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Work-integrated learning (WIL) is central to the delivery of high quality student learning that provides students with the knowledge, skills, attitudes and professional networks for successful careers. In rural and regional Australia WIL placements can be particularly challenging to source due to limited clinical supervision capacity. This article reports regional Allied Health clinical supervisors' perceptions of enablers and barriers to engaging with interprofessional student WIL. A phenomenology of practice framework was used to interpret the data, highlighting three key themes: introducing an interprofessional lens early; tapping into unique possibilities; and setting up for success, balancing challenges with opportunities. The study identified key elements that may contribute to successful Allied Health interprofessional WIL placements in rural and regional settings, including incorporating early student placement opportunities, using shared interprofessional supervision to foster the development of junior clinicians' supervisory skills, and ensuring clarity around the purpose and processes of each interprofessional placement.

Aim: To explore reactions to and preferences for words/phrases used in communications about diabetes among adults with diabetes and parents of children with diabetes. Methods: Eligible adults (aged 18+ years) living with diabetes, or parenting a child with diabetes, were recruited via social media to complete an online cross‐sectional, mixed‐methods survey. Study‐specific items were used to examine 22 commonly used diabetes words/phrases in terms of participants' cognitive perceptions ('helpful', 'respectful', 'accurate', 'harmful', 'judgmental' and 'inaccurate') and emotional reactions ('optimistic', 'motivated', 'supported', 'understood', 'offended', 'blamed', 'distressed' and 'angry'). Open‐ended questions invited further feedback on (non‐)preferred language and its impact(s). Data were analysed using descriptive statistics and inductive thematic analysis. Results: Participants (N = 865) included adults with diabetes (type 1: n = 519; type 2: n = 180, other types: n = 48) and parents of children with diabetes (n = 118). Words/phrases most commonly associated with negative perceptions/emotional responses were 'non‐compliant' (60% judgmental; 47% felt blamed) and '...good/bad' (54% judgmental; 43% blamed). Positive perceptions were reported for 'managing diabetes' (73% helpful, 47% felt understood), 'person with diabetes' (72% respectful; 49% understood), '...within/outside target range' (60% helpful, 44% understood), and 'condition' (58% respectful; 43% understood). Participants' qualitative responses illuminated perceptions, experiences and impacts across five themes: (1) accuracy and simplicity; (2) identity; (3) blame, judgement and stigma; (4) respect and trust and; (5) support, hope and feeling understood. Themes were consistent across diabetes types. Conclusions: These findings provide novel evidence into (non‐)preferred, and potential (negative and positive) impacts of, commonly used diabetes words/phrases, supporting the international #LanguageMatters movement. [ABSTRACT FROM AUTHOR]

In 2014, the School of Medicine Fremantle of the University of Notre Dame Australia initiated a study to explore the curriculum underpinning portfolios used by first-year medical students. The School had used portfolios since 2005 and judged it timely to consider digital technologies as a mechanism to enhance student learning and improve efficiencies. A qualitative approach was adopted that investigated how the curriculum intersected with two ePortfolio platforms: Blackboard and Mahara. Data pertaining to the way in which Blackboard and Mahara ePortfolio platforms supported existing curriculum were collected from students through focus groups and tutors via interviews. As a measure of comparison, data were also collected from students and tutors who used the existing paper-based portfolio system. Findings confirmed that the curriculum should shape the way in which technology solutions are interpreted and implemented. It is posited that low-tech solutions are sometimes most appropriate for the curriculum context. However, exploring the potential of digital technologies helped the School to imagine other possibilities for curriculum renewal. Indeed, one outcome of the research was the development of a plan to re-invigorate portfolios, shifting the current task-based emphasis to one which recognizes the key role of reflection. The study may be of interest to teachers and managers seeking to explore ePortfolios as part of broader curriculum renewal initiatives.

