Skill shortages in health : innovative solutions using vocational education and training

Introduction: This article reports findings of a project funded by the Australian National Council for Vocational Education Research. The project explores solutions to current and projected skills shortages within the health and community services sector, from a vocational education and training perspective. Its purpose is to locate, analyse and disseminate information about innovative models of health training and service delivery that have been developed in response to skill shortages.

Methods: The article begins with a brief overview of Australian statistics and literature on the structure of the national health workforce and perceived skill shortages. The impact of location (state and rurality), demographics of the workforce, and other relevant factors, on health skill shortages is examined. Drawing on a synthesis of the Australian and international literature on innovative and effective models for addressing health skill shortages and nominations by key stakeholders within the health sector, over 70 models were identified. The models represent a mixture of innovative service delivery models and training solutions from Australia, as well as international examples that could be transposed to the Australian context. They include the skill ecosystem approach facilitated by the Australian National Training Authority Skill Ecosystem Project. Models were selected to represent diversity in terms of the nature of skill shortage addressed, barriers overcome in development of the model, healthcare specialisations, and different customer groups.

Results: Key barriers to the development of innovative solutions to skills shortages identified were: policy that is not sufficiently flexible to accommodate changing workplace needs; unwillingness to risk take in order to develop new models; delays in gaining endorsement/accreditation; current vocational education and training (VET) monitoring and reporting systems; issues related to working in partnership, including different cultures, ways of operating, priorities and timelines; workplace culture that is resistant to change; and organisational boundaries. For training-only models, additional barriers were: technology; low educational levels of trainees; lack of health professionals to provide training and/or supervision; and cost of training. Key enhancers for the development of models were identified as: commitment by all partners and co-location of partners; or effective communication channels. Key enhancers for model effectiveness were: first considering work tasks, competencies and job (re)design; high profile of the model within the community; community-based models; cultural fit; and evidence of direct link between skills development and employment, for example VET trained aged care workers upskilling for other health jobs. For training only models, additional enhancers were flexibility of partners in accommodating needs of trainees; low training costs; experienced clinical supervisors; and the provision of professional development to trainers.

Conclusions: There needs to be a balance between short-term solutions to current skill shortages (training only), and medium to longer term solutions (job redesign, holistic approaches) that also address projected skills shortages. Models that focus on addressing skills shortages in aged care can provide a broad pathway to careers in health. Characteristics of models likely to be effective in addressing skill shortages are: responsibility for addressing skills shortage is shared between the health sector, education and training organisations and government, with employers taking a proactive role; the training component is complemented by a focus on retention of workers; models are either targeted at existing employees or identify a target group(s) who may not otherwise have considered a career in health.

Restructuring of education and training in Vietnam : a development and application of arts management training in Australia to Vietnam

The adoption of a more market-oriented economy under doi moi has paved the way for Vietnam to record remarkable human development achievements in the past decades. The Vietnamese education system has been undergoing continuous changes for almost twenty years. Key reforms have been implemented in the education and training sector such as privatising the sector; expanding the schooling system, the vocational education and training (VET) system, and higher education. This paper examines: (1) key reforms implemented in the education and training sector, placed in a broader context of economic reforms in Vietnam; (2) a development of arts management training courses in Vietnam to assist cultural organisations to adjust to social changes, as Vietnamese education institutions have not had much experience in designing training courses in arts and culture management; (3) several arts management training courses in Australian institutions to see the possibility to apply training in arts management in Australia to Vietnam. The findings indicate that a variety of management training modes in Australia can be adapted and applied to the Vietnamese training context. Some factors such as differences in culture, education and training systems, shortages in training staff and resources are also considered in this paper.

International education and challenges for Australia (case study)

The content of this 3rd edition marketing research textbook is practical and up to date and is based on an applied and managerially focused approach. Australian an New Zealand research and examples have been thoroughly intergrated into every chapter.

