"The red dress or the blue?" How do staff perceive that they support decision making for people with dementia living in residential aged care facilities?

Respect for a person's right to make choices and participate in decision making is generally seen as central to quality of life and well-being. When a person moves into a residential aged care facility (RACF), however, decision making becomes more complicated, particularly if the person has a diagnosis of dementia. Little is known about how staff in RACFs perceive that they support decision making for people with dementia within their everyday practice, and this article seeks to address this knowledge gap. The article reports on the findings of a qualitative study conducted in the states of Victoria and Queensland, Australia with 80 direct care staff members. Findings revealed that the participants utilized a number of strategies in their intention to support decision making for people with dementia, and had an overall perception that "a little effort goes a long way."

Designing for collaborative learning spaces : an academic staff development pilot program

To prepare for the delivery of new Bachelor of Science units in collaborative learning spaces, academic and professional staff at Queensland University of Technology piloted an academic development program over the period of a semester. The program was informed by Rogers’ theory of innovation and diffusion (2003) and structured according to Wilson’s framework for faculty development (2007). Through a series of workshops and group mentoring activities, the program modelled inquiry-based learning in a collaborative learning space, and the participants designed and practiced the delivery of teaching activities. This paper provides a preliminary evaluation of the effectiveness of the pilot based on survey responses from participants, notes from the development team who coordinated the program and audience feedback from the final showcase session. The design and structure of the program is discussed as well as possible future directions.

Navigating pathways for academic staff development : implications for institutions and academic ranks

BACKGROUND As engineering schools adopt outcomes - focused learning approaches in response to government expectations and industry requirements of graduates capable of learning and applying knowledge in different contexts, university academics must be capable of developing and delivering programs that meet these requirements. Those academics are increasingly facing challenges in progressing their research and also acquiring different skill sets to meet the learning and teaching requirements. PURPOSE The goal of this study was to identify the types of development and support structures in place for academic staff, especially early career ones, and examine how the type of institution and the rank or role of the staff member affects these structures. DESIGN/METHOD We conducted semi - structured interviews with 21 individuals in a range of positions pertaining to teaching and learning in engineering education. Open coding was used to identify main themes from the guiding questions raised in the interviews and refined to address themes relevant to the development of institutional staff . The interview data was then analysed based on the type of institution and the rank/ role of the participant. RESULTS While development programs that focus on improving teaching and learning are available, the approach on using these types of programs differed based on staff perspective. Fewer academics, regardless of rank/role, had knowledge of support structures related to other areas of scholarship, e.g. disciplinary research, educational research, learning the institutional culture. The type of institution also impacted how they weighted and encouraged multiple forms of scholarship. We found that academic staff holding higher ranking positions, e.g. dean or associate dean, were not only concerned with the success of their respective programs, but also in how to promote other academic staff participation throughout the process. CONCLUSIONS The findings from this stud y extend the premise that developing effective academic staff ultimately leads to more effective institutions and successful graduates and accomplishing this requires staff buy - in at multiple stages of instructional and program development. Staff and administration developing approaches for educational innovation together (Besterfield - Sacre et al., 2014) and getting buy - in from all academic staff to invest in engineering education development will ultimately lead to more successful engineering graduates.

Quality assurance of assessment and moderation discourses involving sessional staff

Quality assurance is a major agenda in tertiary education. The casualisation of academic work, especially in teaching, is also a quality assurance issue. Casual or sessional staff members teach and assess more than 50% of all university courses in Australia, and yet the research in relation to the role sessional staff play in quality assurance of student assessment outcomes is scarce. Moderation processes are a pivotal part of robust quality assurance measures. Drawing upon previous work surrounding four discourses of moderation, this pilot project reports the results of research into the role and impact of sessional staff in moderation processes at tertiary level. Qualitative data were gathered through focus interviews. Results, in the form of various moderation discourses, indicate that sessional staff impact the formal quality assurance processes in numerous ways.

Success factors of engaging higher education students and staff with e-learning tools within Learning Management Systems

This thesis explored the state of the use of e-learning tools within Learning Management Systems in higher education and developed a distinct framework to explain the factors influencing users' engagement with these tools. The study revealed that the Learning Management System design, preferences for other tools, availability of time, lack of adequate knowledge about tools, pedagogical practices, and social influences affect the uptake of Learning Management System tools. Semi structured interviews with 74 students and lecturers of a major Australian university were used as a source of data. The applied thematic analysis method was used to analyse the collected data.

