Associate Professor Caragh Brosnan

Sociology teachers often encounter students studying to be future health professionals; sociology content can assist students to increase their understanding of patients, the social context of health and illness, and the social determinants of health. Engaging these students in sociological thinking can be challenging because of their diverse social locations and their identification with their future profession, which may emphasize clinical competence over broader reflective skills. In this conversation piece, we encourage critical reflection on the assumptions that underpin the teaching of sociology to aspiring health professionals. Through case studies of nursing, medicine, and speech-language pathology, we consider differences in the social locations of students and how sociological ideas are received by these professions. We argue that sociology teachers can assist health professions students to gain more from sociology by understanding these student cohorts and by reflexively considering power relations between teachers and students and between disciplines and professions.

From its inception, the social work profession evolved in tandem with public health, and has historically contributed to public health efforts to restore, protect and promote public health principles. In recent times, however, the most prominent role for health-related social work is in hospital-based, multidisciplinary teams. Curiously, scant attention has been paid to the place of social workers' knowledge - their 'epistemic contribution' - within this medical context. This article reports the findings of a scoping review that examined the role and function of social work knowledge in healthcare teams. Thematic analysis of the literature revealed four key themes: (i) a lack of clarity and visibility - 'Ok, what is my role?'; (ii) knowledge Hierarchies - 'Jack of all trades and master of none'?; (iii) mediator and educator - 'Social work is the glue' and (iv) public health principles - 'We think big'. Findings show that despite social work's epistemic confidence, and alliance with broader public health principles and aims, its knowledge can be marginalised and excluded within the multidisciplinary team context. The article introduces Fricker's theory of 'Epistemic Injustice' as a novel framework for inquiry into health care teams, and the mobilisation of social work knowledge within them.

During the COVID-19 pandemic, courts around the world have introduced a range of technologies to cope with social distancing requirements. Jury trials have been largely delayed, although some jurisdictions moved to remote jury approaches and video conferencing was used extensively for bail applications. While videoconferencing has been used to a more limited extent in the area of sentencing, many were appalled by the news that two people were sentenced to death via Zoom. This article uses actor-network theory (ANT) to explore the role of technology in reshaping the experience of those involved in the sentencing of Punithan Genasan in Singapore.

This study explored the perspectives of medical students from first-in-family (FiF) university backgrounds. Semi-structured interviews focused on steps into, and experiences of medical education, and effects of student identity on social networks. Twenty FiF medical students from one English medical school took part in qualitative interviews. Data was thematically analysed using Bourdieu¿s forms of capital. This research built on an earlier Australian study as part of an international collaboration. The results showed that secondary school/college financial resources for the application to medical school were variable. Medical school was a financial challenge and paid work impacted on academic learning and students¿ health. Not having access to medical contacts was a barrier to school work experience and for the medical school application. A lack of cultural capital meant that participants struggled with the medical degree application. Social networks increased at university; however, there was a division along the lines of educational background. Becoming a medical student had an effect on social relationships for many students ambivalent about their new status. Forms of capital were central to participants¿ experiences. While financial challenges and work experience barriers need addressing, FiF medical student mentors can play an important role in widening participation.

Aim: To explore Registered Nurses¿ attitudes and behaviour towards patients¿ use of complementary therapies. Background: Despite high rates of use of complementary therapies by the general population, little is known of how nurses respond to patients¿ use of these therapies. Design: A two-phase sequential exploratory mixed methods design. Methods: Nineteen Registered Nurses working in Australia participated in a semi-structured interview in 2015¿2016 and emerging themes informed the development of a quantitative survey instrument administered online nationwide in 2016. Findings: Emerging key themes ¿Promoting safe care¿; ¿Seeking complementary therapies knowledge¿;¿ Supporting holistic health care¿; and ¿Integrating complementary therapies in practice¿ were reflected in survey results. Survey responses (N¿=¿614) revealed >90% agreement that complementary therapies align with a holistic view of health and that patients have the right to use them. Most nurses (77.5%) discussed complementary therapies with patients and 91.8% believed nurses should have some understanding of the area. One-third did not recommend complementary therapies and there was a lack of overall consensus as to whether these therapies should be integrated into nursing practice. Nurses with training in complementary therapies held more positive views than those without. Conclusion: Nurses were generally supportive of patients¿ interest in complementary therapies, although their primary concern was safety of the patient. Despite broad acceptance that nurses should have a basic understanding of complementary therapies, there was a lack of consensus about recommendation, integration into nursing practice and referral. Further research should explore how nurses can maintain safe, patient-centred care in the evolving pluralistic healthcare system.

