ORCID Profile
0000-0002-3973-818X
Current Organisation
University of Melbourne
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Medical and Health Sciences not elsewhere classified | Linguistics | Organisational, Interpersonal and Intercultural Communication | Applied Linguistics and Educational Linguistics | Applied Linguistics And Educational Linguistics | Public Health and Health Services | Specialist Studies in Education | Assessment And Evaluation | Education Assessment and Evaluation | Medical And Health Sciences Not Elsewhere Classified | Aged Health Care | Clinical Pharmacy and Pharmacy Practice |
Communication Across Languages and Culture | The professions and professionalisation | Social Structure and Health | Health Related to Ageing | Professions and Professionalisation | Health not elsewhere classified | Social structure and health
Publisher: American Speech Language Hearing Association
Date: 08-06-2018
Abstract: Effective clinical communication is pivotal to the provision of quality hearing health care. To date, audiology students reportedly felt ill-prepared when counseling patients about their hearing impairment, yet there is a paucity of studies exploring how clinical communication is taught and learned in audiology programs. Thus, the aims of the study were (a) to explore final year audiology students' perspectives of their own clinical communication skills during an in-house university clinical placement and (b) to explore students' perceptions of their clinical communication education. Using a qualitative description approach, students were asked to coview their filmed clinical encounter using video reflexivity during a semistructured interview on clinical communication education. Fifteen final year graduate audiology students from The University of Melbourne, Australia, participated in the study. The interviews were audio-recorded and analyzed thematically. The overarching themes of striving to be patient-centered , assessment shapes behavior , and power relations emerged from students' reflection of their own clinical encounter. In addition, the theme what students want described the perceived teaching methods that assisted students' clinical communication practices. The findings of this study highlight the challenges that students perceived during their clinical placement as they strive to enact a patient-centered interaction. An assessment rubric that incorporates communication skills can provide greater opportunities for feedback and self-reflection. Additionally, clinical communication education that adopts experiential learning and is longitudinally integrated into the curriculum can further reinforce students' communication learning needs.
Publisher: Informa UK Limited
Date: 08-07-2022
Publisher: Research Square Platform LLC
Date: 03-06-2021
DOI: 10.21203/RS.3.RS-530357/V1
Abstract: Background Students may be the first to recognise and respond to psychological distress in other students. Peer support could overcome medical student reluctance to seek help despite their high rates of mental ill-health. Yet, despite the adoption of peer support programs, there is little evidence of impact on students. Peer support programs may assume that medical students accept and view peer support positively. We explored these assumptions by asking students about their experiences and views on peer support. Methods Qualitative semi-structured interviews exploring peer support experiences and views on peer support were conducted with ten medical students at two contrasting medical schools. Informed by a constructivist stance, interview transcripts underwent thematic analysis. Results Three groups of themes were identified: participants’ experiences of peer support encounters, concerns about providing support, and views on students’ roles in peer support. Participants readily recalled signs of peer distress. Encounters were ad hoc, informal, and occurred within relationships based on friendship or by being co-located in the same classes or placements. Concerns about initiating and offering support included lack of expertise, maintaining confidentiality, stigma from a mental health diagnosis, and unclear role boundaries, with implications for acceptance of student roles in peer support. Conclusions: Our study emphasised the centrality of social relationships in enabling or discouraging peer support. Relationships developed during medical studies may anticipate the collegial relationships between medical professionals. Nevertheless, only some students are willing to undertake peer support roles. We suggest different strategies for promoting informal peer support that can be offered by any student, to those promoting formal support roles for selected students. Future research focusing on the impact for both the students who receive, and on the students who provide peer support is called for.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/AH17067
Abstract: Objective To identify health literacy issues when providing maternity care to culturally and linguistically erse (CALD) women, and the strategies needed for health professionals to collaboratively address these issues. Methods A qualitative case study design was undertaken at one large metropolitan Australian hospital serving a highly CALD population. Semistructured interviews were conducted with a range of maternity healthcare staff. The data were analysed thematically. The study is informed by a framework of cultural competence education interventions for health professionals and a health literacy framework. Results Eighteen clinicians participated in the interviews (seven midwives, five obstetricians, five physiotherapists, one social worker, and one occupational therapist). Emergent themes of health literacy-related issues were: patient-based factors (communication and cultural barriers, access issues) provider-based factors (time constraints, interpreter issues) and enablers (cultural awareness among staff, technology). Conclusions There are significant health literacy and systemic issues affecting the hospital’s provision of maternity care for CALD women. These findings, mapped onto the four domains of cultural competence education interventions will inform a technology-delivered health literacy intervention for CALD maternity patients. This approach may be applied to other culturally erse healthcare settings to foster patient health literacy. What is known about the topic? There are health inequities for pregnant women of culturally and linguistically erse (CALD) backgrounds. Low health literacy compounded by language and cultural factors contribute to these inequities and access to interpreters in pregnancy care remains an ongoing issue. Pregnancy smart phone applications are a popular source of health information for pregnant women yet these apps are not tailored for CALD women nor are they part of a regulated industry. What does this paper add? This paper provides clinician and language service staff perspectives on key health literacy issues that are both patient-based and provider-based. This research confirms that the complex interplay of social and practical factors contributes to and perpetuates low health literacy, creating barriers to health access it also highlights several enablers for increasing CALD health literacy and access. These include greater health practitioner awareness and accommodation of CALD women’s needs and the provision of culturally and linguistically appropriate eHealth resources. What are the implications for practitioners? eHealth resources are emerging as valuable enabling tools to address the health literacy and information needs of pregnant women. However, these resources need to be used adjunctively with health practitioner communication. Both resource developers and health practitioners need to understand issues affecting CALD patients and their needs. Developers need to consider how the resource addresses these needs. Training of health professionals about culture-specific issues may help to enhance communication with, and therefore health literacy among, in idual cultural groups. Further, formalised language and interpreting training of bi- or multilingual health professionals is advised to ensure that they are able to interpret to a professional standard when called on to do so.
Publisher: Elsevier BV
Date: 10-2020
Publisher: SAGE Publications
Date: 11-03-2019
Abstract: Primary care waiting rooms can be sites of health promotion and health literacy development through the provision of readily accessible health information. To date, few studies have considered patient engagement with televised health messages in the waiting room, nor have studies investigated whether patients ask their clinicians about this information. The aim of this study was therefore to examine patient (or accompanying person) and clinician engagement with waiting room health information, including televised health messages. The mixed methods case study was undertaken in a regional general practice in Victoria, Australia, utilising patient questionnaires, waiting room observations, and clinician logbooks and interviews. The qualitative data were analysed by content analysis the questionnaire data were analysed using descriptive statistics. Patients engaged with a range of health information in the waiting room and reportedly received health messages from this information. 44% of the questionnaire respondents (33 of 74) reported watching the television health program, and half of these reported receiving a take home health message from this source. Only one of the clinicians ( N=9) recalled a patient asking about the televised health program. The general practice waiting room remains a site where people engage with the available health information, with a televised health ‘infotainment’ program receiving most attention from patients. Our study showed that consumption of health information was primarily passive and tended not to activate patient discussions with clinicians. Future studies could investigate any link between the health infotainment program and behaviour change.
