Associate Professor Erica Southgate

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.

Background: There is a growing number of clinical prediction rules (CPRs) relevant to physiotherapy, particularly in the musculoskeletal area, but many students are not learning about them due to lack of awareness or understanding by clinical educators. An educational package specifically designed for physiotherapy clinical educators would aid their understanding of CPRs and ability to utilise them clinically, and also to be able to teach them to students. Objectives: To determine the desired content and preferred methods of delivery of an educational package for clinical educators on musculoskeletal CPRs. Design: A qualitative descriptive approach using semi-structured group and individual interviews with clinical educators. Method: Educators working in the clinical area of musculoskeletal physiotherapy who had an awareness of or interest in CPRs were recruited and interviewed on their views regarding the content and delivery of an educational package on musculoskeletal CPRs. Audio files were transcribed and analysed using framework analysis to explore and develop themes and subthemes. Findings: Content of an educational package should include general information on CPRs to improve familiarity and understanding, including a brief description, purpose, stages of development, application, limitations, and Information to dispel common myths and misunderstandings, as well as some specific examples of commonly-used CPRs. The package should be available in multiple formats to allow for different learning styles, both online via video, webinars, and podcasts, and face-to-face in practical sessions. Conclusions: Clinical educators would find an educational package useful in assisting them to learn about musculoskeletal CPRs and to teach them to students.

Many stroke patients are discharged home due to advances in treatment approaches and reduced residual disability. The aim of this study was to understand health professionals¿ perspectives on the discharge process and continuity of care during the transition between hospital and home for stroke survivors. In this qualitative, descriptive study, we used focus groups with 25 health professionals involved in discharge processes for transition from hospital to home in 2014, in a regional area of Australia. Discontinuity in the discharge process was affected by pressure to discharge patients, discharge medications and associated risks, inadequate or late discharge summaries, and challenges involving carers. Discontinuity in post-discharge services and follow up was affected by availability of post-discharge services, number of services arranged at the time of discharge, general practitioner follow up after discharge, delays and waiting lists, carer problems, and long-term follow up. There were complex organizational barriers to the continuity of care for stroke survivors discharged home. It is important to address these deficits so that stroke survivors and their carers can make the transition home with minimal risk and adequate support following a stroke.

Internationally, university students with disabilities (SWD) are recognised as being under-represented in higher education. They face significant problems accessing appropriate accommodations for their disability. Academic outcomes for this group are lower in terms of achievement and graduation rates. The true size of the SWD group at university is suggested to be different to that reported due to students not disclosing their disability for a variety of reasons including stigma, fear of discrimination, past negative experiences, and gaps in knowledge about available institutional support and accommodations. Research suggests that students do not consider their issues to fall under the term disability, resulting in a hidden population of students who could be better supported by their university. Using an Australian regional university as a case study, this paper examines the SWD population by identifying both disclosed and non-disclosed SWD populations within the domestic undergraduate population as well as information on the nature of students¿ diagnoses or assessment, not previously captured. Using an anonymous online survey which reframed disability using the non-deficit language of learning challenge, the population of those dealing with learning challenges, disclosed and non-disclosed, was identified and a population estimate calculated. Student characteristics that predicted non-disclosure and specific information on the nature of students¿ diagnoses were made and have the potential to develop targeted institutional support for a population that is currently difficult to access.

Purpose: This study aims at establishing the scope of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) health in Australian and New Zealand medical curricula. Methods: We sent medical school curriculum administrators an online cross-sectional survey. Results: The response rate was 15 medical schools (71%): 14 Australian schools and 1 New Zealand school. Respondents included program directors (n = 5; 33%), course coordinators (n = 4; 27%), Heads of School (n = 2; 13%), one Dean (7%), and three others (20%). Most schools (n = 9; 60%) reported 0-5 hours dedicated to teaching LGBTQI content during the required pre-clinical phase; nine schools (60%) reported access to a clinical rotation site where LGBTQI patient care is common. In most schools (n = 9; 60%), LGBTQI-specific content is interspersed throughout the curriculum, but five schools (33%) have dedicated modules. The most commonly used teaching modalities include lectures (n = 12; 80%) and small-group sessions (n = 9; 60%). LGBTQI content covered in curricula is varied, with the most common topics being how to obtain information about same-sex sexual activity (80%) and the difference between sexual behavior and identity (67%). Teaching about gender and gender identity is more varied across schools, with seven respondents (47%) unsure about what is taught. Eight respondents (53%) described the coverage of LGBTQI content at their institution as "fair," two (13%) as "good," and two (13%) as "poor," with one respondent (7%) describing the coverage as "very poor." None of the respondents described the coverage as "very good." Conclusions: Currently, medical schools include limited content on LGBTQI health, most of which focuses on sexuality. There is a need for further inclusion of curriculum related to transgender, gender diverse, and intersex people.

