Digital Commons Network^™

Australian And New Zealand Medical Students' Attitudes And Confidence Towards Providing Nutrition Care In Practice, Breanna Marie Lepre, Jennifer Crowley, Dineo Mpe, Harsh Bhoopatkar, Kylie J. Mansfield, Clare Wall, Eleanor J. Beck

Illawarra Health and Medical Research Institute

The prevalence of lifestyle-related chronic disease is increasing. Doctors in primary care are ideally placed to support patient nutrition care, but recent reviews show education is still lacking. This study aimed to identify medical students’ attitudes towards the role of nutrition in health, nutrition knowledge, and perceptions of nutrition education, in postgraduate (Australia) and undergraduate (New Zealand) programs in order to identify gaps in nutrition knowledge and skills to better inform future education. Second-year graduate and third-year undergraduate students participated in semi-structured focus groups and interviews. A general inductive approach was used to investigate students’ 1) attitudes toward the role …

Effectiveness Of Quality Incentive Payments In General Practice (Equip-Gp): A Study Protocol For A Cluster-Randomised Trial Of An Outcomes-Based Funding Model In Australian General Practice To Improve Patient Care, Gregory Peterson, Grant Russell, Jan Radford, Nicholas Arnold Zwar, Danielle Mazza, Simon Eckermann, Judy Mullan, Marijka Batterham, Athena Hammond, Andrew D. Bonney

Illawarra Health and Medical Research Institute

Background There is international interest in whether improved primary care, in particular for patients with chronic or complex conditions, can lead to decreased use of health resources and whether financial incentives help achieve this goal. This trial (EQuIP-GP) will investigate whether a funding model based upon targeted, continuous quality incentive payments for Australian general practices increases relational continuity of care, and lessens health-service utilisation, for high-risk patients and children. Methods We will use a mixed methods approach incorporating a two-arm pragmatic cluster randomised control trial with nested qualitative case studies. We aim to recruit 36 general practices from Practice-Based Research …

A Self-Reported Survey On The Confidence Levels And Motivation Of New South Wales Practice Nurses On Conducting Advance-Care Planning (Acp) Initiatives In The General-Practice Setting, Emilia Fan, Joel J. Rhee

Faculty of Science, Medicine and Health - Papers: part A

Nurses are well positioned to initiate and conduct advance-care planning (ACP) conversations; however, there has been limited research on practice nurses performing this role in Australia. The aim of the present study was to understand the beliefs, attitudes, perceptions, confidence, training and educational needs of New South Wales practice nurses with regards to involvement in ACP. A cross-sectional online survey was conducted in August to October 2014. Nurses were recruited through nursing organisations and Medicare Locals. There were 147 completed surveys (n = 147). Participants were mostly female registered nurses, with a median age of 50, and 6 years of …

The Development Of Professional Practice Standards For Australian General Practice Nurses, Elizabeth J. Halcomb, Moira Stephens, Julianne Bryce, Elizabeth Foley, Christine Ashley

Faculty of Science, Medicine and Health - Papers: part A

Aims The aim of this study was to explore the current role of general practice nurses and the scope of nursing practice to inform the development of national professional practice standards for Australian general practice nurses.

Background Increasing numbers of nurses have been employed in Australian general practice to meet the growing demand for primary care services. This has brought significant changes to the nursing role. Competency standards for nurses working in general practice were first developed in Australia in 2005, but limited attention has been placed on articulating the contemporary scope of practice for nurses in this setting.

Design …

Development Of Advanced Practice Competency Standards For Dietetics In Australia, Claire Palermo, Sandra Capra, Eleanor J. Beck, Janeane Dart, J Conway, Susan Ash

Faculty of Science, Medicine and Health - Papers: part A

Aim: This study aimed to explore the work roles, major tasks and core activities of advanced practice dietitians in Australia to define the Competency Standards for advanced practice. Methods: A qualitative approach was used to review advanced dietetic practice in Australia involving experienced professionals, mostly dietitians. Four focus groups were conducted with a total of 17 participants and an average of 20 years experience: 15 dietitian practitioners plus 2 employers (1 dietitian and 1 non-dietitian). The focus groups explored the key purpose, roles and outcomes of these practitioners. Data from the focus groups were confirmed with in-depth interviews about their …