Publisher: University of Otago Library
Date: 22-11-2016
Publisher: Frontiers Media SA
Date: 12-05-2023
DOI: 10.3389/FMED.2023.1185818
Abstract: Music therapy is increasingly recognized as an effective support for people living with dementia. However, with incidences of dementia increasing, and limited availability of music therapists, there is a need for affordable and accessible ways that caregivers can learn to use music-therapy based strategies to support the people they care for. The MATCH project aims to address this by creating a mobile application that can train family caregivers in the use of music to support people living with dementia. This study details the development and validation of training material for the MATCH mobile application. Training modules developed based on existing research were assessed by 10 experienced music therapist clinician-researchers, and seven family caregivers who had previously completed personalized training in music therapy strategies via the HOMESIDE project. Participants reviewed the content and scored each training module based on content (music therapists) and face (caregivers) validity scales. Descriptive statistics were used to calculate scores on the scales, while thematic analysis was used to analyze short-answer feedback. Participants scored the content as valid and relevant, however, they provided additional suggestions for improvement via short-answer feedback. The content developed for the MATCH application is valid and will be trailed by family caregivers and people living with dementia in a future study.
Publisher: AMPCo
Date: 05-2012
DOI: 10.5694/MJA10.11473
Abstract: Learning in the clinical setting is the cornerstone of medical school education, but there are strong imperatives to optimise the ways in which students acquire clinical expertise. Deliberate practice is characterised by attention, concentration, effort and repetition of skills it is an important tool for developing and maintaining professional expertise. Research has led to a greater understanding of how medical students develop core clinical skills, especially in the areas of diagnostic reasoning, communication and physical examination. Advances in information technology and instructional design are helping to strengthen the links between formal educational activities and opportunistic learning in the clinical setting.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Informa UK Limited
Date: 09-2007
Publisher: Informa UK Limited
Date: 11-05-2022
DOI: 10.1080/13561820.2022.2066072
Abstract: Peer tutorials - one form of peer-assisted learning (PAL) - are becoming increasingly important in health professions education (HPE). Student tutors usually undergo preparation to support learners in interactive and self-directed learning however, it is unclear whether and to what extent tutors need special preparation to facilitate interprofessional PAL (iPAL) or what impact this preparation might have. To investigate these questions, a mixed-methods study is underway that consists of three sub-studies: (1) an online survey exploring current tutor preparation in Germany, (2) group discussions on training with iPAL tutors in Germany, and (3) interviews with international experts. The quantitative data are analyzed using descriptive statistics, and the qualitative data are analyzed thematically. This study will provide multi-perspective insights into tutor preparation for iPAL. Results may be used to support conclusions and stimulate debate on the didactic legitimacy and design of tutor preparation as well as to inform future research.
Publisher: BMJ
Date: 05-2019
DOI: 10.1136/BMJOPEN-2018-026796
Abstract: The formative aspect of the mini-clinical evaluation exercise (mini-CEX) in postgraduate medical workplace-based assessment is intended to afford opportunities for active learning. Yet, there is little understanding of the perceived relationship between the mini-CEX and how trainees self-regulate their learning. Our objective was to explore trainees’ perceptions of their mini-CEX experiences from a learning perspective, using Zimmerman’s self-regulated learning theoretical framework as an interpretive lens. Qualitative, using semi-structured interviews conducted in 2017. The interviews were analysed thematically. Geriatric medicine training. Purposive s ling was employed to recruit geriatric medicine trainees in Melbourne, Australia. Twelve advanced trainees participated in the interviews. Four themes were found with a cyclical inter-relationship between three of these themes: namely, goal setting, task translation and perceived outcome. These themes reflect the phases of the self-regulated learning framework. Each phase was influenced by the fourth theme, supervisor co-regulation. Goal setting had motivational properties that had significant impact on the later phases of the cycle. A ‘tick box’ goal aligned with an opportunistic approach and poorer perceived educational outcomes. Participants reported that external feedback following assessment was critical for their self-evaluation, affective responses and perceived outcomes. Trainees perceived the performance of a mini-CEX as a complex, inter-related cyclical process, influenced at all stages by the supervisor. Based on our trainee perspectives of the mini-CEX, we conclude that supervisor engagement is essential to support trainees to in idually regulate their learning in the clinical environment.
Publisher: Wiley
Date: 03-06-2015
DOI: 10.1111/JOCN.12879
Abstract: To understand the intercultural communication experiences and associated communication training needs of overseas qualified nurses in the Australian healthcare system from the unique perspectives of nurse educators teaching in accredited bridging programmes. Overseas qualified nurses are an integral part of the nursing workforce in migration destination countries. Communication training needs are more complex when there are cultural, ethnic and language differences between nurses, other health professionals and patients. A qualitative, exploratory research design using semi-structured interviews. All (nine) organisations involved in conducting the Australian Health Practitioner Regulation Agency approved preregistration bridging programmes for overseas qualified nurses within the state of Victoria, Australia, were involved in the study. Participants were 12 nurse educators employed in these organisations. Thematic analysis was undertaken. Three macro themes emerged about the overseas qualified nurses' intercultural communication: (1) pre-existing barriers and enablers to intercultural communication, for ex le, nurses' reluctance to engage in communicative strategies that build rapport with patients, (2) transitional behaviours and impact on communication, including maintenance of perceived cultural hierarchies between health professionals and (3) development of communicative competence, including expanding one's repertoire of conversational gambits. The findings point to the domains and causes of communication challenges facing overseas qualified nurses in new healthcare settings as well as strategies that the nurse educators and nurses can adopt. Communication cannot be merely regarded as a skill that can be taught in a didactic programme. Comprehensive understanding is needed about the sociocultural dimensions of these nurses' orientation, which can impact on how they communicate in their new healthcare settings. The findings can act as triggers for discussion with overseas qualified nurses and other health professionals to raise awareness about the aspects of intercultural communication and to debate alternative viewpoints and explanations. They can also inform changes in the structure and content of the bridging programmes.
Publisher: The Association for Language Testing and Assessment of Australia and New Zealand
Date: 2015
DOI: 10.58379/MFBR6523
Abstract: n/a
Publisher: Wiley
Date: 14-11-2013
DOI: 10.1111/JAN.12296
Abstract: To examine the feedback given by nurse educators and clinicians on the quality of communication skills of nurses in interactions with simulated patients. The quality of communication in interactions between nurses and patients has a major influence on patient outcomes. To support the development of effective nursing communication in clinical practice, a good understanding of what constitutes effective communication is helpful. An exploratory design was used involving in idual interviews, focus groups and written notes from participants and field notes from researchers to investigate perspectives on nurse-patient communication. Focus groups and in idual interviews were held between August 2010-September 2011 with a purposive s le of 15 nurse educators and clinicians who observed videos of interactions between nurses and simulated patients. These participants were asked to give oral feedback on the quality and content of these interactions. Verbatim transcriptions were undertaken of all data collected. All written notes and field notes were also transcribed. Thematic analysis of the data was undertaken. Four major themes related to nurse-patient communication were derived from the educators' and clinicians' feedback: approach to patients and patient care, manner towards patients, techniques used for interacting with patients and generic aspects of communication. This study has added to previous research by contributing grounded evidence from a group of nurse educators and clinicians on the aspects of communication that are relevant for effective nurse-patient interactions in clinical practice.