Education and the colonial construction of whiteness

European imperialism spawned settlements of invasive white communities throughout Asia and Africa. Stoler and Cooper (1997: 27) argue these evolving colonial societies became subject to what amounts to an extended bourgeois project such that "we can not understand the construction of whiteness without exploring its class dimensions". If in terms of that project, nineteenth-century metropolitan society was deemed vulnerable to the ravages of a brutish and unruly working class, these white colonial outposts, whether constituted as settler colonies or colonies of exploitation, were even more vulnerable to the more insidious danger of miscegenation. Racial intermingling became simultaneously an issue of class and race. Imperialism therefore added a further dimension to the on-going detinition of "bourgeois-ness": the discourse of whiteness transforming a national discourse into a discourse on civilisation.

In focusing on education as the colonial authorities' response to what they perceived of as the danger of mixed parentage, this article develops a comparative framework that links coloniai settlements in Asia and Australia. It examines the discourse surrounding miscegenation, education and the "rising generation" in the late nineteenth and early twentieth centuries in the Dutch East Indies British India, French Indo China and (British) Australia. In so doing, I demonstrate the universality of a linked discourse of whiteness and class across Imperial Asia.

The education and information needs of young adults with type 2 diabetes : a qualitative study

Aims and objectives. To identify the preferred content and delivery mode of education information for people aged 25 to 45 with type 2 diabetes to enable them to effectively self-manage their diabetes.

Background. People with type 2 diabetes are required to manage their own health and initiate behavioural changes. Self-management education and resources have typically been targeted at people aged 50 years and older. Little is known about the concerns and needs of younger people in managing type 2 diabetes, which are likely to be different from those of older people.

Design. A qualitative design was considered the most appropriate to elicit participants' views and perceptions of their type 2 diabetes information needs.

Methods. Data were obtained from one focus group (n = 9) and telephone interviews (n = 4) with people aged 25 to 45 with type 2 diabetes conducted in 2008.

Results. Implicit in participants' responses was their need to be active partners in managing their diabetes. Participants wanted information that is easy to understand, brief, consistent, age-specific and about a number of topics that are not adequately covered at present. They wanted a centralised source of information and a range of delivery mode options. Participants expressed some ambivalence about the Internet as a source of information. Participants also wanted age-specific group sessions, support from peers, psychological support, increased understanding of type 2 diabetes in the community, and a focus on preventing diabetes.

Conclusions. Young people with type 2 diabetes have specific diabetes needs and preferred information delivery modes. Participants felt current diabetes education programs do not cater specifically to their age group. Education and information resources need to be developed for the target group, addressing their content and format preferences.

Relevance to clinical practice. Health professionals need to utilise appropriate delivery modes and include information relevant to younger people when providing education information to young adults with type 2 diabetes.

A Foucauldian strategy for vocational education and training research

Vocational education and training (VET) is an area of research dominated by positivist approaches. Such approaches complement the behaviourist educational philosophy known as 'competency-based training' (CBT) that underpins Australia’s VET system. This paper reflects on a quandary encountered by researchers examining the history of competency based education at a TAFE institution in South Australia. The issue was how to account for a series of mutations in the way CBT was understood and practised that subverted the largely unquestioned expectation of progress. The researchers found that Foucault’s 'genealogical' approach allowed for the construction of a mode of intelligibility that lends the history a disturbing cogency. At the centre of this construction is an understanding of CBT as a highly permeable system whose configurability supports the reticulation of multiple forms of power.

Education and training as a social science : some empirical evidence in the Rosebank Business Precinct of Auckland New Zealand

Tertiary institutions should seek continuous feedback from industries to keep track of the needs of businesses to provide education and training. Academics should stay in touch with businesses by networking and consulting. Holland and De Cieri (2006) refer to theories of child learning (pedagogy) to inform their understanding of andragogy, the study of adult learning. Adult learners would be continuous learners and would move in and out of formal education according to individual needs or life circumstances, job requirements or career development. In designing programmes and up-grading curricula, these are important factors to bear in mind so that programmes “cater” for these learners as well.

