Four years after graduation : occupational therapists' work destinations and perceptions of preparedness for practice

Objective: The present study sought to identify the work destinations of graduates and ascertain their perceived preparedness for practice from a regional occupational therapy program, which had been specifically developed to support the health requirements of northern Australians by having an emphasis on rural practice. ---------- Design: Self-report questionnaires and semistructured in-depth telephone interviews. ---------- Participants: Graduates (n = 15) from the first cohort of occupational therapists from James Cook University, Queensland. ---------- Main outcome measure: The study enabled comparisons to be made between rural and urban based occupational therapists, while the semistructured interviews provided a deeper understanding of participants' experiences regarding their preparation for practice. ---------- Results: Demographic differences were noted between occupational therapists working in rural and urban settings. Rural therapists were predominantly younger and had worked in slightly more positions than their urban counterparts. The study also offered some insights into the value that therapists placed on the subjects taught during their undergraduate occupational therapy training, and had highlighted the differences in perceptions between therapists with rural experience and those with urban experience regarding the subjects that best prepared them for practice. Generally, rural therapists reported that all subjects included in the curriculum had equipped them well for practice. ---------- Conclusions: Findings suggest the need to undertake further research to determine the actual nature of rural practice, the personal characteristics of rural graduates and the experiences of students while on rural clinical placements.

Report on the Development and Validation of the Best Practice Decision Matrix

The Co-operative Research Centre for Construction Innovation (CRC-CI) is funding a project known as Value Alignment Process for Project Delivery. The project consists of a study of best practice project delivery and the development of a suite of products, resources and services to guide project teams towards the best procurement approach for a specific project or group of projects. These resources will be focused on promoting the principles that underlie best practice project delivery rather than simply identifying an off-the-shelf procurement system. This project builds on earlier work by Sidwell, Kennedy and Chan (2002), on re-engineering the construction delivery process, which developed a procurement framework in the form of a Decision Matrix

The criminalisation of medical mistakes in Canada : a review

The issue of health professionals facing criminal charges of manslaughter or criminal negligence causing death or grievous bodily harm as a result of alleged negligence in their professional practice was thrown into stark relief by the recent acquittal of four physicians accused of mismanaging Canada’s blood system in the early 1980s. Stories like these, as well as international reports detailing an increase in the numbers of physicians being charged with (and in some cases convicted of) serious criminal offences as the result of alleged negligence in their professional practice, have resulted in some anxiety about the apparent increase in the incidence of such charges and their appropriateness in the healthcare context. Whilst research has focused on the incidence, nature and appropriateness of criminal charges against health professionals, particularly physicians, for alleged negligence in their professional practice in the United Kingdom, the United States, Japan, and New Zealand, the Canadian context has yet to be examined. This article examines the Canadian context and how the criminal law is used to regulate the negligent acts or omissions of a health care professional in the course of their professional practice. It also assesses the appropriateness of such use. It is important at this point to state that the analysis in this article does not focus on those, fortunately few, cases where a health professional has intentionally killed his or her patients but rather when patients’ deaths or grievous injuries were allegedly as a result of that health professional’s negligent acts or omissions when providing health services to that patient.

A review of non-traditional occupational therapy practice placement education : a focus on role-emerging and project placements

Practice placement education has been recognised as an integral and critical component of the training of occupational therapy students. Although there is an extensive body of literature on clinical education and traditional practice placement education models, there has been limited research on alternative placements.-------- This paper reviews the literature on various practice placement education models and presents a contemporary view on how it is currently delivered. The literature is examined with a particular focus on the increasing range of practice placement education opportunities, such as project and role-emerging placements. The drivers for non-traditional practice placement education include shortages of traditional placement options, health reform and changing work practices, potential for role development and influence on practice choice. The benefits and challenges of non-traditional practice placement education are discussed, including supervision issues, student evaluation, professional and personal development and the opportunity to practise clinical skills.--------- Further research is recommended to investigate occupational therapy graduates' perceptions of role-emerging and project placements in order to identify the benefits or otherwise of these placements and to contribute to the limited body of knowledge of emerging education opportunities.

