Health Education in Practice: Journal of Research for Professional Learning
Health Education in Practice: Journal of Research for Professional Learning (HEPJ) (ISSN: 2209-3974) is an electronic journal dedicated to research and evaluation related to health education in practice.
Health Education & Training Institute, NSW Health
Health-professional communication skills and competencies in Australia: An interprofessional content analysis
Purpose Effective communication is central to safe and effective interprofessional collaboration and person-centred care within healthcare systems. A significant proportion of patient complaints and adverse outcomes in Australia are related to communication issues. The aim of this study was to compare and contrast the descriptions of communication skills across nine health-professional competency standards using content analysis. Methodology Researchers from nine distinct health professions used an interprofessional methodology to extract and organise terms related to healthcare communication from professional competency standards documents. Findings Eight domains, with 31 subdomains, were identified and compared by health profession and by overall subdomain frequency. There was a lack of standardised structure for professional practice standards and frequent embedding of communication skills within other core competencies. Also common was imprecise language regarding healthcare communication requirements, and definitions of terms were often lacking. Practical implications Consistent representation of some domains and subdomains across health professions could be a precursor to the development of common communication competencies. These could serve as a benchmark for program accreditations, professional bodies, and interprofessional or healthcare communication education. Value This research adds value due to the interprofessional research method, which modelled interprofessional collaborative practice and allowed interpretation of professional competency standards through a multiprofessional lens. Limitations Nine professional competency standards were included, representing the nine professions of the researchers; therefore, some professional competency standards were not included in the analysis.
Copyright (c) 2025 Health Education in Practice: Journal of Research for Professional Learning https://creativecommons.org/licenses/by-nc-sa/4.0
Interprofessional education in advanced life support training for medical and nursing students
Purpose Interprofessional education (IPE) has emerged as a critical component in healthcare education, especially in the context of advanced life support (ALS) training. IPE has been demonstrated to improve student’s learning experiences and perceived levels of confidence in ALS management. We aimed to investigate how IPE affects undergraduate medical and nursing students’ perceptions of their non-technical skills in ALS simulations. Methodology Medical (44, Joint Medical Program, Universities of Newcastle, and New England) and nursing students (26, Central Coast Nursing Program) attended across the four course days at Central Coast Clinical School, Gosford Hospital. Pre- and post-workshop questionnaires were completed. The course consisted of four skills stations focusing on communication within different aspects of ALS management, and three simulation stations. Findings Of the participants, 49% reported insufficient coverage of non-technical skills in previous course content. There was increased comfort using graded assertiveness from before (81%) to after (96%) the course. Almost all participants (97%) reported a ‘reasonable’ or ‘good’ level of understanding of communication styles and tools post-course. A vast majority of participants recommended this course structure for future students and 91% reported increased communication, leadership and teamwork skills post-course. Research implications This study contributes to a building body of evidence that IPE improves students’ non-technical skills and preparedness for professional work. Practical implications This study indicates that IPE should be included into current Australian university curricula. This model of education can be implemented easily across multiple settings. Originality/value This study was based on preliminary work at Gosford Hospital but had an original study design. Limitations Two key limitations were that there was no control group to compare to and there was an over-representation of medical students compared to the number of nursing students.
A guest speaker-based healthcare workforce preparation course enhances interprofessional education
Purpose To examine the effects of an undergraduate guest-speaker-based healthcare workforce preparation course on students’ understanding of interprofessional education (IPE). Methodology Twenty invited guest speakers from varied healthcare backgrounds came to share their work experiences and perspectives with the class. Qualitative data from weekly reflections and a final reflection paper completed by the students were extracted and analysed. Findings Qualitative themes suggested increased understanding of changes in career path trajectories and the value of public health in prevention and health preservation. Research Implications This pilot project offers insights that may guide future research in conducting a guest-speaker-based course that may enhance student understanding of teamwork and collaboration. Caution must be applied to the interpretation of results in this pilot study as there was a very limited number of participants. Practical Implications Healthcare guest speakers provided a unique educational opportunity for students, increasing their understanding of IPE and career path versatility. Originality To our knowledge, no previous literature exists relating to the possible effect of a guest-speaker-based healthcare workforce-preparation course on student understanding of IPE. Limitations This study had a very small sample size, and larger studies are needed to assess more meaningful change.
Evaluating combined VR-based stress management and de-escalation training for mental health nurses
Aim: This study aimed to assess the acceptability, suitability and training impact of a virtual reality (VR)-based stress-management training tool for mental health nurses in Australia. Background: VR is increasingly being considered a platform suitable for providing training to healthcare professionals. Barriers for adoption include both practical challenges inherent to the technology as well as end-user perceptions. Design: We undertook a pilot feasibility study within a large public training hospital in Australia, to assess the acceptability, suitability, and training impact of the VR-based stress-management training platform, Performance Edge (PE). The program was integrated into a pre-existing one-day emotional awareness and regulation workshop at the Gold Coast Hospital and Health Service (Queensland, Australia) in September 2023. Methods: Observational and self-report data were collected during implementation of the workshop, which integrated five VR-delivered stress-management lessons. Study participants were workshop attendees (mental health nurses) and educators involved in workshop delivery. Results: All participants completed the workshop without encountering technical issues or adverse events. Both educators and attendees provided consistently positive feedback on PE’s usability, suitability, and relevance for healthcare settings. Participants reported increased knowledge, understanding and confidence in stress-management skills immediately and at follow-up, three to six weeks after the workshop. Moreover, clinicians reported actively using stress-management skills more after the training. Conclusions: The VR platform offered practical stress-management skills training, which was perceived to be relevant and suitable among nursing professionals. The use of VR technology in general was also perceived as particularly valuable for this training context, providing a safe and immersive environment. By demonstrating acceptability across a range of metrics, this study supports the feasibility of using VR-delivered stress-management interventions within a clinical workforce. This feasibility trial is an important stepping stone for the broader implementation of VR within healthcare education.