Patients' Attitudes Towards Chaperone Use For Intimate Physical Examinations In General Practice, Lucie C. Stanford, Andrew D. Bonney, Rowena G. Ivers, Judy Mullan, Warren C. Rich, Bridget R. Dijkmans-Hadley

Faculty of Science, Medicine and Health - Papers: part A

BACKGROUND: The objective of this article is to investigate patients' attitudes to the use of chaperones for intimate physical examinations (IPEs) in a sample of Australian general practices. METHODS: A cross-sectional survey of adult patients from 13 randomly selected general practices in regional New South Wales was conducted between September and November 2012. Generalised linear mixed models were used for analysis. RESULTS: Of 780 surveys distributed, 687 (88%) were returned; the age range was 18-91 years and 356 (52%) were from female patients. Most women had never had a chaperone present for a Papanicolaou (Pap) smear (82.6%). Between 23% and …

Wildfire Survival Plans In Theory And Practice, Christine Eriksen, Trent D. Penman, Bronwyn L. Horsey, Ross A. Bradstock

Faculty of Science, Medicine and Health - Papers: part A

Bushfire survival plans are a valuable tool for residents living in fire-prone landscapes. Plans include assigning trigger points for action, roles for all household members, and alternate approaches should the original plan fail. Fire agencies advocate that residents write, practise and discuss these plans before the fire season. In this study we use a multiple-methods approach to examine the theoretical and actual application of bushfire survival plans in south-east Australia. First, we review agency advice regarding survival plans to determine the consistency, clarity and specificity of the advice. Second, an online survey of residents examines the relationships between types of …

Evaluating Women's Knowledge Of The Combined Oral Contraceptive Pill In An Australian Rural General Practice Setting, Sharna Kulhavy, Teresa M. Treweek

Faculty of Science, Medicine and Health - Papers: part A

Background: In addition to the contraceptive action of the combined oral contraceptive pill (COCP), there are a number of other benefits to its use such as menstrual cycle regulation. However, COCP use is also associated with a higher risk of thromboembolism. Despite the prevalence of COCP use, studies have indicated that overall women have poor knowledge of the COCP.

Aim: To evaluate women's knowledge of the COCP in a rural general practice setting. The extent of knowledge was assessed in several domains including: COCP use and effectiveness, mechanism of action, and the risks and benefits of COCP use. …

Evaluation Of Assessment In The Context Of Work-Based Learning: Qualitative Perspectives Of New Graduates, Claire Palermo, Alexandra Chung, Eleanor Beck, Susan Ash, Sandra Capra, Helen Truby, Brian Jolly

Faculty of Science, Medicine and Health - Papers: part A

Aim Evaluation or assessment of competence is an important step to ensure the safety and efficacy of health professionals, including dietitians. Most competency-based assessment studies are focused on valid and reliable methods of assessment for the preparation of entry-level dietitians, few papers have explored student dietitians' perceptions of these evaluations. The present study aimed to explore the perceptions of recent graduates from accredited nutrition and dietetics training programs in Australia. It also aimed to establish the relevance of competency-based assessment to adequately prepare them for entry-level work roles. Methods A purposive sample of newly graduated dietitians with a range of …

Analysis Of The Psychological Impact Of A Vascular Risk Factor Intervention: Results From A Cluster Randomized Controlled Trial In Australian General Practice, Suzanne Helen Mckenzie, Upali W. Jayasinghe, Mahnaz Fanaian, Megan Passey, Mark Fort Harris

Illawarra Health and Medical Research Institute

Background Screening for vascular disease, risk assessment and management are encouraged in general practice however there is limited evidence about the emotional impact on patients. The Health Improvement and Prevention Study evaluated the impact of a general practice-based vascular risk factor intervention on behavioural and physiological risk factors in 30 Australian practices. The primary aim of this analysis is to investigate the psychological impact of participating in the intervention arm of the trial. The secondary aim is to identify the mediating effects of changes in behavioural risk factors or BMI. Methods This study is an analysis of a secondary outcome …

Risky Business: Do Private Practice And Clinical Placement Make A Happy Partnership?, Angela Douglas

Faculty of Science, Medicine and Health - Papers: part A

Abstract of paper presented at the 2013 Exercise & Sports Science Australia Business Forum, 18-19 May, Wollongong, Australia.

