How can healthcare organisations increase doctors' research engagement? A scoping review.

PURPOSE: Clinician engagement in research has positive impacts for healthcare, but is often difficult for healthcare organisations to support in light of limited resources. This scoping review aimed to describe the literature on health service-administered strategies for increasing research engagement by medical practitioners. DESIGN/METHODOLOGY/APPROACH: Medline, EMBASE and Web of Science databases were searched from 2000 to 2021 and two independent reviewers screened each record for inclusion. Inclusion criteria were that studies sampled medically qualified clinicians; reported empirical data; investigated effectiveness of an intervention in improving research engagement and addressed interventions implemented by an individual health service/hospital. FINDINGS: Of the 11,084 unique records, 257 studies were included. Most (78.2%) studies were conducted in the USA, and were targeted at residents (63.0%). Outcomes were measured in a variety of ways, most commonly publication-related outcomes (77.4%), though many studies used more than one outcome measure (70.4%). Pre-post (38.8%) and post-only (28.7%) study designs were the most common, while those using a contemporaneous control group were uncommon (11.5%). The most commonly reported interventions included Resident Research Programs (RRPs), protected time, mentorship and education programs. Many articles did not report key information needed for data extraction (e.g. sample size). ORIGINALITY/VALUE: This scoping review demonstrated that, despite a large volume of research, issues like poor reporting, infrequent use of robust study designs and heterogeneous outcome measures limited application. The most compelling available evidence pointed to RRPs, protected time and mentorship as effective interventions. Further high-quality evidence is needed to guide healthcare organisations on increasing medical research engagement.

Development and implementation of the Specialist Palliative Care in Aged Care (SPACE) Project across Queensland.

There is an urgent and unmet need for specialist palliative care services in residential aged care. The Specialist Palliative Care in Aged Care (SPACE) Project aimed to improve palliative and end-of-life care for older people living in residential aged care facilities in Queensland. A representative working group developed a series of service principles around palliative care practice in aged care (comprehensive resident-focused care, streamlined service, and capacity building). Funding was allocated by population to the health services in Queensland to adapt and implement models of care aligned with these principles. SPACE successfully implemented a variety of decentralised models of care across Queensland. The critical elements for the success of SPACE were the use of an expert working group to define the core innovation, networking and implementation support from the central project team and community of practice, and adaptable models of care led by local facilitators. Lessons learned from this real-world case study could be adopted to guide and ensure the successful implementation and sustainability of future complex interventions in healthcare settings, both nationally and internationally.

Evaluating the use of clinical decision aids in an Australian emergency department: A cross-sectional survey.

OBJECTIVE: To identify healthcare professionals' knowledge, self-reported use, and documentation of clinical decision aids (CDAs) in a large ED in Australia, to identify behavioural determinants influencing the use of CDAs, and healthcare professionals preferences for integrating CDAs into the electronic medical record (EMR) system. METHODS: Healthcare professionals (doctors, nurses and physiotherapists) working in the ED at the Gold Coast Hospital, Queensland were invited to complete an online survey. Quantitative data were analysed using descriptive statistics, and where appropriate, mapped to the theoretical domains framework to identify potential barriers to the use of CDAs. Qualitative data were analysed using content analysis. RESULTS: Seventy-four healthcare professionals (34 medical officers, 31 nurses and nine physiotherapists) completed the survey. Healthcare professionals' knowledge and self-reported use of 21 validated CDAs was low but differed considerably across CDAs. Only 4 out of 21 CDAs were reported to be used 'sometimes' or 'always' by the majority of respondents (Ottawa Ankle Rule for ankle injury, Wells' criteria for pulmonary embolism, Wells' criteria for deep vein thrombosis and PERC rule for pulmonary embolism). Most respondents wanted to increase their use of valid and reliable CDAs and supported the integration of CDAs into the EMR to facilitate their use and support documentation. Potential barriers impacting the use of CDAs represented three theoretical domains of knowledge, social/professional role and identity, and social influences. CONCLUSIONS: CDAs are used variably by healthcare professionals and are inconsistently applied in the clinical encounter. Preferences of healthcare professionals need to be considered to allow the successful integration of CDAs into the EMR.