Welcome to the 8th Volume of the Health Education in Practice: Journal of Research for Professional Learning (HEPJ).
Preparedness for internship – a mixed-methods evaluation of the assistant in medicine program
Purpose: The transition from medical student to doctor is often daunting. With compulsory hands-on clinical exposure and pre-internship training included in Australian medical education, this study aims to explore whether the Assistant in Medicine (AiM) program contributed to students’ feelings of internship preparedness. Methodology: Participants were 2022–2023 alumni of the Joint Medical Program (JMP), run by the Universities of Newcastle and New England. All participants completed the Embedded Senior Medical Student (ESMS) program, a pre-internship program integrated into the final-year curriculum. Most participants also chose to participate in the AiM program. A mixed-method design was utilised to explore the experiences and perceived preparedness for internship. Part 1, a questionnaire, was distributed to eligible participants, focusing on common activities undertaken as a medical student and/or AiM. Identified patterns were used to guide Part 2, focus group discussions. Findings: While the survey data suggested that ESMS students and AiMs had similar exposures to tasks/procedures, focus group discussions revealed key differences in terms of level of independence of practice, type of work performed, sense of responsibility and opportunities to receive teaching. Research implications: This study contributes to the growing body of literature investigating the impact of the AiM program on medical student experience. It also highlights aspects of medical education perceived as valuable for internship preparedness. Practical implications: Further research exploring the AiM program should be utilised to help guide the design of medical school curriculums in relation to preparedness for internship. Originality/value: This study was the first of its kind to investigate the similarities and differences between student placements and the AiM program in Australia. Limitations: Given the retrospective nature of this study, there is a possibility of recall bias. There was a small study population with few participants not taking part in the AiM program.
Organisational Learning Approaches in Healthcare Organisations: A Scoping Review
Purpose: Despite years of analysis and debate, the concept of organisational learning (OL) still lacks a theoretical basis and little information is provided in the way of hands-on application for practitioners. Perceived benefits of OL have been reported, yet very few standardised approaches proposed. This review synthesises the literature on standardised approaches to OL. Methodology: Two research questions guided the review: (1) what OL models, frameworks or approaches currently exist?; and (2) what are the common enablers among these models, frameworks or approaches that might best support OL in a healthcare context? Using a systematic screening and reporting process, 360 pieces of literature were analysed and a final 26 articles were included for review. Results: Seven different OL models, frameworks and/or approaches were identified. Multi-component models were reported most frequently, although this category itself encompasses a wide range of approaches. From these models, frameworks and/or approaches, 14 key enablers were extracted and synthesised into three levels: individual, group and organisational. Practical Implications: There was considerable overlap among all OL models, frameworks and/or approaches identified in the literature, rendering it difficult to synthesise the findings into a single standardised approach. Consideration of OL enablers appeared to be less difficult. These enablers may inform a number of strategies for supporting OL in the healthcare context. Regular appraisal of the effectiveness of these enablers across organisational departments, teams and levels will assist in determining the extent and quality of OL. Limitations: The OL literature remains dominated by persuasive and/or analytical papers, rather than theory development, and does not provide hands- on knowledge for practitioners seeking to enact OL models. Many papers used the terms ‘organisational learning’ and ‘learning organisation’ interchangeably, so relevant material may have been excluded.
Learning together, responding together: interprofessional learning enhancing emergency services collaboration
Purpose This study evaluates the impact of multidisciplinary learning on the confidence, preparedness, and collaborative skills of healthcare and emergency service professionals during a field training exercise. It aimed to assess improvements in communication, teamwork, and decision-making skills, as well as identify areas for further training. Design Conducted at the Charmhaven Rural Fire Service (RFS) Control Centre in August 2024, the exercise involved NSW Ambulance, RFS, the Volunteer Rescue Association, and the Central Coast Local Health District, including doctors and nurses. High-fidelity simulations of emergencies, like mass-casualty incidents, cardiac arrests, and trauma cases, were conducted. Quantitative and qualitative data from pre- and post-exercise surveys measured learning outcomes and participant perceptions. Findings Quantitative data indicated that 100% of participants reported increased knowledge, understanding and collaborative ability across agencies, with confidence in interprofessional collaboration rising from 85.7% to 93.5%. All participants expressed greater appreciation for the operational challenges faced by other agencies. A slight decrease in self-reported preparedness for real-life scenarios (91.1% pre-exercise vs. 85.5% post-exercise) suggested participants recognised personal skill or knowledge gaps. Qualitative responses highlighted teamwork, communication, and cross-agency understanding as primary learning outcomes, though challenges in comprehending agency-specific protocols were also noted. Research Implications This study underscores the role of interprofessional learning (IPL) in bridging theoretical knowledge and practical skills for emergency response. Future research should integrate objective assessments of skill acquisition and improved evaluation engagement strategies. Practical Implications The results suggest IPL should be a regular practice to enhance collaboration and patient outcomes. Addressing training gaps, securing funding, and improving engagement in evaluations are recommended. Value This study supports IPL as essential for enhancing patient outcomes and fostering cohesive emergency responses. Limitations The study’s reliance on self-reported data may introduce bias, and the lack of objective skill assessment suggests further alignment in training content is needed.
