Translation of addictions science into practice

Recent advances in the understanding of the genetic, neurochemical, behavioral and cultural underpinnings of addiction have led to rapid advances in the understanding of addiction as a disease. In fact, advances in basic science and the development of new pharmacological and behavioral therapies associated with them are appearing faster than can be assimilated not only by clinical researchers but practitioners and policy makers as well. Translation of science-based addictions knowledge into improved prevention, assessment and treatment, and communication of these changes to researchers and practitioners are significant challenges to the field. The general aim of this book is to summarize current and potential linkages between advances in addiction science and innovations in clinical practice. Whilst this book is primarily focused on translation, it also encompasses some scientific advances that are relevant to dissemination, and the book is itself a tool for disseminating innovative thinking. The goal is to generate interest in application opportunities from both recent research and theoretical advances.

The ontological deficiencies of process modeling in practice

Business process modeling is widely regarded as one of the most popular forms of conceptual modeling. However, little is known about the capabilities and deficiencies of process modeling grammars and how existing deficiencies impact actual process modeling practice. This paper is a first contribution towards a theory-driven, exploratory empirical investigation of the ontological deficiencies of process modeling with the industry standard Business Process Modeling Notation (BPMN). We perform an analysis of BPMN using a theory of ontological expressiveness. Through a series of semi-structured interviews with BPMN adopters we explore empirically the actual use of this grammar. Nine ontological deficiencies related to the practice of modeling with BPMN are identified, for example, the capture of business rules and the specification of process decompositions. We also uncover five contextual factors that impact on the use of process modeling grammars, such as tool support and modeling conventions. We discuss implications for research and practice, highlighting the need for consideration of representational issues and contextual factors in decisions relating to BPMN adoption in organizations.

A Delphi study to validate an advanced practice nursing tool

Aim This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce.

Inquiry-based science in a primary classroom : professional development impacting practice

The critical factor in determining students' interest and motivation to learn science is the quality of the teaching. However, science typically receives very little time in primary classrooms, with teachers often lacking the confidence to engage in inquiry-based learning because they do not have a sound understanding of science or its associated pedagogical approaches. Developing teacher knowledge in this area is a major challenge. Addressing these concerns with didactic "stand and deliver" modes of Professional Development (PD) has been shown to have little relevance or effectiveness, yet is still the predominant approach used by schools and education authorities. In response to that issue, the constructivist-inspired Primary Connections professional learning program applies contemporary theory relating to the characteristics of effective primary science teaching, the changes required for teachers to use those pedagogies, and professional learning strategies that facilitate such change. This study investigated the nature of teachers' engagement with the various elements of the program. Summative assessments of such PD programs have been undertaken previously, however there was an identified need for a detailed view of the changes in teachers' beliefs and practices during the intervention. This research was a case study of a Primary Connections implementation. PD workshops were presented to a primary school staff, then two teachers were observed as they worked in tandem to implement related curriculum units with their Year 4/5 classes over a six-month period. Data including interviews, classroom observations and written artefacts were analysed to identify common themes and develop a set of assertions related to how teachers changed their beliefs and practices for teaching science. When teachers implement Primary Connections, their students "are more frequently curious in science and more frequently learn interesting things in science" (Hackling & Prain, 2008). This study has found that teachers who observe such changes in their students consequently change their beliefs and practices about teaching science. They enhance science learning by promoting student autonomy through open-ended inquiries, and they and their students enhance their scientific literacy by jointly constructing investigations and explaining their findings. The findings have implications for teachers and for designers of PD programs. Assertions related to teaching science within a pedagogical framework consistent with the Primary Connections model are that: (1) promoting student autonomy enhances science learning; (2) student autonomy presents perceived threats to teachers but these are counteracted by enhanced student engagement and learning; (3) the structured constructivism of Primary Connections resources provides appropriate scaffolding for teachers and students to transition from didactic to inquiry-based learning modes; and (4) authentic science investigations promote understanding of scientific literacy and the "nature of science". The key messages for designers of PD programs are that: (1) effective programs model the pedagogies being promoted; (2) teachers benefit from taking the role of student and engaging in the proposed learning experiences; (3) related curriculum resources foster long-term engagement with new concepts and strategies; (4) change in beliefs and practices occurs after teachers implement the program or strategy and see positive outcomes in their students; and (5) implementing this study's PD model is efficient in terms of resources. Identified topics for further investigation relate to the role of assessment in providing evidence to support change in teachers' beliefs and practices, and of teacher reflection in making such change more sustainable.