Publisher: John Benjamins Publishing Company
Date: 2007
DOI: 10.2104/ARAL0709
Abstract: Classroom discourse analysis has contributed to understandings of the nature of student-teacher interactions, and how learning takes place in the classroom however, much of this work has been undertaken in teacher-directed learning contexts. Student-centred classrooms such as problem-based learning (PBL) approaches are increasingly common in professional disciplines such as the health sciences and medicine. With the globalisation of education, health science and medical education, PBL classrooms are often sites of considerable linguistic and cultural ersity, yet little is known from a classroom discourse perspective about the language demands of PBL. This paper examines the ways in which the students and tutor negotiate and construct meanings through language in one first year physiotherapy PBL tutorial at an Australian university, with a particular focus on the ways in which the discourse is regulated in a student-centred learning environment. The analysis of the classroom discourse is underpinned by Halliday’s systemic functional linguistics. The findings provide a description of the linguistic resources students draw on to co-construct and negotiate knowledge, as well as show how the tutor, with minimal strategic interventions, scaffolds the students’ learning. The findings also suggest that the PBL environment can be a challenging one for students whose cultural and language backgrounds are different from that of the classroom.
Publisher: Elsevier BV
Date: 2004
Publisher: Elsevier BV
Date: 10-2008
Publisher: SAGE Publications
Date: 25-01-2016
Abstract: Online support groups (OSGs) are common sources of both health information and social support. To augment existing qualitative understandings of member roles and identities in OSGs, this article presents a corpus-based investigation of shifts in member lexicogrammatical and discourse-semantic choices in a bipolar disorder OSG. In total, 8.4 million words in 57,000 posts were transformed into a structured, grammatically annotated corpus and investigated using systemic functional linguistics (SFL) as a theoretical framework, focusing on interpersonal and experiential meanings. The findings of mood and transitivity analyses show marked differences between new and veteran members’ language choices over the course of membership in the OSG: particularly, in how veteran members provide advice, and in how new and veteran members ascribe and attribute bipolar disorder to both the self and others. Discussion addresses the affordances and limitations of corpus linguistics and SFL as strategies for providing quantitative support for key claims of earlier research in this field.
Publisher: Public Library of Science (PLoS)
Date: 14-12-2022
DOI: 10.1371/JOURNAL.PONE.0278872
Abstract: Peer-assisted learning (PAL)–especially peer tutorials–are gaining momentum in health professions education, particularly in interprofessional education. As little is known about the use of peer tutorials or the preparation of tutors in this context in Germany and in other countries, this study aims to provide an overview of these interventions. A cross-sectional study with a descriptive-exploratory design was conducted. German institutions for health professions education were contacted, and in iduals with pedagogical responsibilities were invited to participate in an online survey. The survey was informed by two studies in which seven domains were identified as important. These included facts about the institution, the offer of PAL, the use of tutorials, and the design of tutor training. The survey used mostly closed-ended questions. The questionnaire was completed by n = 100 participants. Overall, n = 46 participants indicated that PAL was offered at their institution. Of these 46 participants, 32 (70%) indicated that uniprofessional PAL was offered, 2 (4%) indicated that interprofessional PAL was offered, and 12 (26%) indicated that both forms of PAL were offered. Peer tutoring was the most common format in both cases (73% for uniprofessional and 64% for interprofessional PAL), and mandatory interventions were mostly used to prepare the tutors. These interventions were held by educators or lecturers and were offered mostly face-to-face as workshops or as discussions. Deepening the tutors’ social competencies through training was given high relevance. Regarding content, focus was placed on communication, (self-)reflection, and group management. Eighty-eight participants expressed recommendations for future directions in terms of preparing tutors for interprofessional PAL. Minor differences between the use of uniprofessional and interprofessional PAL and tutor training were found. Nevertheless, implementation strategies varied. In future, preparatory measures for tutors should be more uniformly designed and geared to the specific requirements of uniprofessional and interprofessional learning, and that at best on an empirical basis.
Publisher: JMIR Publications Inc.
Date: 16-11-2018
DOI: 10.2196/MHEALTH.9119
Publisher: SAGE Publications
Date: 16-10-2021
DOI: 10.1177/10497323211043494
Abstract: Communicating about medications across transitions of care is a challenging process for older patients. In this article, we examined communication processes between older patients, family members, and health professionals about managing medications across transitions of care, focusing on older patients’ experiences. A focused ethnographic design was employed across two metropolitan hospitals. Data collection methods included interviews, observations, and focus groups. Following thematic analysis, data were analyzed using Fairclough’s Critical Discourse Analysis and Medication Communication Model. Older patients’ medication knowledge and family members’ advocacy challenged unequal power relations between clinicians and patients and families. Doctors’ use of authoritative discourse impeded older patients’ participation in the medication communication. Older patients perceived that nurses’ involvement in medication communication was limited due to their task-related routines. To reduce the unequal power relations, health professionals should be more proactive in sharing information about medications with older patients across transitions of care.
Publisher: Equinox Publishing
Date: 17-02-2022
DOI: 10.1558/CAM.19234
Abstract: Research has identified the tasks associated with effective patient-centered communication (PCC), but less is known about the contexts that can enable or hinder its implementation. This study explores East Slavic doctors’ perspectives and experiences of intercultural PCC with Western patients. Semi-structured interviews informed by the principles of PCC were carried out with 15 doctors from two private clinics in Ukraine. The interviews were analyzed both for content and themes, informed by the dimensions of culture approach developed by Geert Hofstede and co-authors. The findings suggest disparities between the Ukrainian doctors’ perspectives and experiences of PCC and those encountered in the West, with those of the former seeming to be influenced by socio-historical and educational barriers, and by dimensions of national culture in Ukraine. In conceptualizing PCC, the societal context needs to be taken into account, lest some important functions of medical communication be placed at risk.
Publisher: Elsevier BV
Date: 09-2009
Publisher: Walter de Gruyter GmbH
Date: 2016
DOI: 10.1515/CERCLES-2016-0012
Abstract: In many Western countries such as Australia, international medical graduates (IMGs) play a crucial role in meeting health workforce needs. For doctors for whom English is an additional language and who have received their medical education in non-Western settings, a challenge is the patient-centred approach to communication, which is well established in Western medical education as the optimal approach for safe and effective healthcare. It acknowledges the patient as an active participant in the healthcare interaction, and the importance of the psychosocial dimension of patient well-being. While there is a vast literature on doctor-patient discourse in the qualitative health literature, there is little in the medical education domain that systematically examines the linguistic patterns of doctors who are learning or are less familiar with patient-centred paradigms of communication. This article examines how IMG doctors manage patient-centred interviewing. The data are 15 video-taped 8-minute roleplay consultations of IMGs and simulated patients. Systemic functional linguistics and genre theory provided the theoretical framework and tools to analyse how the doctors realised the tasks of patient-centred communication as informed by the medical education literature, with a particular focus on the tasks of gathering information, providing information and decision-making. The findings suggest that the discourse patterns of doctor-patient communication demonstrated by the IMG doctors were
Publisher: Informa UK Limited
Date: 23-10-2020
DOI: 10.1080/09638288.2020.1836271
Abstract: Effective communication in interprofessional rehabilitation teams is essential for optimal patient care. Despite the established importance, it remains unclear how interprofessional communication (IPC) within teams contributes to rehabilitation service delivery. The aim of this scoping review was to investigate how IPC has been described in rehabilitation literature. Databases (Medline, CINAHL, ERIC, Embase, PsychInfo, and Academic Search Complete) were searched for studies including rehabilitation interprofessional communication. Inclusion and exclusion criteria were identified and applied, data were charted, and thematic analysis conducted. Twenty-nine papers were identified, and analysis revealed interrelated themes: communication processes, and inputs and effects. Formal communication processes were most prevalent, portraying variability in professional participation and a lack of patient involvement in dialogue and decision making. Inputs and effects were described at an organisational, team and in idual level, highlighting the importance of communication throughout the healthcare hierarchy. IPC in rehabilitation is central to effective team function and patient care. To further our understanding, empirical studies examining everyday informal IPC, as well as formal ritualised encounters are needed. Additionally, conceptualisations of IPC would benefit from including the patients' perspective and by using theoretical framing to attend to places, spaces, and artefacts identified in this review.
