Skin cancer medicine in primary care: towards an agenda for quality health outcomes

The number of skin cancer clinics functioning within Australia's primary care environment is increasing rapidly, and significant concerns have been raised about the type and quality of work done by some doctors in some clinics. Mainstream general practice is threatened by perceived fragmentation, and specialist practice in dermatology and plastic surgery is threatened by encroachment into their domains of practice. We propose an agenda of training, standards, accreditation, audit and research to ensure that skin cancer clinics provide optimal health outcomes for patients.

Issues in training in clinical psychology in Australia: Interplay between training goals and legal standards of practice

Training models in clinical psychology vary across regions, as do the laws that regulate professional practice in psychology. Standards for practice and for entry into professional practice may endure past the point of utility in the face of changing health-care systems and evolving international considerations. Herein the authors review aspects of the Australian 4-year training model, including qualifications for entry to the profession, supervision, and the influence of the profession and the universities in maintaining and in changing to a new training model. Aspects of training in clinical psychology in Australia are also discussed, and the Australian and New Zealand accreditation models are contrasted. Suggestions on ways to move forward are offered.

The importance of setting and evaluating standards of telemedicine training

The importance of appropriate training in the use of videoconferencing equipment for clinical purposes is often underestimated when telemedicine projects are established. We developed a user training programme which was delivered via videoconferencing to a group of 130 nurses. Training was delivered on a one-to-one basis. A questionnaire was developed to evaluate user satisfaction and the effectiveness of training. One hundred and two fully completed questionnaires were returned (a 79% response rate). High levels of satisfaction were obtained but the level of user competence reached 100% only when training was supported by a training manual and at least weekly practice. Before establishing a telemedicine service, the following steps appear to be important: identify the required training competencies; deliver a 'hands on' training programme based on the required training competencies; back up the training programme with an instruction booklet; ensure that trainees have at least weekly practice; measure the level of user competence.