Louise McCall

An evaluation of a public health nutrition workforce development intervention for the nutrition and dietetics workforce.

BACKGROUND Workforce development is a key element for building the capacity to effectively address priority population nutrition issues. On-the-job learning and mentoring have been proposed as strategies for practice improvement in public health nutrition; however, there is limited evidence for their effectiveness. METHODS An evaluation of a mentoring circle workforce development intervention was undertaken. Thirty-two novice public health nutritionists participated in one of three mentoring circles for 2 h, every 6 weeks, over a 7-month period. Pre- and post-intervention qualitative (questionnaire, interview, mentor diary) and quantitative (competence, time working in public health nutrition) data were collected. RESULTS The novice public health nutritionists explained the intervention facilitated sharing of ideas and strategies and promoted reflective practice. They articulated the important attributes of the mentor in the intervention as having experience in and a passion for public health, facilitating a trusting relationship and providing effective feedback. Participants reported a gain in competency and had an overall mean increase in self-reported competence of 15% (range 3-48% change; P < 0.05) across a broad range of competency elements. Many participants described re-orienting their practice towards population prevention, with quantifiable increases in work time allocated to preventive work post-intervention. CONCLUSIONS Mentoring supported service re-orientation and competency development in public health nutrition. The nature of the group learning environment and the role and qualities of the mentor were important elements contributing to the interventions effects. Mentoring circles offer a potentially effective strategy for workforce development in nutrition and dietetics.

Empathy levels among health professional students: a cross-sectional study at two universities in Australia.

Background Empathy is paramount in the health care setting, optimizing communication and rapport with patients. Recent empirical evidence suggests that empathy is associated with improved clinical outcomes. Therefore, given the importance of empathy in the health care setting, gaining a better understanding of students’ attitudes and self-reported empathy is important. The objective of this study was to examine self-reported empathy levels of students enrolled in different health disciplines from two large Australian universities. Materials and methods A total of 1,111 students from two different universities enrolled in eight different health professions were administered the Jefferson Scale of Physician Empathy – Health Profession Students version, a 20-item 7-point Likert scale questionnaire to evaluate self-reported empathy levels. Results A total of 1,111 students participated in this study. The majority of participants were from Monash University (n=771), with 340 students from Edith Cowan University. No statistically significant differences were found between universities: Monash University (mean 110.1, standard deviation [SD] 11.8); Edith Cowan University (mean 109.2, SD 13.3, P=0.306). The mean female empathy score (mean 110.8, SD 11.7) was significantly higher than the mean male score (mean 105.3, SD 13.5; P<0.0001; d=0.44). Paramedic students had significantly lower empathy scores (mean 106.3, SD 12.73) than all other participants except nursing students (P<0.0001). Conclusion Results relating to sex are reflective of previous studies. There is some discrepancy in results relating to empathy and its incline/decline as students progress through a program. Further study is warranted to explore why there are variations in empathy levels in students of different health disciplines.

‘They don’t know much about us’: educational reform impacts on students’ learning in the clinical environment

Placements are an integral component of the medical, nursing, and allied health curriculum. Literature on problem-based learning indicates that curriculum change can impact student experience. However, outside of the nursing literature, there is little research on the impact of education reform on students’ experiences of placements. This paper reports on medical, midwifery and paramedic students’ perception of the impact of education reform they experienced in the clinical setting. A qualitative study using a semi-structured schedule was conducted. Data was collected using focus groups (17), individual interviews (48) and written responses (2) from undergraduate students (103) and graduates (27) from a tertiary institution in Victoria, Australia. Recorded interviews were analysed, coded and categorised into themes. Whilst students indicated they were prepared for the impact of educational reform on their placement experience, they perceived that clinical educators responsible for teaching them were less prepared. Three themes were identified from the data: clinical educator’s lack of familiarity with new curriculum, clinical educator’s negative attitudes to curricular change and looking to the future. Our study advances the understanding of the implications of education reform during the clinical placement of medical, midwifery, and paramedic students. Whilst important lessons can be learned from the medical and nursing literature this study highlights that staff responsible for curriculum change need to action change management process to ensure that the clinical educators are able to deliver the revised program.

The role of mentoring in public health nutrition workforce development. Perspectives of advanced-level practitioners

OBJECTIVE To explore the nature, role and utility of mentoring in the development of competence in advanced-level Australian public health nutritionists. DESIGN Qualitative study using in-depth interviews. SUBJECTS AND SETTING Eighteen advanced-level public health nutritionists working in academic and practice settings in Australia. RESULTS The attributes and career pathways of the subjects were consistent with previous findings. Dissatisfaction with clinical practice was a key reason for choosing a career in public health. Experiential learning, postgraduate education and mentoring from both peers and senior colleagues were the most significant contributors to competency development. The subjects supported mentoring as an important strategy for public health nutrition workforce development and articulated the characteristics and models important for mentoring relationships in public health nutrition. CONCLUSIONS The present study suggests mentoring was an important part of competency development for advanced-level public health and community nutritionists in Australia. Mentoring programmes based on experiential learning may assist in developing public health nutrition workforce competence.

