A total of 18/19 schools responded. Of these, 16/18 schools had summative exit-level OSCEs representing content from multiple medical specialties. The total number of OSCE stations varied from 8 to 16, with total OSCE testing time ranging from 70 to 160 min. All schools blueprinted their OSCE to their curriculum, and trained simulated patients and examiners. There was variation in the format of marking rubric used. Conclusions: This study has provided insight into the current OSCE practices of the majority of medical schools in Australia. Whilst the comparative data reveal a wide variation in OSCE practices between schools, many recommended "gold standard" OSCE practices are implemented. The collective awareness of our similarities and differences provides us with a baseline platform, as well as an impetus for iterative quality improvement. Such discourse also serves to develop new gold standards in practice where none have previously existed. [ABSTRACT FROM AUTHOR]

Objective: Trainees across the healthcare sector contend with ubiquitous risk during clinical placement. This has prompted educative action to enhance student competency in unpredictable clinical environments. The objective of this pilot study was to evaluate the impact of Risk Aware, an online blended simulation‐based learning program, upon student preparedness and confidence for clinical placement. Method: A sequential explanatory mixed‐methods design was utilised to evaluate Risk Aware. The Risk Aware program was trialled on 149 first‐year professional psychology postgraduate students across seven Australian universities prior to their first clinical placement. Repeated measures t‐tests investigated the impact of Risk Aware learning modules upon student knowledge and confidence; descriptive statistics and analysis of frequencies summarised student competency following Risk Aware (N = 120). Follow‐up qualitative interviews explored the nature of student knowledge and confidence, and student impressions of Risk Aware (N = 8). Results: Preliminary quantitative findings demonstrated significant increases in student knowledge and confidence (p < 0.05), and low‐to‐average competence, after Risk Aware. Qualitative results corroborated increases in student knowledge and confidence and pointed to early signs of clinical competency. Student impressions of Risk Aware were generally positive and included suggestions to improve program usability. Conclusions: Findings highlight Risk Aware's capacity to increase students' ability to identify and detail responses to risks arising during placement. Further field testing to ascertain students' application of skills is required. Results will inform program modifications to enhance future Risk Aware iterations. [ABSTRACT FROM AUTHOR]

Background: Australian publicly funded mental health services play a significant role in the assessment and management of mental illness for people with intellectual disability. However, there is limited knowledge on their preparedness to meet the needs of this population. Method: Public mental health professionals (n=566) completed an online survey that explored their attitudes, confidence, and training needs in the area of intellectual disability mental health. Descriptive analyses were undertaken. Results: Participants agreed that people with intellectual disability have the right to receive good mental health care, and have the same access to their service. They viewed treating them as part of their role, but given the resources available it was not possible to provide comprehensive care. Participants reported low confidence in key clinical areas and insufficient training. Conclusions: A comprehensive workforce development strategy is required to facilitate the engagement and capacity of public mental health professionals in this area. [ABSTRACT FROM AUTHOR]

Introduction: The impact of medical student psychological distress on academic performance has not been systematically examined. This study provided an opportunity to closely examine the potential impacts of workplace and study related stress factors on student's psychological distress and their academic performance during their first clinical year. Methods: This one-year prospective cohort study was performed at a tertiary hospital based medical school in Melbourne, Australia. Students completed a questionnaire at three time points during the year. The questionnaire included the validated Kessler psychological distress scale (K10) and the General Health Questionnaire-28 (GHQ-28), as well as items about sources of workplace stress. Academic outcome scores were aggregated and correlated with questionnaire results. Results: One hundred and twenty six students participated; 126 (94.7%), 102 (76.7%), and 99 (74.4%) at time points one, two, and three, respectively. 33.1% reported psychological distress at time point one, increasing to 47.4% at time point three. There was no correlation between the K10 scores and academic performance. There was weak negative correlation between the GHQ-28 at time point three and academic performance. Keeping up to date with knowledge, need to do well and fear of negative feedback were the most common workplace stress factors. Conclusions: Poor correlation was noted between psychological distress and academic performance. [ABSTRACT FROM AUTHOR]

Objective: There is pressure domestically and internationally to abandon the “4 + 2” pathway in order to more closely align with other western countries. Yet there is limited empirical evidence to support the benefits of the “postgraduate” pathway above that of the internship model. This study examined the training pathways to qualify for registration as a psychologist in Australia and their relationship to years of practice experience, the anchoring effect, and diagnostic accuracy. Method: A total of 121 psychologists in Australia completed the study requirements via an online questionnaire. The participants were randomly allocated to conditions with those in the experimental groups receiving an introductory statement suggesting a diagnosis (depression or anxiety). The control group received no statement. All participants then reviewed the same de‐identified case material of a real client and formulated a diagnosis based on the information presented. The data were examined using hierarchical binary logistic regression. Results: The study found that endorsement significantly predicted more accurate diagnosis but that additional practice experience did not further increase diagnostic skills in the specialist group. Additional years of practice experience did improve accuracy in those without endorsement. An anchoring effect was not consistently observed. Conclusions: The results suggest that endorsement appears beneficial for improving diagnostic accuracy; however, a similar level of improvement can be acquired through practice experience if endorsement is not pursued. While the endorsement pathway appears advantageous, practice experience also has its merits as an alternative to develop clinical skills. [ABSTRACT FROM AUTHOR]

