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Problem: The mistreatment of medical and nursing students and junior health professionals has been reported internationally in research and the media. Mistreatment can be embedded and normalized in hierarchical healthcare workplaces, limiting the effectiveness of policies and reporting tools to generate change; as a result, some of those who experience mistreatment later perpetuate it. We used a novel, creative approach, verbatim theater , to highlight the complexity of healthcare workplaces, encourage critical reflection, and support long-term culture change. Intervention: Verbatim theater is a theater-for-change documentary genre in which a playscript is devised using only the words spoken by informants. In 2017, 30 healthcare students and health professionals were recruited and interviewed about their experience of work and training by the multidisciplinary Sydney Arts and Health Collective using semi-structured interviews. Interview transcripts became the primary material from which the script for the verbatim theater play ' Grace Under Pressure' was developed. The performing arts have previously been used to develop the communication skills of health professional students; this esthetic expression of the real-life effects of healthcare workplace culture on trainees and students was implemented to stimulate consciousness of, and dialogue about, workplace mistreatment in healthcare work and training. Context: The play premiered at a major Sydney theater in October 2017, attended by the lay public and student and practicing health professionals. In November 2017, three focus groups were held with a sample of audience members comprising healthcare professionals and students. These focus groups explored the impact of the play on reflection and discussion of healthcare culture and/or promoting culture change in the health workplace. We analyzed the focus group data using theoretical thematic analysis, informed by Turner's theory of the relation between 'social' and 'esthetic' drama to understand the impact of the play on its audience. Impact: Focus group members recognized aspects of their personal experience of professionalism, training, and workplace culture in the play, Grace Under Pressure. They reported that the play's use of real-life stories and authentic language facilitated their critical reflection. Participants constructed some learning as 'revelation,' in which the play enabled them to gain significant new insight into the culture of health care and opened up discussions with colleagues. As a result, participants suggested possible remedies for unhealthy aspects of the culture, including systemic issues of bullying and harassment. A small number of participants critiqued aspects of the play they believed did not adequately reflect their experience, with some believing that the play over-emphasized workplace mistreatment. Lessons Learned: Verbatim theater is a potent method for making personal experiences of healthcare workplace and training culture more visible to lay and health professional audiences. In line with Turner's theory, the play's use of real-life stories and authentic language enabled recognition of systemic challenges in healthcare workplaces by training and practicing health professionals in the audience. Verbatim theater provides a means to promote awareness and discussion of difficult social issues and potential means of addressing them.

Background: Technological advancements are rapidly changing nursing education in higher education settings. Nursing academics are enthusiastically blending technology with active learning approaches such as Team Based Learning (TBL). While the educational outcomes of TBL are well documented, the value of blending technology with TBL (blended-TBL) remains unclear. This paper presents a systematic review examining the effectiveness of blended-TBL in higher education health disciplines., Objectives: This paper aimed to identify how technology has been incorporated into TBL in higher education health disciplines. It also sought to evaluate the educational outcomes of blended-TBL in terms of student learning and preference., Method: A review of TBL research in Medline, CINAHL, ERIC and Embase databases was undertaken including the search terms, team based learning, nursing, health science, medical, pharmaceutical, allied health education and allied health education. Papers were appraised using the Critical Appraisal Skills Program (CASP)., Results: The final review included 9 papers involving 2094 student participants. A variety of technologies were blended with TBL including interactive eLearning and social media., Conclusion: There is limited evidence that blended-TBL improved student learning outcomes or student preference. Enthusiasm to blend technology with TBL may not be as well founded as initially thought. However, few studies explicitly examined the value of incorporating technology into TBL. There is a clear need for research that can discern the impact of technology into TBL on student preference and learning outcomes, with a particular focus on barriers to student participation with online learning components., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Moving from participatory approaches incorporating co-design to co-production in health research involves a commitment to full engagement and partnership with people with lived experience through all stages of the research process--start to finish. However, despite the increased enthusiasm and proliferation of research that involves co-production, practice remains challenging, due in part to the lack of consensus on what constitutes co-production, a lack of guidance about the practical steps of applying this approach in respect to diverse research methods from multiple paradigms, and structural barriers within academia research landscape. To navigate the challenges in conducting co-produced research, it has been recommended that attention be paid to focusing and operationalising the underpinning principles and aspirations of co-production research, to aid translation into practice. In this article, we describe some fundamental principles essential to conducting co-production research (sharing power, relational resilience, and adopting a learning mindset) and provide tangible, practical strategies, and processes to engage these values. In doing so, we hope to support rehabilitation researchers who wish to engage in co-production to foster a more equitable, ethical, and impactful collaboration with people with lived experience and those involved in their circle of care. [ABSTRACT FROM AUTHOR]

