Examining the profile and experiences of older sub-acute patients who present to public hospital emergency departments in South East Queensland: A mixed methods approach

There is a scarcity of research that informs Interface Health Service (IHS) development. This research applied a mixed methods approach to profile older emergency department patients and patterns of health service use and to explore their ED experiences in public hospital EDs in South-East Queensland. IHS was under-utilised by older people with complex co-morbidities. Lack of communication and need identification were factors that undermined the effectiveness of IHS in reaching this cohort which highlighted a need for change.

Pathophysiology team teaching: Bioscientist contribution to knowledge integration in a nursing subject

Bioscience content within undergraduate nursing degrees provides foundational knowledge of pathophysiology, anatomy, physiology, microbiology and pharmacology. However, nursing students often find studying the bioscience components of undergraduate nursing program daunting (Friedel & Treagust 2005, Craft et al. 2013). This is related to factors such as the volume of content, degree of difficulty and insufficient linkage between bioscience concepts and nurses' clinical practice. Students who are unable to conceptualise the relevance of bioscience with nursing subjects and subsequent nursing practice may not appreciate the broader importance of bioscience, and hence may adopt a surface approach to learning (Craft et al. 2013). The aim of this study was to develop a model within Nursing Practice in the Context theory subject, to include a bioscientist lecturing to complement the nursing lecturer, in order to explicitly demonstrate links between physiology, pathophysiology and nursing practice.

Malnutrition in children with chronic liver disease accepted for liver transplantation : clinical profile and effect on outcome

The nutritional profiles of 37 children (aged 0.5-14.0 years) with chronic liver disease at the time of acceptance for orthotopic liver transplantation (OLTP) have been evaluated using clinical, biochemical and body composition methods. Nutritional progress while waiting for a donor has been related to outcome, whether transplanted or not. At the time of acceptance, most children were underweight (mean standard deviation (s.d.) weight = -1.4 ± 0.2) and stunted (mean s.d. height = - 2.2 ± 0.4), had low serum albumin (27/35) and had reduced body fat and depleted body cell mass (measured by total body potassium - mean % expected for age = 58 ± 5%, n = 15). Mean ad libitum nutrient intake was 63 ± 5% of recommended daily intake (RDI). Those who died while waiting (n = 8) had significantly lower mean initial s.d. weight compared with those transplanted. The overall actuarial 1 year survival of those who were transplanted (mean waiting time = 75 days) was 81% but those who were initially well nourished (s.d. weight >-1.0) had an actuarial 1 year survival of 100%. There were no significant differences in actuarial survival in relationship to age, type of transplant (whole liver or segmental), liver biochemistry or the presence or absence of ascites. Of the total group accepted for OLTP, whether transplanted or not, the overall 1 year survival for those who were relatively well nourished was 88% and for those undernourished (initial s.d. weight <-1.0) was 38% (P<0.003). Declining nutritional status during the waiting period also adversely affected outcome. We conclude that malnutrition and/or declining nutritional status is a major factor adversely affecting survival in children awaiting OLTP. In transplant units where waiting time is greater than 40 days, earlier referral, prioritization of cases and the use of adult donor livers may reduce this risk and efforts to maintain or improve nutritional status deserve further study.

Creating a standardised teaching and learning framework for social work field placements

Mapping and evaluating a student's progress on placement is a core element of social work education but there has been scant attention to indicate how to effectively create and assess student learning and performance. This paper outlines a project undertaken by the Combined Schools of Social Work to develop a common learning and assessment tool that is being used by all social work schools in Victoria. The paper describes how the Common Assessment Tool (CAT) was developed, drawing on the Australian Association of Social Work Practice Standards, leading to seven key learning areas that form the basis of the assessment of a student's readiness for practice. An evaluation of the usefulness of the CAT was completed by field educators, liaison staff, and students, which confirmed that the CAT was a useful framework for evaluating students' learning goals. The feedback also identified a number of problematic features that were addressed in a revised CAT and rating scale.

