Barriers to pharmacist participation in continuing education in Australia

Background: The pharmacy profession recognises of the need for continuing education (CE), however, the rate of participation in organised CE remains low. Little is known about the reasons for low participation rates in CE, particularly in the Australian context. Aim: This research aimed to identify the barriers to participation of Australian pharmacists in CE. Method: Focus groups were held with Australian community pharmacists, grouped into experienced pharmacists, recently qualified pharmacists, pharmacists with specialist-training needs, and pharmacists practising in rural or remote areas. Focus group transcripts were thematically analysed. Results: Barriers identified by pharmacists included time constraints, accessibility - in terms of travel and cost, relevance, motivation, quality and method of CE delivery. Participants provided ideas to improve uptake of CE. Conclusion: The major barriers identified were time, accessibility and relevance of content. To improve uptake of CE a wider variety of flexibly delivered programs supplemented with in-depth workshops could be utilised.

The primary health professional education : current models and barriers to participation

Introduction
Continuing Education (CE) for health professionals is a life-long process which endeavours to update or enhance knowledge, refine skills, reinforce professional values and support the delivery of professional practice. It plays a pivotal role in the maintenance of professional competence and in the past decade participation in CE has become an expectation of, rather than an option for, practising health professionals. The time and resources required from organisers and participants in
CE and the need to ensure practical outcomes justifies a review of current models being used for its delivery. This entails an understanding of the purpose of CE, a consideration of how it should be delivered, and the role played by assessment in achieving the goals of CE.
Aim of Report
The overall aim of this study is to identify important considerations and subsequently make recommendations for the development of an ideal model(s) of CE for community pharmacy.
Goals of Report
1. Define CE and its role.
2. Identify and assess current CE delivery models.
3. Examine the current status of continuing education and registration requirements for pharmacists.
4. Identify barriers to participation in CE.
5. Identify components and considerations for developing a model of CE delivery.
Methods
The following methods were employed for this project:
1. Literature review
A number of electronic databases were systematically searched in order to profile current trends and concepts in CE. CE structures currently in use were investigated by directly accessing the websites of appropriate associations.
2. Stakeholder interviews
A series of semi-structured interviews were completed with stakeholders from CE delivery organisations across a range of professions including pharmacy.
3. Community pharmacy focus groups
A series of focus group teleconferences were held with groups of pharmacists thought to have distinct CE needs: experienced pharmacists (qualified more than 5 years), recently-qualified pharmacists (5 years or less), rural/remote pharmacists, and pharmacists with specialist training
needs (such as Home Medication Reviews). These focus groups asked about participants’ experiences and opinions in relation to many aspects of CE including its delivery and its assessment.

Is off-campus engineering study off the agenda? Professional accreditation and distance education

In engineering, distance/off-campus study is an essential element of access to education for those in remote locations and/or seeking to upgrade their qualifications via the lifelong learning route whilst employed. Internationally, engineering education accrediting bodies have moved toward outcomes-based assessment of graduate competency, but are still struggling to relinquish their historical attachment to the measurement of inputs. A genuinely outcomes-based accreditation system based on the demonstrated individual student attainment of appropriate graduate attributes (which might be delivered/gained by a range of means) offers the best way forward for an equitable, representative and socially just undergraduate engineering education system that encourages suitably qualified candidates from a range of social, employment, educational, gender, age and geographic circumstances to aspire to the professional sphere of the engineering workforce. Until outcomes-based education becomes the norm in engineering, it is likely that distance learners in engineering will face significant difficulties.

Education and training institutions : building social capital for regional development

Education and training institutions from schools through to universities have a vital role in supporting development in regional Australia. The interaction between these institutions and their rural communities influences the social capital of the community and the extent to which the community is a learning community, willing and able to manage change to the community’s advantage.

There are benefits to be had from a collaborative approach to planning and delivering training. This approach is consistent with theories of social capital that emphasise the crucial part played by networks, values and trust in generating superior outcomes for individuals, communities and regions. Research has found that education and training is most effective in building social capital and learning communities were there is attention to customising or targeting education and training provision to local needs. The key to matching provision with local needs, particularly in the more rural and remote areas, is collaboration and partnerships. Partners can be regional organisations, other educational institutions, businesses and government. The factors that enhance the effectiveness of the collaborations and partnerships are the elements of social capital: networks, shared values and trust, and enabling leadership.

