Development and evaluation of a program to improve clinician and patient communication during a telehealth consultation : C.R.I.S.P. Telehealth

Introduction: The delivery of health care in the 21st century will look like no other in the past. The fast paced technological advances that are being made will need to transition from the information age into clinical practice. The phenomenon of e-Health is the over-arching form of information technology and telehealth is one arm of that phenomenon. The uptake of telehealth both in Australia and overseas, has changed the face of health service delivery to many rural and remote communities for the better, removing what is known as the tyranny of distance. Many studies have evaluated the satisfaction and cost-benefit analysis of telehealth across the organisational aspects as well as the various adaptations of clinical pathways and this is the predominant focus of most studies published to date. However, whilst comments have been made by many researchers about the need to improve and attend to the communication and relationship building aspects of telehealth no studies have examined this further. The aim of this study was to identify the patient and clinician experiences, concerns, behaviours and perceptions of the telehealth interaction and develop a training tool to assist these clinicians to improve their interaction skills. Methods: A mixed methods design combining quantitative (survey analysis and data coding) and qualitative (interview analysis) approaches was adopted. This study utilised four phases to firstly qualitatively explore the needs of clients (patients) and clinicians within a telehealth consultation then designed, developed, piloted and quantitatively and qualitatively evaluated the telehealth communication training program. Qualitative data was collected and analysed during Phase 1 of this study to describe and define the missing 'communication and rapport building' aspects within telehealth. This data was then utilised to develop a self-paced communication training program that enhanced clinicians existing skills, which comprised of Phase 2 of this study to develop the interactive program. Phase 3 included evaluating the training program with 26 clinicians and results were recorded pre and post training, whilst phase 4 was the pilot for future recommendations of this training program using a patient group within a Queensland Health setting at two rural hospitals. Results: Comparisons of pre and post training data on 1) Effective communication styles, 2) Involvement in communication training package, 3) satisfaction pre and post training, and 4) health outcomes pre and post training indicated that there were differences between pre and post training in relation to effective communication style, increased satisfaction and no difference in health outcomes between pre and post training for this patient group. The post training results revealed over half of the participants (N= 17, 65%) were more responsive to non-verbal cues and were better able to reflect and respond to looks of anxiousness and confusion from a 'patient' within a telehealth consultation. It was also found that during post training evaluations, clinicians had enhanced their therapeutic communication with greater detail to their own body postures, eye contact and presentation. There was greater time spent looking at the 'patient' with an increase of 35 second intervals of direct eye contact and less time spent looking down at paperwork which decreased by 20 seconds. Overall 73% of the clinicians were satisfied with the training program and 61% strongly agreed that they recognised areas of their communication that needed improving during a telehealth consultation. For the patient group there was significant difference post training in rapport with a mean score from 42 (SD = 28, n = 27) to 48 (SD = 5.9, n = 24). For communication comfort of the patient group there was a significant difference between the pre and post training scores t(10) = 27.9, p = .002, which meant that overall the patients felt less inhibited whilst talking to the clinicians and more understood. Conclusion: The aim of this study was to explore the characteristics of good patient-clinician communication and unmet training needs for telehealth consultations. The study developed a training program that was specific for telehealth consultations and not dependent on a 'trainer' to deliver the content. In light of the existing literature this is a first of its kind and a valuable contribution to the research on this topic. It was found that the training program was effective in improving the clinician's communication style and increased the satisfaction of patient's within an e-health environment. This study has identified some historical myths that telehealth cannot be part of empathic patient centred care due to its technology tag.