What counts as English in the internationalised Australian university: Implications for teaching and learning

English is currently ascendant as the language of globalisation, evident in its mediation of interactions and transactions worldwide. For many international students, completion of a degree in English means significant credentialing and increased job prospects. Australian universities are the third largest English-speaking destination for overseas students behind the United States and the United Kingdom. International students comprise one-fifth of the total Australian university population, with 80% coming from Asian countries (ABS, 2010). In this competitive higher education market, English has been identified as a valued ‘good’. Indeed, universities have been critiqued for relentlessly reproducing the “hegemony and homogeneity of English” (Marginson, 2006, p. 37) in order to sustain their advantage in the education market. For international students, English is the gatekeeper to enrolment, the medium of instruction and the mediator of academic success. For these reasons, English is not benign, yet it remains largely taken-for-granted in the mainstream university context. This paper problematises the naturalness of English and reports on a study of an Australian Master of Education course in which English was a focus. The study investigated representations of English as they were articulated across a chain of texts including the university strategic plan, course assessment criteria, student assignments, lecturer feedback, and interviews. Critical Discourse Analysis (CDA) and Foucault’s work on discourse enabled understandings of how a particular English is formed through an apparatus of specifications, exclusionary thresholds, strategies for maintenance (and disruption), and privileged concepts and speaking positions. The findings indicate that English has hegemonic status within the Australian university, with material consequences for students whose proficiency falls outside the thresholds of accepted English practice. Central to the constitution of what counts as English is the relationship of equivalence between standard written English and successful academic writing. International students’ representations of English indicate a discourse that impacts on identities and practices and preoccupies them considerably as they negotiate language and task demands. For the lecturer, there is strategic manoeuvring within the institutional regulative regime to support students’ English language needs using adapted assessment practices, explicit teaching of academic genres and scaffolded classroom interaction. The paper concludes with the implications for university teaching and learning.

Recognising change and seeking affirmation: Themes for embeddding Indigenous knowledges on teaching practicum

The imperative for Indigenous education in Australia is influenced by national political, social and economic discourses as Australian education systems continue to grapple with an agreed aspiration of full participation for Aboriginal and Torres Strait Islander students. Innovations within and policies guiding our education systems are often driven by agendas of reconciliation, equity, equality in participation and social justice. In this paper, we discuss key themes that emerged from a recent Australian Office for Learning and Teaching (OLT) research project which investigated ways in which preservice teachers from one Australian university embedded Indigenous knowledges (IK) on teaching practicum . Using a phenomenological approach, the case involved 25 preservice teacher and 23 practicum supervisor participants, over a 30 month investigation. Attention was directed to the nature of subjective (lived) experiences of participants in these pedagogical negotiations and thus preservice and supervising teacher voice was actively sought in naming and analysing these experiences. Findings revealed that change, knowledge, help and affirmation were key themes for shaping discourses around Indigenous knowledges and perspectives in the Australian curriculum and defined the nature of the pedagogical relationships between novice and experienced teachers. We focus particularly on the need for change and affirmation by preservice teachers and their teaching practicum supervisors as they developed their pedagogical relationships whilst embedding Indigenous knowledges in learning and teaching.

Literacy teaching and learning in a digital world: Challenges of a new era

Teachers the world over are aware of the range of new challenges that arise from this new era. One challenge is the role of digital technologies in literacy learning. Despite its reputation for being engaging, digital technologies do not always enhance learning outcomes. Whilst the concerns vary across time and place, the core issue of what is a highly sought after literacy learning outcome in this new era warrants consideration. This paper introduces Kalantzis and Cope’s (2005) theorisation of eight knowledge processes for literacy learning. They claim that experiencing the known, conceptualising by naming, analysing functionally and applying appropriately, whilst necessary, are not on their own sufficient for the development of high level literacy practices. It is their contention that students must also be able to experience the new, conceptualise by theorising, analyse creatively and apply critically. This theorisation forms an auditing framework for considering the outcomes of different uptakes of digital technologies in a Social Studies and a Science unit.