Health professional students must be equipped with the skills necessary to interact with patients. Effective interpersonal skills are difficult to both learn and teach, requiring development, practise and evaluation in both educational and clinical settings. In professions such as physiotherapy, traditional approaches to teaching these skills have encompassed clinical modelling, and stand-alone didactic teaching of the theory behind communication. These provide limited opportunity for students to practise and receive feedback on their interpersonal and communication skills. This paper describes the implementation of an experiential small group learning approach in an undergraduate physiotherapy program and discusses outcomes. Implications for practice are that: experientially based small group learning with opportunities for practise, reflection, self-evaluation and feedback, can improve students' confidence and interpersonal skills; consistent and scaffolded participation in experiential learning opportunities and assessment of this participation across the program is key to this approach. Interpersonal skills remain a challenge for new graduates; support and mentoring in this domain by supervisors may enhance the transition to work.

Part of preparing future health professionals for multidisciplinary work environments involves interprofessional education (IPE). We explore students' perceptions of confidence during IPE and how this impacts their ability to contribute to interprofessional learning. The written reflections of 115 undergraduate Psychology (n = 58) and Dentistry (n = 57) students aged 19-47 years (median = 22 years) who participated in two sessions of IPE utilising motivational interviewing to encourage health behaviour change were analysed. Six themes were identified: Concerns about Confidence Resulted in Additional Prior Preparation, Lack of Confidence as an Impediment to Contribution, An Increase in Confidence as a Result of Doing, Recognising the Value of Confidence, Confidence as an Area for Further Development, and Confidence from the Outset. The importance of confidence in impacting students' ability to actively contribute in IPE should not be underestimated. Educators should seek to maximise student confidence and to create a safe learning environment where further confidence can be built. Further research is needed to determine factors that may boost confidence including the optimal time to incorporate IPE in degree programmes, the best format in which to deliver IPE, and how much IPE to deliver.

Background: Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three‐arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian‐led telehealth intervention at 3 months. Methods: Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non‐core foods were reported. Results: The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) −0.0 to 12.9], p = 0.049), non‐core foods (−6.4%/day [95% CI −12.9 to 0.0], p = 0.049), sweetened drinks (−1.7%/day [95% CI −2.9 to −0.4], p = 0.013), takeaway foods (−2.3%/day [95% CI −4.5 to −0.1], p = 0.045) and sodium (−478 mg/day [95% CI −765 to −191 mg], p = 0.001). Conclusions: A dietitian‐led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change. Highlights: A full range of dietary intake variables, eating behaviours, sleep quality and physical activity was evaluated.There was a significant negative relationship between change in diet quality and change food addiction (FA) symptoms at 3 months compared to baseline, indicating that, as FA symptoms decreased, diet quality increased.Participants allocated to the active intervention group reported statistically significant improvements in a range of dietary intake variables compared to the participants allocated to the passive intervention or control groups. [ABSTRACT FROM AUTHOR]

In their care of children and young people, foster carers report experiencing social isolation and a lack of support. This study examines the social network experiences of Australian foster carers who are members of Mockingbird Family. While well established in the United States and United Kingdom, Mockingbird Family was introduced to Australia offering a new approach to address the unique challenges of foster caring for vulnerable children and young people. The model geographically networks 6–10 foster care households in a 'constellation' with a central 'hub home provider' tasked with providing information, support, and respite care. This study employed a cross-sectional explanatory sequential mixed methods approach to investigate social connections and supports in the first four Australian Mockingbird Family constellations. A social network tool was used to survey participants (n = 27) and two focus groups (n = 20) to gather their experiences. Analysis found the highest mean social network connections with people from within their own Mockingbird Family constellations. Three measures of centrality were used indegree, betweenness and closeness, to report the connections and role of members within each constellation. Comparing constellations at different stages of maturity, the hub home provider was consistently ranked with high betweenness centrality as the bridge. In the longer-running constellations, the hub home provider was ranked with high indegree centrality or the primary source of advice or expert support. This indicated micro-network evolution that may potentially result in reduced reliance on statutory and other formal system supports over time. Changes to micro-dynamics in social support within constellations were explained qualitatively through three themes: leadership and expertise, information diffusion and communication, and trust and familiarity. Mockingbird Family was found to provide social connections and support networks amongst foster carers, indicating the model's capacity to strengthen supports to carers thereby strengthening the immediate environment of children and young people in care. [ABSTRACT FROM AUTHOR]