Perceived barriers and facilitators to preventing hospital-acquired pressure injury in paediatrics: A qualitative analysis.

AIM: This qualitative study aimed to identify nurses' and allied health professionals' perceptions and experiences of providing hospital-acquired pressure injury (HAPI) prevention in a paediatric tertiary hospital in Australia, as well as understand the perceived barriers and facilitators to preventing HAPI. DESIGN: A qualitative, exploratory study of hospital professionals was undertaken using semi-structured interviews between February 2022 and January 2023. METHODS: Two frameworks, the Capability, Opportunity and Motivation Model of Behaviour (COM-B) and the Theoretical Domains Framework (TDF), were used to give both theoretical and pragmatic guidance. Participants included 19 nursing and allied health professionals and data analysis was informed by the framework approach. RESULTS: Analysis revealed nine core themes regarding professionals' beliefs about the barriers and facilitators to HAPI prevention practices across seven TDF domains. Themes included HAPI prevention skills and education, family-centred care, automated feedback and prompts, allocation and access to equipment, everybody's responsibility, prioritizing patients and clinical demands, organizational expectations and support, integrating theory and reality in practice and emotional influence. CONCLUSION: These findings provide valuable insights into the barriers and facilitators that impact paediatric HAPI prevention and can help identify and implement strategies to enhance evidence-based prevention care and prevent HAPI in paediatric settings. IMPACT: Overcoming barriers through evidence-based interventions is essential to reduce HAPI cases, improve patient outcomes, and cut healthcare costs. The findings have practical implications, informing policy and practice for improved preventive measures, education, and staffing in paediatric care, ultimately benefiting patient well-being and reducing HAPIs. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. The focus of the study is on healthcare professionals and their perspectives and experiences in preventing HAPIs in paediatric patients. Therefore, the involvement of patients or the public was not deemed necessary for achieving the specific research objectives.

Developing a strategy to improve data sharing in health research: A mixed-methods study to identify barriers and facilitators.

BACKGROUND: Data sharing presents new opportunities across the spectrum of research and is vital for science that is open, where data are easily discoverable, accessible, intelligible, reproducible, replicable and verifiable. Despite this, it is yet to become common practice. Global efforts to develop practical guidance for data sharing and open access initiatives are underway, however evidence-based studies to inform the development and implementation of effective strategies are lacking. OBJECTIVE: This study sought to determine the barriers and facilitators to data sharing among health researchers and to identify the target behaviours for designing a behaviour change intervention strategy. METHOD: Data were drawn from a cross-sectional survey of data management practices among health researchers from one Australian research institute. Determinants of behaviour were theoretically derived using well-established behavioural models. RESULTS: Data sharing practices have been described for 77 researchers, and 6 barriers and 4 facilitators identified. The primary barriers to data sharing included perceived negative consequences and lack of competency to share data. The primary facilitators to data sharing included trust in others using the data and social influence related to public benefit. Intervention functions likely to be most effective at changing target behaviours were also identified. CONCLUSION: Results of this study provide a theoretical and evidence-based process to understand the behavioural barriers and facilitators of data sharing among health researchers. IMPLICATIONS: Designing interventions that specifically address target behaviours to promote data sharing are important for open researcher practices.

Implementing best practice occupational therapist-led environmental assessment and modification to prevent falls: A qualitative study of two regional and rural public health services in Australia.