A pilot study evaluating an interprofessional education workshop for undergraduate health care students

Department of Physiotherapy, Monash University, Frankston, AustraliaINTRODUCTIONInterprofessional Education (IPE) is the process wherebystudents learn with, from and about other healthcareprofessions (Centre for the Advancement of Interprofes-sional Education, 1997). It is believed that IPE canpotentially improve job satisfaction, increase public appre-ciation of healthcare and promote enhanced holistic patientcare (Meads, Ashcroft, Barr, Scott, & Wild, 2005).To explore the inclusion of IPE into the undergraduatecurriculum of students enrolled in health-related disci-plines, six 1.5 h IPE workshops were designed as part of alarger effort to facilitate IPE provided to students at oneAustralian university. Each workshop was held during theend of semester teaching period between October andNovember 2009, and involved participants from a mini-mum of three different healthcare professions.The aim of each workshop was to introduce key IPEconcepts to students and assist them in developing the skillsand attitudes needed to become effective interprofessionalcollaborative practitioners. The pedagogical framework ofthe workshops and the formulation of educational activitieswas to be guided by six components: (1) patient-centredpractice, (2) interprofessional learning, (3) communicationskills, (4) team work and collaboration, (5) conflictresolution, (6) reflection (Oandasan & Reeves, 2005; TheCombined Universities Interprofessional Learning Unit,2005). The workshops were designed to include recom-mendations based on previous IPE studies, mainly that IPEbe taught in small groups where all disciplines are viewed asequal, and that the material presented is relevant to allfields, and based on real-life clinical problems (Parsell &Bligh, 1999).Each workshop, led by a non-medical facilitator (FM)and authors (BW, TB) focussed on one of three conditions:diabetes mellitus, chronic obstructive pulmonary disease(COPD) or cellulitis. Each condition was presented as aDVD simulation (10 min in length) with the aim ofallowing students to develop an interprofessional andcollaborative team approach to that particular health carechallenge and development of a subsequent joint team plan.Following this, participants were involved in a range of IPE-orientated group activities, such as, ‘Talking Walls’ (Parsell,Gibbs, & Bligh, 1998) where participants were required toexplore one another’s training, roles and responsibilities andthen identify the similarities and differences among these.This report describes students’ attitudes towards IPEusing a questionnaire to elicit the student’s responses, whichimportantly adds to the emerging body of IPE knowledge.METHODSA cross-sectional methodology was used with a paper-basedquestionnaire administered to students to elicit theirthoughts regarding IPE immediately before, shortly afterand 6 months after the IPE workshop (e.g. Time 1, Time 2and Time 3).Undergraduate students enrolled in one of six health-related courses at Monash University: emergency health(paramedics), nursing, midwifery, occupational therapy,physiotherapy and nutrition and dietetics. All students whoparticipated in one of the IPE workshops were eligible toparticipate in the study (n¼62).The Readiness for Interprofessional Learning Scale(RIPLS) is a measure of students’ attitudes towardsengaging in IPE. It is a 19-item scale with three subscales,

Visitor or Inhabitant? Addressing the Needs of Undergraduate Transnational Medical Students

This study was conducted to identify key issues for students in an undergraduate medical course with cross border delivery and the impact of these issues on the students’ ability to learn. Data relating to the student experience and perceived student needs were collected from transnational students and teaching staff from Australia and Malaysia. The results highlight the complexities of migration from one learning environment to another and suggest the need for a cohesive institutional approach to support medical student movement between culturally diverse settings as well as the translation of medical curriculum from one cultural context to another. We describe how the particular needs of transnational students moving across borders align with Maslow’s hierarchy of unmet needs and can be met through low cost, long reach institutional initiatives. These must be supplemented by interpersonal approaches in which institutions can also foster. The outcomes will benefit local as well as transnational students and staff.

Evaluation of a Short Course in Psychiatry for General Practitioners

OBJECTIVE To assess the acceptability and benefits to general practitioners (GPs) of a short course on the management of depression and anxiety. METHOD One hundred and twenty-two GPs from southeast metropolitan Melbourne participated in a five-session short course. Pre- and post-measures of knowledge, attitude and self-evaluated clinical practice and a post-measure of participant satisfaction were completed. RESULTS The course was overwhelmingly appreciated by participating GPs. In the group as a whole, knowledge, attitude and certain elements of clinical practice changed in a positive and predicted direction. General practitioners affirmed the use of an interpersonal and problem-solving framework for patients more commonly than a cognitive-behavioural one. CONCLUSIONS Brief educational interventions are useful and, through improving GP knowledge, attitude and clinical practice, have an important role to play in enhancing the capacity of GPs to assist people with depression and anxiety.

The future of the Primary Examination.

The objective of the Primary Examination is to ensure that trainees have the required level of knowledge and understanding of the four basic sciences of anatomy, pathology, physiology and pharmacology to underpin their further learning and development towards careers as emergency medicine physicians. The candidate is expected to show an understanding of the subject matter and demonstrate their ability to apply their knowledge to the practice of emergency medicine. As part of the curriculum review, ACEM undertook to implement changes to the Primary Examination in order to make it more clinically relevant.

The new ACEM Fellowship Examination: Lessons learnt.

The Australian Medical Council (AMC) requires ‘contemporary approaches to assessment in medical education (that) emphasise a programmatic approach where multiple measures of trainees’ knowledge, skills and professional qualities over time are aggregated and synthesised to inform judgements about progress’.1 In response, ACEM undertook a review of training and assessment in 2010, to ensure that the educational content and method of the advanced training programme continues to be contemporary. The training and assessment working group suggested that