Paramedic knowledge of infectious disease aetiology and transmission in an Australian Emergency Medical System

Introduction: Paramedics and other emergency health workers are exposed to infectious disease particularly when undertaking exposure-prone procedures as a component of their everyday practice. This study examined paramedic knowledge of infectious disease aetiology and transmission in the pre-hospital care environment.--------- Methods: A mail survey of paramedics from an Australian ambulance service (n=2274) was conducted.--------- Results: With a response rate of 55.3% (1258/2274), the study demonstrated that paramedic knowledge of infectious disease aetiology and modes of transmission was poor. Of the 25 infectious diseases included in the survey, only three aetiological agents were correctly identified by at least 80% of respondents. The most accurate responses for aetiology of individual infectious diseases were for HIV/AIDS (91.4%), influenza (87.4%), and hepatitis B (85.7%). Poorest results were observed for pertussis, infectious mononucleosis, leprosy, dengue fever, Japanese B encephalitis and vancomycin resistant enterococcus (VRE), all with less than half the sample providing a correct response. Modes of transmission of significant infectious diseases were also assessed. Most accurate responses were found for HIV/AIDS (85.8%), salmonella (81.9%) and influenza (80.1%). Poorest results were observed for infectious mononucleosis, diphtheria, shigella, Japanese B encephalitis, vancomycin resistant enterococcus, meningococcal meningitis, rubella and infectious mononucleosis, with less than a third of the sample providing a correct response.--------- Conclusions: Results suggest that knowledge of aetiology and transmission of infectious disease is generally poor amongst paramedics. A comprehensive in-service education infection control programs for paramedics with emphasis on infectious disease aetiology and transmission is recommended.

Safer construction voluntary code of practice : implications for SMEs

The majority of Australian construction firms are small businesses, with 97% of general construction businesses employing less than 20 employees and 85% employing less than five employees (Lin and Mills, 2001; Lingard and Holmes, 2001). The Australian Bureau of Statistics’ definition of a small to medium enterprise was used for the purpose of this study (McLennan, 2000). This included small business employing less than twenty people and medium business employing less than 200 people. Although small to medium enterprises (SME) make up the major share of construction organisations in Australia, there is a paucity of published research in relation to occupational health and safety (OHS) issues for this group. Typically, SME organisations “are frequently undercapitalized and depend on continuous cash flow for their continued business” (Cole, 2003; 12). Research by Lin and Mills (2001) indicates that these factors influence the smaller operators’ ability and motivation to achieve high levels of OHS compared to larger firms which tend to integrate OHS into their management systems. According to Lin and Mills (2001; 137) small firms “do not feel the need to focus on OHS in their management systems, instead they often believe that the control of risk is the responsibility of employees”. This report documents findings from a qualitative research study that examined SME organisations’ views of a newly developed voluntary code of practice (VCOP), and ways in which they might implement the code in their businesses. The research also explored respondents’ awareness of current safety issues in industry in the context of their personal experiences.

Orthopaedics and Trauma Queensland Annual Report 2008

Orthopaedics and Trauma Queensland is an internationally recognised research group that is developing into an international leader in research and education. It provides a stimulus for research, education and clinical application within the international orthopaedic and trauma communities. Orthopaedics and Trauma Queensland develops and promotes the innovative use of engineering and technology, in collaboration with surgeons, to provide new techniques, materials, procedures and medical devices. Its integration with clinical practice and strong links with hospitals ensure that the research will be translated into practical outcomes for patients. The group undertakes clinical practice in orthopaedics and trauma and applies core engineering, modelling and clinical skills to challenges in medicine. The research is built on a strong foundation of knowledge in biomedical engineering and incorporates expertise in cell biology, mathematical modelling, human anatomy and physiology and clinical medicine in orthopaedics and trauma. New knowledge is being developed and applied to the full range of orthopaedic diseases and injuries, such as knee and hip replacements, fractures and spinal deformities.

University-industry partnership for pedagogy : some principles for practice

Industries demand a closer alignment of university learning curriculum to real work tasks to better meet the needs of organizations and learners. Both, industries and learners prefer the learning challenges to be based on the exigencies of work to precisely reflect real work circumstances that overtly add to business outcomes. However, such alignment is often complicated and challenging for academics and workplace managers alike. It demands partnerships between universities and industries, similar to arrangements forged for the vocational education and training sector. Such partnerships should allow active participation by learners, academics, workplaces and university administrators to move beyond a teaching orientation to a demonstrably effective learning arrangement through work integrated learning. This paper draws on a case study that negotiated a partnership between a non-government organization and an Australian university to design and facilitate a boutique curriculum that met the needs of learners and their workplace. Data were collected from interviews with participants, a focus group of the interviewees, and feedback from university staff involved in the course delivery. The paper presents a set of principles for universities and industries for partnership to enhance the alignment of academic curriculum to meet organizational and individual learning needs through work integrated learning.

