The work of nurse practitioners : a national work sampling study

Aim: This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. Background. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. --------- Methods: We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover two weeks of work time from a sampling frame of six weeks. --------- Results: A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36.1% of how nurse practitioners spend their time, indirect care accounted for 32.2% and service-related activities made up 31.9%. --------- Conclusion. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation.

Work-related driving safety in light vehicle fleets : a review of past research and the development of an intervention framework

This paper presents a critical review of past research in the work-related driving field in light vehicle fleets (e.g., vehicles < 4.5 tonnes) and an intervention framework that provides future direction for practitioners and researchers. Although work-related driving crashes have become the most common cause of death, injury, and absence from work in Australia and overseas, very limited research has progressed in establishing effective strategies to improve safety outcomes. In particular, the majority of past research has been data-driven, and therefore, limited attention has been given to theoretical development in establishing the behavioural mechanism underlying driving behaviour. As such, this paper argues that to move forward in the field of work-related driving safety, practitioners and researchers need to gain a better understanding of the individual and organisational factors influencing safety through adopting relevant theoretical frameworks, which in turn will inform the development of specifically targeted theory-driven interventions. This paper presents an intervention framework that is based on relevant theoretical frameworks and sound methodological design, incorporating interventions that can be directed at the appropriate level, individual and driving target group.

A national framework for disaster health education in Australia

INTRODUCTION: Recent events have heightened awareness of disaster health issues and the need to prepare the health workforce to plan for and respond to major incidents. This has been reinforced at an international level by the World Association for Disaster and Emergency Medicine, which has proposed an international educational framework. ----------- OBJECTIVE: The aim of this paper is to outline the development of a national educational framework for disaster health in Australia. ----------- METHODS: The framework was developed on the basis of the literature and the previous experience of members of a National Collaborative for Disaster Health Education and Research. The Collaborative was brought together in a series of workshops and teleconferences, utilizing a modified Delphi technique to finalize the content at each level of the framework and to assign a value to the inclusion of that content at the various levels. ----------- FRAMEWORK: The framework identifies seven educational levels along with educational outcomes for each level. The framework also identifies the recommended contents at each level and assigns a rating of depth for each component. The framework is not intended as a detailed curriculum, but rather as a guide for educationalists to develop specific programs at each level. ----------- CONCLUSIONS: This educational framework will provide an infrastructure around which future educational programs in Disaster Health in Australia may be designed and delivered. It will permit improved articulation for students between the various levels and greater consistency between programs so that operational responders may have a consistent language and operational approach to the management of major events.

Geekdom for Grrrls health : Australian undergraduate experiences developing and promoting women’s health in cyberspace

There is an increasing global reliance on the Internet for retrieving information on health, illness, and recovery (Sillence et al, 2007; Laurent et al, 2009; Adams, 2010). People suffering from a vast array of illnesses, conditions, and complaints, as well as healthy travelers seeking advice about safe practices abroad, and teens seeking information about safe sexual practices are all now more likely to go to the internet for information than they are to rely solely on a general practitioner or physician (Santor et al, 2007; Moreno et al, 2009; Bartlett et al, 2010). Women in particular seek advice and support online for a number of health-related concerns regarding issues such as puberty, conception, pregnancy, postnatal depression, mothering, breast-cancer recovery, and ageing healthily (van Zutphen, 2008; Raymond et al, 2005). In keeping with this increasing socio-technological trend, the Women’s Health Unit at the Queensland University of Technology (Q.U.T), Brisbane, Australia, introduced the research, design, and development of online information resources for issues affecting the health of Australian women as an assessment item for students in the undergraduate Public Health curriculum. Students were required to research a particular health issue affecting Australian women, including pregnancy, pregnancy terminations, postnatal depression, returning to the work force after having a baby, breast cancer recovery, chronic disease prevention, health and safety for sex-workers, and ageing healthily. Students were required to design and develop websites that supported people living with these conditions, or who were in these situations. The websites were designed for communicating effectively with both women seeking information about their health, and their health practitioners. The pedagogical challenge inherent in this exercise was twofold: firstly, to encourage students to develop the skills to design and maintain software for online health forums; and secondly, to challenge public health students to go beyond generating ‘awareness’ and imparting health information to developing a nuanced understanding of the worlds and perspectives of their audiences, who require supportive networks and options that resonate with their restrictions, capabilities, and dispositions. This latter challenge spanned the realms of research, communication, and aesthetic design. This paper firstly, discusses an increasing reliance on the Internet by women seeking health-related information and the potential health risks and benefits of this trend. Secondly, it applies a post-structural analysis of the de-centred and mobile female self, as online social ‘spaces’ and networks supersede geographical ‘places’ and hierarchies, with implications for democracy, equality, power, and ultimately women’s health. Thirdly, it depicts the processes (learning reflections) and products (developed websites) created within this Women’s Health Unit by the students. Finally, we review this development in the undergraduate curriculum in terms of the importance of providing students with skills in research, communication, and technology in order to share and implement improved health care and social marketing for women as both recipients and providers of health care in the Internet Age.

