Creating opportunities for interdisciplinary collaboration and patient-centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting.

AIMS AND OBJECTIVES: This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. BACKGROUND: Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in-depth analysis of medication interactions among nurses, doctors, pharmacists and patients. DESIGN: A critical ethnographic approach with video reflexivity was adopted to capture communication strategies during medication activities in two general medical wards of an acute care hospital in Melbourne, Australia. METHODS: A mixed ethnographic approach combining participant observations, field interviews, video recordings and video reflexive focus groups and interviews was employed. Seventy-six nurses, 31 doctors, 1 pharmacist and 27 patients gave written consent to participate in the study. Data analysis was informed by Fairclough's critical discourse analytic framework. FINDINGS: Clinicians' use of communication strategies was demonstrated in their interpersonal, authoritative and instructive talk with patients. Doctors adopted the language discourse of normalisation to standardise patients' illness experiences. Nurses and pharmacists employed the language discourses of preparedness and scrutiny to ensure that patient safety was maintained. Patients took up the discourse of politeness to raise medication concerns and question treatment decisions made by doctors, in their attempts to challenge decision-making about their health care treatment. In addition, the video method revealed clinicians' extensive use of body language in communication processes for medication management. CONCLUSIONS: The use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient-centred medication management in an acute hospital setting. Language discourses shaped and were shaped by complex power relations between patients and clinicians and among clinicians themselves. RELEVANCE TO CLINICAL PRACTICE: Clinicians need to be encouraged to have regular conversations to talk about and challenge each other's practices. More emphasis should be placed on ensuring that patients are given opportunities to voice their concerns about how their medications are managed.

Identifying knowledge gaps in seagrass research and management: An Australian perspective.

Seagrass species form important marine and estuarine habitats providing valuable ecosystem services and functions. Coastal zones that are increasingly impacted by anthropogenic development have experienced substantial declines in seagrass abundance around the world. Australia, which has some of the world's largest seagrass meadows and is home to over half of the known species, is not immune to these losses. In 1999 a review of seagrass ecosystems knowledge was conducted in Australia and strategic research priorities were developed to provide research direction for future studies and management. Subsequent rapid evolution of seagrass research and scientific methods has led to more than 70% of peer reviewed seagrass literature being produced since that time. A workshop was held as part of the Australian Marine Sciences Association conference in July 2015 in Geelong, Victoria, to update and redefine strategic priorities in seagrass research. Participants identified 40 research questions from 10 research fields (taxonomy and systematics, physiology, population biology, sediment biogeochemistry and microbiology, ecosystem function, faunal habitats, threats, rehabilitation and restoration, mapping and monitoring, management tools) as priorities for future research on Australian seagrasses. Progress in research will rely on advances in areas such as remote sensing, genomic tools, microsensors, computer modeling, and statistical analyses. A more interdisciplinary approach will be needed to facilitate greater understanding of the complex interactions among seagrasses and their environment.

Multidisciplinary research perspectives in education shared experiences from Australia and China

The editors of this extraordinary book, Indika Liyanage and Badeng Nima, have brought together a wonderfully wide-ranging collection of chapters. The breadth and depth of the studies of education issues in China and Australia are impressive. The topics encompass important questions concerning education policies, curricula, pedagogy, equality, parental engagement, cultural heritage, and anti-drug education. The scope of the book includes Chinese and Australian settings that range from kindergartens to higher education, and from rural to urban environments. The diversity of the book strengthens rather than weakens its coherence, because the golden thread running through all the chapters is a portrayal of the complexity of education provision when global, national and local forces interact. Written by academics with hands-on experience, the chapters provide evidence-based discussions of practical conundrums, enriched by the sophisticated use of interdisciplinary approaches. As a result, this book is powerful, challenging and ground-breaking.