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.NEDT.2022.105379
Abstract: Increasing demand and limited supply of clinical placements in nursing underscore the need to better understand the role of clinical placements in students' learning. Identifying pedagogically rich activities that support work place learning alongside factors that influence educational outcomes has the potential to optimise professional placement experiences. To explore student nurses perceptions of the value of nursing clinical placements to their learning. A descriptive research design was employed using a sequential mixed method approach. A cross-sectional student survey captured students' perceptions of work integrated learning based on the perceived contribution of a pre-determined list of activities undertaken on clinical placement. Four Australian universities took part. Participants included students undertaking entry to practice programs. Four hundred and sixty-nine students completed the survey. Thirty-eight students participated in 12 focus groups. Participants rated PRA including interacting and time with patients and performing assessments as the most useful activities. Less useful, were activities that took them away from the patient. To maximise workplace learning, consideration must be given to ensuring students are presented with goal directed activities that support learning and are focused on an expanding scope of practice with opportunities to discuss and engage with staff.
Publisher: Informa UK Limited
Date: 30-03-2023
Publisher: International Journal of Medical Education
Date: 30-05-2022
Publisher: Wiley
Date: 16-07-2015
DOI: 10.1111/TCT.12423
Abstract: Communication in emergency departments (EDs), often between several health professionals and patients and relatives, is a major cause of patient complaint and error however, communication-skills teaching for medical students largely focuses on in idual clinician-patient interactions. We developed and implemented an evidence-informed online resource, Communication for Health in Emergency Contexts (CHEC www.chec.meu.medicine.unimelb.edu.au/resources) to raise medical students' awareness of the challenges of communication in the ED, and to provide students with communication strategies for addressing these challenges. The foundation of the CHEC resource was the findings and data from a large research project conducted at five emergency departments in Australia over the period 2006-2009. From this, we developed ED scenarios and teaching vignettes using authentic communication data. The project included a nationwide medical curriculum scoping phase, involving interviews with medical students and educators, on ED communication curriculum needs in order to inform the educational activities. The CHEC resource provides students with the opportunity to follow real-life scenarios through all stages of the ED journey, whereas insights from ED medical and nursing staff provide learning opportunities about interprofessional communication for medical students. Evaluation suggests that students find the resource useful, and that the resource has been successfully embedded in medical and junior doctor training on communication and quality and safety. The CHEC resource enhances the capacity of busy clinical educators to raise students' awareness of the communication needs of emergency health care by focusing on communication in high-stress, time-pressured settings using a web format. The CHEC resource provides students with the opportunity to follow real-life scenarios through all stages of the ED journey.
Publisher: Elsevier BV
Date: 02-2019
Publisher: Wiley
Date: 31-07-2022
DOI: 10.5694/MJA2.51651
Publisher: Wiley
Date: 27-05-2022
DOI: 10.1111/HEX.13524
Abstract: Communicating about medications across transitions of care is important in older patients who frequently move between health care settings. While there is increasing interest in understanding patient communication across transitions of care, little is known about older patients' involvement in formal and informal modes of communication regarding managing medications. The aim of this paper was to explore how older patients participated in managing their medications across transitions of care through formal and informal modes of communication. The study was conducted across two metropolitan hospitals: an acute hospital and a geriatric rehabilitation hospital in metropolitan Melbourne, Australia. A focused ethnographic design was used involving semi‐structured interviews ( n = 50), observations (203 h) and in idual interviews or focus groups ( n = 25). Following thematic analysis, data were analysed using Fairclough's Critical Discourse Analysis. Data analysis revealed two major discursive practices, which comprised of an interplay between formal and informal communication and environmental influences on formal and informal communication. Self‐created patient notes were used by older patients to initiate informal discussion with health professionals about medication decisions, which challenged traditional unequal power relations between health professionals and patients. Formal prompts on electronic medication administration records facilitated the continuous information discourse about patients' medications across transitions of care and encouraged health professionals to seek out older patients' preferences through informal bedside interactions. Environmental influences on communication comprised health professionals' physical movements across private and public spaces in the ward, their distance from older patients at the bedside and utilization of the computer systems during patient encounters. Older patients' self‐created medication notes enabled them to take on a more active role in formal and informal medication communication across transitions of care. Older patients and family members did not have continuous access to information about medication changes during their hospital stay and systems often failed to address older patients' key concerns about their medications, which hindered their active involvement in formal and informal communication. Older adults, family members and health professionals volunteered to be interviewed and observed.
Publisher: AMPCo
Date: 09-2016
DOI: 10.5694/MJA16.00216
Publisher: MDPI AG
Date: 08-04-2021
Abstract: Communication breakdowns contribute to medication incidents involving older people across transitions of care. The purpose of this paper is to examine how interprofessional and intraprofessional communication occurs in managing older patients’ medications across transitions of care in acute and geriatric rehabilitation settings. An ethnographic design was used with semi-structured interviews, observations and focus groups undertaken in an acute tertiary referral hospital and a geriatric rehabilitation facility. Communication to manage medications was influenced by the clinical context comprising the transferring setting (preparing for transfer), receiving setting (setting after transfer) and ‘real-time’ (simultaneous communication). Three themes reflected these clinical contexts: dissemination of medication information, safe continuation of medications and barriers to collaborative communication. In transferring settings, nurses and pharmacists anticipated communication breakdowns and initiated additional communication activities to ensure safe information transfer. In receiving settings, all health professionals contributed to facilitating safe continuation of medications. Although health professionals of different disciplines sometimes communicated with each other, communication mostly occurred between health professionals of the same discipline. Lack of communication with pharmacists occurred despite all health professionals acknowledging their important role. Greater levels of proactive preparation by health professionals prior to transfers would reduce opportunities for errors relating to continuation of medications.
Publisher: Elsevier BV
Date: 07-2014
Publisher: Elsevier BV
Date: 2002
Publisher: SAGE Publications
Date: 23-06-2022
DOI: 10.1177/15271544221102964
Abstract: Forecasts predict a growing shortage of skilled nursing staff in countries worldwide. Nurse migration is already a common strategy used to address nursing workforce needs. Germany, the UK, and Australia are reviewed here as ex les of destination countries for nurse migrants. Agreements exist between countries to facilitate nurse migration however, it is not evident how nurse migrants have contributed to data on which these arrangements are based. We examined existing primary research on nurse migration, including educational needs and initiatives to support policymakers’, stakeholders’, and health professions educators’ decisions on measures for ethical and sustainable nurse migration. We conducted a rapid evidence assessment to review available empirical research data which involved, was developed with, or considered migrant nurses to address the research question: what are the findings of research that directly involves migrant nurses in producing primary research data? A total of 56 papers were included. Four main themes were identified in this research data: Research does not clearly define what is meant by the term migrant nurses discrimination is often reported by migrant nurses language and communication competencies are important and structured integration programs are highly valued by migrant nurses and destination healthcare employers. Migrant nurses continue to experience discrimination and reduced career opportunities and therefore should be included in research about them to better inform policy. Structured integration programs can improve the experience of migrant nurses by providing language support (if necessary), a country-specific bridging program and help with organisational hurdles. Not only researching migrant nurses but making them active partners in research is of great importance for successful, ethical, and sustainable migration policies. A broader evidence base, especially with regard to the views and experiences of migrant nurses and their educational support needs, should be promoted to make future immigration policy more needs-based, sustainable and ethically acceptable.