Implementation and evaluation of a new model of nursing practice in radiation oncology

Patients undergoing radiation therapy for cancer face a series of challenges that require support from a multidisciplinary team which includes radiation oncology nurses. However, the specific contribution of nursing, and the models of care that best support the delivery of nursing interventions in the radiotherapy setting, is not well described. In this case study, the Interaction Model of Client Health Behaviour and the associated principles of person-centred care were incorporated into a new model of care that was implemented in one radiation oncology setting in Brisbane, Australia. The new model of care was operationalised through a Primary Nursing/Collaborative Practice framework. To evaluate the impact of the new model for patients and health professionals, multiple sources of data were collected from patients and clinical staff prior to, during, and 18 months following introduction of the practice redesign. One cohort of patients and clinical staff completed surveys incorporating measures of key outcomes immediately prior to implementation of the model, while a second cohort of patients and clinical staff completed these same surveys 18 months following introduction of the model. In-depth interviews were also conducted with nursing, medical and allied health staff throughout the implementation phase to obtain a more comprehensive account of the processes and outcomes associated with implementing such a model. From the patients’ perspectives, this study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being, patients continue to be satisfied with nursing care in this specialty, and that they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. From the health professionals’ perspective, there was evidence of attitudinal change by nursing staff within the radiotherapy department which reflected a greater understanding and appreciation of a more person-centred approach to care. Importantly, this case study has also confirmed that a range of factors need to be considered when redesigning nursing practice in the radiotherapy setting, as the challenges associated with changing traditional practices, ensuring multidisciplinary approaches to care, and resourcing a new model were experienced. The findings from this study suggest that the move from a relatively functional approach to a person-centred approach in the radiotherapy setting has contributed to some improvements in the provision of individualised and coordinated patient care. However, this study has also highlighted that primary nursing may be limited in its approach as a framework for patient care unless it is supported by a whole team approach, an appropriate supportive governance model, and sufficient resourcing. Introducing such a model thus requires effective education, preparation and ongoing support for the whole team. The challenges of providing care in the context of complex interdisciplinary relationships have been highlighted by this study. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

Implementing an emergency department patient admission predictive tool : insights from practice

Purpose: This paper aims to show that identification of expectations and software functional requirements via consultation with potential users is an integral component of the development of an emergency department patient admissions prediction tool. ---------- Design/methodology/approach: Thematic analysis of semi-structured interviews with 14 key health staff delivered rich data regarding existing practice and future needs. Participants included emergency department staff, bed managers, nurse unit managers, directors of nursing, and personnel from health administration. ---------- Findings: Participants contributed contextual insights on the current system of admissions, revealing a culture of crisis, imbued with misplayed communication. Their expectations and requirements of a potential predictive tool provided strategic data that moderated the development of the Emergency Department Patient Admissions Prediction Tool, based on their insistence that it feature availability, reliability and relevance. In order to deliver these stipulations, participants stressed that it should be incorporated, validated, defined and timely. ---------- Research limitations/implications: Participants were envisaging a concept and use of a tool that was somewhat hypothetical. However, further research will evaluate the tool in practice. ---------- Practical implications: Participants' unsolicited recommendations regarding implementation will not only inform a subsequent phase of the tool evaluation, but are eminently applicable to any process of implementation in a healthcare setting. ---------- Originality/value: The consultative process engaged clinicians and the paper delivers an insider view of an overburdened system, rather than an outsider's observations.