Emotion and learning influence the learning landscape in sonography
Introduction: Ultrasound is a rapidly expanding field that requires sonographers to continually update their skills through peer learning for optimal patient care. The exchange of skills between learner and teacher involves the cognitive, psychomotor and affective domains, which form a ‘learning landscape’. Significant literature is available regarding the first two of these, but the integration of affective skills (emotion and communication) is often overlooked. Feedback and feedback literacy are also factors contributing to and developing from the interaction. Therefore, our aim was to expand on our previous work to understand how the learning landscape and role of feedback impact Australian sonographers performing complex arteriovenous fistula (AVF) ultrasound examinations. Methods: As previously reported, 50 surveys and 16 semi-structured interviews with Australian sonographers on their experience learning a new, complex ultrasound study (AVF) were linked, to report further in-depth findings of their learning experience and the effects of the learning landscape. Recruitment occurred via an Australian professional association. After transcribing the interviews, thematic analysis was conducted and integrated with the survey data. Results: The combination of survey and interview data allowed the investigation of self-reported levels of competency and confidence, and how this aligned with learners’ subsequent positive and/or negative attitudes towards performing the new study, demonstrating both the influence of the support provided in the initial learning landscape, and the role of feedback / feedback literacy in consequent attitudes to towards the new skill. Conclusion: The learning landscape significantly influences how learners perceive taught skills and process acquired knowledge. The importance of pedagogical support and resources for both peers and learners, in the areas of the affective domain and feedback literacy, is imperative in peer learning situations to optimise the learning experience.
Exploring rural maternity clinicians’ views of an interprofessional education program
Purpose Maternity and Newborn Emergencies (MANE), a two-day face-to-face interprofessional education program, aimed to improve the safety culture of maternity services in rural and regional health services across Victoria, Australia. An evaluation of the program was conducted between 2017 and 2020. The aim of this study was to explore clinicians’ views of the impact of MANE on safety culture and clinical governance. Methodology This study used a qualitative design including, focus groups and an online survey at five health services – one in each Victorian rural health region. Data were thematically analysed using an inductive approach. Findings Data were collected between 2018 and 2020, via four focus groups and one online survey (due to COVID-19 restrictions), with a total of 46 participants. Three themes were identified: MANE was a high quality, professional education program; it led to changes in clinicians’ confidence, skills, and behaviour; and had a positive impact on clinical governance and safety culture. Research implications Clinicians reported that MANE improved safety culture and clinicians’ understanding of clinical governance, with the delivery by external experts considered key to program success. These findings support previously reported outcomes of the MANE evaluation in which participants reported an improvement in knowledge and confidence. Practical implications Education programs like MANE appear to improve clinical governance and safety culture in health services. Value This study adds to the evidence of strategies that health services can consider to strengthen their clinical governance structures and safety culture. Limitations Data from one health service were obtained by written response to the questions which did not allow for participants to respond to their colleagues’ views. Most focus group attendees were midwives or nurses, with only one doctor attending one focus group. This study was conducted only one month after MANE, therefore it is unknown whether these views were sustained. Keywords: clinical governance, interprofessional education, emergencies, safety culture, maternity emergencies, neonatal emergencies
Curriculum critique – Rural Research Capacity Building Program
Purpose: This paper provides a critique of the curriculum of the Rural Research Capacity Building Program, a novice researcher training program conducted by New South Wales Health in Australia. Approach: Using a framework approach, aspects of the curriculum are explored with reference to existing literature and 10 years of program coordinator experience implementing the curriculum. Findings: This critique has found that the curriculum provides structure and flexibility for teaching and learning practices. A competency-based framework provides clarity for learners in knowing when program requirements have been met. By encouraging learners to compile a portfolio of evidence, achievement of competency can be demonstrated against all aspects of the curriculum. As the program targets motivated self-directed learners, the ability to tailor learning experiences within the curriculum is a critical component. Research implications: This critique provides a foundation for further research exploring specific aspects of curriculum delivery. Practical implications: Formal critique of curriculum allows for ongoing refinement of teaching practices. Originality/value: Formal curricula of workplace-based training programs are rarely explored in the literature. Critiques of curricula provide an important tool to examine teaching methods and program outcomes. Limitations: The Rural Research Capacity Building Program is a single program, which may limit the generalisability of these findings. Keywords: curriculum, adult learning, research education
Evaluating the impact of the Assistant in Medicine (AiM) program on medical workforce efficiency and preparedness in NSW, Australia
The Assistant in Medicine (AiM) program allows selected final-year medical students to take on more responsibility while also supporting the junior doctor workforce. This study aimed to evaluate the impact of the AiM program on current medical staff, including junior doctors, registrars and consultants working in public teaching hospitals on NSW’s Central Coast. Furthermore, it aimed to investigate the effect of this AiM program on final-year medical students, their learning and the transition to internship. This cross-sectional study surveyed a select group of 75 medical officers and all 28 final-year medical students employed as AiMs on the Central Coast during July– September 2023. Of the medical officers surveyed, 53.3% felt that they were able to see more, or substantially more, patients on a shift where they had an AiM present and 71.8% felt that a shift with an AiM present was more or substantially more enjoyable than one without. Our results also show that the AiM program allowed doctors to focus on higher-level tasks and to find more enjoyment in their shifts, which may be beneficial in reducing the high rates of burnout seen in the current junior doctor cohort. The entire cohort of student respondents indicated that the AiM position helped them to feel more prepared for internship, with 95% feeling more integrated into the team, indicating enhanced clinical readiness. Furthermore, this study indicates that all the final-year medical students participating in the AiM program on the Central Coast found the program to be beneficial to their learning, increasing their exposure to clinical skills and better preparing them for internship. Limitations of this study include a low response rate from doctors working in the local health district and the limited ability to explore qualitative data within the current study design.