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. Objectives: This study drew on the theory of Bourdieu to explore FiF students¿ experiences at one Australian medical school, aiming to identify any barriers faced and inform strategies for equity. Methods: Twenty-two FiF students were interviewed about their backgrounds, expectations and experiences of medical school. Interviews were recorded, transcribed and analysed thematically. Findings illustrate the influence and interaction of Bourdieu's principal forms of capital (social, economic and cultural) in FiF students¿ experiences. Results: The absence of health professionals within participants¿ networks (social capital) was experienced as a barrier to connecting with fellow students and accessing placements. Financial concerns were common among interviewees who juggled paid work with study and worried about expenses associated with the medical programme. Finally, participants¿ ¿medical student¿ status provided access to new forms of cultural capital, a transition that was received with some ambivalence by participants themselves and their existing social networks. Conclusions: This study revealed the gaps between the forms of capital valued in medical education and those accessible to FiF students. Admitting more students from diverse backgrounds is only one part of the solution; widening participation strategies need to address challenges for FiF students during medical school and should enable students to retain, rather than subdue, their existing, diverse forms of social and cultural capital. Embracing the diversity sought in admissions is likely to benefit student learning, as well as the communities graduates will serve. Change must ideally go beyond medical programmes to address medical culture itself.

This study compared pre-service teachers¿ perceptions of their professional competencies at two campuses of a large regional teacher education university, where one campus provided students 22% more hours of professional placement in schools and related educational settings. Students who had experienced more hours in schools and such settings were more positive about their, ability to apply their knowledge of students and how they learn, classroom management, professional knowledge and practice, and community engagement; however, when students felt well supported during professional experience, such differences diminished. Additional hours were not associated with pre-service teachers¿ perceptions of their ability to apply subject content and teaching; plan, assess and report; and effective student communication. Researchers argued that this pointed to the crucial role of good classroom mentors in teacher professional experience but also the value of students¿ tertiary teacher education in preparing them for classroom teaching.

Objectives: This study was designed to elucidate why students from backgrounds of lower socio-economic status (SES) and who may be first in their family (FIF) to enter university continue to be under-represented in medical schools. Methods: Academically able high school students (n = 33) from a range of socio-economic backgrounds participated in focus groups. School careers advisors (n = 5) were interviewed. Students discussed their career and education plans and ideas about a medical career. Careers advisors discussed enablers and barriers to a medical career for their students. Results: Students of lower SES and of FIF status attending schools situated in poorer geographic locations had limited access to suitable work experience and, despite their participation in gifted and talented classes, were considered to be at greater risk of not achieving the high level of academic achievement required for admission to medical school. Conclusions: There is utility in exploring intersecting differences and Appardurai's theory of the 'capacity to aspire' for the purpose of understanding the causes of the under-representation of disadvantaged students in medical schools. A focused materialist approach to building the aspirations of disadvantaged students, particularly those attending schools located in poorer areas, is required if effective pre-entry equity programmes are to be developed and evaluated. Alternatively, medical schools might rethink their reliance on very high academic attainment in the admission process. Discuss ideas arising from the article at www.mededuc.com discuss.

BACKGROUND: There is little health specific literature on returning nurses with injuries to work despite the high incidence of injuries and the workforce shortages of these professionals. OBJECTIVE: To identify enabling factors and barriers to return-to-work for nurses with injuries from the perspective of return-to-work coordinators. PARTICIPANTS: Workplace return-to-workcoordinators employed in a health or disability facility who had worked on a rehabilitation case with a nurse with injuries in the past 12 months in New South Wales (NSW), Australia. METHOD: Five focus groups were conducted with 25 return-to-work coordinators from 14 different organisations, representing different health sectors (aged, disability, public and private hospital and community health) in metropolitan and rural areas of NSW, Australia. RESULTS: This study reports findings specifically relating to the provision of suitable duties for nurses with injuries. Four key themes were identified: suitable duties; supernumerary positions; nurse specialisation and tailoring of return-to-work plans. CONCLUSIONS: This study identified that return-to-work coordinators were resourceful and innovative in their approach to the provision of suitable duties for nurses with injuries and highlighted the importance of including clinical duties in any return-to-work program and of tailoring the return-to-work to the nurses' work and personal circumstances.