Work integrated learning as a component of the capstone experience in undergraduate law

Background: The “Curriculum renewal in legal education” project has been funded by the Australian Learning and Teaching Council with the core objectives being the articulation of a set of final year curriculum design principles, and the development of a model of a transferable final year program. Through these principles and the development of the model, it is anticipated that the final year experience for law students will provide greater opportunity for them to understand the relevance of their learning, and will enhance their capacity to make decisions regarding their career path. Discussion / Argument: This paper reports on the project’s progress to date, and presents an argument for the inclusion of work integrated learning (WIL) as a component of the final year experience in undergraduate law programs. The project has identified that the two principal objectives of capstone experiences are to provide closure and to facilitate transition to post-university life. Reflective practice and Bruner’s spiral curriculum model are the central theoretical foundations by which these objectives can be achieved. Experiential learning is also increasingly seen as an essential element of a capstone experience. WIL is consistent with the objectives of capstones in focusing on the transition to professional practice and providing opportunities for reflection. However, the ability of WIL to meet all of the objectives of capstones, particularly closure and integration, may be limited. Conclusions / Implications: The paper posits that while WIL should be considered as a potential component of a capstone experience, educators should ensure that WIL is not equated with a capstone experience unless it is carefully designed to ensure that all of the objectives of capstones are met. Keywords: Work-integrated learning, capstone, final year experience, law

Using poster presentations as assessment of work integrated learning

Background / context: The ALTC WIL Scoping Study identified a need to develop innovative assessment methods for work integrated learning (WIL) that encourage reflection and integration of theory and practice within the constraints that result from the level of engagement of workplace supervisors and the ability of academic supervisors to become involved in the workplace. Aims: The aim of this paper is to examine how poster presentations can be used to authentically assess student learning during WIL. Method / Approach: The paper uses a case study approach to evaluate the use of poster presentations for assessment in two internship units at the Queensland University of Technology. The first is a unit in the Faculty of Business where students majoring in advertising, marketing and public relations are placed in a variety of organisations. The second unit is a law unit where students complete placements in government legal offices. Results / Discussion: While poster presentations are commonly used for assessment in the sciences, they are an innovative approach to assessment in the humanities. This paper argues that posters are one way that universities can overcome the substantial challenges of assessing work integrated learning. The two units involved in the case study adopt different approaches to the poster assessment; the Business unit is non-graded and the poster assessment task requires students to reflect on their learning during the internship. The Law unit is graded and requires students to present on a research topic that relates to their internship. In both units the posters were presented during a poster showcase which was attended by students, workplace supervisors and members of faculty. The paper evaluates the benefits of poster presentations for students, workplace supervisors and faculty and proposes some criteria for poster assessment in WIL. Conclusions / Implications: The paper concludes that posters can effectively and authentically assess various learning outcomes in WIL in different disciplines while at the same time offering a means to engage workplace supervisors with academic staff and other students and supervisors participating in the unit. Posters have the ability to demonstrate reflection in learning and are an excellent demonstration of experiential learning and assessing authentically. Keywords: Work integrated learning, assessment, poster presentations, industry engagement.