Transforming paramedic training with virtual reality
Purpose This study aims to evaluate the effectiveness of virtual reality (VR) training in enhancing paramedics' preparedness and response skills in mass casualty incidents (MCIs). Design This was an observational study of registered paramedics and intensive care paramedic students from NSW Ambulance. Participants completed a 30-minute VR training session simulating a car crash MCI scenario, plus pre- and post-intervention surveys measuring gaming literacy, prior simulation experience and perceived improvements in MCI skills. Findings Results indicated significant improvements in paramedics' MCI response self-efficacy. Prior to VR training, only 30.0% felt confident in managing an MCI. Post-training, over 90% reported improved skills in triage and patient management, as well as improvement in self-identified areas of weakness. Participants found the VR technology easy to use and highly immersive, with all respondents indicating the scenario mimicked real-world conditions and was transferable to their workplace. Research implications This study highlights the need for standardised protocols and comprehensive performance metrics in VR training to ensure consistent outcomes across different settings. Future research should focus on long-term skill retention and objective performance data (e.g., heat mapping, time tracking) to validate VR training effectiveness. Practical implications The findings support integrating VR training into paramedic education to bridge the gap between theoretical knowledge and practical application in MCI scenarios. Tailoring VR modules to address individual gaming literacy can enhance user engagement and training effectiveness. Value This study contributes to the growing body of literature on VR in emergency medical training by demonstrating its potential to significantly improve paramedic readiness and performance in MCIs. The use of VR provides a realistic, repeatable, and immersive training environment that traditional methods lack. Limitations Limitations include a small sample size, lack of longitudinal data on skill retention, and the absence of objective performance measurements. Future research should address these gaps to validate and enhance the effectiveness of VR training in paramedicine.
Multidisciplinary team-based primary care: questions for general practice training
Multidisciplinary teams delivering person-centred care are a central feature of primary care reforms in Australia and North America. General Practice is a primary care service that prioritises clinical person-centred care. The recent Strengthening Medicare Taskforce Report recognised that a person-centred team care approach needs strengthened education and training programs to support multidisciplinary teams in general practice. While the premise of multidisciplinary care is well established, strengthening education and training programs in general practice offers opportunities at the vocational training level and for intra-practice education. This Education in Practice paper discusses the relevance to contemporary general practice of findings from Tasmanian research projects conducted over the past decade, addressing three questions for general practice training: How can approaches to team-based education be tailored to different general practice settings? What strategies are best for delivering interprofessional training in general practice? How can patients be involved in the process of training and education of collaborative healthcare teams? The challenges presented by these questions are addressed by drawing from a consensus project on best practice in interprofessional training for collaborative primary healthcare, and from projects using in-person and online education and training. We propose a model that uses the clinical training space as a way of promoting multidisciplinary general practice. The model incorporates online and face-to-face spaces, where primary health professionals, patients, practices/teaching organisations, educators and technology are aligned through facilitation and feedback channels in ways that promote collaborative practice. Tasmania, as an island state with close connections between its university, state public health service and GP training, is well placed to have the strategic conversations about coordinating general practice education and training to meet the need for an integrated primary care workforce.
