ORCID Profile
0000-0002-1569-6464
Current Organisation
University of Adelaide
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Publisher: Oxford University Press
Date: 10-2013
Publisher: Wiley
Date: 09-2009
Publisher: Wiley
Date: 30-03-2018
DOI: 10.1111/MEDU.13580
Abstract: Rural community-based medical education (RCBME), in which medical student learning activities take place within a rural community, requires students, clinical teachers, patients, community members and representatives of health and government sectors to actively contribute to the educational process. Therefore, academics seeking to develop RCBME need to understand the rural context, and the views and needs of local stakeholders. The aim of this review is to examine stakeholder experiences of RCBME programmes internationally. This narrative literature review of original research articles published after 1970 utilises Worley's symbiosis model of medical education as an analysis framework. This model proposes that students experience RCBME through their intersection with multiple clinical, social and institutional relationships. This model seeks to provide a framework for considering the intersecting relationships in which RCBME programmes are situated. Thirty RCBME programmes are described in 52 articles, representing a wide range of rural clinical placements. One-year longitudinal integrated clerkships for penultimate-year students in Anglosphere countries were most common. Such RCBME enables students to engage in work-integrated learning in a feasible manner that is acceptable to many rural clinicians and patients. Academic results are not compromised, and a few papers demonstrate quality improvement for rural health services engaged in RCBME. These programmes have delivered some rural medical workforce outcomes to communities and governments. Medical students also provide social capital to rural communities. However, these programmes have significant financial cost and risk student social and educational isolation. Rural community-based medical education programmes are seen as academically acceptable and can facilitate symbiotic relationships among students, rural clinicians, patients and community stakeholders. These relationships can influence students' clinical competency and professional identity, increase graduates' interest in rural careers, and potentially improve rural health service stability. Formal prospective stakeholder consultations should be published in the literature.
Publisher: Wiley
Date: 04-2012
DOI: 10.5694/MJA10.11488
Abstract: Gaining clinical experience for an extended period of time in teaching hospitals is one of the enduring strengths of medical education. Teaching hospitals have recently faced significant challenges, with increasing specialisation of services and workload pressures reducing clinical learning opportunities. New clinical teaching environments have been established in Australia, particularly in rural and regional areas these are proving to be ideal contexts for student learning. The new clinical teaching environments have shown the importance of developing symbiotic relationships between universities and health services. Symbiotic clinical learning is built around longitudinal, patient-based learning emphasising priority health concerns. The symbiotic framework provides a basis for reconstructing clinical teaching in teaching hospitals so th@they continue to play a vital role in Australian medical education, with additional clinical experience provided by primary care and community, rural and regional hospitals.
Publisher: Informa UK Limited
Date: 06-10-2022
Publisher: University of Otago Library
Date: 07-07-2023
Abstract: In this paper, we argue that Australian & New Zealand Association for Health Professional Educators (ANZAHPE) is a nurturing organisation and envision what cultivating this means for its future. We use communities of practice and social learning to examine ANZAHPE’s evolution as a nurturing association. We describe two ANZAHPE innovations, the unique conference presentation format called the “personally arranged learning session”, or “PeArLS”, and a new professional development program called “ANZAHPE Online”. We then reflect on how these function as nurturing structures in which members embody ANZAHPE’s philosophy of community learning. From these ex les, we draw out future directions for the association.
Publisher: Wiley
Date: 18-10-2012
DOI: 10.1111/J.1365-2923.2012.04331.X
Abstract: Longitudinal integrated clerkships (LICs) have been widely implemented in both rural and urban contexts, as is now evident in the wealth of studies published internationally. This narrative literature review aims to summarise current evidence regarding the outcomes of LICs for student, clinician and community stakeholders. Recent literature was examined for original research articles pertaining to outcomes of LICs. Students in LICs achieve academic results equivalent to and in some cases better than those of their counterparts who receive clinical education in block rotations. Students in LICs are reported to have well-developed patient-centred communication skills, demonstrate understanding of the psychosocial contributions to medicine, and report more preparedness in higher-order clinical and cognitive skills in comparison with students in traditional block rotations (TBRs). Students in LICs take on increased responsibility with patients and describe having more confidence in dealing with ethical dilemmas. Continuity of supervision reportedly facilitates incremental knowledge acquisition, and supervisors provide incrementally progressive feedback. Despite early disorientation regarding the organising of their learning, students feel well supported by the continuity of student-preceptor relationships and value the contributions made by these. Students in LICs living and working in rural areas are positively influenced towards primary care and rural career choices. A sound body of knowledge in the field of LIC research suggests it is time to move beyond descriptive or exploratory research that is designed to justify this new educational approach by comparing academic results. As the attributes of LIC alumni are better understood, it is important to conduct explanatory research to develop a more complete understanding of these findings and a foundation for new theoretical frameworks that underpin educational change. Longitudinal integrated clerkships are now recognised as representing credible and effective pedagogical alternatives to TBRs in medical education.
Publisher: Informa UK Limited
Date: 03-05-2013
Publisher: Oxford University Press
Date: 10-2013
Publisher: Elsevier BV
Date: 05-1991
DOI: 10.1016/S0161-6420(91)32238-3
Abstract: Snellen acuity, reading line, and keratometry were measured in a cohort of 60 patients at 2 or more years after penetrating keratoplasty was performed. Patients were asked to complete a questionnaire to elicit information on their perceptions of visual function and the success of the procedure. Using preferred correction, a Snellen acuity of 6/18 or better was achieved by 65%, and a reading line of N8 or better was achieved by 57% of index grafts. Thirty-eight percent had more than 5 diopters (D) of astigmatism in the graft. Approximately 75% of patients reported satisfaction with their graft (satisfaction being associated with better acuity in the grafted eye than the other eye), graft clarity, and a perceived improvement in lifestyle. Dissatisfaction appeared to be associated with graft failure and problems with contact lens wear. The findings have implications for patient selection for corneal transplantation and for the measurement of outcome.
Publisher: Elsevier BV
Date: 1989
DOI: 10.1016/S0161-6420(89)32949-6
Abstract: Immunohistochemical staining analysis using monoclonal antibodies was performed on 107 recipient corneas removed at graft. There were significantly more infiltrating cells bearing one or more of the leukocyte-common antigen, class II major histocompatibility complex antigens, various myeloid-lineage markers, and a peripheral T cell marker, in the graft beds of those recipients who subsequently lost a corneal graft than there were in the graft beds of those for whom the outcome was successful. The hypothesis that large numbers of leukocytes in the recipient graft bed would be correlated with subsequent graft failure was examined by actuarial graft survival analysis. Recipients whose corneas contained fewer than 50 leukocyte-common antigen-positive cells/mm2 of corneal stroma showed a 3-year actuarial graft survival of 83%, compared with 39% in those whose corneas contained more than 50 such cells/mm2. The corneal leukocyte count was a particularly useful prognostic indicator of outcome in those patients judged clinically to be at risk of graft failure.
No related grants have been discovered for Julie Ash.