This study was financed by Auckland City Council focussing on Auckland’s Rosebank Business Precinct (ARBP). The surrounding communities, particularly Mäori, Pacific peoples and recent migrants, experience disparities in employment. Our research questions were:
• Is there a skills match between the present-day workforce and actual business needs over the medium term?
• What can these data tell us about Rosebank’s trajectory as a skilled business cluster and about its future workforce requirements?
• What education and training will be necessary for these organisations to maintain their competitive advantage and profit margins?

The target population were the 500-600 businesses operating on Rosebank Road. A total of 529 businesses were identified. Interviews with 102 companies with a 36-question questionnaire were conducted. The sampling frame was owner-managers (senior, non-shareholding managers). Of the respondent firms, 68.75% had vacancies for up to 3 months and 31.24% vacancies for 6 months.

This paper highlights areas identified in the ARBP for developing programmes and curricula for tertiary institutions to provide employable students with the right knowledge, skills and attributes (KSAs) to grow existing ventures. A fine balance must be struck between human and organisational needs. In the analysis and discussion we point out what education or training is necessary for the ARBP to provide greater efficiencies and subsequent improvement to their profit levels by current and future employees entering the workforce; well “equipped” employees with knowledge and skills to add value in their organisations. Recommendations, future perspectives and conclusions form the last part of this paper

Collaboration : integrating education and clinical practice : The Case of La Trobe University/The Alfred Clinical School of Nursing

A Clinical School of Nursing combines resources, opportunities and benefits for hospital and university staff as well as students. Collaboration is essential in the partnership between the two institutions and aspects will be explored in this paper, including antecedent conditions of organisational commitment, cooperation and trust, identification of costs, and a formal agreement. Collaboration itself is built on cooperative endeavour, willing participation, shared planning and decision making, a team approach, and shared responsibility and power. These attributes are readily identifiable in this exciting initiative.

Integrating nursing research education and practice : safe administration of medications

The integration of the best available evidence into the delivery of safe patient care is a challenging but important task. Southern Health in partnership with Deakin University embarked on a joint initiative to develop a culture of inquiry and evidencebased nursing practice.

Language, power and ruling relations in vocational education and training

This thesis uses institutional ethnography to explore the text-based regulatory framework of the Australian Vocational Education and Training (VET) sector. Training Packages are national competency standards used to assess local workplace practice. The Australian Quality Training Framework (AQTF) is a national compliance framework used to audit local learning and assessment practice. These texts operate in a ‘symbiotic relationship’ to achieve a policy goal of national consistency. The researcher explicates the social relations of VET starting from her disquiet as a practitioner. The thesis argues that Training Packages and the AQTF socially organise the content and delivery of local learning and assessment activities. VET practitioners struggle to use these texts to support good practice, and their hidden work maintains an unstable VET system. Yet the extralocal mode of ruling offers no room to challenge VET policy. The thesis explicates three themes. Interview data is used to explore the contrast between the institutional language of Training Packages and the vernacular of workplaces in which these texts are activated. Many practitioners and participants simply do not understand Training Package competency standards. Using these texts to judge employee performance shifts the policing of workplace practice from local sites to external VET authorities. A second theme emerges as the analysis explores why VET practitioners use this excluding language in their work with participants. Interview data reveals that local training organisations achieve different readings as they engage with ruling VET texts. Some organisations use the national texts as broad frameworks, allowing practitioners to create spaces for meaningful learning. Other organisations adopt a narrow and rule-bound reading of national texts, displacing practitioners’ authority over their own practice. A third theme is explored through examination of a sequence of VET texts. The review and redevelopment of the mandatory qualifications for VET practitioners identified the language of the competency standards as a significant accessibility issue. These concerns were reshaped and subsumed in an official response that established the use of this language as a compulsory assessable requirement and a language and literacy benchmark. The thesis presents a new understanding of VET as a regulatory framework established through multiple levels of ruling texts that connect local sites to national government agendas. While some individual practitioners are able to navigate through this system, there is an urgent need for practitioners as a profession to challenge national hegemony.