Copyright (c) 2024 Health Education in Practice: Journal of Research for Professional Learning
Evaluating FREDeX (Falls Reduction and Empathy Development eXperience) – a novel simulation training program for healthcare workers
Abstract Purpose: Care after falls constitutes a substantial cost to the Australian health system. The Falls Reduction and Empathy Development Experience (FREDeX), a hybrid simulation training program, was designed in rural NSW. This paper initiates a multi-pronged evaluation of FREDeX. Methodology: Pre- and post-training survey data was collected from voluntary FREDeX trainees. Surveys included validated empathy, compassion, and person-centred-care assessment tools, as well as questions about workshop quality and open-ended response questions. Findings: There was significant improvement in trainees' empathy, compassion, and person-centred care scores. Trainees expressed positivity about FREDeX, noting facilitators and challenges of the program, and implications for professional practice. FREDeX enhanced empathy, aiding better patient understanding, communication, and personalised care. Implications: Significant evidence has emerged demonstrating the efficacy of virtual reality and other simulation training for empathy and compassion in clinical contexts. FREDeX enhances soft skills through a hybrid simulation training approach, proving to be engaging and educational. It is valuable for the delivery of person-centred care, and a compelling program based on effectiveness and ease of implementation. Originality and value: FREDeX has demonstrated implications for improving empathy and compassion in rural and urban healthcare professionals and enables more person-centred care. The positive outcomes from FREDeX suggest broader adoption of hybrid simulation training may enhance soft skills and healthcare quality, emphasising the potential of technology-driven learning for health workforce capacity. Limitations: While this evaluation demonstrates the value of FREDeX, further evaluation will seek to bridge the gap between demonstrated improvements in assessed metrics of care ability and direct improvements to patient care, by assessing fall rates, harm assessments, and clinical notes for participating facilities. This will endeavour to determine changes in fall prevalence and improvement in management and care for falls.
An evaluation of the use of a “short moment of intensive training” (SMIT) in delivering trauma-nursing education
Abstract Background In 2021, Westmead Hospital opened a 13-bed trauma ward, drawing the nursing workforce from various surgical specialties and generating an urgent need for trauma-nursing education. The SMIT (short moment of intensive training) method was developed to deliver targeted, flexible, priority focused and customised education. Aim The primary aim of the study was to demonstrate that specific education on chest trauma using the SMIT method improved nurses’ knowledge and confidence in caring for patients who have experienced trauma. Methods Nurses who met the recruitment criteria completed a pre-SMIT chest-trauma knowledge assessment and trauma-nursing confidence assessment. The SMITs, comprising five sessions, were conducted by the trained instructors. On completion of each session, the instructor recorded the duration of the session, and the nurses completed the “Participant Feedback of SMIT” tool. Once a nurse had completed all five SMITs, they completed the post-SMIT knowledge and confidence assessments. Results A sample size of 13 nurses participated in the study; 14 nurses were recruited, and one excluded. A statistically significant difference was found between the post-SMIT and pre-SMIT knowledge tests (p = 0.003), and post-SMIT and pre-SMIT confidence tests (p = 0.000). No difference was found in the amount of time needed to complete the knowledge test post-SMIT (p = 0.434). Instructor feedback included the time-consuming nature of one-to-one teaching, and the need to conduct sessions close together to minimise the need to revise previous content. Conclusions The SMIT teaching method was beneficial for our novice cohort of trauma nurses to increase their knowledge and confidence in treating patients with chest trauma. Recommendations for future research include additional trauma topics, and application of SMITs to other clinical settings. Keywords: Trauma Nurse Education, nursing confidence, critical thinking, chest trauma, trauma ward education, opportunistic learning, teachable moment.
Copyright (c) 2024 Health Education in Practice: Journal of Research for Professional Learning https://creativecommons.org/licenses/by-nc-sa/4.0
Sleep Patterns and Awareness in Medical Imaging Students Using Wearable Technology
Purpose This study explores the relationship between sleep quality and fatigue in medical imaging students using biometric devices. It examines the impact that objectively measuring and discussing sleep data has on students’ understanding and appreciation of the role of sleep in their academic and professional practices. Design The study adopts a case-based approach, with participants engaging in open collaborative discussions and personal investigation of their sleep data. Biometric devices were used to record sleep data over the course of one semester. Findings Results show that while all students recognised the importance of sleep, they had very little knowledge about sleep patterns, the effects of sleep on performance and memory, or sleep consistency. However, students engaged with their data and showed interest in learning more about sleep. As the study progressed, participants moved away from discussing sleep duration and focused more on the impact of sleep types on patterns of sleep quality. Some students used this newfound knowledge to try and change their sleep behaviours and optimize their performance, while others struggled to change their habits. Implications Overall, this study highlights the need for a more comprehensive approach to sleep education and the potential for personal analytics to facilitate understanding and behaviour change.
