Felicity Croker

Situated Learning as a Model for the Design of an Interactive Multimedia Program on Medication Administration for Nurses

SUMMARY According to Collins (1988), the perspective taken by advocates of the situated learning model, as a basis for instruction, is that knowledge and skills should be acquired in contexts that reflect the ways in which that knowledge will be useful in a real life situation. This case study examines the use of a situated learning framework for the design of an interactive multimedia program on medication administration for nursing students. The key aspects of this framework which could be incorporated into the multimedia design were: (1) authentic contexts that reflect the way knowledge is used in real life; (2) authentic activities which learners would engage in during their career roles; (3) access to expert performance and modelling of the processes involved; and (4) opportunities for students to reflect on their learning. The outcomes of the project are briefly discussed.

Using the World Wide Web To Improve Medication Calculation Skills.

SUMMARY Pharmacological therapeutics have advanced in recent years. As a consequence of this, the complexity of calculations required by health‐care professionals has increased concomitantly. The continuing incidence of medication errors reported in the literature indicates that, in order to maintain competence in calculating medications from drug order sheets, undergraduate and registered nurses need opportunities to practise and review this skill. Identifying this need, an interdisciplinary team at James Cook University involving nursing, education and computer science staff developed a computer‐assisted learning (CAL) package. This allows nurses to practise in a supportive environment, at their own pace, receiving immediate feedback. The purpose of the paper is fourfold. First, it discusses the reasons why practice in medication calculations was delivered as a CAL package on the World Wide Web. Second, it describes the development of the package including design features, constraints and cost effective...

Dental anxiety in patients attending a student dental clinic

BackgroundThis study investigated the expectations and experiences of a sample of new patients visiting an Australian regional university Student Dental Clinic with regard to anxiety provoking and alleviating stimuli in the clinical environment. Differences in anxiety levels were examined by age, gender and the type of procedure undergone.MethodsThe number of dental patients who participated in the study was 102 (56 males, 43 females). The study used a pre-treatment/post-treatment design to assess the effect of the dental procedure on anxiety levels of patients. The Modified Dental Anxiety Scale (MDAS) was used to measure anxiety levels in patients at pre-treatment. Questions were also asked about factors which may increase (length of the appointment, invasiveness of procedure) or decrease (perceived student interpersonal skills and clinical ability) dental fear.ResultsFemales reported higher total MDAS scores (M = 11.93) compared to males (M = 9.94). Younger patients (M = 12.15) had higher dental anxiety than older patients (M = 9.34). There was a reduction in dental anxiety from pre-treatment (M = 1.92) to post-treatment (M = 1.23) on the single item anxiety measure though most of the treatment being undergone by patients was for less complex procedures.ConclusionsPatients’ anticipatory experience of anxiety was higher than the anxiety experience after having undergone treatment at the student dental clinic. Student interpersonal skills and clinical ability as perceived by the patient can lessen dental anxiety in patients. Clinical Supervisor-student ratios need to be more equivalent in order to reduce the time length of appointments which currently are associated with increased patient anxiety levels in student dental clinics.

Applying social innovation theory to examine how community co-designed health services develop: using a case study approach and mixed methods

BackgroundCitizen participation in health service co-production is increasingly enacted. A reason for engaging community members is to co-design services that are locally-appropriate and harness local assets. To date, much literature examines processes of involving participants, with little consideration of innovative services are designed, how innovations emerge, develop and whether they sustain or diffuse. This paper addresses this gap by examining co-designed initiatives through the lens of social innovation – a conceptualisation more attuned to analysing grassroots innovation than common health services research approaches considering top-down, technical innovations. This paper considers whether social innovation is a useful frame for examining co-designed services.MethodsEighty-eight volunteer community-based participants from six rural Australian communities were engaged using the same, tested co-design framework for a 12-month design and then 12-month implementation phase, in 24 workshops (2014–16). Mixed, qualitative data were collected and used to formulate five case studies of community co-designed innovations. A social innovation theory, derived from literature, was applied as an analytical frame to examine co-design cases at 3 stages: innovation growth, development and sustainability/diffusion.ResultsSocial innovation theory was found relevant in examining and understanding what occurred at each stage of innovation development. Innovations themselves were all adaptations of existing ideas. They emerged due to local participants combining knowledge from local context, own experiences and exemplars. External facilitation brought resources together. The project provided a protective niche in which pilot innovations developed, but they needed support from managers and/or policymakers to be implemented; and to be compatible with existing health system practices. For innovations to move to sustainability/diffusion required political relationships. Challenging existing practice without these was problematical.ConclusionsSocial innovation provides a useful lens to understand the grassroots innovation process implied in community participation in service co-design. It helps to show problems in co-design processes and highlights the need for strong partnerships and advocacy beyond the immediate community for new ideas to thrive. Regional commissioning organisations are intended to diffuse useful, co-designed service innovations. Efforts are required to develop an innovation system to realise the potential of community involvement in co-design.

