Tenure, mobility and retention of nurses in Queensland, Australia: 2001 and 2004

Aim. Data were collected on tenure, mobility and retention of the nursing workforce in Queensland to aid strategic planning by the Queensland Nurses Union (QNU). Background. Shortages of nurses negatively affect the health outcomes of patients. Population rise is increasing the demand for nurses in Queensland. The supply of nurses is affected by recruitment of new and returning nurses, retention of the existing workforce and mobility within institutions. Methods. A self-reporting, postal survey was undertaken by the QNU members from the major employment sectors of aged care, public acute and community health and private acute and community health. Results. Only 60% of nurses had been with their current employer more than 5 years. In contrast 90% had been in nursing for 5 years or more and most (80%) expected to remain in nursing for at least another 5 years. Breaks from nursing were common and part-time positions in the private and aged care sectors offered flexibility. Conclusion. The study demonstrated a mobile nursing workforce in Queensland although data on tenure and future time in nursing suggested that retention in the industry was high. Concern is expressed for replacement of an ageing nursing population.

Emotion and performance

The study of emotions in organizational settings has attained considerable prominence in recent years, but I critical issue remains unresolved. This is the relationship between emotion and performance. in this special issue, 5 articles address this topic from a variety of viewpoints. Two are theoretical essays that deal, respectively, with emotion and creativity and the relationships between individual and team performance. Three are empirical studies that canvass the emotion-performance nexus across levels of analysis: within person, between persons, and in groups. Between them, the 5 articles present a strong case for the nexus of emotions and performance, but, more important, they provide a platform for potentially fruitful future research in this burgeoning area.

Research, knowledge and design

The discussion about relations between research and design has a number of strands, and presumably motivations. Putting aside the question whether or not design or “creative endeavour” should be counted as research, for reasons to do with institutional recognition or reward, the question remains how, if at all, is design research? This question is unlikely to have attracted much interest but for matters external to Architecture within the modern university. But Architecture as a discipline now needs to understand research much better than in the past when ‘research’ was whatever went on in building science, history or people/environment studies. In this paper, I begin with some common assumptions about design, considered in relation to research, and suggest how the former can constitute or be a mode of the latter. Central to this consideration is an understanding of research as the production of publicly available knowledge. The method is that of conceptual analysis which is much more fruitful than is usually appreciated. This work is part of a larger project in philosophy of design, in roughly the analytical tradition.

The Rural Clinical Division: a student journey to rural medicine

Background: The University of Queensland has through an Australian Government initiative, established a Rural Clinical Division (RCD) at four regional sites in the southern and central Queensland. Over the fi rst four years of the existence of the RCD, an integrated package of innovative medical education has been developed. Method: The integrated aspects of the RCD program include: The Rural Medical Rotation: Every medical student undertakes an eight week rural rotation in Year 3. Year 3 and 4 MBBS - 100 students are currently spending one to two years in the rural school and demand is increasing. Interprofessional Education - Medical and Allied Health students attend lectures, seminars and workshops together and often share the same rural clinical placement. Rural health projects - allow students to undertake a project of benefi t to the rural community. Information Technology (IT) - the Clinical Discussion Board (CDB) and Personal Digital Assistants (PDA) demonstrate the importance of IT to medical students in the 21st century. Changing the Model of Medical Education - The Leichhardt Community Attachment Placement (LCAP), is a pilot study that resulted in the addition of three interns to the rural workforce. All aspects of the RCD are evaluated with surveys using both qualitative and quantitative free response questions, completed by all students regularly throughout the academic year. Results: Measures of impact include: Student satisfaction and quality of teaching surveys – 86-91% of students improved their clinical skills and understanding across all rotations. Academic results and progress – RCD students out-perform their urban colleagues. Intent to work in rural areas – 90% of students reported a greater interest in rural medicine. Intern numbers – rural / regional intern placements are increasing. Conclusions: The RCD proves to be a site for innovations all designed to help reach our primary goal of fostering increased recruitment of a rural medical workforce.

Challenge or opportunity: can regional training hospitals capitalise on the impending influx of interns?

To the Editor: The increase in medical graduates expected over the next decade presents a huge challenge to the many stakeholders involved in providing their prevocational and vocational medical training. 1 Increased numbers will add significantly to the teaching and supervision workload for registrars and consultants, while specialist training and access to advanced training positions may be compromised. However, this predicament may also provide opportunities for innovation in the way internships are delivered. Although facing these same challenges, regional and rural hospitals could use this situation to enhance their workforce by creating opportunities for interns and junior doctors to acquire valuable experience in non-metropolitan settings. We surveyed a representative sample (n = 147; 52% of total cohort) of Year 3 Bachelor of Medicine and Bachelor of Surgery students at the University of Queensland about their perceptions and expectations of their impending internship and the importance of its location (ie, urban/metropolitan versus regional/rural teaching hospitals) to their future training and career plans. Most students (n = 127; 86%) reported a high degree of contemplation about their internship choice. Issues relating to career progression and support ranked highest in their expectations. Most perceived internships in urban/metropolitan hospitals as more beneficial to their future career prospects compared with regional/rural hospitals, but, interestingly, felt that they would have more patient responsibility and greater contact with and supervision by senior staff in a regional setting (Box). Regional and rural hospitals should try to harness these positive perceptions and act to address any real or perceived shortcomings in order to enhance their future workforce.2 They could look to establish partnerships with rural clinical schools3 to enhance recruitment of interns as early as Year 3. To maximise competitiveness with their urban counterparts, regional and rural hospitals need to offer innovative training and career progression pathways to junior doctors, to combat the perception that internships in urban hospitals are more beneficial to future career prospects. Partnerships between hospitals, medical schools and vocational colleges, with input from postgraduate medical councils, should provide vertical integration4 in the important period between student and doctor. Work is underway to more closely evaluate and compare the intern experience across regional/rural and urban/metropolitan hospitals, and track student experiences and career choices longitudinally. This information may benefit teaching hospitals and help identify the optimal combination of resources necessary to provide quality teaching and a clear career pathway for the expected influx of new interns.

Project to investigate improving literacy and numeracy outcomes of distance education students in the early years of schooling

The project was commissioned to investigate and analyse the issue of effective support for distance education students in the early years of school to maximise literacy and numeracy outcomes. The scope of this project was limited to students living in rural and remote areas who are undertaking education at home and who are in their early years of schooling. For the purpose of this project, the early years are conceptualised as the first three years of formal compulsory schooling in each of the States and Territories. There were a number of key tasks for the project which included: 1. Examining of the role of home tutors/supervisors This included interviewing personnel from the State and Territory distance education providers as well as the principals, teachers, home tutors and children. 2. Describing literacy and numeracy teaching and learning, and the use of information and communication technologies (ICT) in distance education This aspect of the project involved a critical review and analysis of relevant literature and reports in the last five years, and a consideration of the new initiatives that had been implemented in the States and Territories in the last two years. 3. The development of resources Through examination of the role of home tutors/supervisors, and an examination of literacy and numeracy and the use of technology in distance education, three resources were developed: ● A guide for home tutors/supervisors and schools of distance education about effective intervention and assessment strategies to support students’ learning and to assist the home tutors/supervisors in implementing ICT to support the development of literacy and numeracy in the early years. ● A calendar of activities for literacy and numeracy that would act as a stimulus for integrated and authentic activity for young children. ● An embryonic website of resources for the stakeholders in rural and distance education that might act as a catalyst for future resource building and sharing. In this way the final key task of the project, which was to create a context for a strategic dissemination plan, was realised when a strategy to address effective dissemination of the findings of the project so as to maximise their usefulness for the relevant groups was achieved.