Implementation of a new model of clinical education for regional occupational therapy student clinical placements.

Expansion of occupational therapy education programs has resulted in increased student numbers and demand on clinicians to host clinical placements while also maintaining the delivery of high-quality, safe clinical services to patients. Much of the research about innovative placement models, including student contributions to service delivery, has been conducted in metropolitan areas. Therefore, there is a need to develop models that are suited to regional settings that face diversity of caseload, more generalised occupational therapy roles and variations in patient flow. The aim of the present study was to describe the initial application of the Calderdale Framework in student education in a regional context and look at lessons learnt. The Calderdale Framework provided a structured, clinically governed process whereby occupational therapists were able to determine which tasks could be allocated to students and provided a framework to support student training and competency development. The Calderdale Framework has been used successfully to implement allied health models involving professional skill sharing and delegation of tasks to allied health assistants, but it has not been used in clinical education. Pilot implementation of the Calderdale Framework showed that the model supports quality and safety of student-provided occupational therapy services and that the teaching method provides a platform for student skill development. These results warrant further investigation and are potentially transferrable to student education in other health professions.

Oceans apart, yet connected: Findings from a qualitative study on professional supervision in rural and remote allied health services.

OBJECTIVE: Improving the quality and safety of health care in Australia is imperative to ensure the right treatment is delivered to the right person at the right time. Achieving this requires appropriate clinical governance and support for health professionals, including professional supervision. This study investigates the usefulness and effectiveness of and barriers to supervision in rural and remote Queensland. DESIGN: As part of the evaluation of the Allied Health Rural and Remote Training and Support program, a qualitative descriptive study was conducted involving semi-structured interviews with 42 rural or remote allied health professionals, nine operational managers and four supervisors. The interviews explored perspectives on their supervision arrangements, including the perceived usefulness, effect on practice and barriers. RESULTS: Themes of reduced isolation; enhanced professional enthusiasm, growth and commitment to the organisation; enhanced clinical skills, knowledge and confidence; and enhanced patient safety were identified as perceived outcomes of professional supervision. Time, technology and organisational factors were identified as potential facilitators as well as potential barriers to effective supervision. CONCLUSIONS: This research provides current evidence on the impact of professional supervision in rural and remote Queensland. A multidimensional model of organisational factors associated with effective supervision in rural and remote settings is proposed identifying positive supervision culture and a good supervisor-supervisee fit as key factors associated with effective arrangements.

A systematic review of professional supervision experiences and effects for allied health practitioners working in non-metropolitan health care settings.

INTRODUCTION: In regional, rural, and remote settings, allied health professional supervision is one organizational mechanism designed to support and retain the workforce, provide clinical governance, and enhance service delivery. A systematic approach to evaluating the evidence of the experience and effects of professional supervision for non-metropolitan allied health practitioners and their service delivery is needed. METHODS: Studies investigating the experience and effects of professional supervision across 17 allied health disciplines in non-metropolitan health services were systematically searched for using standardized keywords across seven databases. The initial search identified 1,574 references. Of these studies, five met inclusion criteria and were subject to full methodological appraisal by both reviewers. Two studies were primarily qualitative with three studies primarily quantitative in their approach. Studies were appraised using McMaster critical appraisal tools and data were extracted and synthesized. RESULTS: Studies reported the context specific benefits and challenges of supervision in non-metropolitan areas and the importance of supervision in enhancing satisfaction and support in these areas. Comparison of findings between metropolitan and non-metropolitan settings within one study suggested that allied health in non-metropolitan settings were more satisfied with supervision though less likely to access it and preferred supervision with other non-metropolitan practitioners over access to more experienced supervisors. One study in a regional health service identified the lack of an agreed upon definition and functions of supervision when supervisors from diverse allied health disciplines were surveyed. While methodologically weak, all studies reported positive perceptions of supervision across professionals, supervisors, and managers. This is in accordance with previous research in the wider supervision literature. DISCUSSION: Considering the large pool of studies retrieved for further investigation, few of these met inclusion criteria demonstrating the paucity of primary research in this area. Increased training, policies, and implementation frameworks to ensure the definition and functions of supervision are agreed upon across the allied health disciplines in non-metropolitan areas is needed. Furthermore, systematic evaluation of supervision implementation in non-metropolitan settings, investigation of the experience and effects of distance based supervision (versus face-to-face), and increased rigor in research studies investigating non-metropolitan allied health profession supervision is needed.