Objective This study assessed lay people and clinicians' recognition of an at risk mental state (ARMS) for psychosis, their intentions to recommend help, and the equivalence of written and videotaped vignettes when detecting the problem. Methods In an Australian online survey, 52 lay people and 32 psychologists with provisional or full registration were randomly assigned to either a videotaped or written vignette of someone with an ARMS. Measures assessed detection and labelling of the mental health problem, and lay people's intentions to recommend help. Results Data were analysed with Chi-Square statistics, Fisher's Exact tests, and Multinomial Logistic Regression. Lay people frequently detected that a mental health problem existed but labelled it incorrectly. All clinicians detected that a mental health problem existed and most labelled it correctly. Lay people's detection that a mental health problem existed was not associated with vignette type but videotaped vignettes produced significantly more correct labelling. Clinicians had poorer labelling when the vignette was videotaped. Correct labelling was associated with intentions to recommend help to a doctor, psychiatrist, and psychologist/counsellor but not with other help sources or with 'no help.' Conclusions Results indicated that if lay people received further education about ARMS, they may be more likely to recommend help to certain mental health professionals. They further highlight the need to use multiple vignette methods in mental health literacy research and the importance of simulated learning about ARMS in professional training environments. Replication of these results in larger samples is required. [ABSTRACT FROM AUTHOR]

Objective: The increasing prevalence of chronic disease has been largely attributed to long-term poor nutrition and lifestyle choices. This study investigates the attitudes of our future physicians toward nutrition and the likelihood of incorporating nutrition principles into current treatment protocols.Methods: Setting: The setting of this study was an Australian university medical school.Subjects: Subjects including year 1-4 students (n = 928) in a 4-year medical bachelor, bachelor of surgery (MBBS) degree program. Students were invited to participate in a questionnaire based on an existing instrument, the Nutrition in Patient Care Attitude (NIPC) Questionnaire, to investigate their attitudes toward nutrition in health care practices.Results: Respondents indicated that "high risk patients should be routinely counseled on nutrition" (87%), "nutrition counseling should be routine practice" (70%), and "routine nutritional assessment and counseling should occur in general practice" (57%). However, despite overall student support of nutritional counseling (70%) and assessment (86%), students were reluctant to perform actual dietary assessments, with only 38% indicating that asking for a food diary or other measure of dietary intake was important.Conclusion: These findings demonstrate that future physicians are aware of the importance of considering nutrition counseling and assessment. However, students are unlikely to adequately integrate relevant nutritional information into their treatment protocols, evidenced by their limited use of a basic nutritional assessment. This is potentially the result of a lack of formal nutrition education within their basic training. [ABSTRACT FROM AUTHOR]

The provision of mental health care has recently focused on the concept of recovery-oriented care. Clinical placements are important for imparting recovery-oriented knowledge and skills to students. However, it has been determined that not all clinical placements are beneficial for future nursing professionals. The aim of this study was to examine what elements of professional learning were facilitated by engagement in a recovery- and recreation-based clinical placement for pre-registration nursing students calledRecovery Camp. Qualitative data were collected through individual interviews and reflective journals of pre-registration nurses. Findings from this study indicate thatRecovery Campenhanced students' understanding of stigma, developed their professional knowledge and applied skills, and helped them gain insight into the role a consumer plays in his/her own recovery journey. Placements that allow pre-registration nurses the opportunity to authentically engage with people with a lived experience of mental illness may assist in the effective development of future professionals in meeting their diverse needs. [ABSTRACT FROM AUTHOR]

Introduction: Increasingly recognized as a core component of contemporary health profession education, interprofessional learning outcomes remain difficult to define and assess across disciplines. The aim of this study was to identify a single set of interprofessional learning competency statements with relevance to all health professions. Methods and results: Six national and international interprofessional competency frameworks were reviewed and combined to give a total of 165 competency statements. Following a process of mapping and grouping these statements into common content areas, duplicate content was removed. In addition, content deemed as a core competency for one or more individual health professions was removed. A round table of experts reviewed the remaining statements and agreed a final set of eight. Each statement was expressed as a specific learning outcome that could be assessed and which described behaviors and practices that students could routinely expect to engage with, and participate in, during the course of their study. Conclusion: Identifying specific interprofessional competencies that students of all health professions require will enable more effective implementation of interprofessional learning activities and assessment within the core curriculum. [ABSTRACT FROM AUTHOR]

Context:Longitudinal integrated clerkships (LIC) are widely used as an educational method, particularly in rural areas. They are good for facilitating hands-on learning and deep relationships between student, patients, and supervisors. Objectives:This study sought to examine and compare learning experience of third-year rural medical students studying specialties (women’s health, aged care, child and adolescent heath, mental health, general practice) by either a traditional hospital-based rotation or a LIC in a rural general practice setting. Methods:Data was collected from two groups of rural students (LIC; traditional hospital-based) over two academic years, utilizing focus groups to investigate general experiences of living and learning rurally, within the different educational models. Results:Results reaffirmed that there was no perceived academic disadvantage to studying medicine rurally. Studying medicine in a rural area provides increased access to patients, more hands-on experience, and close relationships with patients and colleagues. LIC students reported increased confidence in clinical skills, felt better prepared for internship, however experienced more social isolation than students in hospital-based rotations. Conclusions:Students undergoing a rural LIC feel more confident in their clinical skills and preparedness for practice than other rural students. This study supports the use of LICs as a powerful educational tool. [ABSTRACT FROM PUBLISHER]