Publisher: The Royal Australian College of General Practitioners
Date: 06-2018
Publisher: University of Otago Library
Date: 27-11-2017
Publisher: Wiley
Date: 10-05-2012
DOI: 10.1002/TESQ.26
Publisher: Elsevier BV
Date: 02-2021
Publisher: The Royal Australian College of General Practitioners
Date: 03-2022
Publisher: Equinox Publishing
Date: 29-11-2011
DOI: 10.1558/CAM.V8I1.41
Abstract: In Australia, international medical graduates (IMGs) play a crucial role in addressing workforce shortages in healthcare. Their ability to deliver safe and effective healthcare in an unfamiliar cultural setting is intrinsically tied to effective communication. Hospital based medical clinical educators, who play an important role in providing communication training to IMGs, would benefit from practical resources and an understanding of the relevant pedagogies to address these issues in their teaching. This paper aims to examine the nature of an interdisciplinary collaboration to develop multimedia resources for teaching clinical and ethical communication to IMGs. We describe the processes and dynamics of the collaboration, and outline the methodologies from applied linguistics, medical education, and health ethics that we drew upon. The multimedia consist of three video clips of challenging communication scenarios as well as experienced IMGs talking about communication and ethics. The multimedia are supported by teaching guidelines that address relevant disciplinary concerns of the three areas of collaboration. In the paper’s discussion we point out the pre-conditions that facilitated the interdisciplinary collaboration. We propose that such collaborative approaches between the disciplines and participants can provide new perspectives to address the multifaceted challenges of clinical teaching and practice.
Publisher: Oxford University Press (OUP)
Date: 09-2020
DOI: 10.1093/EURPUB/CKAA165.532
Abstract: Nurse migration is increasingly seen as an appropriate response to address nursing shortages in overburdened health systems. This paper aims to analyse the situation in Germany, the UK and Australia and identify similarities and differences in the dimensions, perceptions and processing of nurse migration in different health systems. A rapid evidence assessment and comparative situation analysis of routine data obtained from public health, education and labour market reporting systems, and academic and grey literature were carried out in Jan-Feb 2020. Primary outcome measures were key data of nurse population and migration, barriers and opportunities, and educational initiatives to support migrating nurses to meet the requirements to work in the destination country. Germany, the UK and Australia are confronted with an ageing and increasingly chronically ill population and severe nursing shortages. Skilled migration is seen as an opportunity to address these problems, but each country is faced with different contextual conditions and requirements. Data on the nurse workforce obtained from public health, educational and labour market reporting systems are more differentiated and extensive in the UK and Australia than in Germany. Furthermore, there is a substantial amount of published literature in the UK (n = 65) and Australia (n = 87) on nurse migration and on how the countries address challenges in this area in comparison to the German context, where such research is limited (n = 7). Available research focuses on the economic, epidemiological and geographical impact and distribution of nurse migration. Qualitative dimensions and educational requirements are less well discussed. Evidence on nursing migration is strongly based on quantitative factors and may not reflect current needs. More information about qualitative aspects of nurse migration is required to develop recommendations that support enhanced nursing workforce migration. Nurse Migration presents many challenges that have not yet been fully researched. Results of a comparative analysis of three countries offer the opportunity to highlight missed opportunities.
Publisher: Routledge
Date: 20-09-2022
Publisher: SAGE Publications
Date: 16-07-2023
DOI: 10.1177/14713012231190578
Abstract: There is a growing demand for interpreter-mediated cognitive assessments for dementia. However, most interpreters lack specialist knowledge of dementia and cognitive assessment tools. This can negatively affect the way instructions and responses are conveyed between clinicians and patients, undermining clinicians’ ability to accurately assess for cognitive impairment. This article reports on the co-design of an online dementia training package, MINDSET, which aims to address this gap. Two iterative online co-design workshops were conducted in October and November 2021, using a World Café approach. Sixteen clinicians, interpreters, and multilingual family carers of a person with dementia participated. Based on these workshops, training and assessment materials were developed and tested with 12 interpreters from April to June 2022. The training package comprises online modules: 1) Knowledge of Dementia and Australia’s Aged Care System, 2) Briefings and Introductions, 3) Interpreting Skills, 4) Interpreting Ethics, and 5) Cross-cultural Communication. The codesign process highlighted ergent perspectives between clinicians and interpreters on an interpreter’s role during a cognitive assessment, but it also facilitated negotiation and consensus building, which enriched the training content. The training is now developed and will be evaluated in a randomized control trial and subsequent implementation study.
Publisher: John Benjamins Publishing Company
Date: 2006
DOI: 10.2104/ARAL0610
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.SOCSCIMED.2015.08.038
Abstract: In physiotherapy, the therapeutic relationship--in which a therapist and patient work together to achieve treatment goals--is increasingly seen as the foundation of patient care. How the therapeutic relationship is established and enacted, however, is not well understood. One way to better understand the nature of the relationship is to examine how therapists and patients evaluate and inform each other about the patient's physical capacity, sensation, and emotions. As the patient and therapist's talk is the primary means to realise and exchange such evaluations, our focus is on evaluative language used by the therapist and patient in their interactions. The aim of this paper is to examine the language and function of evaluation in physiotherapy consultations. The study is a discourse analytic one using Appraisal Theory. In Appraisal Theory, language resources that speakers use to construe evaluations such as emotions, judgments of behaviour and aesthetics are expressed as a system. The sub-systems are Affect (expressing emotion), Judgment (assessing behaviour) and Appreciation (evaluating processes and objects). The data are a convenience s le of 18 consultations from two cultural and therapeutic settings: primary healthcare (Sweden, Australia) and hospital rehabilitation (Australia). The findings show that both patient and therapist utilise all sub-systems of Appraisal however, use of the sub-systems by the therapist and patient differs functionally. Judgment and Appreciation play a central role in therapists' co-construction of patients' physical history and presenting problem. In contrast, patient Affect evaluations, mainly to do with emotions about loss of capacity and pain, are generally not followed up by the therapist. The findings suggest that while patients engage with the therapeutic relationship from a clinical and interpersonal perspective, therapists are more narrowly focused on their own clinical tasks. The study findings have implications for understandings of the therapeutic relationship in physiotherapy and can inform teaching.