The Influence Of Longitudinal Integrated Clerkships On Clinical Scholarship In Regional And Rural Communities Of Practice, Kathryn M. Weston, Judith Nicky Hudson

Faculty of Science, Medicine and Health - Papers: part A

All senior medical students at the University of Wollongong undertake a longitudinal integrated community-based cle rkship, supervised by experienced generalist practitioners (GPs) in a regional or ru ral community. Prior to the first clerkship, GP preceptors predicted outcomes from their relationship with the long-term students, including a more scholarly approach to clinical pract ice. This prompted exploration of preceptor post·clerkship perceptions In the light of Grigsby and Tl10rndykes (2011) recent working definition of dlnical scholarship in academic medicine.

Addressing The Deficiencies In The Evidence-Base For Primary Practice In Regional Australia - Sentinel Practices Data Sourcing (Spds) Project: A Pilot Study, Abhijeet Ghosh, Karen E. Charlton, Lisa Girdo, Marijka J. Batterham, Keith Mcdonald

Faculty of Science, Medicine and Health - Papers: part A

Background Chronic disease risk on a population level can be quantified through health surveys, either continuous or periodic. To date, information gathered from primary care interactions, using sentinel sites, has not been investigated as a potentially valuable surveillance system in Australia.

Methods A pilot study was conducted in a single General Practice in a regional area of New South Wales, Australia to assess the feasibility of accessing data obtained through a computerised chronic disease management program that has been designed for desktop application (Pen Computer Systems (PCS) Clinical Audit Tool: ™ PCS CAT). Collated patient data included information on chronic …

Culturally And Linguistically Diverse General Practitioners' Utilisation Of Practice Nurses, Elizabeth J. Halcomb, Yenna Salamonson, Melissa Cooper, Jennifer L. Clauson, Lien Lombardo

Faculty of Science, Medicine and Health - Papers: part A

Background Practice nurses are primarily employed by general practitioners, however little is known about the barriers to practice nurse employment from the perspective of general practitioners (GPs). Aim This paper seeks to explore solo, culturally and linguistically diverse (CALD) general practitioners' perceptions of the practice nurse role, and to identify the barriers and facilitators of these doctors employing nurses within their practice. Methods A descriptive study, using semi-structured interviews, was conducted from July to August 2010. Participants were CALD GPs working as solo practitioners who were members of a Division of General Practice in South Western Sydney. Quantitative data were …

Electronic Discharge Summary Driving Advice: Current Practice And Future Directions, John Carmody, Michael Carey, Victoria Traynor, Don Iverson

Faculty of Science, Medicine and Health - Papers: part A

Background Driving is a complex task. Many older drivers are unaware of their obligation to inform authorities of conditions which may impact upon their driving safety. Aims This study sought to establish the adequacy of driving advice in electronic discharge summaries from an Australian stroke unit. Method One month of in-patient electronic discharge summaries were reviewed. A predetermined list of items was used to assess each electronic discharge summary: age; gender; diagnosis; relevant co-morbidities; deficit at time of discharge; driving advice; length of stay; and discharge destination. Results Of 41 participants, the mean age was 72 years. Twenty patients had …

Connectgpr: Implementing A Virtual Community Of Practice For General Practice Training, Stephen Barnett

Faculty of Science, Medicine and Health - Papers: part A

Abstract of paper the presented at the 2013 Medicine 2.0: World Congress on Social Media, Mobile Apps, Internet/Web 2.0, 25 September, London.

Practice Based Evidence: What Determines Clozpapine Prescribing Practice?, N B. Pai, S C. Vella

Faculty of Science, Medicine and Health - Papers: part A

Abstract of poster that presented at the 15th ISAM Annual Meeting: Managing Addiction through Evidence-Based Medical and Psychosocial Interventions, 21-23 November 2013, Kuala Lumpur, Malaysia.