Networks are most effective where there were opportunities and structures for interaction, which can be termed interactional infrastructure, that foster networks within the region, and networks that extended outside the region. Interactional infrastructure includes regional forums, committee structures, consultative processes and opportunities for informal discussion addressing the issues of education, training and employment in a community or region. Better outcomes are evident when there is an interactional infrastructure that is resourced with financial, physical and human resources of sufficient quantity and quality. Collaborations provide access to a greater range of external resources through extended external networks. Effective networks and shared visions, values and trust among the partners in a collaboration, are fostered by enabling leaders. Educational institutions are well placed to supply the ‘human infrastructure’ that makes collaborations and partnerships work, including enabling leadership.

Attention to factors associated with the quality of social capital, especially interactional infrastructure including leadership, shared vision and values and networks within and external to the community, can be expected to improve the effectiveness of education and training outcomes. More importantly, a collaborative approach to planning for education and training in rural regions will build the capacity of regions and their constituent communities to develop and change by building social capital resources. Leadership is an important driver of processes that build community and regional capacity and ultimately produce social and economic benefits through regional development. Educational providers in rural regions are well placed to act as enabling leaders.

Responding to rural skills shortages : innovations using vocational education and training

Aims & Rationale/Objectives
To locate, analyse and make accessible innovative models of health training and service delivery that have been developed in response to a shortage of skills.

Methods
Drawing on a synthesis of Australian and international literature on innovative and effective models for addressing health skill shortages, 50 models were selected for further study. Models were also identified from nominations by key health sector stakeholders. Selected models represent diversity in terms of the nature of skill shortage addressed, barriers overcome in developing the model, health care specialisations, and customer groups.

Principal Findings
Rural and remote areas have become home to a set of innovative service delivery models. Models identified encompass local, regional and state/national responses. Local responses are usually single health service-training provider partnerships. Regional responses, the most numerous, tend to have a specific focus, such as training young people. A small number of holistic state or national responses, eg the skills ecosystem approach, address multiple barriers to health service provision. Typical barriers include unwillingness to risk-take, stakeholder differences, and entrenched workplace cultures. Enhancers include stakeholder commitment, community acceptance, and cultural fit.

Discussion
Of particular interest is increasing numbers of therapy assistants to help address shortages of allied health professionals, and work to formalise their training, and develop standards of practice and policy. Other models likely to help address skill shortage amongst VET health workers focus on recruiting, supporting and training employees from a range of disadvantaged target groups, and on providing career paths with opportunities for staff to expand their skills. Such models are underpinned by nationally recognised qualifications, but each solution is targeted to a particular context in terms of the potential workforce and local need.

Learning from a distance : the experience of remote students

While there has been research into the provision of ‘distance’ and ‘off-campus’ education, both in relation to technology and to curriculum, little attention has been given to the experiences of students studying in geographically remote locations, where the remoteness has been an aspect of investigation. This study aimed to investigate the experiences of such students, and to suggest strategies to support them. The students recruited for this project were undergraduate and postgraduate students from remote locations around Australia who had studied at Deakin University between 2003 through 2007. They were interviewed by telephone. The three key issues identified by participants were a sense of isolation, the attitudes and knowledge of the teaching staff; and students’ knowledge and use of learning technologies.

Social entrepreneurship and partnerships with regional and remote schools

This paper explores how notions of social entrepreneurship have inspired the author to engage in innovative partnerships with two small rural schools in Central Queensland, Australia. It explores practical ways in which to help rural schools contribute to the transformation of their schools, considering that we are now in an information-based society operating in a postmodern world where change happens quickly and continually. The paper explores the mapping of the journeys undertaken both by the schools and by the author as a university lecturer, and analyses how the concept of social entrepreneurship is used to empower schools with these changes. Two partnerships with local schools are examined in terms of helping the participants become social entrepreneurs by deploying innovative problem solving strategies that can provide ways forward to help to begin to revolutionise the regional and rural education 'industry' and in the process engage regional and rural communities.

