Maree O’Keefe

The Colleague Development Program: a multidisciplinary program of peer observation partnerships

Background: As an introduction to peer observation of teaching, a multi-disciplinary program of peer observation partnerships was implemented across Faculty of Health Sciences. The ‘Colleague Development Program’ focussed on formative feedback and on promoting collegiality within and across traditional discipline boundaries. Aims: To describe the development, implementation, and evaluation of the Colleague Development Program. Methods: Participants asked a trusted colleague to observe their teaching. Feedback on good practice and suggestions for improvement were sought. Colleague observations were guided by specific learning objectives articulated by participants. Following the teaching observation/s, the colleague observer and the participant discussed the extent to which the participants learning objectives had been achieved. A written summary of mutually agreed outcomes was prepared. Program evaluation included anonymous participant questionnaire and focus group discussions. Results: Forty-two staff enrolled in the program with 23 completing all elements and participating in the evaluation. Participants reported increased confidence in teaching, confirmation of good practice, exposure to new ideas, and a greater sense of institutional support and collegiality. Conclusions: Situating peer evaluation within a collegial partnership overcame participants’ concerns about being the subject of ‘evaluation’ and ‘criticism’ by emphasising existing collegiality and trust amongst peers.

A student-centred feedback model for educators.

Background:  Effective feedback is instrumental to effective learning. Current feedback models tend to be educator driven rather than learner‐centred, with the focus on how the supervisor should give feedback rather than on the role of the learner in requesting and responding to feedback.

Health-Service Organisation, Clinical Team Composition and Student Learning

Although clinical placements are an integral part of health-profession education, in contrast to university settings where education is a primary focus of activity, the health services that host these placements are primarily configured for clinical services. As a result, health-service staff supervise students in an environment where work priorities are centred on patient care rather than on student learning. Moreover, health services are complex and dynamic environments where student-learning opportunities vary greatly. As part of a project to identify and build leadership capacity for quality student learning within clinical teams, a model for team development was tested in three different health-service teams. The process of identifying and enrolling the selected teams permitted some observations to be made by the project team regarding the ways in which the organisation of health services shaped student-learning opportunities. The more complex the health service in terms of size, clinical team composition and patient or client care responsibilities, the fewer opportunities staff had to come together as a team to discuss and plan student learning. In addition, the more complex the health service, the greater the number of universities placing students and the greater the number of different programmes and levels of study represented, rendering the task of planning more difficult. It is proposed that what is required are negotiations across institutions that are sensitive to the complexities of clinical practice and also mindful of the need for students to be supported and engaged in ways that allow them to contribute and learn effectively in doing so.

Parental and societal support for adolescent immunization through school based immunization programs

OBJECTIVES Adolescent immunizations such as human papillomavirus vaccine have been implemented through school based immunization programs (SBIPs) in Australia. We assessed community attitudes toward immunization of adolescents though SBIPs. METHODS A cross-sectional population survey of rural and metropolitan households in South Australia in 2011. Univariate and multiple regression analyses identified predictors of support for a SBIP. RESULTS Participation rate was 57.3% with 1926 adults interviewed. Overall, 75.9% regarded school as the best place to offer adolescent immunizations, with 16.4% preferring the family physician. Parents of high school students were most supportive (88.4%) of a SBIP with 87.9% of their adolescents reported as having participated in the program. Adults 18-34 years (79.4%) were more likely to support a SBIP compared to older adults (68.7% of >55 years) [adjusted OR=2.39, p=0.002] and men were more supportive (80.3%) than women (71.7%) [adjusted OR=1.54, p=0.003]. Reasons for participation in the SBIP included convenience (39.9%), public funding for the service (32.4%), and confidence in immunization recommendations (21.0%). CONCLUSIONS Public support for the SBIP was very high particularly amongst parents whose adolescent/s had participated in the program.

Defining a set of common interprofessional learning competencies for health profession students

Abstract Introduction: Increasingly recognized as a core component of contemporary health profession education, interprofessional learning outcomes remain difficult to define and assess across disciplines. The aim of this study was to identify a single set of interprofessional learning competency statements with relevance to all health professions. Methods and results: Six national and international interprofessional competency frameworks were reviewed and combined to give a total of 165 competency statements. Following a process of mapping and grouping these statements into common content areas, duplicate content was removed. In addition, content deemed as a core competency for one or more individual health professions was removed. A round table of experts reviewed the remaining statements and agreed a final set of eight. Each statement was expressed as a specific learning outcome that could be assessed and which described behaviors and practices that students could routinely expect to engage with, and participate in, during the course of their study. Conclusion: Identifying specific interprofessional competencies that students of all health professions require will enable more effective implementation of interprofessional learning activities and assessment within the core curriculum.

Ethical challenges in school-based immunization programs for adolescents: a qualitative study

OBJECTIVES We investigated ethical issues in school-based immunization programs for adolescents and how they are addressed. METHODS We used qualitative methods and an ethnographic approach to observe 9 secondary schools on immunization days in South Australia in 2011; concurrently, we conducted 9 focus groups with female secondary school students, 6 semistructured interviews with parents, and 10 interviews with nurses and teachers. We explored ethical challenges from the perspective of these groups. RESULTS We identified ethical challenges for the delivery of adolescent immunization in a school-based setting in 3 main areas: informed consent, restrictions on privacy, and harm to students in the form of fear and anxiety. CONCLUSIONS We found areas in which the design and delivery of school-based immunization programs can be improved. Information about immunization should be provided in ways that are appropriate to young people and their parents, and privacy protections should be enhanced when possible. Involving young people in the design and delivery of programs would assist with making these improvements.