Publisher: Springer Science and Business Media LLC
Date: 31-07-2023
DOI: 10.1186/S12909-023-04537-1
Abstract: Improving oncology-specific knowledge and skills of healthcare professionals is critical for improving the outcomes of people with cancer. Many current postgraduate education offerings may be inaccessible to busy professionals, contain minimal consumer input or do not focus on the multidisciplinary nature of cancer care. In response to these needs, a Master of Cancer Sciences degree was developed. Our aim is to describe the development of the Master of Cancer Sciences. We describe the development of the Master of Cancer Sciences, including its theoretical and its pedagogical underpinnings. Our approach to curriculum design was guided by Kern’s Six-Step Approach to Medical Curriculum and underpinned by the Seven Principles of Online Learning. These approaches were further underpinned by the Cognitive Theory of Multimedia Learning which informed our approach to audio and visual information design. The pedagogy is interactive, experiential, interprofessional and importantly, includes consumers as educators. In practice, learning activities include peer feedback, multidisciplinary team meeting simulations, group work and clinical role plays. The online environment was visually shaped through infographics, high-quality educational videos and gamification. We have designed a Master of Cancer Sciences that is one of the first wholly online, cancer-specific Masters’ programs. Its industry-led curriculum using evidence-based pedagogical choices utilises a range of novel digital formats and integrates the consumer perspective to provide a holistic overview of the field. Quantitative and qualitative evaluation of learning outcomes is ongoing.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2011
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 06-2023
Publisher: ACM
Date: 28-11-2017
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 07-2023
Publisher: Informa UK Limited
Date: 27-08-2018
Publisher: SAGE Publications
Date: 09-11-2015
Abstract: The aim of this paper is to investigate from a discourse analytic perspective task authenticity in the speaking component of the Occupational English Test (OET), an English language screening test for clinicians designed to reflect the language demands of health professional–patient communication. The study compares the OET speaking sub-test roleplay performances of 12 doctors who were successful OET candidates with practice Objective Structured Clinical Examination (OSCE) roleplay performances of 12 international medical graduates (IMGs) preparing for the Australian Medical Council clinical examination. The premise for the comparison is that the OSCE roleplays can represent communication practices that are valued within the medical profession therefore a finding of similarity in the discourse structure across the OET and the OSCE roleplays could be taken as supporting the validity of the OET as a tool for eliciting relevant communication skills in the medical profession. The study draws on genre theory as developed in Systemic Functional Linguistics (SFL) in order to compare the roleplay discourse structure and the linguistic realizations of the two tasks. In particular, it examines the role relationships of the participants (i.e. the tenor of the discourse), and the ways in which content is represented (i.e. the field of the discourse) by roleplay participants. The findings reveal some key similarities but also important differences. Although both tests inevitably fall short in terms of authentic representation of real world interactions, the findings suggest that the OET task, for a range of reasons including time allowances, training of test interlocutors, and the limits of contextual information provided to candidates, constrains candidate topic exploration and treatment negotiation, compared to the OSCE format. The paper concludes with proposals for mitigating these limitations in the interests of enhancing the OET’s capacity to elicit more professionally relevant language and communication skills.
Publisher: Wiley
Date: 26-06-2016
DOI: 10.1111/TCT.12392
Abstract: Front-line administrative, academic and clinical teaching staff often find themselves providing pastoral and learning support to students, but they are often not trained for this role, and this aspect of their work is under-acknowledged. Staff participating in an action research study at two medical schools identified common concerns about the personal impact of providing student support, and of the need for professional development to carry out this responsibility. This need is magnified in clinical placement settings that are remote from on-c us services. Informed by participatory action research, brief interactive workshops with multimedia training resources were developed, conducted and evaluated at eight health professional student training sites. These workshops were designed to: (1) be delivered in busy clinical placement and university settings (2) provide a safe and inclusive environment for administrative, academic and clinical teaching staff to share experiences and learn from each other (3) be publicly accessible and (4) promote continued development and roll-out of staff training, adapted to each workplace (see www.uws.edu.au/meusupport). The workshops were positively evaluated by 97 participants, with both teaching and administrative staff welcoming the opportunity to discuss and share experiences. Staff supporting health professional students have shared, often unmet, needs for support themselves Staff supporting health professional students have shared, often unmet, needs for support themselves. Participatory action research can be a means for producing and maintaining effective training resources as well as the conditions for change in practice. In our workshops, staff particularly valued opportunities for guided discussion using videos of authentic cases to trigger reflection, and to collaboratively formulate student support guidelines, customised to each site.
Publisher: Springer Science and Business Media LLC
Date: 20-04-2022
DOI: 10.1186/S12909-022-03368-W
Abstract: Students may be the first to recognise and respond to psychological distress in other students. Peer support could overcome medical student reluctance to seek help despite their high rates of mental ill-health. Yet, despite the adoption of peer support programs, there is little evidence of impact on students. Peer support programs may assume that medical students accept and view peer support positively. We explored these assumptions by asking students about their experiences and views on peer support. Qualitative semi-structured interviews exploring peer support experiences and views on peer support were conducted with ten medical students at two contrasting medical schools. Informed by a constructivist stance, interview transcripts underwent thematic analysis. Three groups of themes were identified: participants’ experiences of peer support encounters, concerns about providing support, and views on students’ roles in peer support. Participants readily recalled signs of peer distress. Encounters were ad hoc, informal, and occurred within relationships based on friendship or by being co-located in the same classes or placements. Concerns about initiating and offering support included lack of expertise, maintaining confidentiality, stigma from a mental health diagnosis, and unclear role boundaries, with implications for acceptance of student roles in peer support. Our study emphasised the centrality of social relationships in enabling or discouraging peer support. Relationships developed during medical studies may anticipate the collegial relationships between medical professionals. Nevertheless, only some students are willing to undertake peer support roles. We suggest different strategies for promoting informal peer support that can be offered by any student, to those promoting formal support roles for selected students. Future research focusing on the impact for both the students who receive, and on the students who provide peer support is called for.
Publisher: Springer Science and Business Media LLC
Date: 29-03-2019
Publisher: Informa UK Limited
Date: 09-10-2017
DOI: 10.1080/14992027.2017.1385863
Abstract: Patient-centred communication (PCC) is an essential skill for effective healthcare provision and is accepted as a core competency in medicine and allied health. In audiology, recent studies have shown that audiologists rarely display PCC in adult hearing interactions. This highlights a need to investigate how PCC is taught and learnt in audiology. There is a paucity of studies on PCC in audiology education. The aim of this study is to examine educator perceptions of teaching PCC, including barriers and facilitators, in Australian graduate audiology programmes. Semi-structured interviews were conducted with audiology educators responsible for communication training. Interview transcripts were analysed using qualitative content analysis. Nine participants, including programme coordinators and key teaching staff from all six Australian audiology programmes participated in the study. PCC education was found to be influenced by four emerging themes: professional culture and values, contextual factors, knowledge and understanding of PCC and in idual factors. These results provide an insight into the competing agendas involved in implementing PCC education in both the university and clinical component of audiology programmes. The findings can play a role in refining and building the evidence-base for teaching and facilitating patient-centred audiological care in future audiologists.
Publisher: The Royal Australian College of General Practitioners
Date: 06-2018
Publisher: Springer Science and Business Media LLC
Date: 22-04-2019
DOI: 10.1007/S10459-019-09892-7
Abstract: Medical schools, programs and educators are increasingly expected to address medical student stress and wellbeing, yet also ensure student competence and fitness to practice. Educators play a central role in supporting students when evaluating a student's concerns and in deciding whether support and/or sanction should be offered. It is not known how educators approach or resolve such potentially contradictory responses. We conducted an interview study of 21 medical educators from a range of professional backgrounds across 11 on-c us and clinical teaching sites. Using Positioning Theory to inform our thematic analysis, we found that participants adopted an overarching position of Diagnostician, and at times, two alternative positions, the Judge and the Confidant when supporting students. In their narratives of support encounters, in idual students were positioned as Good Students or Troubling Students. For most, educator positions were fluid and responsive to the storylines enacted in encounters. Rigidly adopting Judge or Confidant positions could lead to "failure to fail" and violations of professional boundaries. Positioning Theory locates student support in a moral space and helps explain the consternation experienced by educators when support is not effective. Positioning analysis offers a language, and metaphors which are meaningful to educators, for framing discussion and reviews of support practices and progression decisions. Such insights could encourage reflective practice and guide further research to inform practice when students with troubling concerns and persistently borderline performances require support.