Background:: Many people integrate complementary and alternative medicine (CAM) into their health care. Nurses potentially play a significant role in communicating with patients about their CAM utilisation. Aim:: The study aimed to explore whether, how and why nurses working in Australia communicate about patients¿ CAM use. Methods:: This paper reports on phase one of a mixed methods study. Qualitative data was obtained, via interviews, with nineteen registered nurses who work in a wide variety of clinical environments across all states of Australia. Findings:: Four themes related to nurses¿ communication with patients about CAM, were developed from the qualitative data; engaging with patients about CAM, communication with doctors about patients¿ use of CAM, connecting with CAM practitioners and barriers to CAM communication. Discussion:: Despite their positive attitudes, nurses are often not comfortable discussing or documenting patients¿ CAM use. Furthermore, nurses perceive that patients may be apprehensive about disclosing their use. CAM communication with colleagues is moderated by the workplace culture and the perceived attitude of co-workers. There is very little evidence of nurses referring or collaborating with CAM practitioners. Professional expectation, time restraints and the nurses¿ lack of relevant CAM knowledge all have a powerful effect on limiting CAM communication. Conclusion:: Communication about patients¿ use of CAM is imperative to support safe therapeutic decisions. Currently, this is limited in the Australian healthcare workplace. The nursing professional needs to consider introducing basic CAM education and flexible guidelines to enable nurses¿ to respond appropriately to the patient driven demand for CAM.

Objective: To identify communication patterns of Registered Nurses regarding patients¿ use of complementary therapies. Methods: A cross-sectional online survey conducted in 2017 recruited Australian Registered Nurses working in any area of nursing. Results: Responses of 614 Registered Nurses were analysed. Patient-initiated discussion of complementary therapies were common for 77% of nurses; nurse-initiated discussions were perceived by 73% (sometimes/almost always/always). Nurses¿ personal use of complementary therapies predicted discussion with patients and education-based, oncology, or aged care/rehabilitation nurses were most likely to initiate dialogue. Many (55%) did not ¿recommend¿ a particular therapy, although 12% ¿almost always/always¿ did so. Four out of five nurses (84%) documented patients¿ use and communicated with medical/nursing colleagues about this use. Conversely, 61% ¿never¿ or ¿almost never¿ communicated with a complementary therapy practitioner. Conclusion: Nurses working in Australia often discuss complementary therapies, however they rarely specifically recommend their use. Their workplace environment and clinical context influenced nurses¿ willingness to communicate about complementary therapy use. Practice implications evidence: suggests the need for policy development to promote communication between mainstream healthcare providers and complementary therapy practitioners to support the delivery of safe, high quality patient care.

Background The use of complementary therapies is becoming, increasingly prevalent. This has important implications for nurses in, terms of patient care and safety. Objective The aim of this meta-synthesis is to review, critically, appraise and synthesize the existing qualitative research to develop a new, more substantial interpretation of nurses' attitudes regarding the, use of complementary therapies by patients. Data sources; A search of relevant articles published in English between, January 2000 and December 2015 was conducted using the following, electronic databases; MEDLINE, CINAHL and AMED. Reference lists of selected papers and grey literature were also interrogated for pertinent, studies. Design This review is reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines.Data were extracted and analysed using a thematic synthesis process. Results Fifteen articles were included in this review. Five analytical themes emerged from the data relating to nurses' attitude towards complementary therapies: the strengths and weaknesses of conventional medicine; Complementary therapies as a way to enhance nursing practice;patient empowerment and patient-centeredness; cultural barriers and enablers to integration; and structural barriers and enablers to integration. Discussion Nurses' support for complementary therapies is not an attempt to challenge mainstream medicine but rather an endeavour to improve the quality of care available to patients. There are, however, a number of barriers to nurses' support including institutional culture and clinical context, as well as time and knowledge limitations. Conclusion Some nurses promote complementary therapies as an opportunity to personalise care and practice in a humanistic way. Yet, nurses have very limited education in this field and a lack of professional frameworks to assist them. The nursing profession needs to consider how to address current deficiencies in meeting the growing use of complementary therapies by patients.

Interprofessional education (IPE) ¿ students of different professions learning together, from and about each other ¿ is increasingly common in health professional degrees. Despite its explicit aims of transforming identities, practices and relationships within/across health professions, IPE remains under-theorised sociologically, with most IPE scholarship focussed on evaluating specific interventions. In particular, the significance of a shared knowledge base for shaping professional power and subjectivity in IPE has been overlooked. In this paper we begin to develop a framework for theorising IPE in allied health, by drawing parallels with a cognate area in which there has already been fruitful conceptual development: interdisciplinarity. Specifically, we offer a worked example of how the two areas may be brought into dialogue, by deploying Barry, Born and Weszkalnys¿ (2008) conceptualisation of interdisciplinarity as a lens for understanding IPE. Following Barry et al. (2008) we delineate a number of ¿modes¿ and ¿logics¿ of knowledge-production that emerge both in IPE literature and in our own empirical study of IPE. Our empirical data are drawn from 32 semi-structured interviews with 19 allied health students participating in an IPE curriculum at one Australian university. Findings point to the emergence of interprofessional practitioner identities among students that have the potential to undermine traditional epistemological boundaries and transcend role-based distinctions in future health profession(al)s. We argue that Barry et al.¿s ¿logic of ontology¿ sheds light on previously unidentified processes of transformation within IPE, and offers a theoretical framework that can explain the importance of a shared pan-professional knowledge base for the reflexive individual construction of new interprofessional ontological subjects.

