A cross-disciplinary approach to learning medical physiology and behavioral skills involving drama students performing as simulated patients.

The early years of physiology education in medical curricula provide unique challenges. As well as inculcating concepts that are seen as difficult, modern curricula require that students learn in context in case-based learning courses. Additionally, regulating bodies stress that the soft skills of compassion, communication, and empathy are embedded throughout curricula. This has driven work in our organization involving drama and final-year medicine students during which they collaborate in realistic simulations of doctor/patient interactions. We adapted this transdisciplinary approach to second-year physiology tutorials. This emphasized the holistic importance of physiology to patient care, while also embedding "human factors" skills from the very earliest stages of the curriculum. After preparing by attending acting classes based on aspects of Konstantin Stanislavski's "System," the authors supervised tutorials in which drama students participated in a "physiology of hypofertility" session for second-year medical students, playing a 34-year-old woman with premature menopause (or their partner). Opinion (from all students) was evaluated by Likert questionnaires (which included open questions). A focus group of drama students was also interviewed, and the conversation was recorded for thematic analysis. Positive Likert scores were recorded for the authenticity of the tutorials, skills development, fostering empathy, and motivating students to improve. All participants evaluated the tutorial as highly enjoyable. These scores are reflected in positive open commentary on the questionnaires and in the focus group interviews. The results suggest that even basic science tutorials give opportunities for interdisciplinary study and enhancement of behavioral skills while gaining enthusiastic student acceptance.NEW & NOTEWORTHY This work details how physiology tutorials for early years medical students are transformed by taking the clinical case off the two-dimensional page and instead having the case scenario acted by drama students. This adds context and authenticity. The benefits are twofold: emphasizing the importance of physiology to the budding clinician and embedding empathy and compassion from the earliest points in a clinician's career.

The Spatial Dynamics of Homelessness in Australia: Urbanisation, Intra-City Dynamics and Affordable Housing.

While homelessness in Australia has remained relatively stable at the national level, its spatial distribution is becoming more nuanced. This paper draws on homelessness estimates produced by the Australian Bureau of Statistics to explore the spatial dynamics of homelessness in Australia over a fifteen-year period. Building on existing work, we show that homelessness is becoming more urbanised with evidence of spatial convergence, mainly driven by a surge in severe crowding in our major cities. However, when exploring intra-city patterns, we find distinctive intra-city spatial dynamics featuring strong suburbanisation of 'couch surfing' in state capital cities, contrasting with shifts in severe crowding numbers toward middle and inner regions of most state capitals. We argue that these dynamics reflect the retreat of affordable rental housing supply to the outer suburban fringe, and the coping strategies that 'couch surfers' and those aspiring to live in the inner cities are compelled to follow in response to the changing spatial configuration of affordable housing.

Lesbian, gay and bisexual homelessness in Australia: Risk and resilience factors to consider in policy and practice.

Lesbian, gay and bisexual (LGB) people are more likely than heterosexual people to experience homelessness. The study aimed to compare risk and resilience factors commonly associated with homelessness according to sexual identity to inform more LGB-inclusive and targeted policy and service provision in this area. The study involved analysis of data from two Australian surveys: the General Social Survey 2014 (n = 17,401) and the Journeys Home study (n = 1,659). Chi-squared analyses of the survey data compared LGB with heterosexual respondents. Bisexual respondents had a significantly earlier average age of first homelessness, and were more likely to have repeated episodes of homelessness than lesbian, gay or heterosexual respondents. Risk factors that were higher among bisexual people included family violence, conflict and rejection and substance use issues. LGB respondents were twice as likely to have experienced discrimination as heterosexual respondents, more likely to have experienced violence and have mental health problems. Conversely, resilience factors for LGB respondents included being more likely to access friends for support in times of crisis, and to be involved in civic or political groups. We suggest that LGB people at risk of homelessness need effective responses based on their risk and resilience factors, including targeted peer support and mainstream services that affirm and acknowledge their diverse sexual identities. Australian policies should encourage improved LGB data collection and specific service responses. Primary prevention approaches include educating families of origin about LGB identities and assertive outreach to prevent housing loss.

Analysing the impact of COVID-19 on urban transitions and urban-regional dynamics in Australia.

In this paper, we draw on insights from economic theory on urban growth, large shocks and spatial dynamics to assess COVID-19 flow-on effects and potential disruptive legacy in urban-regional dynamics. Urban dynamics in Australia are assessed at national, regional and intra-urban scales. Long-term and short-term urban dynamics are analysed against random growth, locational fundamentals and increasing returns theories of urban growth and adjustment. A focus in Australia and elsewhere is the potential effect of COVID-19 on where people want to live, enabled in part by technological connectivity that releases some workers from proximity to work constraints when choosing a home. Our results suggest that urbanisation trends and adjustments to shocks differ for capital cities and noncapital cities. At the inter-regional migration level, Australia's largest urban system, Sydney, is characterised by a cointegration relationship between outmigration and Sydney property prices relative to other housing markets. At finer spatial scales, COVID-19 had a negative impact on house prices within Sydney and may, for some micro-geographies and/or towns and regional centres, lead to significant change. However, typically this effect on houses (not units) began to dissipate in the period June-November 2020, when also controlling for housing policy pre- and post-COVID-19.