Evaluation of a multicomponent educational intervention to decrease general practice registrars’ prescribing of benzodiazepines and related drugs: the BENEFIT prospective controlled study
Background: Benzodiazepines and medicines (including Z-drugs) are associated with frequent and serious related adverse effects. Despite this, they are frequently prescribed by general practitioners (GPs). We aimed to evaluate the effectiveness of a multi-component educational intervention designed to decrease the prescribing and initiation of these drugs by GPs in training ('registrars'). Methods/design: A pragmatic non-randomised, non-equivalent control-group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study was used to assess an educational intervention delivered to registrars in Australia. The intervention was underpinned by the Behaviour Change Wheel framework and included face-to-face workshops with pre- and post-session readings, a webinar for supervisors, and facilitation of registrar-supervisor dyad interactions. Analyses employed univariable and multivariable logistic regression. The p-value of an interaction term in the multivariable regression was used to determine the statistical significance of intervention-related change. Results: Analyses included data of 1,088 intervention registrars and 1,003 control registrars. While some decrease in prescribing was seen, compared to the change from pre-post in controls, there were no statistically significant decreases in the ‘Intention to Treat’ (interaction aOR = 0.92, 95%CI: 0.70, 1.20, p = 0.52) or ‘On Treatment’ (interaction aOR = 0.87, 95%CI: 0.65, 1.16, p = 0.33) populations, and no statistically significant decrease in new prescriptions in the ‘Intention to Treat’ population (interaction aOR = 0.88, 95%CI: 0.58, 1.35, p = 0.57). Implications: Our study may have implications for further research aiming to identify effective strategies to promote appropriate benzodiazepine prescribing among GP registrars. Continued education for registrars around rational benzodiazepine prescribing is essential. This study is an initial step in evaluating the behaviour change intervention and further investigation and extended observation is warranted. This study highlights the educational challenges in improving rational benzodiazepine prescribing. Limitations: Randomization in the study design was not practicable. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12618000824268
Feasibility of personalised online learning programs aligned with authentic workplace practice
Introduction: Online learning is an accessible method that enables medical practitioners to undertake training to develop new, and reinforce existing, knowledge and skills. Early career medical practitioners may find engaging in online learning particularly beneficial as they have a stronger motivation to refine knowledge and skills than their more senior peers. One under-explored mechanism to strengthen the delivery of online learning for medical practitioners is the use of clinical data to tailor learning so it is closely aligned with the individual health professional’s clinical practice. Methodology: This study aimed to evaluate the feasibility of personalising an online learning program for early career doctors working in oncology using electronic medical record (EMR) data. An online program was developed by clinical domain experts that could be triggered using pathology orders and/or results closely aligned to when the test was ordered in clinical practice. The program content was designed to cover three categories: (1) test ordering, (2) interpreting test results, and (3) patient management. Early career medical practitioners undergoing oncology training were recruited to participate in the study. The program was evaluated using metrics captured by the online learning platform, and a post-program survey. Results: All early career medical practitioners eligible to participate in the study consented to participate (n=5). It was feasible to personalise the online program using pathology ordering data. Further, analysis of survey responses indicated that personalising an online learning program using EMR data was acceptable to early career doctors and facilitated engagement with the course. Conclusion: Personalising an online learning program for early career medical practitioners in cancer care using electronic health-record data is both feasible and acceptable.
Attitudes towards research in graduate-entry Australian physiotherapy students: a survey
Purpose: To assess the attitudes towards research in a two-year, graduate-entry Master of Physiotherapy course. Methodology: All students starting (T0) and ending (T1) their degrees in 2020 and 2021 were invited to complete the revised Attitudes Towards Research Questionnaire. This is a three-factor instrument with 13 statements assessing Research Usefulness (four statements, scores ranging from 4 to 28), Research Anxiety (five statements, scores ranging from 5 to 35), and Positive Research Predispositions (four statements, scores ranging from 4 to 28). Each statement was scored using a seven-item Likert scale ranging from ‘Strongly Agree’ (1) to ‘Strongly Disagree’ (7). Student responses between T1 and T0 for factor scores were compared using independent samples t-tests and summarised using mean differences (95% CIs). We defined the minimally important difference as 15% of the scale range. Findings: Ninety-seven percent (n=124/129) of students completed the survey at T0 and 57% (n=79/125) at T1. We found no difference between T0 and T1 in research anxiety (0.2 points, 95% CI: –1.5 to 2.0) and research usefulness (–0.9 points, 95% CI: –1.8 to 0.1), but a significant (although not meaningful) decrease in positive research predispositions between T0 and T1 (–1.7 points, 95% CI –3.2 to –0.2). Research implications: Qualitative research could complement these quantitative findings and provide in-depth reasons for student scores. Practical implications: Educators need more active strategies to improve attitudes and engagement in research-focused subjects to further engage students. Originality/value: This is the first study to document attitudes towards research in an Australian graduate-entry Master of Physiotherapy program. Limitations: There is likely bias (unclear in which direction) at T1 given that 57% of students completed the survey. Surveys were not linked, so group differences were assessed independently. Keywords: Evidence-based practice; research methods; Master of Physiotherapy, UTS Physiotherapy Student surveys (PHYSS) study
An Education Model for Paediatric Palliative Care
Introduction: Meeting the palliative care needs of children and their families is complex and challenging. For countries such as Australia, whose relatively small paediatric palliative care population is dispersed across a very large geographical area, one challenge is maintaining a skilled workforce in regional, rural, and remote areas, where, when compared to major cities, there are fewer resources, and the workforce is often transient. Methods: The Quality of Care Collaborative Australia (QuoCCA) Pop-up Model of Education was used to provide palliative care education to health professionals across three geographical locations and facilities, to facilitate a 2,500-km transfer of a child with complex palliative care needs from a tertiary hospital to the remote family home on Country. Results: Each Pop-Up provided effective education to facilitate the successful transfer of the child to the next hospital location. Over 18 months, three Pop-Ups occurred. Relational learning and real-time problem solving enabled health professionals to build confidence and capacity to successfully transfer the child from the regional hospital to the remote family home. Implications: The QuoCCA Education Pop-up Model is a feasible method to deliver timely access to speciality education. The model can be successfully applied in multiple settings. Keywords: paediatric, palliative care, integrated health care delivery, learning, rural, education models.