Revisiting 'how we learn' in academia : practice-based learning exchanges in three Australian universities

Ideas of 'how we learn' in formal academic settings have changed markedly in recent decades. The primary position that universities once held on shaping what constitutes learning has come into question from a range of experience-led and situated learning models. Drawing on findings from a study conducted across three Australian universities, the article focuses on the multifarious learning experiences indicative of practice-based learning exchanges such as student placements. Building on both experiential and situated learning theories, the authors found that students can experience transformative and emotional elucidations of learning, that can challenge tacit assumptions and transform the ways they understand the world. It was found that all participants (hosts, students, academics) both teach and learn in these educative scenarios and that, contrary to common (mis)perceptions that academics live in 'ivory towers', they play a crucial role in contributing to learning that takes place in the so-called 'real world'.

Telling tales, shaping stories : the creative practitioner and the artful life story

Norman K. Denzin (1989) claims that the central assumption of the biographical method—that a life can be captured and represented in a text—is open to question. This paper explores Denzin’s statement by documenting the role of creative writers in re-presenting oral histories in two case studies from Queensland, Australia. The first, The Queensland Business Leaders Hall of Fame, was a commercial research project commissioned by the State Library of Queensland (SLQ) in 2009, and involved semi-formal qualitative interviews and digital stories. The second is an on-going practice-led PhD project, The Artful Life: Oral History and Fiction, which investigates the fictionalisation of oral histories. Both projects enter into a dialogue around the re-presentation of oral and life histories, with attention given to the critical scholarship and creative practice in the process. Creative writers represent a life having particular preoccupations with techniques that more closely align with fiction than non-fiction (Hirsch and Dixon 2008). In this context, oral history resources are viewed not so much as repositories of historical facts, but as ambiguous and fluid narrative sources. The comparison of the two case studies also demonstrates that the aims of a particular project dictate the nature of the re-presentation, revealing that writing about another’s life is a complex act of artful ‘shaping’. Alistair Thomson (2007) notes the growing interdisciplinary nature of oral history scholarship since the 1980s; oral histories are used increasingly in art-based contexts to produce diverse cultural artefacts, such as digital stories and works of fiction, which are very different from traditional histories. What are the methodological implications of such projects? This paper will draw on self-reflexive practice to explore this question.

Supervising clinical placement

Internship and practicum are the pinnacle of the therapist training experience. During these fieldwork experiences trainees are challenged to apply what they have learned in coursework and research to a real-life workplace situation. Internship is where the rigorous science of the profession and the imperfect art of the practice intersect and trainees begin to develop clinical wisdom. The trainee therapist being prepared for their responsibilities who has a successful relationship with their supervisor can optimise the gains from this integrated experience. In this chapter, an introduction to supervised internship or practicum encounters is provided with the trainee therapist and future supervisor squarely in mind.

Craft, process and art : teaching and learning music composition in higher education

This paper explores models of teaching and learning music composition in higher education. It analyses the pedagogical approaches apparent in the literature on teaching and learning composition in schools and universities, and introduces a teaching model as: learning from the masters; mastery of techniques; exploring ideas; and developing voice. It then presents a learning model developed from a qualitative study into students’ experiences of learning composition at university as: craft, process and art. The relationship between the students’ experiences and the pedagogical model is examined. Finally, the implications for composition curricula in higher education are presented.

Thinking spatially, acting collaboratively : a GIS-based health decision support system for improving the collaborative health-planning practice

The field of collaborative health planning faces significant challenges due to the lack of effective information, systems and the absence of a framework to make informed decisions. These challenges have been magnified by the rise of the healthy cities movement, consequently, there have been more frequent calls for localised, collaborative and evidence-driven decision-making. Some studies in the past have reported that the use of decision support systems (DSS) for planning healthy cities may lead to: increase collaboration between stakeholders and the general public, improve the accuracy and quality of the decision-making processes and improve the availability of data and information for health decision-makers. These links have not yet been fully tested and only a handful of studies have evaluated the impact of DSS on stakeholders, policy-makers and health planners. This study suggests a framework for developing healthy cities and introduces an online Geographic Information Systems (GIS)-based DSS for improving the collaborative health planning. It also presents preliminary findings of an ongoing case study conducted in the Logan-Beaudesert region of Queensland, Australia. These findings highlight the perceptions of decision-making prior to the implementation of the DSS intervention. Further, the findings help us to understand the potential role of the DSS to improve collaborative health planning practice.