Disparities in dental health of rural Australians: hospitalisation rates and utilisation of public dental services in three communities in North Queensland.

INTRODUCTION The oral health of rural Australians continues to lag behind that of those living in metropolitan areas. Research has shown that people living in rural areas are more likely to suffer from dental caries (decay), visit the dentist less often and have poorer access to oral health services. The purpose of the study was to examine hospitalisations for dental conditions and utilisation of public dental services in three rural communities in Queensland compared with the whole of Queensland. METHODS Aggregated hospitalisation data for dental conditions and counts of public outpatient service data were requested for residents of three rural communities in Queensland and for the whole of Queensland for the calendar year 2013. Hospitalisation rates per 1000 and risk ratios were calculated to examine the risk of hospitalisation for dental procedures for those living in the selected rural communities and the rest of Queensland. Data were grouped by gender, age and Indigenous status and comparisons made between Queensland and the rural communities. Outpatient service data were converted to percentage of all services delivered to allow comparisons between groups of different sizes. Population data were grouped into age cohorts and compared with the proportion of public oral health services delivered to each age cohort. RESULTS Residents of the rural communities were twice as likely to be hospitalised and children aged 0-14 years living in the communities were three times more likely to be hospitalised for dental conditions compared to residents of the rest of Queensland. Outpatient oral service data showed that the proportion of services delivered to children aged up to 14 years living in the rural communities was less than the whole of Queensland. Interestingly, in one rural community where the public dental service was open to all, the distribution of public oral health services aligned with the age distribution of the population. CONCLUSIONS The study showed that residents of these rural communities experience poorer oral health and are a greater risk of hospitalisation for dental conditions compared with the whole of Queensland. Whilst public dental services account for a small proportion of all dental care across the state, service utilisation data provide a unique insight into the population groups who may not be accessing public dental services. In the rural context, more effective use of the local workforce and a flexible approach to funding models could have a positive impact on access to dental care.

Book Reviews : RESEARCH METHODOLOGY: A STEP-BY-STEP GUIDE FOR BEGINNERS Ranjit Kumar Melbourne, Addison Wesley Longman, 1996, xvi, 276 pp.,

[Extract] Anyone teaching a research subject to students enrolled in a professional degree knows how resistant they are to the content. They are taking the research subject because they have to, not because they want to, and many consider it largely irrelevant to their career plan. Often they are overwhelmed, especially by quantitative methods. At the same time, collaborative research groups are being organised between health professionals and academics. The need for evidence based practice becomes apparent to many professionals only after they enter the work-place. In both situations, there is a place for a text such as this one.Throughout the book Kumar makes links between research, the development of theory and its relevance to practice. Kumar provides an excellent guide to research methodology, an essential foundation to teaching methods. The structure of the book takes the reader step-by-step through an eight-stage research process from formulating a research problem to design, sampling, writing a research proposal, collecting and processing data, through to writing up an report. Aside from the subject matter covered in the body of the text, the author provides a useful appendix of exercises to stimulate the process of developing a research project. Teachers will find this a useful starting point in the development of tutorial work in subjects covering methodology, and students will find the process of completing the exercises useful in gaining experience with developing a research project. Like all good teachers, Kumar’s work is based on sound pedagogical principles. Through listening to his students over many years he has adapted his teaching to meet the needs of novices. The material moves from