Research trends of post disaster reconstruction : the past and the future

Natural disasters can have adverse effect on human lives. To raise the awareness of research and better combat future events, it is important to identify recent research trends in the area of post disaster reconstruction (PDR). The authors used a three-round literature review strategy to study journal papers published in the last decade that are related to PDR with specific conditions using the Scopus search engine. A wide range of PDR related papers from a general perspective was examined in the first two rounds while the final round established 88 papers as target publications through visual examination of the abstracts, keywords and as necessary, main texts. These papers were analysed in terms of research origins, active researchers, research organisations, most cited papers, regional concerns, major themes and deliverables, for clues of the past trends and future directions. The need for appropriate PDR research is increasingly recognised. The publication number multiplied 5 times from 2002 to 2012. For PDR research with a construction perspective, the increase is sixfold. Developing countries such as those in Asia attract almost 50% researchers' attention for regional concerns while the US is the single most concentrated (24%) country. Africa is hardly represented. Researchers in developed countries lead in worldwide PDR research. This contrasts to the need for expertise in developing countries. Past works focused on waste management, stakeholder analysis, resourcing, infrastructure issue, resilience and vulnerability, reconstruction approach, sustainable reconstruction and governance issues. Future research should respond to resourcing, integrated development, sustainability and resilience building to cover the gaps. By means of a holistic summary and structured analysis of key patterns, the authors hope to provide a streamlined access to existing research findings and make predictions of future trends. They also hope to encourage a more holistic approach to PDR research and international collaborations.

Supporting cooperation and caring through large group experiences

Cooperation and caring are best taught within a group as it promotes connectedness, collaborative effort, and relationship building.

Building resilience in transcultural adults (BRiTA) : developing a novel preventative intervention

There is a dearth of preventative programs that enhance the Australian culturally and linguistically diverse (CALD) adults’ resilience to cope with the acculturation process. This article introduces the reader to the BRiTA Futures for Adults and Parents, a culture and language sensitive program for the CALD. The conceptual framework and the development process are described. The manualised program consisting of one introductory and eight intervention modules is presented. A training program is also developed to train facilitators, who can deliver the program in English or other languages. Preliminary trials indicated that the program was received well by the consumers. A block mode, instead of the traditional weekly sessions, appeared to be more practical for the small population for which it was trialled. Implications and future directions are discussed.

Exploring community building with an awareness display

In this paper, we present a field trial of a pervasive system called Panorama that is aimed at supporting social awareness in work environments. Panorama is an intelligent situated display in the staff room of an academic department. It artistically represents non-critical user generated content such as images from holidays, conferences and other social gatherings, as well as textual messages on its display. It also captures images and videos from different public spaces of the department and streams them onto the Panorama screen, using appropriate abstraction techniques. We studied the use of Panorama for two weeks and observed how Panorama affected staff members' social awareness and community building. We report that Panorama simulated curiosity and learning, initiated new interactions and provided a mechanism for cherishing old memories.

Integrated access control for smart buildings using building information models

This thesis investigates the use of building information models for access control and security applications in critical infrastructures and complex building environments. It examines current problems in security management for physical and logical access control and proposes novel solutions that exploit the detailed information available in building information models. The project was carried out as part of the Airports of the Future Project and the research was modelled based on real-world problems identified in collaboration with our industry partners in the project.

Insurance and trust : lessons from the Christchurch Cathedral

This article examines important insurance and trust law issues that may confront trustees charged with the governance and protection of unique properties with broad community and heritage significance. Often trustee roles are assumed by community leaders without full appreciation of the potential difficulties and consequences when unforeseen circumstances arise. Three recent New Zealand court decisions in relation to the deconstruction and repair of the Christchurch Cathedral and to the interim construction of a transitional"cardboard Cathedral" highlight how difficult - and legally exposed - the role of trustee can be. The Cathedral cases go to the heart of defining the core purpose for which a Trust is created and examine the scope of discretion in fulfilling this charge its Trustees carry. Arising in the wake of the devastating Christchurch earthquakes, the Cathedral's Trustees were called upon to consider the best directions forward for a criplled and dangerous building subject to potential demolition, the wellbeing of the Cathedral's direct community, and the broader heritage and identity factors that this 'heart' of Christchurch represented. In the context of a seemingly grossly underinsured material damage cover - and faced with broader losses across the Diocese's holdings - the Trustees found that their sense of mission failed to gel with that of a community-based heritage buildings preservation trust. The High Court had to consider how monies received under the material damage policy could be applied by the Trustee in deconstructing, reinstating or repairing the Cathedral and if monies could be partly deployed to create an interim solution in the former of a transitional cathedral - all this in the context of the site-specific purpose of the Cathedral trust. The cases emphasise further the need to assess professionally the nature and quantum of cover effected to protect against various risks. In addition, in the case of historic or unusual buildings extra care must be exercised to take account additional costs associated with reinstatement so as to substantially retain the character and intrinsic value of such properties.