This article explores the implementation of an innovative approach to mental health care in a private health setting. Open Dialogue is a recovery-oriented approach to mental health that emerged in Finland, which emphasises family involvement, interdisciplinary collaboration and a flexible, needs-adapted approach. Early research is promising; however, little research has explored Open Dialogue outside Finland. This study aimed to explore the introduction of this approach at a private, inpatient young-adult mental health unit in Australia. Drawing on data from a long-term ethnographic field study that included 190 hours of observation and qualitative interviews, the findings show that despite staff members being inspired by and supportive of Open Dialogue, the existing ideology and organisational structures of the unit conflicted with the integration of Open Dialogue principles. Dialogical ways of working were challenged by medical dominance and emphasis on economic efficiencies. This study emphasises the importance of a 'good' fit between organisational cultures and innovations. It also highlights the challenges of moving towards recovery-oriented and family-focused models of care in the Australian neoliberal health care context. There is a need for organisational and ideological change in health services that is receptive to, and meaningfully supports, efforts to implement recovery-oriented care. [ABSTRACT FROM AUTHOR]

The evidence for efficacy of family‐based approaches for psychological problems is extensive, although model‐specific effects have not been established. However, implementation of family therapy approaches in tertiary mental health settings has been challenging due to factors such as negative staff attitudes and difficulties engaging families. Open Dialogue is an emerging network‐based therapy that has a focus on genuine collaboration, flexibility, authenticity, and openness. This study describes the experiences and perspectives of clinicians, service users and families, following training in Open Dialogue, within a child and adolescent mental health service, and an adolescent inpatient unit in public mental health services. A total of 16 participants (11 clinicians and five service users and family members) took part in semi‐structured interviews regarding their experiences with Open Dialogue. Interpretative phenomenological analysis was used to analyse interview transcripts. Four major themes were identified from interviews with clinicians: valuing responses from families, learning from families and privileging their expertise, hesitation about doing family therapy, and engaging with authenticity and flexibility. Three themes emerged from family interviews: hesitation about doing family therapy, valuing collaboration and openness, and opening space for more talk. These themes are relevant to challenges of family therapy in public mental health settings and future directions for implementation. [ABSTRACT FROM AUTHOR]

Abstract: Open Dialogue is a resource‐oriented approach to mental health care that originated in Finland. As Open Dialogue has been adopted across diverse international healthcare settings, it has been adapted according to contextual factors. One important development in Open Dialogue has been the incorporation of paid, formal peer work. Peer work draws on the knowledge and wisdom gained through lived experience of distress and hardship to establish mutual, reciprocal, and supportive relationships with service users. As Open Dialogue is now being implemented across mental health services in Australia, stakeholders are beginning to consider the role that peer workers might have in this model of care. Open Dialogue was not, initially, conceived to include a specific role for peers, and there is little available literature, and even less empirical research, in this area. This discussion paper aims to surface some of the current debates and ideas about peer work in Open Dialogue. Examples and models of peer work in Open Dialogue are examined, and the potential benefits and challenges of adopting this approach in health services are discussed. Peer work in Open Dialogue could potentially foster democracy and disrupt clinical hierarchies, but could also move peer work from reciprocal to a less symmetrical relationship of ‘giver’ and ‘receiver’ of care. Other models of care, such as lived experience practitioners in Open Dialogue, can be conceived. However, it remains uncertain whether the hierarchical structures in healthcare and current models of funding would support any such models. [ABSTRACT FROM AUTHOR]