BACKGROUND: Occupational therapist-led environmental assessment and modification (EAM) is effective in reducing falls for populations at high risk. Two regional and rural public health services in Queensland devised an implementation strategy to embed best practice occupational therapist-led EAM. METHODS: A qualitative study was conducted to compare the determinants of implementation success across the different health services, using the COM-B model of behaviour change. Six semi-structured interviews were completed with occupational therapists involved at each site, following 12 months of implementation. Interview data were triangulated with minutes from three combined site steering committee meetings, eight local steering committee meetings, and field notes. Thematic analysis was completed to compare barriers and facilitators to best practice uptake of EAM and differences in outcomes between the two sites. RESULTS: Both sites commenced implementation with similar states of capability and motivation. After 12 months, one site considered that practice change had been embedded as noted in steering committee minutes and comments; however, the other site observed limited progress. According to the COM-B analysis, opportunity (the factors that lie outside the individual's control) had a significant influence on how both sites were able to respond to the practice change and navigate some of the unexpected challenges that emerged, including the COVID-19 pandemic. Existing team structure, multiple responsibilities of key stakeholders, differences in access to resources, and lack of connection between complementary services meant that COVID-19 disruptions were only a catalyst for unveiling other systemic issues. CONCLUSION: This study highlights the power of external factors on influencing behaviour change for best practice implementation. Learnings from the study will provide deeper understanding of completing implementation projects in regional and rural contexts and support the future implementation of EAM in occupational therapy clinical settings.

Understanding how and why quality circles improve standards of practice, enhance professional development and increase psychological well-being of general practitioners: a realist synthesis.

OBJECTIVES: To understand how and why participation in quality circles (QCs) improves general practitioners' (GPs) psychological well-being and the quality of their clinical practice. To provide evidence-informed and practical guidance to maintain QCs at local and policy levels. DESIGN: A theory-driven mixed method. SETTING: Primary healthcare. METHOD: We collected data in four stages to develop and refine the programme theory of QCs: (1) coinquiry with Swiss and European expert stakeholders to develop a preliminary programme theory; (2) realist review with systematic searches in MEDLINE, Embase, PsycINFO and CINHAL (1980-2020) to inform the preliminary programme theory; (3) programme refinement through interviews with participants, facilitators, tutors and managers of QCs and (4) consolidation of theory through interviews with QC experts across Europe and examining existing theories. SOURCES OF DATA: The coinquiry comprised 4 interviews and 3 focus groups with 50 European experts. From the literature search, we included 108 papers to develop the literature-based programme theory. In stage 3, we used data from 40 participants gathered in 6 interviews and 2 focus groups to refine the programme theory. In stage 4, five interviewees from different healthcare systems consolidated our programme theory. RESULT: Requirements for successful QCs are governmental trust in GPs' abilities to deliver quality improvement, training, access to educational material and performance data, protected time and financial resources. Group dynamics strongly influence success; facilitators should ensure participants exchange knowledge and generate new concepts in a safe environment. Peer interaction promotes professional development and psychological well-being. With repetition, participants gain confidence to put their new concepts into practice. CONCLUSION: With expert facilitation, clinical review and practice opportunities, QCs can improve the quality of standard practice, enhance professional development and increase psychological well-being in the context of adequate professional and administrative support. PROSPERO REGISTRATION NUMBER: CRD42013004826.

Long term tailored implementation of structured "TREAT" journal clubs in allied health: a hybrid effectiveness-implementation study.

BACKGROUND: Allied Health Professionals (AHPs) commonly use journal clubs (JCs) to support Evidence-Based Practice (EBP). There is however little research regarding implementing and sustaining JCs in the long term, and their impact on EBP use and skills in AHPs. This study investigated the impact of implementing a structured JC format, called "TREAT" (previously only investigated across 6 sessions), over a longer period of 16 sessions for AHPs in a public health service. The study also investigated AHP's attendance, adherence, satisfaction and barriers and enablers to implementing the format. METHODS: A mixed methods hybrid-effectiveness implementation design was employed, guided by the Knowledge-to-Action cycle. EBP skills, confidence, use, and attitudes were assessed (Adapted Fresno Test, EBPQ, tailored journal club culture questionnaire) at baseline, and after 10 and 16-monthly sessions. Satisfaction and impact on clinical practice were explored using questionnaires at 10 and 16-months, with free-form responses identifying enablers and barriers to EBP culture and implementation. Data on attendance and adherence to the TREAT format were also collected. RESULTS: Six JCs comprising a total of 132 unique participants from seven Allied Health professions were assessed across three time points. EBP skills improved on the Adapted Fresno Test after 10-monthly (6.6 points: 95% CI, 0.43 to 12.7) and 16-monthly sessions (7.8 points, 95% CI, 0.85 to 14.7), and on self-reported total EBPQ ratings of confidence at 10-months (4.9 points: 95% CI, 2.2 to 7.5) and 16-months (5.7 points: 95% CI 2.7 to 8.7). Of 132 AHPs, 88 reported adopting new treatments/resources and 64 reported updating clinical procedures. Mean attendance was 5.7 sessions (SD = 3.8). Adherence to TREAT components in each session was 86% (95% CI, 83% to 89%). Most participants recommended the format and reported a desire to continue. Enablers to the JC included using clinically relevant topics and active participation while reported barriers included limited time to prepare. CONCLUSIONS: Despite variable attendance, TREAT JCs can continue to be implemented within a service for 16 monthly-sessions, and may contribute to improved EBP skills and confidence and changes in clinical practice over time. Tailoring of implementation strategies was shown to be important to address local enablers and barriers.