A Qualitative Evaluation Of New Zealand Consumers Perceptions Of General Practice Nurses, Elizabeth J. Halcomb, Kath Peters, Deborah Davies

Faculty of Science, Medicine and Health - Papers: part A

Background An important consideration in health service delivery is ensuring that services meet consumer needs and that consumers are satisfied with service delivery. Patient satisfaction can impact on compliance with suggested treatments and therefore impact on health outcomes. Comparatively few studies have explored consumer satisfaction with nurses in general practice. Methods A sub-group of 18 consumers from a larger quantitative evaluation of consumer satisfaction with New Zealand general practice nurses participated in semi-structured telephone interviews. Interview data was analysed using thematic analysis. Results Four major themes emerged from the data. These themes highlighted that, despite confusion experienced by some consumers …

Social Media Experiments: Scholarly Practice And Collegiality, Chris Gibson, Leah Maree Gibbs

Faculty of Science, Medicine and Health - Papers: part A

We draw out and seek to build on two key insights in Kitchin et al. (2013), namely the possibilities of social media for transforming knowledge production practices and for generating new spaces of collegiality and communality. Most promising are capacities to shape the terms of academic labour and to disrupt binaries of core/periphery, research/impact and academic/public.

Using Formative Feedback To Identify And Support First Year Chemistry Students With Missing Or Misconceptions. A Practice Report, Gwen Lawrie, Anthony Wright, Madeleine Schultz, Timothy Dargaville, Glennys O'Brien, Simon B. Bedford, Mark Williams, Roy Tasker, Hayden Dickson, Christopher Thompson

Faculty of Science, Medicine and Health - Papers: part A

Students entering tertiary studies possess a diverse range of prior experiences in their academic preparation for tertiary chemistry so academics need tools to enable them to respond to issues in diversity in conceptual models possessed by entering students. Concept inventories can be used to provide formative feedback to help students identify concepts that they need to address to improve construction of subsequent understanding enabling their learning. Modular, formative learning activities that can be administered inside or outside of class in first year chemistry courses have been developed. These activities address key missing and mis-conceptions possessed by incoming student. Engagement in …

Preventive Evidence Into Practice (Pep) Study: Implementation Of Guidelines To Prevent Primary Vascular Disease In General Practice Protocol For A Cluster Randomised Controlled Trial, Mark Fort Harris, Jane Lloyd, John Litt, Mieke Van Driel, Danielle Mazza, Grant Russell, Jane Smith, Chris Del Mar, Elizabeth Denney-Wilson, Sharon M. Parker, Yordanka Krastev, Upali W. Jayasinghe, Richard J. Taylor, Nicholas Zwar, Jinty Wilson, Helen Bolger-Harris, Justine Waters

Faculty of Science, Medicine and Health - Papers: part A

Background: There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD) and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession.Methods: We hypothesise that the intervention will alter the behaviour of clinicians and patients resulting in improvements of recording of lifestyle and physiological risk factors (by 20%) and increased adherence to guideline recommendations for: the …

What Is Different In Psychiatric Practice In Developing And Developed World? An Experiential Account From Australia And India, Nagesh Pai, Naveen Chandra

Faculty of Science, Medicine and Health - Papers: part A

Abstract of a paper presented at the 65th Annual National Conference of Indian Psychiatric Society, Bangalor, 10-13 Jan, 2013. This is a narrative account of two psychiatrists (from Wollongong, NSW and Mangalore, India) who swapped their location or practice and reviewed their experiences.

Clinical Placements In General Practice: Relationships Between Practice Nurses And Tertiary Institutions, Kath Peters, Elizabeth J. Halcomb, Susan Mcinnes

Faculty of Science, Medicine and Health - Papers: part A

As a practice-based discipline a key component of undergraduate nurse education is clinical practice experience. The quality of clinical experiences has a significant impact on the students' ability to function competently post graduation. The relationship between higher education institutions (HEIs) and health service placement providers impacts upon the quality of clinical placements. In Australia, the growth of primary care nursing and the shortage of acute clinical places has prompted HEIs to explore the placement of students in general practice. Given the increasing attention being paid to non-traditional clinical placements, it is timely to explore how universities are establishing relationships and …

Virtual Communities Of Practice In Medicine, Stephen Barnett

Graduate School of Medicine - Papers (Archive)

No abstract provided.