Conservation communication camp : come with ideas, leave with a plan

IUCN´s core work involves generating knowledge and tools to influence policy and practice for nature conservation. Whilst it appears that we are collectively making progress in some areas, we acknowledge the need to improve our communication processes and practices to ´move to action´ in this regard. We need to extend the influence of the science and the knowledge beyond the documents to achieve effective impact and action. The training course will focus on the process of getting the conservation messages out to a wider audience. This interactive and participatory training course will develop the skills and knowledge needed to communicate effective conservation messages for a range of IUCN internal and external audiences. The course will cover: • what is communication for conservation? • the communication planning process (developing your communication objectives) • identifying and understanding your target audiences • developing your conservation message • choosing your communication media and • evaluating the effectiveness of your communication strategies. A unique feature of the training course will be the use of Web 2.0 tools in innovative conservation communications e.g. use of social media in concept branding and social marketing. In the spirit of the Forum´s objective of ´Sharing know how´, each participant will bring a current conservation issue to the training course and will leave with their own communication plan. Potentially, the training course adopts a cross-thematic approach as the issues addressed could be drawn from any of the IUCN´s program themes. Primarily though, the training course´s best fit is with the ´Valuing and Conserving Biodiversity´ theme since it will provide concrete and pragmatic solutions to enhancing the implementation of conservation measures through participatory planning and capacity building.

Critical factors for waste management in office building retrofit projects in Australia

Office building retrofit is a sector being highlighted in Australia because of the mature office building market characterised by a large proportion of ageing properties. The increasing number of office building retrofit projects strengthens the need for waste management. Retrofit projects possess unique characteristics in comparison to traditional demolition and new builds such as partial operation of buildings, constrained site spaces and limited access to as-build information. Waste management activities in retrofit projects can be influenced by issues that are different from traditional construction and demolition projects. However, previous research on building retrofit projects has not provided an understanding of the critical issues affecting waste management. This research identifies the critical factors which influence the management of waste in office building retrofit projects through a literature study and a questionnaire survey to industry practitioners. Statistical analysis on a range of potential waste issues reveals the critical factors, as agreed upon by survey respondents in consideration of their different professional responsibilities and work natures. The factors are grouped into five dimensions, comprising industry culture, organisational support and incentive, existing building information, design, and project delivery process. The discussions of the dimensions indicate that the waste management factors of office building retrofit projects are further intensified compared to those for general demolition and construction because retrofit projects involve existing buildings which are partially operating with constrained work space and limited building information. Recommendations for improving waste management in office building retrofit projects are generalised such as waste planning, auditing and assessment in the planning and designing stage, collaboration and coordination of various stakeholders and different specialists, optimised building surveying and BIM technologies for waste analysis, and new design strategies for waste prevention.

Social and cultural drivers of incentive effectiveness in infrastructure projects

Formal incentives systems aim to encourage improved performance by offering a reward for the achievement of project-specific goals. Despite argued benefits of incentive systems on project delivery outcomes, there remains debate over how incentive systems can be designed to encourage the formation of strong project relationships within a complex social system such as an infrastructure project. This challenge is compounded by the increasing emphasis in construction management research on the important mediating influence of technical and organisational context on project performance. In light of this challenge, the research presented in this paper focuses on the design of incentive systems in four infrastructure projects: two road reconstructions in the Netherlands and two building constructions in Australia. Based on a motivational theory frame, a cross case analysis is conducted to examine differences and similarities across social and cultural drivers impacting on the effectiveness of the incentive systems in light of infrastructure project context. Despite significant differences in case project characteristics, results indicate the projects’ experience similar social drivers impacting on incentive effectiveness. Significant value across the projects was placed on: varied performance goals and multiple opportunities to across the project team to pursue incentive rewards; fair risk allocation across contract parties; value-driven tender selection; improved design-build integration; and promotion of future work opportunities. However, differences across the contexts were identified. Results suggest future work opportunities were a more powerful social driver in upholding reputation and establishing strong project relationships in the Australian context. On the other hand, the relationship initiatives in the Dutch context seemed to be more broadly embraced resulting in a greater willingness to collaboratively manage project risk. Although there are limitations with this research in drawing generalizations across two sets of case projects, the results provide a strong base to explore the social and cultural influences on incentive effectiveness across different geographical and contextual boundaries in future research.