Effect of Care Coordination Using an Allied Health Liaison Officer for Chronic Noncomplex Medical Conditions in Children: A Multicenter Randomized Clinical Trial.

IMPORTANCE: There is a paucity of high-quality evidence on the effect of care coordination on health-related quality of life among children with chronic noncomplex medical conditions (non-CMCs). OBJECTIVE: To examine whether care coordination delivered by an Allied Health Liaison Officer results in improved quality-of-life (QOL) outcomes for children with chronic non-CMCs and their families. DESIGN, SETTING AND PARTICIPANTS: This multicenter, open label, randomized clinical trial was conducted in pediatric outpatient clinics at 3 Australian hospitals with tertiary- and secondary-level pediatric care facilities. A total of 81 children with chronic non-CMCs and their families participated in the trial for a period of up to 12 months between October 2017 to October 2020. Primary care reviews were offered at 1 week, 3 months, and 6 months after diagnosis. INTERVENTIONS: Eligible children were randomized 1:1 to receive care coordination or standard care. Families of children receiving care coordination were provided access to an Allied Health Liaison Officer, who was responsible for facilitation of health care access across hospital, education, primary care, and community sectors. MAIN OUTCOMES AND MEASURES: The primary outcomes were scores on the Pediatric Quality of Life Inventory (PedsQL), version 4.0, and the PedsQL Family Impact Module, version 2.0, measured at 6 and 12 months. An intent-to-treat approach was used to analyze the data. RESULTS: Of 81 children (mean [SD] age, 8.2 [3.5] years; 55 [67.9%] male), 42 (51.9%) were randomized to care coordination and 39 (48.1%) to standard care. Compared with standard care, care coordination resulted in greater improvements in overall PedsQL scores (difference in score changes between groups, 7.10; 95% CI, 0.44-13.76; P = .04), overall PedsQL Family Impact Module scores (difference in score changes between groups, 8.62; 95% CI, 1.07-16.16; P = .03), and family functioning QOL (difference in score changes between groups, 15.83; 95% CI, 5.05-26.62; P = .004) at 12 months after diagnosis. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, care coordination improved the quality of life of children with chronic non-CMCs and their families. Further studies should explore specific non-CMCs that may benefit most from care coordination and whether an orientation among health services to provide such a coordination model could lead to longer-term improved clinical outcomes. TRIAL REGISTRATION: http://anzctr.org.au Identifier: ACTRN12617001188325.

Embedded researchers in Australia: Survey of profile and experience across medical, nursing and midwifery and allied health disciplines.