Multidisciplinary review of teaching and assessing competency attainment by non-medical prescribers

Background Prescribing is a complex task, requiring specific knowledge and skills, and the execution of effective, context-specific clinical reasoning. Systematic reviews indicate medical prescribing errors have a median rate of 7% [IQR 2%-14%] of medication orders [1-3]. For podiatrists pursuing prescribing rights, a clear need exists to ensure practitioners develop a well-defined set of prescribing skills, which will contribute to competent, safe and appropriate practice. Aim To investigate the methods employed to teach and assess the principles of effective prescribing in the undergraduate podiatry program and compare and contrast these findings with four other non-medical professions who undertake prescribing after training at Queensland University of Technology. Method The NPS National Prescribing Competency Standards were employed as the prescribing standard. A curriculum mapping exercise was undertaken to determine whether the prescribing principles articulated in the competency standards were addressed by each profession. Results A range of methods are currently utilised to teach prescribing across disciplines. Application of prescribing competencies to the context of each profession appears to influence the teaching methods used. Most competencies were taught using a multimodal format, including interactive lectures, self-directed learning, tutorial sessions and clinical placement. In particular clinical training was identified as the most consistent form of educating safe prescribers across all five disciplines. Assessment of prescribing competency utilised multiple techniques including written and oral examinations and research tasks, case studies, objective structured clinical examination exercises and the assessment of clinical practice. Effective and reliable assessment of prescribing undertaken by students in diverse settings remains challenging e.g. that occurring in the clinical practice environment. Conclusion Recommendations were made to refine curricula and to promote efficient cross-discipline teaching by staff from the disciplines of podiatry, pharmacy, nurse practitioner, optometry and paramedic science. Students now experience a sophisticated level of multidisciplinary learning in the clinical setting which integrates the expertise and skills of experience prescribers combined with innovative information technology platforms (CCTV and live patient assessments). Further work is required to establish a practical, effective approach to the assessment of prescribing competence especially between the university and clinical settings.

A visual profile of Queensland Indigenous children

Purpose Little is known about the prevalence of refractive error, binocular vision, and other visual conditions in Australian Indigenous children. This is important given the association of these visual conditions with reduced reading performance in the wider population, which may also contribute to the suboptimal reading performance reported in this population. The aim of this study was to develop a visual profile of Queensland Indigenous children. Methods Vision testing was performed on 595 primary schoolchildren in Queensland, Australia. Vision parameters measured included visual acuity, refractive error, color vision, nearpoint of convergence, horizontal heterophoria, fusional vergence range, accommodative facility, AC/A ratio, visual motor integration, and rapid automatized naming. Near heterophoria, nearpoint of convergence, and near fusional vergence range were used to classify convergence insufficiency (CI). Results Although refractive error (Indigenous, 10%; non-Indigenous, 16%; p = 0.04) and strabismus (Indigenous, 0%; non-Indigenous, 3%; p = 0.03) were significantly less common in Indigenous children, CI was twice as prevalent (Indigenous, 10%; non-Indigenous, 5%; p = 0.04). Reduced visual information processing skills were more common in Indigenous children (reduced visual motor integration [Indigenous, 28%; non-Indigenous, 16%; p < 0.01] and slower rapid automatized naming [Indigenous, 67%; non-Indigenous, 59%; p = 0.04]). The prevalence of visual impairment (reduced visual acuity) and color vision deficiency was similar between groups. Conclusions Indigenous children have less refractive error and strabismus than their non-Indigenous peers. However, CI and reduced visual information processing skills were more common in this group. Given that vision screenings primarily target visual acuity assessment and strabismus detection, this is an important finding as many Indigenous children with CI and reduced visual information processing may be missed. Emphasis should be placed on identifying children with CI and reduced visual information processing given the potential effect of these conditions on school performance

How Jung's concept of the wounded healer can guide learning and teaching in social work and human services

The concept of the “wounded healer” has been used to explain why those with adverse childhood histories often enter helping professions such as social work and human services (SWHS). Psychotherapist Carl Jung (1875–1961) believed wounded healers developed insight and resilience from their own experiences, enabling transformative interventions to occur with clients. Concerns exist that students with adverse childhood histories in SWHS may display unresolved emotional issues. This journal article explores how Jung’s interpretation of the wounded healer can be critically applied to understanding the learning needs of SWHS students with histories of abuse, neglect or other childhood adversity. The relevance of the wounded healer to SWHS education is explored in three key areas: - 1) the increased possibility of the occurrence of countertransference; - 2) the potential for vicarious traumatisation and burnout, and; - 3) personal and professional resilience displayed by SWHS students with a history of childhood adversity. The wounded healer metaphor allows for a more nuanced understanding of SWHS students with these histories. It also provides insight into the pedagogical considerations associated with teaching this student cohort.