Collaboration in Web N.0: Stigmergy and virtual pheromones

The aim of this project was to develop a general theory of stigmergy and a software design pattern to build collaborative websites. Stigmergy is a biological term used when describing some insect swarm-behaviour where 'food gathering' and 'nest building' activities demonstrate the emergence of self-organised societies achieved without an apparent management structure. The results of the project are an abstract model of stigmergy and a software design pattern for building Web 2.0 components exploiting this self-organizing phenomenon. A proof-of-concept implementation was also created demonstrating potential commercial viability for future website projects.

The National Curriculum and history school textbooks in Australia and the Russian Federation

This chapter analyses recent policy reforms in the national history curriculum in both Australia and the Russian Federation. It analyses those emphases in the national curriculum in history that depict new representations and historiography and the ways in which this is foregrounded in History school textbooks. In doing so, it considers the debates about what version of the nation’s past are deemed significant, and what should be transmitted to future generations of citizens. In this discussion of national history curricula, consideration is made of the curriculum’s officially defined status as an instrument in the process of ideological transformation, and nation-building. The chapter also examines how history textbooks are implicit in this process, in terms of reproducing and representing what content is selected and emphasised in a national history curriculum.

Introduction to Point and Counterpoint: What does the Review of the Australian Curriculum mean for History?

The April 2015 edition of Curriculum Perspectives has a special focus and casts light on the continuing development of the Australian Curriculum. This paper provides an introduction to a series of papers in the Point and Counterpoint section of this edition on the Review of the Australian Curriculum with reference to History. It makes clear that History is one of the most contested areas of the curriculum and that whilst politicians and policy makers are concerned with the importance of history in relation to national identity and nation building, history serves other purposes. The paper reiterates the need to pay attention to the particularities of discipline–based knowledge for the study of history in schools and the central role of inquiry for student learning in history. In doing so, it establishes the context for the five papers which follow.

Design and control of MIRA: A lightweight climbing robot for ship inspection

The inspection of marine vessels is currently performed manually. Inspectors use tools (e.g. cameras and devices for non-destructive testing) to detect damaged areas, cracks, and corrosion in large cargo holds, tanks, and other parts of a ship. Due to the size and complex geometry of most ships, ship inspection is time-consuming and expensive. The EU-funded project INCASS develops concepts for a marine inspection robotic assistant system to improve and automate ship inspections. In this paper, we introduce our magnetic wall–climbing robot: Marine Inspection Robotic Assistant (MIRA). This semiautonomous lightweight system is able to climb a vessels steel frame to deliver on-line visual inspection data. In addition, we describe the design of the robot and its building subsystems as well as its hardware and software components.

Gearing up academics for collaborative Building Information Modelling (BIM) education

Building information modelling (BIM) radically changes the practices in architecture, engineering and construction (AEC) and creates new job opportunities. Many governments, such as the United Kingdom, have made BIM a mandatory requirement. This substantially drives the demand for a BIM-literate workforce. Universities are facing the challenge to incorporate BIM into their curricula and produce “BIM ready” graduates to meet the needs of the industry. Like other universities, Queensland University of Technology (QUT) is at the heart of this change and aspires to develop collaborative BIM education across AEC. Previous BIM education studies identify that inadequate BIM awareness of AEC academics is one of the challenges for developing a BIM curriculum and there is a dearth in the learning and teaching support for academics on BIM education. Equipping the AEC academics for a more BIM focused curriculum is all the while more important. This paper aims to leverage knowledge drawn from a Learning & Teaching project currently undertaken at QUT. Its specific objectives are to: 1) review the existing learning and teaching initiatives on BIM education; and 2) briefly describe the learning and teaching activities on collaborative BIM education at QUT. Significance of the paper lies on revealing the importance of building up the capacity of AEC academics for collaborative BIM education. The paper contributes to sparking the interests in better equipping AEC academics to understand what curriculum changes would assist in BIM uptake within the relevant courses to provide context for changes in units; and how the use of BIM can improve the understanding by students of the large amounts of professional knowledge they need to function effectively as graduates.