AIMS AND OBJECTIVES: This study explores embedded researcher's age, qualifications, research environment and experience in healthcare and academic organisations in Australia and makes comparisons across three core professional disciplines of nursing and midwifery, medicine and allied health. BACKGROUND: The embedded researcher model, where a researcher is embedded as a core member of the clinical team, offers promise to support the implementation of research evidence into practice. Currently, there is a lack of clarity about how the model has been adopted across the three largest professional disciplines in Australian health care. DESIGN: A cross-sectional survey was designed and reported, using the STROBE Statement. METHODS: A purposive sample of embedded researchers was invited to participate in an exploratory online survey. Embedded researchers worked, or had worked, for a minimum of 30% of their time, in a healthcare organisation doing research or building research capacity. Participant responses were extracted from the survey and imported into SPSS for analysis. RESULTS: Perspectives of 100 Australian embedded researchers were compared across nursing and midwifery (36%, n = 37), allied health (35%, n = 36) and medicine (26%, n = 27). Professional differences are reported in respondents' qualifications and experience, employment conditions and their research cultures and environments. Comparatively, most nursing and midwifery embedded researchers were older, more clinically experienced than allied health respondents, who were more research qualified. Medical-embedded researchers are typically older, more clinically experienced and focussed on producing personally relevant clinical research. Nursing and midwifery embedded researchers reported doing clinical research within their teams, as well as research capacity building, management and clinical practice roles. CONCLUSIONS: Embedded researchers describe different career trajectories across the three largest professional disciplines in Australian health care. RELEVANCE TO CLINICAL PRACTICE: Embedded researchers from different professional disciplines enact their work differently. It appears that when they engage in research capacity building via a range of management and networking roles, embedded researchers contribute to their organisation's research culture and receive greater recognition for their achievements.

Embedded researchers' purpose and practice: Current perspectives from Australia.

OBJECTIVE: The embedded researcher model proposes that if research is co-produced with academics, clinical staff will have greater engagement with and ownership of the research findings, and they will be able to integrate evidence in practice. This paper describes the role and purpose of embedded researchers in Australian healthcare settings. METHODS: A purposive sample of current and former embedded researchers were invited to participate in an exploratory online survey. Embedded researchers were defined as individuals with research qualifications who worked, or had worked, for at least 30% of their time in a healthcare organisation doing research or research capacity building. RESULTS: Most embedded researchers described a dual purpose, in building clinicians' capacity for research while also undertaking clinical research. Only a small proportion of respondents described their purpose as supporting and improving clinical practice. Most embedded researchers described working to both traditional academic key performance indicators and a complementary range of clinical performance and healthcare service indicators. CONCLUSION: Embedded researchers provide more research development and engagement in health services than is recognised or currently reported. In addition to traditional academic indicators, they described a broad range of clinical and health service indicators which measured capacity building.

Relationship Between Research Culture and Research Activity of Medical Doctors: A Survey and Audit.

PURPOSE: To describe the research capacity and culture, and research activity (publications and new projects) of medical doctors across a health service and determine if the research activity of specialty groups correlated with their self-reported "team" level research capacity and culture. METHODS: Cross-sectional, observational survey and audit of medical doctors at a tertiary health service in Queensland. The Research Capacity and Culture (RCC) validated survey was used to measure self-reported research capacity/culture at organisation, team and individual levels, and presence of barriers and facilitators to research. An audit of publications and ethically approved research projects was used to determine research activity. RESULTS: Approximately, 10% of medical doctors completed the survey (n= 124). Overall, median scores on the RCC were 5 out of 10 for organisational level, 5.5 for specialty level, and 6 for individual level capacity and culture; however, specialty-level scores varied significantly between specialty groups (range 3.1-7.8). Over 80% of participants reported lack of time and other work roles taking priority as barriers to research. One project was commenced per year for every 12.5 doctors employed in the health service, and one article was published for every 7.5. There was a positive association between a team's number of publications and projects and their self-reported research capacity and culture on the RCC. This association was stronger for publications. CONCLUSION: Health service research capacity building interventions may need a tailored approach for different specialty teams to accommodate for varying baselines of capacity and activity. When evaluating these initiatives, a combination of research activity and subjective self-report measures may be complementary.

Challenges and enablers of the embedded researcher model.