Information–movement coupling in developing cricketers under changing ecological practice constraints

Changing informational constraints of practice, such as when using ball projection machines, has been shown to significantly affect movement coordination of skilled cricketers. To date, there has been no similar research on movement responses of developing batters, an important issue since ball projection machines are used heavily in cricket development programmes. Timing and coordination of young cricketers (n = 12, age = 15.6 ± 0.7 years) were analyzed during the forward defensive and forward drive strokes when facing a bowling machine and bowler (both with a delivery velocity of 28.14 ± 0.56 m s−1). Significant group performance differences were observed between the practice task constraints, with earlier initiation of the backswing, front foot movement, downswing, and front foot placement when facing the bowler compared to the bowling machine. Peak height of the backswing was higher when facing the bowler, along with a significantly larger step length. Altering the informational constraints of practice caused major changes to the information–movement couplings of developing cricketers. Data from this study were interpreted to emanate from differences in available specifying variables under the distinct practice task constraints. Considered with previous findings, results confirmed the need to ensure representative batting task constraints in practice, cautioning against an over-reliance on ball projection machines in cricket development programmes.

Nursing students’ knowledge and practice of infection control precautions : an educational intervention

Aim. This paper is a report of the effectiveness of a purpose-designed education program in improving undergraduate nursing students’ understanding and practice of infection control precautions. Background. The severe acute respiratory syndrome outbreak in 2003 highlighted that healthcare workers were under-prepared for such an epidemic. While many in-service education sessions were arranged by institutions in response to the outbreak, preservice nursing education has overlooked preparation for handling such infectious disease epidemics. Method. A quasi-experimental design was used and a 16-hour, purpose-designed infection control education programme was implemented for preservice nursing students in southern Taiwan. Self-administered questionnaires were distributed at three time points during the period September 2005 to April 2006 to examine the sustainability and effectiveness of the intervention. Results. A total of 175 preservice nursing students participated in the study. Following the education programme, students in the intervention group showed a statistically significant improvement across time in their knowledge of these precautions [F(2, 180) = 13Æ53, P < 0Æ001] and confidence in resolving infectionrelated issues [F(1Æ79, 168Æ95) = 3Æ24] when compared with those in the control group. Conclusion. To improve nursing students’ capacity in responding to infectious epidemics, an educational programme that integrates the theme of infection precautions, learning theory and teaching strategies is recommended for all nursing institutes.

Measuring the effect of patient comfort rounds on practice environment and patient satisfaction : A pilot study

Hourly rounding in the acute hospital setting has been proposed as an intervention to increase patient satisfaction and safety, and improve the nursing practice environment, but the innovation has not been adequately tested. A quasiexperimental pretest post-test non-randomized parallel group trial design was used to test the effect of hourly patient comfort rounds on patient satisfaction and nursing perceptions of the practice environment, and to evaluate research processes and instruments for a proposed larger study. A Patient Satisfaction Survey instrument was developed and used in conjunction with the Practice Environment Scale of the Nursing Work Index. Results on patient satisfaction showed no significant changes. Significant changes were found for three of the five practice environment subscales. Consistent with the aim of a pilot study, this research has provided important information related to design, instruments and process that will inform a larger sufficiently powered study.

Challenges in implementing evidence-based practice into mental health services

This paper highlights challenges in implementing mental health policy at a service delivery level. It describes an attempt to foster greater application of recovery-orientated principles and practices within mental health services. Notwithstanding a highly supportive policy environment, strong support from service administrators, and an enthusiastic staff response to training, application of the training and support tools was weaker than anticipated. This paper evaluates the dissemination trial against key elements to promote sustained adoption of innovations. Organisational and procedural changes are required before mental health policies are systematically implemented in practice.

Boys 'doing' and 'undoing' media education : new possibilities for theory and practice