Barriers to, and enablers of, participation in the Allied Health Rural and Remote Training and Support (AHRRTS) program for rural and remote allied health workers: a qualitative descriptive study.

BACKGROUND: Allied health professionals play a critical role in enhancing health outcomes in primary and tertiary settings. Issues affecting the recruitment and retention of allied health workers in rural and remote areas are multifactorial. Access to relevant and effective continuing professional development is argued to be a recruitment and retention strategy for health professionals in non-metropolitan areas, however trial of the effectiveness of professional development programs and identification of enablers and barriers to participation is needed. The Allied Health Rural and Remote Training and Support (AHRRTS) program aimed to provide an integrated program of education and professional support activities for allied health professionals working within Queensland Health in rural and remote locations. The aim of this study was to explore enablers and barriers to access to, and effective participation in, the AHRRTS program from various allied heath stakeholders' perspectives. METHODS: A qualitative descriptive study utilising semi-structured interviews with various allied heath stakeholders was undertaken. The interview questions focussed on a number of issues pertinent to AHRRTS program, with specific probing questions regarding barriers and enablers to participation in the AHRRTS program. The interviews were then transcribed verbatim and analysed using thematic analysis. RESULTS: Using purposive sampling, a total of 55 stakeholders were interviewed for this study. Time, organisational factors and travel were identified as common barriers and organisational factors, travel and presentation modes were identified as common enablers. Interestingly, some of these factors act as barriers and/or enablers highlighting that these are essentially two sides of the same coin. The findings suggest that while it is important to have policies and procedures for ongoing support of allied health professionals, it should be complemented by enabling strategies to address persistent barriers. CONCLUSION: The study suggests that while a program such as AHRRTS is accessible and facilitates participation in a number of ways, significant barriers to participation continue to persist at the coal face. Addressing these barriers will require a targeted, multifaceted approach. Lessons from this study provide unique insights into factors which influence the successful implementation and sustainability of recruitment and retention initiatives for rural and remote allied health workers.

A prospective study of young females' sexual subjectivity: associations with age, sexual behavior, and dating.

Sexual self-perceptions are important aspects of sexuality, which can undergo significant change during adolescence and early adulthood. The purpose of this study was to describe these changes among girls (N = 251; ages 16-25) over one year, and to examine associations of sexual self-perceptions (sexual subjectivity) with age, sexual behavior, and romantic status. Sexual body-esteem, perceptions of entitlement to desire and pleasure, sexual efficacy, and sexual self-reflection were investigated as elements of sexual subjectivity. All sexual subjectivity elements were higher among girls who had more sexual experience and/or had steady romantic partners during the study. Perception of entitlement to desire and pleasure increased over time, whereas sexual body-esteem showed the most stability and had minimal associations with sexual or romantic experiences. The greatest increases in sexual subjectivity were found among girls who began the study with the least sociosexual experience and self-reflection also increased for girls who had first coitus after the start of the study. Overall, girls who had sexual intercourse the earliest (before age 16) had the highest sexual subjectivity, but sexual subjectivity increased the most among girls without coital experience or who had more recent first coitus.

Positive and negative romantic relationship quality: age, familiarity, attachment and well-being as correlates of couple agreement and projection.

Capturing the multiple aspects of the romantic peer context is a significant challenge for research. One often recommended option is to use reports of multiple relationship features from both members of the romantic dyad. Using a new measure, we extended an existing model of dyadic perception (Kenny & Acitelli, 2001) to investigate associations between couples' (N = 148) reports about the positive and negative dimensions of their romantic relationships. Differences by participant age and relationship length were examined to test developmental hypotheses, and attachment and well-being were examined as correlates of participants' romantic perceptions. Agreement between partners was low, but associations of individuals' reports about themselves and their partners were high (projection). Agreement about negative romantic behaviors was higher in older compared to younger individuals and agreement about positive behaviors was higher in longer compared to shorter relationships. Partner similarity in negative behavior was higher than similarity in positive behavior. Individuals with better well-being reported more positive romantic behaviors, and attachment security was associated in some cases. Males were more negative about romantic behaviors than females, but there was no gender difference in agreement or projection.