CONTEXT: Students from backgrounds of low socio-economic status (SES) or who are first in family to attend university (FiF) are under-represented in medicine. Research has focused on these students' pre-admission perceptions of medicine, rather than on their lived experience as medical students. Such research is necessary to monitor and understand the potential perpetuation of disadvantage within medical schools.

There is increasing pressure on complementary and alternative medicine (CAM) to follow the evidence-based approach promoted in allied health and medicine, in which the randomised control trial represents the evidence gold standard. However, many CAM advocates see these methods as undermining the holism of CAM practice. This paper explores how such tensions are managed in CAM university departments ¿ settings in which particular forms of knowledge and evidence are given ¿official¿ imprimatur by CAM educators and researchers. By comparing two types of CAM, the paper also unpacks differences within this broad category, asking whether CAM academic disciplines comprise different ¿epistemic cultures¿ (Knorr-Cetina, K. (1999). Epistemic cultures: How the sciences make knowledge. Cambridge, MA: Harvard University Press). Interviews were conducted with 20 lecturers in Chinese medicine and osteopathy, across five Australian universities, and augmented with observation in two degree programs. Findings reveal contrasting ontological and epistemological perspectives between the two academic fields. Chinese medicine lecturers had largely adopted bioscientific models of research, typically conducting laboratory work and trials, although teaching included traditional theories. Osteopathy academics were more critical of dominant approaches and were focused on reframing notions of evidence to account for experiences, with some advocating qualitative research. The study illustrates CAM¿s ¿epistemic disunity¿ while also highlighting the particular challenges facing academic CAM.

High quality education programs are essential for preparing the next generation of Chinese medicine (CM) practitioners. Currently, training in CM occurs within differing health and education policy contexts. There has been little analysis of the factors influencing the form and status of CM education in different regions. Such a task is important for understanding how CM is evolving internationally and predicting future workforce characteristics. This paper compares the status of CM education in Australia and Hong Kong across a range of dimensions: historical and current positions in the national higher education system, regulatory context and relationship to the health system, and public and professional legitimacy. The analysis highlights the different ways in which CM education is developing in these settings, with Hong Kong providing somewhat greater access to clinical training opportunities for CM students. However, common trends and challenges shape CM education in both regions, including marginalisation from mainstream health professions, a small but established presence in universities, and an emphasis on biomedical research. Three factors stand out as significant for the evolution of CM education in Australia and Hong Kong and may have international implications: continuing biomedical dominance, increased competition between universities, and strengthened links with mainland China.

In 2012, the group ¿Friends of Science in Medicine¿, mostly comprising academic doctors and scientists, lobbied to remove teaching in complementary and alternative medicine (CAM) from Australian universities. Seemingly inspired by an earlier UK-based campaign, the group approached vice-chancellors and the media, arguing that CAM degrees promoted ¿pseudo-science¿ and ¿quackery¿. Although epistemological disputes between biomedicine and CAM are well documented, their emergence in a higher education context is less familiar. This article explores the position-taking of those on each side of the debate, via a thematic analysis of stakeholders¿ views as reported in news articles and other outlets. Bourdieu¿s concepts of capital and autonomy are used to sketch out the stakes of the struggle. It is argued that the debate is significant not only for what it reveals about the current status of CAM professions in Australia, but for what it suggests more broadly about legitimate knowledge in the university.

This article attends to the processes through which neuroscience and the neuro are enacted in a specific context: a translational neuroscience research group that was the setting of an ethnographic study. The article therefore provides a close-up perspective on the intersection of neuroscience and translational research. In the scientific setting we studied, the neuro was multiple and irreducible to any particular entity or set of practices across a laboratory and clinical divide. Despite this multiplicity, the group¿s work was held together through the ¿promise of porosity¿ ¿ that one day there would be translation of lab findings into clinically effective intervention. This promise was embodied in the figure of the Group Leader whose expertise spanned clinical and basic neurosciences. This is theorized in terms of a contrast between cohesion and adhesion in interdisciplinary groupings. We end by speculating on the role of ¿vivification¿ ¿ in our case mediated by the Group Leader ¿ in rendering ¿alive¿ the expectations of interdisciplinary collaboration.

The ethical issues neuroscience raises are subject to increasing attention, exemplified in the emergence of the discipline neuroethics. While the moral implications of neurotechnological developments are often discussed, less is known about how ethics intersects with everyday work in neuroscience and how scientists themselves perceive the ethics of their research. Drawing on observation and interviews with members of one UK group conducting neuroscience research at both the laboratory bench and in the clinic, this article examines what ethics meant to these researchers and delineates four specific types of ethics that shaped their day-to-day work: regulatory, professional, personal and tangible. While the first three categories are similar to those identified elsewhere in sociological work on scientific and clinical ethics, the notion of 'tangible ethics' emerged by attending to everyday practice, in which these scientists' discursive distinctions between right and wrong were sometimes challenged. The findings shed light on how ethical positions produce and are, in turn, produced by scientific practice. Informing sociological understandings of neuroscience, they also throw the category of neuroscience and its ethical specificity into question, given that members of this group did not experience their work as raising issues that were distinctly neuro-ethical. © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.