Laughing with the lecturer: The use of humour in shaping university teaching

This paper addresses the ways in which humour is used by university academics to shape teaching personas. Based upon the work of Mauss and Foucault, and employing semi-structured, in-depth interviews with a range of university teachers, this research suggests that most tertiary teachers deliberately fashion various kinds of teaching persona, which they then perform in lectures and tutorials. The use of humour is widely seen as an important component within this form of self-shaping, as it fits within dominant frameworks of expectation regarding contemporary models of “edutainment”. This research demonstrates that a wide range of practices of the self—including physical, verbal, and relational elements—are employed by academics as part of shaping various humorous teaching personas. Some boundaries exist limiting the use of these pedagogic characters; for example, arguments about natural ability with humour prefigure who is most likely to deploy humour as a practice of professional self-formation. Also, professional concerns regarding seniority and job security are also factored into decision-making regarding those humorous personas likely to be considered appropriate within particular tertiary teaching contexts.

Vineland Adaptive Behavior Scales - II profile of young children with Autism Spectrum Disorder

Adaptive behaviour is a crucial area of assessment for individuals with Autism Spectrum Disorder (ASD). This study examined the adaptive behaviour profile of 77 young children with ASD using the Vineland-II, and analysed factors associated with adaptive functioning. Consistent with previous research with the original Vineland a distinct autism profile of Vineland-II age equivalent scores, but not standard scores, was found. Highest scores were in motor skills and lowest scores were in socialisation. The addition of the Autism Diagnostic Observation Schedule (ADOS) calibrated severity score did not contribute significant variance to Vineland-II scores beyond that accounted for by age and nonverbal ability. Limitations, future directions, and implications are discussed.

Teaching for Learning, Living and Serving

I offer four eclectic maxims for schooling. They do not represent a cohesive philosophy of schooling or education, but they are a sampling of my views which I hope reflect and honour the great life’s work of Phil Hughes.

Why the Constraints-Led Approach is not teaching games for understanding: A clarification

Background There is some apparent confusion regarding similarities and differences between two popular physical education (PE) pedagogical frameworks, that is, the Constraints-Led Approach (CLA) and Teaching Games for Understanding (TGfU). Purpose Our aim in this commentary is to detail important theoretical and pedagogical concepts that distinguish these approaches, as well as to recognise where commonalities exist. Findings In particular, we note that TGfU had its roots in the 1960s in the absence of a substantial theoretical framework, although several attempts to retrospectively scaffold theories around TGfU have subsequently emerged in the literature. TGfU is a learner-centred approach to PE in which teachers are encouraged to design modified games to develop the learner's understanding of tactical concepts. In contrast, the CLA has arisen more recently from the umbrella of Nonlinear Pedagogy (NLP), emerging from the empirically rich theoretical framework of ecological dynamics. The CLA adopts a ‘learner–environment’ scale of analysis in which practitioners are encouraged to identify and modify interacting constraints (of task, environment and learner) to facilitate the coupling of each learner's perceptual and action systems during learning. The CLA is a broader framework which has been adapted for the design of (re)learning environments in PE, sport and movement therapy. Other key distinctions between the approaches include: the overall goals; the way in which the learner and the learning process are modelled; the use of questioning as a pedagogical tool; the focus on individual differences vs. generic concepts; and how progressions and skill interjections are planned and implemented. Conclusions Despite such distinctions, the two approaches are somewhat harmonious and key similarities include: their holistic perspective of the learner; the proposed role of the teacher and the design characteristics of learning tasks in each. Both TGfU and the CLA have a powerful central focus on the nature of learning activities undertaken by each individual learner. This clarification of TGFU and the CLA is intended to act as a catalyst for more empirical work into the complementarity of these juxtaposed pedagogical approaches to learning design.