Case studies in human rights education and critical educational science

This thesis offers an account of the history and effects of three curriculum projects sponsored by the Australian Human Rights Commission between 1983 and 1986. Each project attempted to improve observance of human rights in and through Australian schools through participatory research (or critical educational science). That is, the research included, as a conscious feature, the effort to develop new forms of curriculum work which more adequately respect the personal and professional rights of teachers, especially their entitlement as persons and professionals to participate in planning, conducting and controlling the curriculum development, evaluation and implementation that constitutes their work. In more specific terms, the Australian Human Rights Commission's three curriculum projects represented an attempt to improve the practice and theory of human rights education by engaging teachers in the practical work of evaluating, researching, and developing a human rights curriculum. While the account of the Australian Human Rights Commission curriculum project is substantially an account of teachers1 work, it is a story which ranges well beyond the boundaries of schools and classrooms. It encompasses a history of episodes and events which illustrate how educational initiatives and their fate will often have to set within the broad framework of political, social, and cultural contestation if they are to be understood. More exactly, although the Human Rights Commission's work with schools was instrumental in showing how teachers might contribute to the challenging task of improving human rights education, the project was brought to a premature halt during the debate in the Australian Senate on the Bill of Rights in late 1985 and early 1986. At this point in time, the Government was confronted with such opposition from the Liberal/National Party Coalition that it was obliged to withdraw its Bill of Rights Legislation, close down the original Human Rights Commission, and abandon the attempt to develop a nationwide program in human rights education. The research presents an explanation of why it has been difficult for the Australian Government to live up to its international obligations to improve respect for human rights through education. More positively, however, it shows how human rights education, human rights related areas of education, and social education might be transformed if teachers (and other members of schools communities) were given opportunities to contribute to that task. Such opportunities, moreover, also represent what might be called the practice of democracy in everyday life. They thus exemplify, as well as prefigure, what it might mean to live in a more authentically democratic society.

Community school teacher education and the construction of pedagogical discourse in Papua New Guinea