Publisher: The Association for Language Testing and Assessment of Australia and New Zealand
Date: 2013
DOI: 10.58379/MOUR8675
Abstract: n/a
Publisher: SAGE Publications
Date: 26-04-2016
Publisher: Informa UK Limited
Date: 06-05-2015
Publisher: Springer Science and Business Media LLC
Date: 26-05-2016
Publisher: Elsevier BV
Date: 12-2010
Publisher: Elsevier BV
Date: 09-2009
Publisher: John Benjamins Publishing Company
Date: 15-04-2019
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 05-2023
Publisher: BMJ
Date: 06-12-2018
Publisher: Equinox Publishing
Date: 31-12-2018
DOI: 10.1558/JAPL.31857
Publisher: JMIR Publications Inc.
Date: 05-10-2017
Abstract: regnancy apps are a booming global industry, with most pregnant women in high-income countries now using them. From the perspective of health care and health information provision, this is both encouraging and unsettling the demand indicates a clear direction for the development of future resources, but it also underscores the importance of processes ensuring access, reliability, and quality control. his review provides an overview of current literature on pregnancy apps and aims at describing (1) the ways in which apps are used by women, in general, and by those of a culturally and linguistically erse (CALD) background (2) the utility and quality of information provided and (3) areas where more research, development, and oversight are needed. e chose a narrative review methodology for the study and performed a structured literature search including studies published between 2012 and 2017. Searches were performed using MEDLINE, EMBASE, and CINAHL databases. Studies were identified for inclusion using two separate search criteria and strategies: (1) studies on pregnancy apps and pregnant women’s use of these apps and (2) studies on CALD pregnant women and their use of technology for accessing information on and services for pregnancy. Overall, we selected 38 studies. e found that pregnancy apps were principally used to access pregnancy health and fetal development information. Data storage capability, Web-based features or personalized tools, and social media features were also popular app features sought by women. Lower rates of the pregnancy app uptake were indicated among lower-income and non-English-speaking women. Preliminary evidence indicates that a combination of technological, health literacy, and language issues may result in lower uptake of pregnancy apps by these groups however, further investigation is required. A marked limitation of the health app industry is lack of regulation in a commercially dominated field, making it difficult for users to assess the reliability of the information being presented. Health professionals and users alike indicate that given the choice, they would prefer using pregnancy apps that are relevant to their local health care context and come from a trusted source. Evidence indicates a need for greater health professional and institutional engagement in the app development, as well as awareness of and guidance for women’s use of these resources. his is the first review of pregnancy app use, types of information provided, and features preferred by pregnant women in general and by those of a CALD background in particular. It indicates the demand for access to accurate information that is relevant to users, their community, and their associated health services. Given the popularity of pregnancy apps, such apps have enormous potential to be used for the provision of accurate, evidence-based health information.
Publisher: International Journal of Medical Education
Date: 31-08-2012
Publisher: SAGE Publications
Date: 26-04-2016
Abstract: Low-participation of culturally and linguistically erse (CALD) patients in medical research remains a problem in migrant and refugee destination countries such as Australia. The aims of this study were to explore i) CALD persons’ perceptions and experiences of the medical system and medical research, in this case, older Italian Australians and ii) the views of research professionals on CALD patient participation in medical research. A qualitative study was conducted in Melbourne, Australia, in 2015 utilising in-depth interviews and focus groups with four stakeholder groups: older Italian Australians (n=21) adult children of older Italian Australians (n=10) hospital Human Research Ethics Committee administrators (n=4) and clinical researchers (n=4). The data were analysed for content and thematic analysis. Themes for the CALD and family group were getting by in medical interactions receptivity to medical research: testing the waters and, receptivity to technology for support: passive versus active. Themes for the researcher and HREC groups about CALD patient participation in research were: exclusion cultural factors and e-consent. Our findings from four stakeholder perspectives and experiences confirm that there were considerable cultural, linguistic, and resourcing barriers hindering the participation of older Italian-Australians in medical research. Furthermore, our findings showed that in this study setting there were few enabling strategies in place to address these barriers despite the national ethics guidelines for equitable participation in research. The findings informed the creation of a multimedia tool whose purpose is to address and improve representation of CALD groups in clinical research.
Publisher: Wiley
Date: 30-06-2019
DOI: 10.1111/JOCN.14942
Abstract: To understand the interprofessional and intraprofessional communication patterns of overseas qualified nurses as they coordinate care for patients in Australian hospitals. Numerous studies have informed the transitioning experiences of overseas qualified nurses with non-English-speaking backgrounds working in English-speaking workplaces. Only a few observational studies have involved examining the intercultural communication experiences of overseas qualified nurses, and none have considered their intra- and interprofessional communication patterns. A qualitative design was adopted, using participant observation and discourse analysis. This study was from January 2017 to March 2017. Thirteen overseas qualified nurses working in acute, subacute and interventional cardiology settings in a Melbourne metropolitan hospital were shadowed over a period of 12 weeks to collect data that inform their communication patterns. The COREQ checklist was used. This observational study informed by genre analysis revealed that intra- and interprofessional communication occurred more commonly under the clinical communication goals of coordinating care and less commonly under facilitating intervention. Communication strategies ranged from structured interactions with use of communication tools to unstructured ad hoc interactions. Analysis of the discourse patterns demonstrated that effectiveness of interactions was affected by hesitancy, lack of assertion and few strategies to manage inadequate or aggressive communication by other team members. Poor clinical communication with peers was not always caused by the nurses from non-English-speaking backgrounds. Positive interpersonal interactions with laughter, language-switching and small talk were evident in interactions with nurses from similar cultural backgrounds but were rare with local colleagues. The linguistic evidence from this study shows variations in communication competency between participants, which emphasises the importance of not viewing overseas qualified nurses' communication training needs as homogenous. With the growing multicultural nature of healthcare teams, this study underscores the need for intercultural communication training for team integration and patient safety. Continuous professional development should incorporate intercultural communication training to ensure team effectiveness within nursing teams as well as interprofessional teams.
Publisher: Elsevier BV
Date: 04-2023
Publisher: John Benjamins Publishing Company
Date: 2009
DOI: 10.2104/ARAL0919
Publisher: University of Otago Library
Date: 16-12-2022
Abstract: Introduction: Students and universities increasingly seek flexibility in learning options, however terms such as flexible are not consistently defined in the medical education literature. This review aimed to 1) propose a definition for flexibility in medical education and 2) create a typology of contemporary ex les of how flexibility has been operationalised in medical education. Method: A systematic scoping review of papers published in English since 2009 was undertaken. The focus was on papers reporting initiatives to create flexibility in primary medical programs. Results: Based on review of 1,641 search returns and 140 full-text articles, two interconnected concepts were identified: flexibility and in idualisation. Flexibility describes mechanisms that allow students choice in how they allocate time and resources to meet the requirements of their course, including time-variable progression, acceleration, deceleration, articulated degree entry and exit options, and pedagogical approaches that reduce time required in classrooms. In idualisation describes options that enable student-driven direction, extension or expansion of medical education into special interest areas, including dual degrees, breadth subjects, curriculum tracks, elective service-learning pathways, electives and selectives. Conclusions: Though not always clearly defined as such, international medical education literature describes a rich variety of flexibility and in idualisation initiatives. While the constructs of flexibility and in idualisation are interconnected, they can assist curriculum designers to differentiate between the mechanisms that enable flexibility in how students meet course requirements and the mechanisms that enable in idual choice in what students study. Flexibility and in idualisation initiatives target different needs, including both students’ needs and medical workforce needs they also suggest different institutional and financial implications. Consensus on and consistent use of common terminology about flexibility and in idualisation initiatives will improve the “searchability” and synthesis of research on such initiatives and their impacts and enablers, as well as encourage further research, publication and synthesis of outcomes of such initiatives.