Demand for clinical placements in physiotherapy education continues to outstrip supply. Peer assisted learning, in various formats, has been trialled to increase training capacity and facilitate student learning during clinical education. There are no documented examples of measurable or repeatable peer assisted learning models to aid clinicians in implementing these strategies. The aim of this research was to develop a repeatable and quantifiable peer assisted learning model of clinical education for paired undergraduate physiotherapy students. Additionally, the project aimed to evaluate the impact of clinician engagement in the model development process on their self-rated ability to facilitate peer assisted learning. A series of four workshops was conducted to facilitate development and refinement of a peer assisted learning model by physiotherapy clinical educators. The workshops introduced relevant peer learning principles and a range of clinically relevant educational tools to educators. Consensus was targeted on the tools and approaches that would underpin the peer assisted learning model. A survey investigating participants' self-rated ability to facilitate components of peer assisted learning was administered prior to, and on completion of, the workshop series. Educators agreed on a model to facilitate student peer interaction in clinical reasoning, observation of performance, risk identification and mitigation, and feedback and coaching. Tools to evaluate student and clinical educator outcomes were developed. On completion of the workshops, participants reported significantly more confidence in their ability to facilitate peer assisted learning. Development of a peer assisted learning model of clinical education that is acceptable to clinical educators was achieved through stakeholder involvement from concept stage. Assessment of educator knowledge and confidence, combined with critical review of stakeholder feedback at multiple stages in model development, appeared effective in conveying ownership of the model to clinical educators and identifying the support required for confidence in facilitating peer assisted learning.

Simple Summary: The current evidence regarding Indigenous* women and breast cancer in Australia shows lower prevalence but higher mortality rates. There are a range of reasons for this, including co-morbidities, lack of access to health services and low health information fluency. Perhaps most importantly, breast cancer health policy and service delivery practice do not meet the needs of Indigenous women in Australia, according to Indigenous women. Talking and listening to Indigenous women about breast cancer highlight that the solutions to improve breast cancer outcomes are available and that they are not complex. Indigenous women must be involved in the improvement of policy and practice in order for these outcomes to improve. *Terminology: We respectfully refer to Aboriginal and Torres Strait Islander people as "Indigenous". In Australia, the incidence rate of breast cancer is lower in Indigenous* women than non-Indigenous women; however, the mortality rate is higher, with Indigenous women 1.2 times more likely to die from the disease. This paper provides practical and achievable solutions to improve health outcomes for Indigenous women with breast cancer in Australia. This research employed the Context–Mechanism–Outcome (CMO) framework to reveal potential mechanisms and contextual factors that influence breast cancer outcomes for Indigenous women, stratified into multiple levels, namely, micro (interpersonal), meso (systemic) and macro (policy) levels. The CMO framework allowed us to interpret evidence regarding Indigenous women and breast cancer and provides nine practical ways to improve health outcomes and survival rates. [ABSTRACT FROM AUTHOR]

Given that the number of children and young people needing care keeps rising and fewer people are becoming foster carers, efforts to support carers and workers in foster caring are essential. This paper considers the experiences of carers and foster care agency workers involved in Australia's piloting of the Mockingbird Family. With a view understanding experience, data were collected via focus groups with carers and agency workers (n = 20) involved in piloting, implementation and evaluation. Deductive analysis applied the theory of experience to generate understanding of experience, as both intrinsic and extrinsic dimensions to capture strengths in the Mockingbird Family's foster caring networks. These dimensions of experience included collective passions of carers and workers; experiential change over time; collective experiences as a moving force; and experiences as transformational. Understanding of experience associated with the perceived strengths of the Mockingbird Family, including strategies to promote strong professional relationships between carers and workers, is an important element in strengthening environments of children and young people in care. Safe and stable environments are crucial for wellbeing. [ABSTRACT FROM AUTHOR]