Architecture for a free subjectivity : Deleuze and Guattari at the Horizon of the Real

Architecture for a Free Subjectivity reformulates the French philosopher Gilles Deleuze's model of subjectivity for architecture, by surveying the prolific effects of architectural encounter, and the spaces that figure in them. For Deleuze and his Lacanian collaborator Félix Guattari, subjectivity does not refer to a person, but to the potential for and event of matter becoming subject, and the myriad ways for this to take place. By extension, this book theorizes architecture as a self-actuating or creative agency for the liberation of purely "impersonal effects." Imagine a chemical reaction, a riot in the banlieues, indeed a walk through a city. Simone Brott declares that the architectural object does not merely take part in the production of subjectivity, but that it constitutes its own.

Axial elongation following prolonged near work in myopes and emmetropes

Background/aims: To investigate the influence of a period of sustained near work upon axial length in groups of emmetropes and myopes. Methods: Forty young adult subjects (20 myopes and 20 emmetropes) were recruited for the study. Myopes were further classified as either early onset (EOM), late onset (LOM), stable (SM) or progressing (PM) subgroups. Axial length was measured with the IOLMaster instrument before, immediately after and then again 10 minutes after a continuous 30 minute near task of 5 D accommodation demand. Measures of distance objective refraction were also collected. Results: Significant changes in axial length were observed immediately following the near task. EOM axial length elongated on average by 0.027 ± 0.021 mm, LOM by 0.014 ± 0.020 mm, EMM by 0.010 ± 0.015 mm, PM by 0.031 ± 0.022 mm, and SM by 0.014 ± 0.018 mm. At the conclusion of the 10 minute regression period, axial length measures were not significantly different from baseline values. Conclusion: Axial elongation was observed following a prolonged near task. Both EOM and PM groups showed increases in axial length that were significantly greater than emmetropes

Dramatic character development personas to tailor apartment designs for different residential lifestyles

This chapter reports on research work that aims to overcome some limitations of conventional community engagement for urban planning. Adaptive and human-centred design approaches that are well established in human-computer interaction (such as personas and design scenarios) as well as creative writing and dramatic character development methods (such as the Stanislavsky System and the Meisner Technique) are yet largely unexplored in the rather conservative and long-term design context of urban planning. Based on these approaches, we have been trialling a set of performance based workshop activities to gain insights into participants’ desires and requirements that may inform the future design of apartments and apartment buildings in inner city Brisbane. The focus of these workshops is to analyse the behaviour and lifestyle of apartment dwellers and generate residential personas that become boundary objects in the cross-disciplinary discussions of urban design and planning teams. Dramatisation and embodied interaction of use cases form part of the strategies we employed to engage participants and elicit community feedback.

Education-to-work transitions of aspiring creatives

Despite some segments of the creative industries in Australia performing better than other segments in terms of earnings and employment growth, they all rely on highly skilled workers and face similar workforce challenges. Workers typically experience multiple entry attempts, spells of unemployment, short-term contracts, high degrees of mobility, casual/part-time employment within and outside the creative industries, and pressure to ensure their skills remain relevant. Skills shortages and gaps, an insufficient supply of high quality industry-ready graduates, difficulties in predicting demand for skills, weak linkages between industry and education providers, reliance on overseas talent in some segments, limited opportunities for workers to engage in skill development, and pressure on workers to keep abreast of technological developments are ongoing issues in the creative industries workforce. In response to these concerns, the Australian Research Council, three State Governments, industry, and a large vocational education and training (VET) provider funded Queensland University of Technology (QUT) to conduct the 60Sox project. This three-year project investigated the education, training, and work experiences of aspiring creatives defined as new entrants, recent graduates, and students enrolled in creative industries courses. It involved the largest survey of aspiring creatives ever undertaken in Australia, attracting 507 respondents, and a survey of 50 employers. Using the framework proposed by Hannan, Raffe, and Smyth (1996), this article presents findings from an analysis of the macro and micro labour market outcomes of aspiring creatives using data from the two 60Sox project surveys and publicly available sources. The analysis confirmed that many graduates of creative industries courses who participated in the 60Sox survey and the national surveys for the National Centre for Vocational Education Research and Graduate Careers Australia were struggling to make a successful transition from education to work. This article also discusses the causes of this key finding and possible solutions to address transition issues.