Building capacity and promoting health through online volunteering
Purpose Significant changes to in-person volunteering were necessary during the COVID-19 pandemic. Health Volunteers Overseas (HVO) responded to the pandemic by developing an online education platform and pivoting to online volunteering. This qualitative study explores the dynamics of online volunteering and provides visibility to this novel trend in the training of health professionals in resource-scarce countries. Methodology/approach Barriers and facilitators, actual and potential outcomes, and recommendations for online volunteering were addressed through a comparative case study approach focusing on three HVO global projects: physical therapy in Rwanda and Ghana, oral health in Nepal, and anesthesiology—a multi-country collaboration between Bhutan, Cambodia, and Laos. Findings A total of 15 participants, including project directors, host country representatives, and teaching volunteers, were interviewed online. Three themes emerged through the online interviews with HVO volunteers, project directors, and host country directors: Creating Space, the Future is Hybrid, and Geographical Expansion. Research implications Online volunteering provides a new opportunity for volunteers to expand their networks, learn new skills, and meet the needs of the host country participants. There is also an opportunity to expand projects beyond national boundaries, but logistical, cultural, and linguistic challenges must be considered. Practical implications Online volunteering is a feasible approach for building teaching and research capacity globally, and volunteer agencies should consider a hybrid model combining online volunteering with in-person volunteering. Originality Online volunteering provides support to meet the needs of both volunteers and in-country program participants. Limitations This study focused on the volunteer, project director, and host coordinator experience and not on the learner. More research is needed to investigate how online and in-person dynamics coalesce.
Welcome to the 7th Volume of the Health Education in Practice: Journal of Research for Professional Learning (HEPJ). We are pleased to open the first volume of HEPJ published under a continuous publication model. The continuous publication model will allow us to maintain our commitment to increase the visibility of the knowledge published on HEPJ by expediting its dissemination, with articles being published as soon as they undergo our rigorous process of peer review and production. By eliminating the need to wait for a predetermined number of articles to form a volume, we aim to provide authors with the immediacy they desire and, consequently, increase the likelihood of their work receiving timely citations. I hope you enjoy reading our journal.
Changing how ‘rural’ is understood in health professional education
Purpose: For students enrolled in tertiary education courses, learning to work rurally is mainly reliant on placement experiences. An international scoping review (Adams 2023) found that rural placement and other learning experiences are seldom supported by published evidence or evaluative research related to rural theory, specific curricula content, pedagogy or assessment. The implications of the scoping review findings are discussed using relevant theoretical perspectives. This argument aims to raise awareness amongst health professional educators of opportunities and outcomes that may support confident, capable, autonomous work in broader scopes of practice through specific, structured rural content in health professional curricula. Findings: Once theoretical foundations of rural education are established, structured evaluation of educational design and advancement of the scholarship of learning and teaching can occur. Research implications: Extension of research into educational practice in rural contexts can contribute to rural health professional retention and improved health outcomes for rural populations. Originality/value: This paper highlights a novel approach to rural health professional education for rural practice beyond standardised curricula delivered in rural contexts. Limitations: The lack of published research does not mean that rural curricula and pedagogy do not exist in health professional curricula. Instead, it highlights that rural health education rarely includes analysis/evaluation of health programme content. [1] The terms ‘rural’, ‘remote’ and ‘regional’ are often poorly differentiated and used interchangeably in the literature. ‘Rural’ is used throughout this document, although the authors wish to acknowledge the considerable differences between the practice contexts.
Online learning for allied health knowledge translation: A systematic review
Purpose: To synthesise evidence on the effectiveness of online learning platforms for facilitating knowledge translation in allied health professionals. Methodology: A systematic review of the literature searched three databases (Medline-OVID, CINAHL, Embase) in November 2023 for studies measuring outcomes of knowledge translation initiatives targeting allied health professionals delivered using online learning platforms. Papers were eligible if allied health professionals made up at least 50% of the sample, most of the learning component was online, and comparative data was reported. Data were extracted using a customised form. Quality of studies was appraised using the Downs and Black checklist. Meta-analyses were conducted where sufficient homogenous data were available. Findings: Twenty-three studies published over a 13-year period were included in this review primarily using pre-post study designs. All reported improvements in either knowledge, skill and/or confidence, with an meta-analysis (n=9 studies) showing a significant increase in knowledge gain after exposure to online learning (SMD 1.39; 95% CI = 0.96-1.83). However, there is little evidence that participation in online learning is associated with a change in clinical practice. Research Implications: This study supports previous research that online learning can improve knowledge but highlights a need for more rigorous studies addressing the impacts on behaviour change. Practical Implications: Online learning is an effective way of improving knowledge, skill and/or confidence but additional knowledge translation strategies may be needed to lead to a behaviour change. Originality/Value: Synthesis of current knowledge of the value and limitations of online learning as a tool to facilitate the implementation of evidence into practice in the allied health professions. Limitations: This review was limited to studies published in the English language only. The quality of studies in this field is low. Few studies measure behaviour change.