Rethinking attitudes to student clinical supervision and patient care: a change management success story

BackgroundThe aim of this project was to explore the process of change in a busy community dental clinic following a team development intervention designed to improve the management of student supervision during clinical placements.MethodsAn action research model was used. Seven members of a community dental clinic team (three dentists, two dental therapists, one dental assistant and the clinic manager), together with the university clinical placement supervisor participated in the team development intervention. The intervention consisted of two profiling activities and associated workshops spread six months apart. These activities focused on individual work preferences and overall team performance with the aim of improving the functioning of the clinic as a learning environment for dental students. Evaluation data consisted of 20 participant interviews, fourteen hours of workplace observation and six sets of field notes. Following initial thematic analysis, project outcomes were re-analysed using activity theory and expansive learning as a theoretical framework.ResultsAt project commencement students were not well integrated into the day-to-day clinic functioning. Staff expressed a general view that greater attention to student supervision would compromise patient care. Following the intervention greater clinical team cohesion and workflow changes delivered efficiencies in practice, enhanced relationships among team members, and more positive attitudes towards students. The physical layout of the clinic and clinical workloads were changed to achieve greater involvement of all team members in supporting student learning. Unexpectedly, these changes also improved clinic functioning and increased the number of student placements available.ConclusionsIn navigating the sequential stages of the expansive learning cycle, the clinical team ultimately redefined the ‘object’ of their activity and crossed previously impervious boundaries between healthcare delivery and student supervision with benefits to all parties.

The Medical Education Priorities of Parents Who Use Complementary and Alternative Medicine

Many parents use complementary and alternative medicine (CAM) for their children. A number of medical schools are introducing CAM teaching, and this study was undertaken to explore the medical education priorities of parents who use CAM for their children. A total of 27 parents (25 females, 2 males) participated in 1 of 6 focus group discussions. Transcripts were analyzed using an iterative process of concept identification, hypothesis testing, and detailed comparisons. Participant preferences for health care for their children were complex and informed by previous health care experiences and current family health care needs. Using CAM allowed parents choice and control in managing their family’s health care. Many participant priorities for medical education in CAM echoed key principles of patient-centered care in addition to specific suggestions for curriculum development. Participating parents believed that it was important to increase medical students’ knowledge and understanding of both CAM modalities and the perspectives of parents.

Identifying common learning outcomes for health: celebrating diversity and maximising benefit from regulatory necessity

13 and second-year students who had not yet received lectures on musculoskeletal diseases. Clinical students had completed all coursework and at least six months of required clinical clerkships. We compared the proportion of students endorsing the pharmaceutical advertisement’s explanation between the two groups using a 2 test. We received 247 responses, which after excluding students who stated that they did not have enough of an understanding, yielded 120 responses, 86 pre-clinical and 37 clinical. Half of pre-clinical students chose the television advertisement’s explanation with 27% of students endorsing the Mayo Clinic’s explanation. In contrast, only 16% of clinical students endorsed the advertisement’s explanation with 49% endorsing the Mayo Clinic’s explanation. The decrease between preclinical to clinical students endorsing a pharmaceutical explanation (p5 0.01) and increase between students endorsing Mayo Clinic’s explanation (p1⁄4 0.02) were both significant. The study’s main finding suggests that pre-clinical medical students’ understanding of FM may be influenced by DTCA and that after sufficient medical education, students’ understanding of FM becomes more influenced by evidence-based sources, successfully reversing any influence DTCA may have.

Implementing interprofessional learning curriculum: how problems might also be answers

BackgroundDespite interprofessional learning (IPL) being widely recognised as important for health care professions, embedding IPL within core curriculum remains a significant challenge. The aim of this study was to identify tensions associated with implementing IPL curriculum for educators and clinical supervisors, and to examine these findings from the perspective of activity theory and the expansive learning cycle (ELC).MethodsWe interviewed 12 faculty staff and ten health practitioners regarding IPL. Interviews were semi-structured. Following initial thematic analysis, further analysis was undertaken to characterise existing activity systems and the contradictions associated with implementing IPL. These findings were then mapped to the ELC.ResultsFive clusters of contradictions were identified: the lack of a workable definition; when and what is best for students; the leadership hot potato; big expectations of IPL; and, resisting cultural change. When mapped to the ELC, it was apparent that although experienced as challenges, these contradictions had not yet generated sufficient tension to trigger ‘break through’ novel thinking, or contemplation and modelling of new solutions.ConclusionsThe application of activity theory and the ELC offered an approach in which the most troublesome challenges might be reframed as opportunities for change. Seemingly intractable problems could be worked on to identify and address underlying fears and assumptions. If sufficient tension can be generated, an ELC could then be triggered. In reframing challenges as opportunities, the power of tensions and contradictions as potential levers for effective change might be more successfully accessed.