Pedagogical discourse in Papua New Guinea (PNG) community schooling is mediated by a western styles education. The daily administration and organisation of school activity, graded teaching and learning, subject selection, content boundaries, teaching and assessment methods are all patterned after western schooling. This educational settlement is part of a legacy of German, British and Australian government and non-government colonialism that officially came to an end in 1975. Given the colonial heritage of schooling in PNG, this study is interested in exploring particular aspects of the degree of mutuality between local discourses and the discourses of a western styled pedagogy in post-colonial times, for the purpose of better informing community school teacher education practices. This research takes place at and in the vicinity of Madang Teachers College, a pre-service community school teachers college on the north coast of Papua New Guinea. The research was carried out in the context of the researcher’s employment as a contract lecturer in the English language Department between 1991-1993. As an in-situ study it was influenced by the roles of different participants and the circumstances in which data was gathered and constituted, data which was compatible with participants commitments to community school teacher education and community school teaching and learning. In the exploration of specific pedagogic practices different qualitative research approaches and perspectives were brought to bear in ways best suited to the circumstances of the practice. In this way analytical foci were more dictated by circumstances rather by design. The analytical approach is both a hermeneutic one where participants’ activities are ‘read like texts’, where what is said or written is interpreted against the background of other informing contexts and texts, to better understand how understandings and meanings are produced and circulated; and also a phenomenological one where participants’ perspectives are sought to better understand how pedagogical discursive formations are assimilated with the ‘self’. The effect of shifting between these approaches throughout the study is to build up a sense of co-authorship between researcher and participants in relation to particular aspects of the research. The research explores particular sites where pedagogic discourse is produced, re-produced, distributed, articulated, consumed and contested, and in doing so seeks to better understand what counts as pedagogical discourse. These are sites that are largely unexplored in these terms, in the academic literature on teacher education and community schooling in PNG. As such, they represent gaps in what is documented and understood about the nature of post-colonial pedagogy and teacher training. The first site is a grade two community school class involved in the teaching and early learning of English as the ‘official’ language of instruction. Here local discourses of solidarity and agreement are seen to be mobilised to make meaningful, what are for the teacher and children moments in their construction as post-colonial subjects. What in instructional terms may be seen as an English language lesson becomes, in the light of the research perspectives used, an exercise in the structuring of new social identities, relations and knowings, problematising autonomous views of teaching and learning. The second site explores this issue of autonomous (decontextualised) teaching and learning through an investigation of student teachers’ epistemological contextualisations of knowledge, teaching and learning. What is examined is the way such orientations are constructed in terms of ‘traditional’ and ‘modern’ epistemological and pedagogical alignments, and, in terms of differently conceived notions of community, in a problematisation of the notion of community schooling. The third and fourth sites examine reflective accounts of student teachers’ pedagogic practices, understandings and subjectivities as they confront the moral and political economies and cultural politics of schooling in School Experiences and Practicum contexts, and show how dominant behaviourist and ‘rational/autonomous’ conceptions of what counts as teaching and learning are problematised in the way some students teachers draw upon wider social discourses to construct a dialogue with learners. The final site is a return to the community school where the discourse of school reports through which teachers, children and parents are constructed as particular subjects of schooling, are explored. Here teachers report children’s progress over a four year period and parents write back in conforming, confronting and contesting ways, in the midst of the ongoing enculturation of their children. In this milieu, schooling is shown to be a provider of differentiated social qualifications rather than a socially just and relevant education. Each of the above-mentioned studies form part of a research and pedagogic interest in understanding the ‘disciplining’ effects of schooling upon teacher education, the particular consequences of those effects, what is embraces, resisted and hidden. Each of the above sites is informed by various ‘intertexts’. The use of intertexts is designed to provide a multiplicity of views, actions and voices while enhancing the process of cross-cultural reading through contextualising the studies in ways that reveal knowledges and practices which are often excluded in more conventional accounts of teaching and learning. This research represents a journey, but not an aimless one. It is one which reads the ideological messages of coherence, impartiality and moral soundness of western pedagogical discourse against the school experiences of student-teachers, teachers, children and parents, in post-colonial Papua New Guinea, and finds them lacking.

Adolescent girls in physical education and sport : an analysis of influences on participation