Networked interactive whiteboards : rationale, affordances and new pedagogies for regional Australian higher education

This article presents an argument for the use of networked interactive whiteboards (NIWBs) in regional Australian higher education and identifies new pedagogies for this context. Most Australian universities operate multiple campuses, and many use video conference facilities to deliver courses across these sites. For students at remote video conference sites, their classroom experience is often one of isolation and limited student to student contact. In this article, NIWBs are proposed as a tool to enhance this mode of delivery and exploratory research into the additional affordances they provide is presented. By using networking with IWBs, annotation and gesture can be shared across distances. Emerging possibilities from the integration of NIWBs with video conference, web conference and lecture capture systems are also explored. Three new pedagogies for regional Australian higher education are proposed based on these new capabilities.

Practice nurses' role and knowledge about diabetes management within rural and remote Australian general practices

Background: The increasing prevalence of diabetes and obesity represents a significant disease burden in Australia. Practice nurses (PNs) play an important role in diabetes education and management.

Aim: To explore PNs' roles, knowledge and beliefs about diabetes education and management in rural and remote general practice in Australia.

Method: Exploratory study undertaken in three phases: 1) Pilot study to test the performance of the questionnaire; 2) One-shot cross-sectional survey using self-complete questionnaires; 3) Individual interviews.

Results: Ten PNs completed the pilot test; the draft questionnaire was deemed appropriate to the study purpose. Then, 65 questionnaires were distributed to PNs and 21 responded. Fourteen respondents had worked in the role <5 years, and most PNs attended diabetes education programmes in their workplace. A minority (40%) used diabetes management guidelines regularly. Most knew obesity to be the most common risk factor for diabetes but only 50% knew that glycosylated haemoglobin indicates blood glucose levels over the preceding three months. Self-reported competency to assess patients' self-care practices and medication management practices varied.

Conclusion: PNs' diabetes management was self-reported; their knowledge varied and their perceived benefits of diabetes education differed from those of patients.

Using mobile phones as placed resources for literacy learning in a remote Indigenous community in Australia

Despite massive funding from the Australian government, the literacy achievement of Australian Indigenous children remains significantly lower than for non-Indigenous. With the aim of identifying innovative ways to improve Indigenous children's literacy achievement, this study explored the social practices surrounding everyday mobile phone use by Indigenous people in a remote Australian community. Informed by the notion of ‘placed resources’, which highlights the understanding that digital literacies are best considered as resources situated by social practices that have local effect, the study surveyed 95 people living in a remote Indigenous community about their mobile phone practices. The study also examined a video of a literacy event between a mother and her child around the use of a mobile phone. The findings revealed the strong relational aspects of phone use in remote communities. Integral to the concept of placed resources is a respect for the practices communities find important as they adopt artefacts for their everyday communication.

A nurse managed kidney disease program in regional and remote Australia

Health services that aim to prevent and manage chronic kidney disease (CKD) in rural and remote Aboriginal communities in Australia, including the Goldfields region of Western Australia (WA), require innovative approaches. Nursing roles can significantly improve access to renal services in rural and remote areas as they are able to address a range of renal health promotion and prevention activities, and provide renal clinical education and support to Aboriginal people. The Goldfields Kidney Disease Nursing Management Program (GKDNMP), funded through the Council of Australian Governments (COAG) National Partnership Agreements, was developed to provide a comprehensive approach to primary health care that incorporates a range of health promotion and disease management activities. In the first year, the program increased home dialysis rates and decreased patient travel due to expanded access to renal care within the region. Context-specific health programs generated in response to local needs can be successful in addressing specific health care challenges in rural and remote health.