PURPOSE: The embedded researcher is a healthcare-academic partnership model in which the researcher is engaged as a core member of the healthcare organisation. While this model has potential to support evidence translation, there is a paucity of evidence in relation to the specific challenges and strengths of the model. The aim of this study was to map the barriers and enablers of the model from the perspective of embedded researchers in Australian healthcare settings, and compare the responses of embedded researchers with a primary healthcare versus a primary academic affiliation. DESIGN/METHODOLOGY/APPROACH: 104 embedded researchers from Australian healthcare organisations completed an online survey. Both purposive and snowball sampling strategies were used to identify current and former embedded researchers. This paper reports on responses to the open-ended questions in relation to barriers and enablers of the role, the available support, and recommendations for change. Thematic analysis was used to describe and interpret the breadth and depth of responses and common themes. FINDINGS: Key barriers to being an embedded researcher in a public hospital included a lack of research infrastructure and funding in the healthcare organisation, a culture that does not value research, a lack of leadership and support to undertake research, limited access to mentoring and career progression and issues associated with having a dual affiliation. Key enablers included supportive colleagues and executive leaders, personal commitment to research and research collaboration including formal health-academic partnerships. RESEARCH LIMITATIONS/IMPLICATIONS: To support the embedded researcher model, broader system changes are required, including greater investment in research infrastructure and healthcare-academic partnerships with formal agreements. Significant changes are required, so that healthcare organisations appreciate the value of research and support both clinicians and researchers to engage in research that is important to their local population. ORIGINALITY/VALUE: This is the first study to systematically investigate the enablers and challenges of the embedded researcher model.

What influences allied health clinician participation in research in the public hospital setting: a qualitative theory-informed approach.

OBJECTIVES: Using theoretical frameworks from implementation science, we aimed to systematically explore the barriers and enablers to research active allied health professionals (AHP) participating and leading research in the hospital setting. DESIGN: A qualitative interview study informed by behaviour change theory. SETTING: Single Australian tertiary hospital and health service. PARTICIPANTS: We recruited a convenience sample of 21 AHPs working within a hospital who were seeking to actively participate in/or lead research within their workplace. DATA COLLECTION: Semistructured interviews explored perceived barriers and enablers to research participation, informed by the 14 domains of the theoretical domains framework (TDF). Transcribed interviews were deductively coded and mapped to the TDF. A deeper level of inductive coding was used to identify emergent themes that influenced behaviour change, according to the three key constructs of: capability, opportunity and motivation (COM-B). RESULTS: Barriers and enablers to research participation were identified within nine predominant domains of the TDF. Most enablers to engaging in research related to the motivation or opportunity constructs of the COM-B. These enablers included positive beliefs about the consequences of research participation, enabling social influences, peer support and motivation for skill development and to inform practice. Predominant barriers related to environmental context and resources (eg, reduced funding or time), emotional responses of being overwhelmed and perceptions of reduced capability. CONCLUSION: This study identified key barriers and enablers to behaviour change related to AHPs participating and/or leading research. Motivation and opportunities to participate in research may be enabled by maximising social influence opportunities, reiterating beliefs about positive consequences of research and considering AHP's emotional responses. Implementation science frameworks may provide a more systematic and holistic understanding of factors which influence research participation including enhancing knowledge, motivation and opportunity.

Outcomes of a funding initiative to promote allied health research activity: a qualitative realist evaluation.

BACKGROUND: Providing funding for clinicians to have protected time to undertake research can address a commonly cited barrier to research - lack of time. However, limited research has evaluated the impact or mechanisms of such funding initiatives. In the current economic environment, it is important that funding is used efficiently and judiciously and that mechanisms and contexts that may assist with maximising outcomes of funding initiatives are identified. This study aimed to describe the medium-term outcomes of a funding initiative to promote allied health research activity and to identify the key mechanisms and contexts that facilitated these outcomes. METHODS: We used a qualitative research design informed by a realist evaluation, to conduct 10 semi-structured interviews with allied health professionals who had participated in a funding initiative 1-3 years ago. Questions explored outcomes, mechanisms and contexts of the funding initiative. Data was thematically coded into context-mechanism-outcome configurations. RESULTS: Medium term outcomes included increased individual research opportunities, influence on team research culture and impact on clinical work/practice. Other outcomes included increased clinician confidence, knowledge and skill, and research outputs. However, some participants still had difficulties progressing research. Four context-mechanism-outcome configurations were identified to explain which contexts and mechanisms produced these outcomes. Examples of contexts included perception of managerial support, undertaking a research-based higher degree and joint applications, while mechanisms included accessing infrastructure and resources as well as individual researcher factors like motivation. CONCLUSION: Providing funding to allied health professionals to undertake and complete research can lead to important outcomes, including increased research opportunities, capacity and culture, increased research outputs, and changes to clinical practice. Outcomes are influenced by unique contexts and mechanisms and these should be considered in future implementation of similar funding initiatives.