ISBAR+ a communication tool to advocate for patients
Introduction Recognising the importance of social determinants of health is a key part of the curriculum for health practitioners. The ability to advocate on behalf of patients is a competency that demonstrates enacting this understanding in practice. Communication frameworks are used to structure difficult conversations in multiple settings, notably handover. There is no commonly accepted communication framework to structure a patient advocacy conversation. Approach We assembled a team with skills in patient advocacy, healthcare communication, community advocacy, education and business negotiation to identify the knowledge, skills and attitudes required and to develop a framework suitable for this purpose. We chose to adapt the ISBAR framework as an existing communication framework commonly used for handover. Outcomes ISBAR+ is a framework that is based on a person-centred approach and ‘integrated negotiation’. ‘Intention and Inquiry’ involves a compassionate understanding of the patient’s position. ‘Situation’ is a succinct framing of the problem. ‘Background’ is the information required for the decision-maker to make a person-centred decision. The next step is ‘alignment’ of the priorities of the patient, practitioner and decision-maker. ‘Response’ is the proposed solution, and ‘+’ (‘plus’) is the actions taken for implementation. Conclusions ISBAR+ provides a framework for conversations advocating on behalf of patients that draws from the literature around advocacy inside and outside health. A communication framework allows the development and evaluation of interventions to teach and promote this critical function to promote person-centred care.
GP registrars' deprescribing in older patients: a non-randomised controlled study.
Purpose: To evaluate the effect of a multi-component educational program aimed at improving general practitioner (GP) trainees’ (registrars') deprescribing in patients 65 years and over. The hypothesis was that an educational program would increase registrars' deprescribing of potentially inappropriate medicines (PIMs) in older patients, relative to a control group, six months post-education. Design: This was a pragmatic, non-randomised, non-equivalent control group design nested within an ongoing cohort study of registrars' practice (the ReCEnT study). The program consisted of an online module, face-to-face sessions for registrars, webinars for their supervisors, and facilitation of the registrar–supervisor dyad, including case-based discussions of deprescribing in teaching meetings. The program was underpinned by the Behaviour Change Wheel framework and delivered to registrars of a single registrar educational/training organisation (other educational/training organisations served as controls). Primary outcome measures were deprescribing any medicines and deprescribing medicines categorised as PIMs. Secondary outcomes were deprescribing of medications taken for three months or more and dose reduction with a view to deprescribing (cessation). Findings: Data from 779 education-receiving registrars and 438 control registrars were analysed. Intervention group registrars showed no significant increase in deprescribing of any medication compared to controls (interaction aOR 1.00 (95%CI 0.69, 1.46) or of PIMs (aOR 1.29 (95%CI 0.74, 2.24), or significant changes in secondary outcomes. Research implications: Despite no differences in prescribing, in this analysis, six months post-intervention, aspects of the findings suggest extended observation and further evaluation may be indicated. Practical implications: The continuation of education for registrars around deprescribing of PIMs is essential. Further investigation is required to assess the effectiveness and efficiency of the behaviour change approach adopted in this study. Originality/value: The multi-component behaviour change theory-based approach is novel for this educational setting, and this is an initial step in evaluating the approach. Limitations: The major limitation is that randomisation in the study design was not practicable.
Welcome to the 6th Volume, 1st Issue of Health Education in Practice: Journal of Research for Professional Learning. We have a very interesting series of articles in this volume.
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The review of Aboriginal and Torres Strait Islander content within an undergraduate paramedicine degree curriculum
A review of Aboriginal and Torres Strait Islander content within an accredited paramedicine degree curriculum was undertaken as part of major course review and ongoing evaluation of the program. The aim of which was to ensure the course content was appropriate and relevant to Aboriginal and Torres Strait Islander communities. All content and teaching activities were audited where specific content was explored and noted. Findings were presented to a review team where good practice was highlighted and areas for development were addressed. This has encouraged staff to seek opportunities to embed content in both clinical and non-clinical skills, knowledge teaching and experiences. In addition to encouraging further review of other diverse communities.
Website redesign in a maternity setting: Co-designing a resource for consumer support and education
Women want to be informed about their healthcare. Google searches provide an accessible option for women during pregnancy, but the content is largely unmonitored. Women have expressed dissatisfaction and confusion about receiving conflicting information from clinicians across the maternity service. It is essential for providers to offer person-centred care and listen to the voices of consumers. If the aim is to provide a service women want to use, women must have the opportunity to voice what they want. The local health district (LHD) maternity website development project aimed to redesign maternity website pages over 12 months to meet community needs and increase hits to the site by 70% within six months. Consumers were approached to participate through maternity services in a regional Australian health district where approximately 3,500 babies are born yearly. In a three-phase participatory action research study, researchers identified the areas of concern for consumers, worked with them to co-design and implement a new website, and evaluated the changes. Almost 20% of women who birthed from January to March 2022 responded to the evaluation survey. Half of these had explored the website. After the upgrades, the number of hits to the district website service page increased by 875 (from 124 to 999). Post-development surveys showed that women who felt they received inconsistent information at the hospital during their pregnancy were more likely to visit the website for clarification (p = 0.009). Of women who visited the website, 78% found the information useful, and 73% said they would use it again. This study highlighted that women engaging in maternity services desire access to relevant, quality information through digital technology. Maternity website development improvements increased patient satisfaction and reduced confusion, providing a reliable source of accessible health information for consumers.