Client recommendations for financial incentives on construction projects

Purpose: To provide recommendations for construction clients who design and implement financial incentive mechanisms (FIMs) on projects. ---------- Methodology: Four large Australian building projects commissioned by government clients under managing contractor contracts and completed between 2001 and 2005 were examined to explore the ‘drivers’ that promoted motivation toward financial incentive goals. The results were triangulated across data sources, projects and stakeholder types. ---------- Findings: FIM design should incorporate: 1. flexibility to modify goals and measurement procedures over time, 2. multiple goals covering different project areas, 3. distribution of rewards across all the key organizations contributing to team performance (e.g. potentially not just the contractor, but the subcontractors and consultants) and a reward amount sufficient to be valued by potential recipients. FIM benefits are maximized through the following complementary procurement initiatives: 4. equitable contract risk allocation, 5. early contractor involvement in design, 6. value-driven tender selection, 7. relationship workshops, and 8. future work opportunities.---------- Research Limitations: This paper provides practical recommendations to industry and hence does not emphasize theoretical aspects.---------- Practical Implications: The uptake of these recommendations is likely to increase the impact of FIMs on motivation and improve project and industry outcomes. Although the study focuses on government clients of building projects, all the recommendations would seem to apply equally to private-sector clients and to non-building projects.---------- Originality: In order to improve motivation and reward high performance, clients are increasingly using FIM in their construction contracts. Despite the rising use of financial incentives, there is a lack of comprehensive construction-specific knowledge available to help clients maximize outcomes. The study addresses this gap in the literature.

Talking the talk and walking the walk : how managers can influence the quality of work-life balance in a construction project

Purpose – The construction industry in Australia is characterised by a long work-hours culture, with conditions that make it difficult for staff to balance their work and non-work lives. The objective of this paper is to measure the success of a work-place intervention designed to improve work-life balance (WLB) in an alliance project in the construction industry, and the role the project manager plays in this success. Design/methodology/approach – The paper focuses on an alliance case study. Interviews were conducted at two points in time, several months apart, after the interventions were implemented. Findings – Results showed that staff on the whole were more satisfied with their work experience after the interventions, and indicated the important role that managers' attitudes and behaviours played. Originality/value – Managerial support for work-life initiatives is a critical element in achieving WLB and satisfaction with working arrangements. The fact that the manager “talked the talk and walked the walk” was a major contributing success factor, which has not previously been demonstrated.

Bridging the gap between tertiary education and work : a model of situated learning in accountancy

In professions such as teaching, health sciences (medicine, nursing, allied health), and built environment (engineering), significant work-based learning through practica is an essential element before graduation. However, there is no such requirement in Accountancy. This thesis reports the findings of a qualitative case study of the development and implementation of a Workplace Learning Experience Program in Accountancy at the Queensland University of Technology (QUT) in Australia. The case study of this intervention, based on sociocultural learning theory, provides the grounds for the development of a new model of teaching and learning for accounting education. The survey and interview-based study documents the responses of two cohorts of university students and a group of employers to a work placement program. The study demonstrates that a 100 hour work placement in Accountancy has elements that enhance student learning. It demonstrates the potential value of the application of sociocultural theories of learning, especially the concept of situated learning involving legitimate peripheral participation (Lave & Wenger, 1991). This research establishes the theoretical base for a paradigm shift for the Accountancy profession to acknowledge work placements prior to graduation as a major element of learning. It is argued that the current model of accounting education requires reform to better align university and workplace learning.