Developing occupational therapists' capabilities for decision-making capacity assessments: how does a support role facilitate workplace learning?

INTRODUCTION: Healthcare practitioners are required to develop capabilities in an effective and efficient manner. Yet, developing capabilities in healthcare settings can be challenging due to the unpredictable nature of practice and increasing workloads. Unsurprisingly, healthcare practitioner development is often situated outside of practice, for example in formal teaching sessions. Supporting practitioners to develop capabilities through engagement with day-to-day practice, whilst advantageous in terms of authenticity and being highly valued, remains a key challenge for healthcare educators. This qualitative interview study aimed to explain, from the learner's perspective, how a dedicated support role develops occupational therapists' capability to contribute to decision-making capacity assessments. METHODS: Individual semi-structured interviews were conducted with a purposive sample of 12 occupational therapists. Informed by workplace learning theory, interview transcripts were analyzed using thematic analysis process. RESULTS: Participants provided rich descriptions of how they developed in their capability to engage in decision-making capacity assessments. Participants reported that their learning was facilitated by the dedicated support role in three key ways: 1) structuring a journey of learning, 2) providing tailored guidance, and 3) fostering a supportive learning environment. DISCUSSION: Participants valued the authentic workplace learning opportunities afforded by the dedicated support role. Findings suggest that capabilities, such as decision-making capacity assessment, can be developed through practice when enriched by a dedicated support role. However, further research examining the sustainability and transferability of this model and its application to other capabilities are warranted.

The embedded researcher model in Australian healthcare settings: comparison by degree of "embeddedness".

The embedded researcher model is a health-academic partnership where researchers are core members of a healthcare organization, with an aim to support evidence translation. The purpose of this study was to describe the characteristics and experiences of embedded researchers in Australian healthcare settings, and investigate how the model is experienced differently based on the level of "embeddedness." This exploratory study utilized a purpose-designed online survey. Responses were described using Word and Excel and analyzed using SPSS. To investigate how the model was experienced based on the level of "embeddedness," we tested for differences in responses between respondents with primary academic vs healthcare affiliations. A total of 104 embedded researchers from nursing and midwifery, allied health and medicine completed the survey, with equal numbers reporting a primary academic vs primary healthcare affiliation. Most indicated that research is a strategic objective of the healthcare organization (85.9%) yet almost a third (31%) reported that research outputs were not measured. While 60% agreed that clinical practice informed by research was valued, only 28% reported having adequate resources. Of those with a formal dual affiliation over a quarter reported conflict between expectations of the healthcare and academic organizations. Respondents with a primary academic affiliation were older, more qualified, had more research experience, had been in the role longer, and had more positive perceptions of the research culture of healthcare organizations. This study provides a starting point for healthcare organizations and academic institutions to partner in the further development and implementation of this model.

Exploring future health workforce educational needs: a qualitative investigation.

OBJECTIVE: Given the predicted changes ahead for both healthcare and educational systems, this study was designed to explore perspectives of senior health clinicians and academics about the educational needs of the future health workforce. Participants were asked about how universities could best provide post-qualification education to enable current and future health professionals to meet changing workplace demands and expectations. METHODS: An exploratory study was conducted across academic and clinical settings in Queensland. A convenience sample of 12 senior academic and clinical managers participated in semi-structured, discursive interviews. Data were coded and categorised into emergent themes with verification by the first two authors. RESULTS: Participants described and critiqued current patterns of learning by health professionals, including completion of traditional postgraduate degrees and professional development courses. They suggested innovative approaches for future education, proposing that learning should be aligned with practice needs and made available through flexible and connected learning opportunities. Further, they were of the view that workplace learning should be recognised academically through arrangements such as credit for prior learning. CONCLUSIONS: Participants concluded that universities have an important role, in partnership with key stakeholders, to educate health professionals to be able to meet the needs of changing workplace demands and expectations.