This study investigates the influences on participation in physical activity of thirty adolescent girls from a metropolitan secondary school in Victoria. It seeks to understand how they perceived, experienced and explained their involvement or non involvement in both competitive and non competitive physical activity during four years of their secondary schooling. Participants experienced physical education as both a single sex group in Years 7 and 9 and a coeducational group in Years 8 and 10. They were exposed to a predominantly competitive curriculum in Years 7 to 9 and a less structured, more social, recreational program in Year 10. These experiences enabled them to compare the differences between class structures and activity programs and identify the significant issues which impacted on their participation. Large Australian population studies have revealed that fewer girls participated in sport and regular physical activity than boys. An important consequence is that girls miss out on the health benefits associated with participating in physical activity. Other research has found adolescence is the time that girls drop out of competitive sport. However, an important issue is whether girls who drop out of competitive sport cease to be involved in any physical activity. There are some studies which have reported good participation rates by adolescent girls in non competitive, recreational forms of physical activity and the possibility exists that they may drop out of competitive and into non competitive physical activity. This study primarily utilises a qualitative approach in contrast to previous studies which have largely relied upon the use of surveys and questionnaires. Whilst quantitative research has provided useful information about the bigger picture, there are limitations caused by reliance on the researchers' own interpretations of the data. Additionally there is no opportunity for any clarification and explanation of findings and trends by the respondents themselves. The current study utilized qualitative individual and collective interviews in three stages. Questions were asked in the broad areas of coeducation and single sex classes, preferences for competitive or recreational activity and body image issues. Some quantitative information focusing on nature and extent of current activity patterns was also gathered in the first stage. Thirty Year 10 girls participated in individual first interviews. Nine selected girls then took part in the second (individual) and third (collective) interview stages. Results revealed three groups based on the nature of physical activity involvement: [1] competitive activity group, [2] social activity group and [3] transition group. The transition group represented those who were in the process of withdrawing from competitive sport to take up more non competitive, recreational activity. The most significant difference between groups was skill level. On the whole those entering adolescence with the highest skill levels, such as those in the competitive group, were the most confident and relished competing against others. The social group was low in skill and confidence and had predominantly negative experiences in physical education and sport because their deficiencies were plainly visible to all. Similarly, a lack of skill improvement relative to those of 'better performers' affected the interest and confidence levels of those in the transition group. Boys' domination in coeducational classes through verbal and physical intimidation of the less competent and confident girls and exclusion of very competent girls was a major issue. Social and transition group members demonstrated compliance with boys' power by hanging back and sitting out of competitive activities. Conversely, the competitive group resisted boy's attempts to dominate but had to work hard to demonstrate their athletic capabilities in order to do so. Body image issues such as the skimpy physical education and sport uniform along with body revealing activities such as swimming and gymnastics, heightened feelings of self-consciousness and embarrassment for most girls. When strategies were adopted by social and transition group members to avoid any body exposure or physical humiliation, participation levels were subsequently affected. However, where girls felt confident about their physical abilities and body image, they were able to ignore their unflattering uniforms and thus participation was unaffected. Specific teaching practices such as giving more attention to boys, for example by segregating the sexes in mixed classes to focus attention on boys, reinforced stereotypical notions of gender and contributed to the inequities for girls in physical education. The competitive group were frustrated with having to prove themselves as capable as boys in order to receive greater teacher attention. The transition group rejected teacher's attempts to coerce them into participating in the inter school sports program. The social group believed that teachers viewed and treated them less favourably than others because of their limited skills. Girls were not passive in the face of these obstacles. Rather than give up physical activity they disengaged from competitive sport and took up other forms of activity which they had the confidence to perform. These activity choices also reflected their expanding social interests such as spending time with male and female friends outside school and increased demands on their time by study and part time work commitments. This study not only highlighted the diversity and complexity of attitudes and behaviours of girls towards physical activity but also demonstrated that they display agency in making conscious, sensible decisions about their physical activity choices. Plain Language Summary of Thesis Adolescent girls in physical education and sport; An analysis of influences on participation by Julia Whitty Submitted for the degree of Master of Applied Science Deakin University Supervisor: Dr Judy Ann Jones This study investigates the influences on participation in physical activity of thirty adolescent girls from a metropolitan secondary school in Victoria in order to understand how girls' perceived, experienced and explained their involvement or non involvement in both competitive and non competitive physical activity. Qualitative individual and collective interviews were conducted. Questions focussed on attitudes about coeducation and single sex classes, preferences for competitive or recreational activity and feelings about body image. Some quantitative information about the nature and extent of current activity patterns was also gathered in the first stage. Thirty Year 10 girls participated in individual first interviews. Nine selected girls then took part in the second (individual) and third (collective) interview stages. Results revealed three clearly different groups based on the nature of physical activity involvement (1) Competitive, (2) Social and (3) Transition (those in the process of withdrawing from competitive sport to take up more non competitive, recreational activity). The major difference between groups was skill level. Those entering adolescence with the highest skill levels were more competent and confident in the coeducational and competitive sport setting. Other significant issues included boys' domination, body image and teaching behaviours and practices.