The purpose of this study is to investigate how secondary school media educators might best meet the needs of students who prefer practical production work to ‘theory’ work in media studies classrooms. This is a significant problem for a curriculum area that claims to develop students’ media literacies by providing them with critical frameworks and a metalanguage for thinking about the media. It is a problem that seems to have become more urgent with the availability of new media technologies and forms like video games. The study is located in the field of media education, which tends to draw on structuralist understandings of the relationships between young people and media and suggests that students can be empowered to resist media’s persuasive discourses. Recent theoretical developments suggest too little emphasis has been placed on the participatory aspects of young people playing with, creating and gaining pleasure from media. This study contributes to this ‘participatory’ approach by bringing post structuralist perspectives to the field, which have been absent from studies of secondary school media education. I suggest theories of media learning must take account of the ongoing formation of students’ subjectivities as they negotiate social, cultural and educational norms. Michel Foucault’s theory of ‘technologies of the self’ and Judith Butler’s theories of performativity and recognition are used to develop an argument that media learning occurs in the context of students negotiating various ‘ethical systems’ as they establish their social viability through achieving recognition within communities of practice. The concept of ‘ethical systems’ has been developed for this study by drawing on Foucault’s theories of discourse and ‘truth regimes’ and Butler’s updating of Althusser’s theory of interpellation. This post structuralist approach makes it possible to investigate the ways in which students productively repeat and vary norms to creatively ‘do’ and ‘undo’ the various media learning activities with which they are required to engage. The study focuses on a group of year ten students in an all boys’ Catholic urban school in Australia who undertook learning about video games in a three-week intensive ‘immersion’ program. The analysis examines the ethical systems operating in the classroom, including formal systems of schooling, informal systems of popular cultural practice and systems of masculinity. It also examines the students’ use of semiotic resources to repeat and/or vary norms while reflecting on, discussing, designing and producing video games. The key findings of the study are that students are motivated to learn technology skills and production processes rather than ‘theory’ work. This motivation stems from the students’ desire to become recognisable in communities of technological and masculine practice. However, student agency is not only possible through critical responses to media, but through performative variation of norms through creative ethical practices as students participate with new media technologies. Therefore, the opportunities exist for media educators to create the conditions for variation of norms through production activities. The study offers several implications for media education theory and practice including: the productive possibilities of post structuralism for informing ways of doing media education; the importance of media teachers having the autonomy to creatively plan curriculum; the advantages of media and technology teachers collaborating to draw on a broad range of resources to develop curriculum; the benefits of placing more emphasis on students’ creative uses of media; and the advantages of blending formal classroom approaches to media education with less formal out of school experiences.

Supervision practice for allied mental health professionals within a large mental health workforce : exploring the phenomenon

This paper reports on an exploration of the concept of 'supervision' as applied to allied health professionals within a large mental health service in one Australian State. A two-part methodology was used, with focus group interviews conducted with allied health professionals, and semi-structured telephone interviews with service managers. Fifty-eight allied health professionals participated in a series of seven focus groups. Semi-structured interviews were conducted with the Directors or Managers of mental health services in all 21 regions in the state. Allied health professionals and service managers both considered supervision to be an important mechanism for ensuring staff competence and best practice outcomes for consumers and carers. There was strong endorsement of the need for clarification and articulation of supervision policies within the organization, and the provision of appropriate resourcing to enable supervision to occur. Current practice in supervision was seen as ad hoc and of variable standard; the need for training in supervision was seen as critical. The supervision needs of newly graduated allied health professionals and those working in rural and regional areas were also seen as important. The need for a flexible and accessible model of supervision was clearly demonstrated.

Practice briefing : Is BOT the best financing model to procure infrastructure projects? A case study of the Hong Kong-Shuhai-Macau Bridge

Abstract: Purpose – Several major infrastructure projects in the Hong Kong Special Administrative Region (HKSAR) have been delivered by the build-operate-transfer (BOT) model since the 1960s. Although the benefits of using BOT have been reported abundantly in the contemporary literature, some BOT projects were less successful than the others. This paper aims to find out why this is so and to explore whether BOT is the best financing model to procure major infrastructure projects. Design/methodology/approach – The benefits of BOT will first be reviewed. Some completed BOT projects in Hong Kong will be examined to ascertain how far the perceived benefits of BOT have been materialized in these projects. A highly profiled project, the Hong Kong-Zhuhai-Macau Bridge, which has long been promoted by the governments of the People's Republic of China, Macau Special Administrative Region and the HKSAR that BOT is the preferred financing model, but suddenly reverted back to the traditional financing model to be funded primarily by the three governments with public money instead, will be studied to explore the true value of the BOT financial model. Findings – Six main reasons for this radical change are derived from the analysis: shorter take-off time for the project; difference in legal systems causing difficulties in drafting BOT agreements; more government control on tolls; private sector uninterested due to unattractive economic package; avoid allegation of collusion between business and the governments; and a comfortable financial reserve possessed by the host governments. Originality/value – The findings from this paper are believed to provide a better understanding to the real benefits of BOT and the governments' main decision criteria in delivering major infrastructure projects.