Supporting staff to identify residents in pain: A controlled pretest-posttest study in residential aged care

Practical strategies are needed to improve pain awareness among aged care staff and promote a systematic approach to pain identification using evidence-based tools. The purpose of this study was to evaluate a pain identification tool for use by nursing and non-professional staff in residential aged care facilities (RACFs). A controlled pretest-posttest intervention design was conducted in two RACFs in Brisbane, Australia. Completed surveys were returned by 216 staff and 74 residents at baseline and 218 staff and 94 residents at 3-month follow-up. Chart audits were conducted on 308 residents at baseline and 328 at follow-up. Groups were compared on: (1) staff knowledge and attitudes regarding pain, perceived confidence and skills for pain assessment, and perceived quality of pain management, (2) frequency of pain assessments and use of pain interventions, and (3) residents’ perceptions of the quality of pain management. Both groups had high knowledge scores and reported high levels of confidence, skills and perceived quality of pain management at baseline and follow-up. The intervention group showed significant improvement in routine pain assessment and use of non-drug pain interventions. However, due to unexpected changes in control group conditions, both groups increased episodic pain assessment. Overall, staff believed the intervention was clinically useful and fostered a team approach to pain assessment. We found the introduction of pain identification resources with implementation strategies to support frontline staff was partially effective in improving staff and resident outcomes. Nonetheless, our findings confirm the need for change and importance of translational pain research in RACFs.

Social media in higher education: Strategy and support for staff and students

In 2013, social networking was the second most popular online activity after internet banking for Australians (ABS, 2014). The popularity and apparent ubiquity of social media is one of the most obvious and compelling arguments for integrating such technologies into higher education. Already, social media impacts a wide range of activities ranging in scope from marketing and communication to teaching and learning in higher education (Hrastinski & Dennen, 2012). Social media presents many exciting possibilities and opportunities for higher education. This session will focus on one staff focussed and one student focussed social media innovation currently underway at QUT. First, it will focus on the actions of QUT’s social media working group. The working group’s aim is to ensure an overarching social media policy for the university is developed and implemented that supports staff in the use of social media across a range of activities. Second, it will discuss the eResponsible and eProfessional Online resources for students project. The focus of this project is to develop a suite of online resources targeted at the devel opment of social media skills for undergraduate students at QUT. These initiatives are complementary and both aim to minimise risk while maximising opportuniti es for the university

Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: A pragmatic, stepped-wedge, cluster-randomised controlled trial

- Background Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme. - Methods Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Units were randomly assigned to intervention or control groups by use of computer-generated, random allocation sequences. We included patients admitted to the unit during the study with a Mini-Mental State Examination (MMSE) score of more than 23/30 to receive individualised education that was based on principles of changes in health behaviour from a trained health professional, in addition to usual care. We provided information about patients' goals, feedback about the ward environment, and perceived barriers to engagement in falls-prevention strategies to staff who were trained to support the uptake of strategies by patients. The coprimary outcome measures were patient rate of falls per 1000 patient-days and the proportion of patients who were fallers. All analyses were by intention to treat. This trial is registered with the Australian New Zealand Clinical Trials registry, number ACTRN12612000877886). - Findings Between Jan 13, and Dec 27, 2013, 3606 patients were admitted to the eight units (n=1983 control period; n=1623 intervention period). There were fewer falls (n=196, 7·80/1000 patient-days vs n=380, 13·78/1000 patient-days, adjusted rate ratio 0·60 [robust 95% CI 0·42–0·94], p=0·003), injurious falls (n=66, 2·63/1000 patient-days vs 131, 4·75/1000 patient-days, 0·65 [robust 95% CI 0·42–0·88], p=0·006), and fallers (n=136 [8·38%] vs n=248 [12·51%] adjusted odds ratio 0·55 [robust 95% CI 0·38 to 0·81], p=0·003) in the intervention compared with the control group. There was no significant difference in length of stay (intervention median 11 days [IQR 7–19], control 10 days [6–18]). - Interpretation Individualised patient education programmes combined with training and feedback to staff added to usual care reduces the rates of falls and injurious falls in older patients in rehabilitation hospital-units.

Differences in identifying healthcare associated infections using clinical vignettes and the influence of respondent characteristics: A cross-sectional survey of Australian infection prevention staff

Background Australia has commenced public reporting and benchmarking of healthcare associated infections (HAIs), despite not having a standardised national HAI surveillance program. Annual hospital Staphylococcus aureus bloodstream (SAB) infection rates are released online, with other HAIs likely to be reported in the future. Although there are known differences between hospitals in Australian HAI surveillance programs, the effect of these differences on reported HAI rates is not known. Objective To measure the agreement in HAI identification, classification, and calculation of HAI rates, and investigate the influence of differences amongst those undertaking surveillance on these outcomes. Methods A cross-sectional online survey exploring HAI surveillance practices was administered to infection prevention nurses who undertake HAI surveillance. Seven clinical vignettes describing HAI scenarios were included to measure agreement in HAI identification, classification, and calculation of HAI rates. Data on characteristics of respondents was also collected. Three of the vignettes were related to surgical site infection and four to bloodstream infection. Agreement levels for each of the vignettes were calculated. Using the Australian SAB definition, and the National Health and Safety Network definitions for other HAIs, we looked for an association between the proportion of correct answers and the respondents’ characteristics. Results Ninety-two infection prevention nurses responded to the vignettes. One vignette demonstrated 100 % agreement from responders, whilst agreement for the other vignettes varied from 53 to 75 %. Working in a hospital with more than 400 beds, working in a team, and State or Territory was associated with a correct response for two of the vignettes. Those trained in surveillance were more commonly associated with a correct response, whilst those working part-time were less likely to respond correctly. Conclusion These findings reveal the need for further HAI surveillance support for those working part-time and in smaller facilities. It also confirms the need to improve uniformity of HAI surveillance across Australian hospitals, and raises questions on the validity of the current comparing of national HAI SAB rates.