Background: Implementing appropriate shift work schedules can help mitigate the risk of sleep impairment and reduce fatigue of healthcare workers, reducing occupational health and safety risks. In Australia, the organisation has a responsibility to make sure all reasonable measures are taken to reduce fatigue of staff. Therefore, it is important to assess what the current rostering processes is for staff responsible for creating the rosters for nurses. Aim: The aims of the project were to understand (1) who creates the rosters and what the process is, (2) what training and knowledge these staff have in establishing rostering schedules that optimise the sleep and wellbeing of staff, and (3) what the benefits and limitations are of current rostering practices. Methods: Findings were generated through semi-structured interviews, using cluster coding to form categories. Twenty four nurses responsible for rostering staff were interviewed from three different sites in Victoria (one metropolitan and two regional/rural hospitals). Data was analysed using selected grounded theory methods with thematic analysis. Results: The common themes that came out of the interviews were that rostering staff were under prepared, unaware of fatigue and safety guidelines and polices from governing bodies and had not received any education or training before taking on the role. The most common rostering style was self-rostering, where staff could submit preferences. However, there were concerns about staff fatigue but were divided as to who should be responsible, with many saying it was up to staff to preference shifts that they could cope with. The final theme was cultural barriers to change. Conclusion: While self-rostering resulted in staff having more freedom and flexibility, shift preferences may be influenced more so by a need to fit with lifestyle rather than to minimise fatigue and increase safety in the workplace. Greater consideration of the impact of shift work schedules on fatigue is required to ensure that the layers of clinical governance in health care organisations minimise the risk of occupation health and safety issues for employees delivering direct patient care. [ABSTRACT FROM AUTHOR]

The National Human Papillomavirus (HPV) Vaccination Program in Australia commenced in 2007 for girls and in 2013 for boys, using the quadrivalent HPV [4vHPV] vaccine. In Australia, students are primarily vaccinated en masse, on school grounds, after parental/ guardian consent is obtained. Students most often receive little, or no, education at school about HPV or HPV vaccination prior to immunisation. There is also some uncertainty about where young people can and should obtain reliable information about the vaccine, outside of school. We conducted a cluster randomised controlled trial of a complex intervention in schools. This study aimed to improve: (1) student knowledge about HPV vaccination; (2) psycho-social outcomes and (3) vaccination uptake. In this paper, we briefly outline our educational intervention and discuss its implementation by educators including facilitators and barriers. We also discuss the study findings pertaining to student knowledge about HPV and HPV vaccination and their attitudes to vaccination across control and intervention schools. Study results showed students in intervention schools demonstrate greater knowledge and understanding of HPV and HPV vaccination. Greater knowledge and understanding of HPV and HPV vaccination appeared to promote positive attitudes towards vaccination and supported confidence with vaccination.

Objectives: To explore if there are differences in shift patterns and work‐related factors between metropolitan and regional/rural healthcare shift workers and their risk of poor sleep and mental health. Furthermore, explore whether these factors impact on medical errors, workplace and car/near car accidents. Design: A cross‐sectional study. Setting: An anonymous online survey of healthcare shift workers in Australia. Participants: A total of 403 nurses, midwives and paramedics completed the survey. Main outcome measures: Sample characteristics, employment location, shift work‐related features, sleep and mental health measurements, workplace accidents, medical errors and car/near car accident post shift. Results: Regional/rural healthcare shift workers were significantly older, had more years' experience, worked more nights, on‐call and hours per week. Those in metropolitan areas took significantly longer (minutes) to travel to work, had higher levels of anxiety, increased risk of shift work disorder, reported significantly more workplace accidents and were more likely to have a car/near car accident when commuting home post shift. Both groups reported ~25% having a medical error in the past year. Workplace accidents were related to more on‐call shifts and poor sleep quality. Medical errors were associated with fewer years' experience, more evening shifts and increased stress. Car accidents were associated with metropolitan location and increased depression. Conclusion: Differences in work‐related factors between metropolitan and regional/rural healthcare shift workers were observed. Some of these factors contributed to occupational health and safety risks. Further exploration is needed to understand how to reduce occupational health and safety risks, and improve employee and patient safety both in both regional/rural and metropolitan areas. [ABSTRACT FROM AUTHOR]