Integrating kinect and haptics for interactive STEM education in local and distributed environments

Skill shortage is a realistic social problem that Australia is currently facing, especially in the fields of Science, Technology, Engineering and Mathematics (STEM). Various approaches have been proposed to soften this issue. By now the most successful approach is to attract pre-university youth and university freshmen into those fields before they make a decision on future subjects by introducing them with interactive, modifiable and inspiring virtual environments, which incorporates most essential knowledge of STEM. We propose to design a comprehensive virtual reality platform with immersive interactions, pluggable components and flexible configurations. It also involves haptics, motion capture and gesture recognition, and could be deployed in both local and distributed environments. The platform utilizes off the shelf low cost haptics and motion capture products, however the fidelity can be maintained at a good level. The proposed platform has been implemented with different configurations and has been tested on a group of users. Preliminary test results show that the interactivity, flexibility and fidelity of the platform are highly appreciated by users. User surveys also indicate that the proposed platform could help pre-university students and university freshmen build an overview of various aspects of STEM education. Besides, users are also positive on the fact that the platform enabled them to identify the challenges for higher education in STEM by providing them opportunities to interactively modify system configurations and instantly experience the corresponding results both visually and haptically.

Knowledge making by pre-service teachers on a professional placement experience in a remote Australian indigenous community

This paper reports on the preliminary investigations of an emerging program of research in which the authors are engaged. The program aims to generate new understandings for effective teacher education drawing on data from non-Indigenous pre-service teachers who undertook a teaching placement in remote Indigenous schools in Australia. The overall goals of this research gather around the notion of ‘building belonging’. The initial stage of this project sought to enable pre-service teachers to increase their awareness of the places and institutional practices operating within and between remote Indigenous communities and themselves. The twelve participants were interviewed while on three-week placements around Katherine and in Maningrida in the Northern Territory, Australia, during 2012. The paper elaborates various ways in which the remote placement experience began to challenge, positively disrupt, question and even (re) shape their professional learning and identities. Existing literature reporting on the experiences of largely white, middle class pre-service teachers in unfamiliar cultural contexts draws attention to themes of disruption, and the potential for meaningful and transformative professional learning experiences in such contexts (eg Gannon, 2010; Marble, 2012; Phillips, 2011; Ryan & Healy, 2009). Drawing on some of these insights from the literature, our preliminary reading of the data reveal the variety of ways and differing extents to which participants experienced disruptive, or potentially transformative professional learning moments during the placement. We conclude the paper by pointing towards some key areas for further investigation, in order to progress our research program around building belonging between pre-service teachers and remote Indigenous communities.

Context matters: SETE mapping of teacher education in diverse contexts

The Studying the Effectiveness of Teacher Education (SETE) project (2010- ) investigates, as a priority, how well equipped teacher education graduates are to meet the requirements of diverse school settings. This paper outlines notions of diversity as reflected in large-scale longitudinal data sets including quantitative teacher and principal surveys (n=5,000+), national audit of teacher education programs (n=500+), and analysis of data from intensive case studies which track 170 graduate teachers through the first three years of their teaching career.

The dynamic interplay of news media and bilingual education policy in Australia's Northern Territory 1988-2008

his study investigates the dynamic interplay between news media and the Northern Territory’s policy of bilingual education for indigenous children living in some remote communities. It provides evidence to support the argument that the media-related practices of a range of policy actors resulted in policy processes being shaped to a significant degree by ‘media logic’. The research is based on depth interviews and uses the spoken words of participants to gain access to the local experiences and perspectives of those invested in developing, influencing and communicating the bilingual education policy. Through the analysis of more than 20 interviews with journalists, public servants, academics, and politicians as well as indigenous and non-indigenous bilingual education advocates, I have identified a range of media-related practices that have enabled policy actors to penetrate the policy debate, define problems for policymaking and public discussion through the news media, and thereby exert particular forms of influence in the policy process. The study also provides a ‘southern theory’ analysis of the Yolngu public sphere and a Bourdesian understanding of the journalism sub-field of indigenous reporting in the Northern Territory. It shows that issues of physical and cultural remoteness and the need for journalists to develop cultural competence are the hallmarks of this reporting specialization. It also identifies marked differences in journalists’ relationships with government, academic and indigenous sources and how these differences play out in the way participants understand the production and reception of media texts. This research makes an innovative contribution to Australian Journalism Studies by demonstrating how indigenous epistemologies and knowledges offer fresh perspectives and insights about news media and indigeneity that can be brought into balance with northern theories to build what Connell (2007) has called ‘southern theory’. This dovetails with another key outcome, which is the development of an academic form of journalism that serves indigenous peoples’ self-determinist aims for scholarly research, based in indigenous perspectives and research methodologies.