Publisher: Wiley
Date: 2022
DOI: 10.1002/TRC2.12349
Abstract: The number of Australian residents with dementia is projected to double by 2058, with 28% currently being migrants from non‐Anglophone countries. There will be growing demand for professional interpreters for cognitive assessments and dementia‐related health consultations in the future. Interpreting cognitive assessments can be challenging for interpreters inaccurate interpreting can influence assessment outcomes. The Improving Interpreting for Dementia Assessments (MINDSET) project will upskill interpreters through an online training course in dementia and cognitive assessments. The training has been co‐designed with key stakeholders from the interpreting sector, dementia‐related services, and family caregivers, and has been user‐tested with 12 interpreters. The training aims to improve the quality of interpreter‐mediated communication during cognitive assessments, and thereby improve the accuracy and acceptability of cognitive assessments with older people who have limited English proficiency. We are conducting a single‐blinded randomized controlled trial to evaluate the effectiveness of the training. We aim to enroll 150 interpreters, and allocate them to equal parallel groups. The intervention group will receive access to the MINDSET training, which comprises 4 hours of resources covering five domains: dementia knowledge, cross‐cultural communication, briefings and debriefings, interpreting skills, and interpreting ethics. The control group will be assigned to a wait list, and will receive access to the training after the trial. Participants will be assessed according to the five domains, via the Dementia Knowledge and Assessment Scale, multiple‐choice questions, video‐simulated assessments, and ethical scenarios. Assessments will occur at baseline (prior to the intervention group completing the training), 3 months after enrollment, and 6 months after enrollment. The trial is ongoing. Recruitment began in June 2022. This is the first time a training resource for interpreters in dementia has been trialed. If successful it may represent a technologically innovative way to offer training to both trainee and practicing interpreters. Interpreters are crucial in facilitating cognitive assessments for allophone speakers. Interpreters would benefit from training to improve assessment accuracy. Our study has co‐designed specialized dementia training for interpreters. This is a protocol to evaluate the training's efficacy in a randomized controlled trial.
Publisher: SAGE Publications
Date: 26-04-2016
Abstract: Cultural Respect Encompassing Simulation Training (CREST) is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically erse (CALD) patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming and to investigate the fidelity of cultural sensitivity – defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire – of the streamed simulations. In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic c uses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city c us in 2014. Cultural competency, teaching and learning evaluations were conducted. Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P .05). Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals’ learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training.
Publisher: Wiley
Date: 06-12-2022
DOI: 10.1111/JOCN.16162
Abstract: Communication about managing medications during transitions of care can be a challenging process for older patients since they often have complex medication regimens. Previous studies highlighted that links between communication breakdowns and medication incidents in older patients occur mainly at discharge or in the post‐discharge period. Little attention has been paid to exploring communication strategies facilitating patient‐centred medication communication at transitions of care from a discourse‐analytic perspective. To explore, through a discursive lens, strategies that enable patient‐centred medication communication at transitions of care. A focused ethnographic study was employed for this study. The study was reported according to the COREQ checklist. Interviews, observations and focus groups were analysed utilising Critical Discourse Analysis and the Medication Communication Model following thematic analysis. Data collection was undertaken in eight wards across two metropolitan hospitals in Australia. Patient preferences and beliefs about medications were identified as important characteristics of patient‐centred communication. Strategies included empathetic talk prioritising patients' medication needs and preferences for medications informative talk clarifying patients' concerns and encouraging talk for enhancing shared decision‐making with older patients. Challenges relating to the use of these strategies included patients' hearing, speech or cognitive impairments, language barriers and absence of interpreters or family members during care transitions. To enhance medication communication, nurses, doctors and pharmacists should incorporate older patients' preferences, previous experiences and beliefs, and consider the challenges faced by patients across transitions. Strategies encouraging patients' contribution to decision‐making processes are crucial to patient‐centeredness in medication communication. Nurses need to engage in informative talk more frequently when administering the medications to ensure older patients' understanding of medications prescribed or altered in hospital settings.
Publisher: Swinburne University of Technology
Date: 17-02-2013
Publisher: Informa UK Limited
Date: 05-01-2019
DOI: 10.1080/14992027.2018.1538574
Abstract: This study has two interconnected aims. The first was to better understand how audiology students co-construct hearing assessments with patients while supervised by a clinical educator. The second was to investigate how students' communication aligns with principles of patient-centred communication. Twenty-three final year audiology students from two Australian universities participated in the study. The supervised student-patient hearing appointments were video-recorded and transcribed. Genre analysis, a form of discourse analysis, was carried out to identify the structure and communication patterns. The six-function model of medical communication was adopted as an analytical framework to map students' patient-centred communication. The findings showed generic structure of the hearing assessments were the main stages of taking a history, providing a diagnosis, and initiating management plans. For patient-centred communication functions, students demonstrated their ability to foster the relationship and gather information. The communication functions of decision-making, enablement, and responding to patients' emotions were rarely observed. A significant relationship was found between clinical educators' interjection as a function of students' patient-centred communication tendencies. To enhance students' patient-centred communication, teaching should include explaining and planning as well as addressing additional aspects of patient-centred communication. Support of clinical educators is needed to optimise students' communication skills learning.
Publisher: Unpublished
Date: 2011
Publisher: Wiley
Date: 05-12-2017
DOI: 10.1111/MEDU.13143
Abstract: For academic staff, responding to student concerns is an important responsibility. Professional staff, or non-academic staff who do administrative work in medical schools, are often the first to be approached by students, yet there is little research on how they manage student issues. Informed by the conceptual framework of emotional labour, we examined the experiences of professional staff, aiming to identify theoretical and practical insights for improving the provision of student support. We examined the scope of support provided, the impact of providing this support on staff and how these impacts can be managed. Professional staff at two medical schools were invited to participate in semi-structured qualitative interviews. Interviews were transcribed and independently analysed for emergent themes. Data analysis continued with purposive s ling for maximum variation until thematic saturation was reached. Findings were returned to participants in writing and via oral presentations for member checking and refinement. Twenty-two female staff from clinical, teaching and commercial backgrounds at nine urban and rural teaching sites were interviewed. Participants described providing support for erse concerns, from routine requests to life-threatening emergencies. Four major themes emerged: firstly, all described roles consistent with emotional labour. Secondly, student support was regarded as informal work, and not well recognised or defined. Consequently, many drew upon their personal orientation to provide support. Finally, we identified both positive and negative personal impacts, including ongoing distress after critical events. Professional staff perform a range of student support work, leading to emotional, personal and work impacts. In turn, they need support, recognition and training in this essential but under-recognised role. Emotional labour offers a conceptual framework for understanding the gendered nature and impact of this work and how it may be managed. We suggest practical strategies for promoting positive and preventing negative effects on staff from supporting medical students.
Publisher: BMJ
Date: 04-2017
Publisher: Informa UK Limited
Date: 2012
Publisher: Informa UK Limited
Date: 04-06-2023
Start Date: 2009
End Date: 2012
Funder: Australian Research Council
View Funded ActivityStart Date: 2014
End Date: 07-2017
Amount: $168,000.00
Funder: Australian Research Council
View Funded ActivityStart Date: 10-2010
End Date: 12-2013
Amount: $130,442.00
Funder: Australian Research Council
View Funded ActivityStart Date: 06-2017
End Date: 12-2021
Amount: $299,000.00
Funder: Australian Research Council
View Funded Activity