Regular physical activity is an important component of diabetes management. However, there are limited data on the habitual physical activity of people with or at risk of diabetes-related foot complications. The aim of this study was to describe the habitual physical activity of people with or at risk of diabetes-related foot complications in regional Australia. Twenty-three participants with diabetes from regional Australia were recruited with twenty-two participants included in subsequent analyses: no history of ulcer (N = 11) and history of ulcer (N = 11). Each participant wore a triaxial accelerometer (GT3X+; ActiGraph LLC, Pensacola, FL, USA) on their non-dominant wrist for 14 days. There were no significant differences between groups according to both participant characteristics and physical activity outcomes. Median minutes per day of moderate-to-vigorous physical activity (MVPA) were 9.7 (IQR: 1.6–15.7) while participants recorded an average of 280 ± 78 min of low-intensity physical activity and 689 ± 114 min of sedentary behaviour. The sample accumulated on average 30 min of slow walking and 2 min of fast walking per day, respectively. Overall, participants spent very little time performing MVPA and were largely sedentary. It is important that strategies are put in place for people with or at risk of diabetes-related foot complications in order that they increase their physical activity significantly in accordance with established guidelines. [ABSTRACT FROM AUTHOR]

Collaborative learning (CL), a core component of inquiry-based learning approaches, aims to support students' development of key skills (e.g., working in multidisciplinary teams). To design effective CL activities, we need to understand students' perceptions about CL. However, few studies have examined students' understandings of CL. This qualitative study aimed to address this gap by analyzing participants' constructions of their CL experiences. Focus group data (14 first- and 14 fourth-year dental student volunteers) were analyzed by an inductive thematic analysis strategy. The findings explained students' perspectives of key factors for facilitating positive learning within an inquiry-based CL context, namely having a "right" mix of students and facilitating balanced participation and interactions, especially questioning, explaining, and managing knowledge conflicts and understanding their thinking processes when learning.

A problem-based learning (PBL) assumption is that silence is incompatible with collaborative learning. Although sociocultural studies have reinterpreted silence as collaborative, we must understand how silence occurs in PBL groups. This essay presents students' explanations of dominance, leadership, and silence as PBL group roles. An ethnographic investigation of PBL groups, informed by social constructionism, was conducted at two dental schools (in Australia and Ireland). The methods used were observation, interviews, and focus groups. The participants were volunteer first-year undergraduates. Students attributed dominance, silence, and members' group roles to personal attributes. Consequently, they assumed that groups divided naturally into dominant leaders and silent followers. Sometimes silence had a collaborative learning function, but it was also due to social exclusion. This assumption enabled social practices that privileged some group members and marginalized others. Power and participation in decision making in PBL groups was restricted to dominant group members.

Objective: Australia has implemented a nation-wide programme providing a human papillomavirus (HPV) vaccine to girls and boys through school-based programmes. Previous research has identified three distinct areas for attention: (1) lack of understanding about HPV and HPV vaccination, (2) young people's desire for involvement in decision-making about HPV vaccination and (3) fear of HPV vaccination. We aimed to develop an intervention to address young people's low levels of understanding, to promote their involvement in consent and reduce vaccination-related fear and anxiety. Design, Setting, Methods: Formative qualitative research was conducted in six public, private and Catholic schools in the Sydney metropolitan area. Girls who were offered the vaccine in a school programme and aged 12-13 years were interviewed in focus groups. Piloting of materials was conducted in three private schools across Sydney with both girls and boys, and changes and additions were made to the materials in accordance with feedback. Results: We developed an educational intervention aimed at addressing gaps in young people's knowledge and understanding, and offering strategies to improve confidence with vaccination and reduce needle-related anxiety. Components of the final intervention include film chapters, a magazine, a website, an app and teacher support materials. The intervention is designed for teachers and/or nurses to deliver and is linked to the school-based HPV vaccination programme. Conclusions: This is the first educational intervention designed for young people in HPV school-based vaccination, to be developed from empirical data with the involvement of young people themselves.

Groups are central to problem-based learning (PBL) and educational and professional outcomes relevant to clinical education. However, PBL groups in practice may differ from theoretical conceptions of groups. Therefore, this study explored students' understandings of the purpose and value of PBL groups for their learning. We conducted a naturalistic study with novice (first-year) students at two dental schools (Australia, Ireland), using observation and interviews analyzed thematically. Students constructed PBL learning as individual knowledge gain, and group purpose as information gathering and exchange; few students acknowledged the learning potential of group processes. Group value depended on assessment and curriculum context. Findings are explained in relation to how students' epistemologies and perceptions of their learning contexts shaped group behaviour. Implications for health professional education practice are considered.