General Practice Training And Virtual Communities Of Practice - A Review Of The Literature, Stephen Barnett, Sandra C. Jones, Sue Bennett, Donald C. Iverson, Andrew D. Bonney

Graduate School of Medicine - Papers (Archive)

Background: Good General Practice is essential for an effective health system. Good General Practice training is essential to sustain the workforce, however training for General Practice can be hampered by a number of pressures, including professional, structural and social isolation. General Practice trainees may be under more pressure than fully registered General Practitioners, and yet isolation can lead doctors to reduce hours and move away from rural practice. Virtual communities of practice (VCoPs) in business have been shown to be effective in improving knowledge sharing, thus reducing professional and structural isolation. This literature review will critically examine the current evidence …

Increasing Medical Students' Capacity To Practice Evidence-Based Medicine Through Improving Student Participation And Interest In Journal Club, Warren C. Rich, Judy Mullan, Kathryn M. Weston, Peter L. Mclennan

Graduate School of Medicine - Papers (Archive)

Research indicates that graduating doctors believe they are deficient in the skills needed to become evidence-based practitioners. To address this the University of Wollongong’s new Graduate School of Medicine has embedded research and critical analysis (RCA) skills into the case-based curriculum. A key component of the RCA curriculum is improving the medical students’ critical appraisal skills by participating in Journal Club during their first phase of the course. Feedback from the first two student cohorts participating in Journal Club suggested that it was not important or interesting.

To increase the level of interest, enthusiasm and participation in Journal Club peer-assessment …

A Scholarly Spin On Practice: The Impact Of Longitudinal Integrated Clerkships On The Development Of Academic Scholarship In General Clinical Practice, Judith N. Hudson, Kathryn M. Weston

Graduate School of Medicine - Papers (Archive)

All senior medical students at the University of Wollongong in Australia undertake a longitudinal integrated community-based clerkship in a regional or rural community. In addition to continuity of patient care and curriculum, the clerkship offers each student individualized professional development by experienced generalist practitioners. These practitioners predicted outcomes from their relationship with the long-term students, including a more scholarly approach to clinical practice (1). In 1990, Boyer outlined the concept of four domains of scholarship: discovery, integration, application and teaching (2). More recently, a working definition of clinical scholarship in academic medicine has been proposed 930. This paper describes the …

Dementia And Driving: An Approach For General Practice, John Carmody, Victoria Traynor, Donald C. Iverson

Faculty of Health and Behavioural Sciences - Papers (Archive)

Background As our population ages, the proportion of drivers with dementia will continue to rise. Increasingly, health professionals are faced with the clinical dilemma of determining fitness to drive. Unfortunately, the management of drivers with dementia is fraught with hazards.

Objective This article attempts to provide an overview of the complex issue of driving and dementia as it relates to general practitioners in Australia. In addition, an evidence based management strategy is proposed.

Discussion When determining an individual’s fitness to drive, a clinician’s input may have legal, ethical, emotional and social ramifications. At present, a clear consistent national protocol detailing …

Translation Of Tobacco Policy Into Practice In Disadvantaged And Marginalized Subpopulations: A Study Of Challenges And Opportunities In Remote Australian Indigenous Communities, Jan A. Robertson, Katherine M. Conigrave, Rowena Ivers, Kim Usher, Alan R. Clough

Faculty of Health and Behavioural Sciences - Papers (Archive)

Background: In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT), extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives …

Exercise Counselling: When Undergraduate Practice-Based Learning And Community Outreach Combine, Everyone Appears To Be A Winner, Angela Douglas, Jennifer Wilkie, Herbert Groeller

Faculty of Science, Medicine and Health - Papers: part A

Abstract of paper presented at the 5th Exercise & Sports Science Australia Conference 2012.