A holistic, institution-wide approach to building sessional staff capacity

Sessional Academics enhance students’ learning experience by bringing a diverse range of perspectives and expertise into the classroom. As industry specialists, research students, and recent graduates who have excelled in their courses, they complement the discipline expertise of career academics. With increasing casualization of the academic workforce, Sessional Academics now deliver the majority of face-to-face undergraduate teaching in Australian Universities. To enable them to realize their full potential as effective contributors to student learning and course quality, universities need to offer effective training and access to advice and support and facilitate engagement in university life. However, in the face of complex and diverse contexts, overwhelming numbers, and the transitory nature of sessional cohorts, few universities have developed a comprehensive, systematic approach. During the past three years at QUT, we have set out to develop a multifaceted approach to Sessional Academic support and development. In this paper I will explain why and how we have done so, and describe the range of strategies and programs we have developed. They include a central academic development program, which is structured and scaffolded with learning objectives and outcomes, and aligned with a graduate certificate in Academic Practice; a Sessional Academic Success program, which deploys experienced, school-based sessional academic success advisors to provide local support, build a sense of community, and offer discipline focused academic development; an online, dialogic communication strategy; and opportunities to present and be acknowledged for good learning and teaching practices. Together, these strategies have impacted on sessional academics’ confidence, learning and teaching capacity, reflection and engagement.

The introduction of an Inter-professional learning unit: staff and student perspectives

Background The School of Clinical Sciences comprises a number of health disciplines including podiatry, paramedic science, pharmacy, medical imaging and radiation therapy. A new inter-professional unit was introduced in 2014, which covered key introductory learnings applicable for future health practitioners. This study examined teaching staff and student perspectives about their experience with the new unit for first year students. Methods Qualitative interviews with teaching staff (n=9) and focus group interviews with students (5 groups which ranged in size from 4-30) were conducted. Extensive notes were taken during the interviews Issues emerging from the interviews were identified and organised according to themes and subthemes. Results Four major themes were identified namely: Something new; To be or not to be that is the question; Advantages of the new unit; and Areas for improvement. Previous staff experience with inter-professional learning (IPL) had been ad-hoc, whereas the new unit brought together several disciplines in a planned and deliberate way. There was strong philosophical agreement about the value of IPL but some debate about the extent to which the unit provided IPL experience. The unit was seen as assisting students’ social and academic adjustment to university and provided opportunity for professional socialisation, exposure to macro and micro aspects of the Australian health care system and various types of communication. For podiatry students it was their first opportunity to formally meet and work with other podiatry students and moved their identity from ‘university student’ to ‘podiatry student’. Other positives included providing the opportunity for staff and students to interact at an early stage with the perceived benefit of reducing attrition. Areas for unit improvement included institutional arrangements, unit administration aspects and assessment. Conclusion The unit was seen as beneficial by staff and students however, students were more polarised in their views than staff. There was a tension between feeling apart of and learning about one's own profession and feeling apart of and learning about the roles of other health professionals in relation to patient care and the health care system.

“We have to work within the system!”: Staff perceptions of organizational barriers to decision making for older adults with dementia in Australian aged care facilities

The current study explored the perceptions of direct care staff working in Australian residential aged care facilities (RACFs) regarding the organizational barriers that they believe prevent them from facilitating decision making for individuals with dementia. Normalization process theory (NPT) was used to interpret the findings to understand these barriers in a broader context. The qualitative study involved semi-structured interviews (N = 41) and focus groups (N = 8) with 80 direct care staff members of all levels working in Australian RACFs. Data collection and analysis were conducted in parallel and followed a systematic, inductive approach in line with grounded theory. The perceptions of participants regarding the organizational barriers to facilitating decision making for individuals with dementia can be described by the core category, Working Within the System, and three sub-themes: (a) finding time, (b) competing rights, and (c)not knowing. Examining the views of direct care staff through the lens of NPT allows possible areas for improvement to be identified at an organizational level and the perceived barriers to be understood in the context of promoting normalization of decision making for individuals with dementia.

Group portrait at the farewell banquet for Dr. William Antopol from the laboratory staff of Mount Sinai Hospital; Ken's Chop House, New York city Portraits Groups

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Group portrait at the farewell banquet for Dr. William Antopol from the laboratory staff of Mount Sinai Hospital; Ken's Chop House, New York city Portraits Groups

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