Collaborative reflective experience and practice in education explored through self-study and arts-based research

Eight teacher educators used self-study methodology to engage in reflective practice to overcome their isolation as individual teachers and researchers, and to facilitate professional development. Their research question asked: How can we continue to develop our teaching practice to ensure we are high quality, contemporary teacher educators? They contributed collaboratively in one overarching research project as well as through several focussed projects that explored issues in their individual teaching practices including: sustainability, creativity, curriculum design, pedagogy, assessment, and the learning experiences for students. This paper explores the outcomes from collaborative inquiry that five of the eight educator/researchers engaged in during a research-writing retreat. It documents their experience using arts-based strategies in which drawings were created about their experiences of engaging in a collaborative project and smaller focussed self-study projects. Analysis involved inquiring into each other’s drawings through recorded conversation. The metaphoric representations found through analysing the drawings provided insight into participants’ teaching practices and identities as teacher educators. Six months later when the participants had developed their projects further and used other artsbased methods to understand these experiences, they reflected on the key issues for their teaching practices that had arisen from undertaking this Collaborative Reflective Experience and Practice in Education research. Arts-based inquiries and reflective analysis over six months, constitute this paper. The experiences and analyses are shared to show how creating and sharing metaphoric meaning of visual representations is useful in self-study research to drill down into the real issues. Importantly, this in-depth sharing provides authentic interdisciplinary links when individual educators share their own approaches to teaching in their disciplined area. Findings suggest that gaining new insights into each other’s discipline-based approaches to teacher education through these methods, revealed different responses to pedagogical challenges and allowed for new possibilities for understanding the landscape of teacher education.

Interdisciplinary mathematics education: a state of the art

This book provides an essential introduction to the state-of the-art in interdisciplinary Mathematics Education. First, it begins with an outline of the field’s relevant historical, conceptual and theoretical backgrounds, what “discipline” means and how inter-, trans-, and meta-disciplinary activities can be understood. Relevant theoretical perspectives from Marx, Foucault and Vygotsky are explained, along with key ideas in theory, e.g. boundaries, discourses, identity, and the division of labour in practice. Second, the book reviews research findings of mainly empirical studies on interdisciplinary work involving mathematics in education, in all stages of education that have become disciplined. For example, it reports that a common theme in studies in middle and high schools is assessing the motivational benefits for the learner of subsuming disciplinary motives and even practices to extra-academic problem-solving activities; this is counter-balanced by the effort needed to overcome the disciplinary boundaries in academic institutions, and in professional identities. These disciplinary boundaries are less obviously limitations in middle and primary schools, and in some vocational courses. Third and finally, it explores selected case studies that illustrate these concepts and findings, both in terms of the motivational benefits for learners and the institutional and other boundaries involved.

Positioning research and new knowledge systems

Debates into the positioning of research and aligning them with new knowledge systems has received mixed reactions. Many argue that research needs to follow discrete silos of disciplinary knowledge where knowledge needs to remain within a particular and defined construct. However, in the global world that we now embrace, there is a burgeoning of new knowledge systems that have disrupted ‘traditional’ processes of carrying out research and foregrounded the encompassing of new knowledge systems that follow research pathways and methodologies that are all encompassing of the multifaceted educational and social systems that embrace specific postcolonial and indigenous societies. Much of this corollary has stemmed from historical and political factors that have seen the rise of some disciplines of knowledge and the non-awareness’s and non-recognition of others. This paper articulates from an auto-ethnographic perspective the discussion surrounding the positioning of research, new knowledge systems and interdisciplinary learning in the areas of International and Aboriginal students. Focusing on postcolonial theory and Aboriginal approaches to research, the author foregrounds the tensions of historiography, hybridity, subjectivities, collaborative sharing and voice through what she terms a ‘strands of knowledge’ approach in these two areas. In the process, the author conceptualises two definitions. These are: intra-paradigm shifts and the irreducibility of the ethics of research and discusses how they are integral concepts when researching in or around particular cultural communities and groups.