Clinical Prediction Rules (CPRs) have been developed to assist in the physiotherapy management of low back pain (LBP) although little is known about the factors that may influence their implementation in clinical practice. This study used qualitative research methodology to explore the knowledge, attitudes and practices/behaviours of physiotherapists in relation to these tools. Four semi-structured focus groups involving 26 musculoskeletal physiotherapists were conducted across three Australian geographic regions. A fictitious LBP case scenario was developed and used to facilitate group discussion. Participant knowledge of CPRs was found to be mixed, with some clinicians never having previously encountered the term or concept. LBP CPRs were often conceptualised as a formalisation of pattern recognition. Attitudes towards CPRs expressed by study participants were wide-ranging with several facilitating and inhibiting views identified. It was felt that more experienced clinicians had limited need of such tools. Only a small number of participants expressed that they had ever used LBP CPRs in clinical practice. To optimise the successful adoption of an LBP CPR, researchers should consider avoiding the use of the term 'rule' and ensure that the tool and its interface are uncomplicated and easy to use. Understanding potential barriers, the needs of clinicians and the context in which CPRs will be implemented will help facilitate the development of tools with the highest potential to positively influence physiotherapy practice. © 2013 Elsevier Ltd.

This paper reviews international and Australian literature related to living with hepatitis C infection. At present scholarly research into this worldwide epidemic focuses on medical and scientific understandings of the virus and its effects on people's health-related quality of life. Exploration of the sociocultural impact of hepatitis C infection is for the most part absent from this literature. However, a nascent academic inquiry into living with hepatitis C infection points to a complex range of concerns regarding diagnosis, disclosure, stigmatization and discrimination against people with hepatitis C. The increasing association of hepatitis C infection with injecting drug use and the medicalization of those affected by the virus suggests a need for further social research. For example, injecting drug users' access to healthcare and information on reducing transmission are two important areas that are poorly understood. In this paper the authors argue for an expanded sociocultural understanding of hepatitis C to account for the material effects of medicalization, stigmatization and discrimination, and the sociocultural impact of treatment on the lives of people with hepatitis C infection. The article concludes with suggestions for future directions in social research to address the silence surrounding living with hepatitis C infection.

Controlled illicit drug use has received relatively scant scholarly attention. This article seeks to examine the phenomenon of controlled drug use among inner Sydney gay men by accounting for the range of social regulatory mechanisms that contribute to managed use. The article explores the socio-historical contexts in which such use is embedded and investigates the social norms of control that have developed. We argue that the folk pharmacology of Sydney gay men consists of a range of folk harm reduction strategies usually delivered by lay experts or 'network nannies'. These nannies serve several functions including teaching initiates about the practices of controlled use. The concluding discussion considers potential problems regarding the role of nannies and implications for peer education. © 2001 Elsevier Science B.V. All rights reserved.

Focusing on the outcry which followed the Sydney Gay and Lesbian Mardi Gras Board's anti-drug statement of late 1992, this article explores the overwhelmingly negative reaction against Mardi Gras' position from both health agencies and members of the gay and lesbian community. Based on an analysis of 'Letters to the editor' in the Sydney gay press, counter discourses and subjugated knowledges used to contest Mardi Gras' position are identified. The significance of these counter discourses in relation to major discourses evident within drug theorizing and research is examined. This article argues that cultural and subcultural constructions of pleasure, lifestyle and health need to be considered if the demand for illicit substances is to be adequately accounted for.

This paper uses qualitative data, from a study which embedded virtual reality (VR) in high school science classes, to produce an exemplar designed to illustrate how the technology can promote engagement and Deeper Learning for students. Application of the Deeper Learning conceptual framework to the exemplar provides unique insights into how VR can be deployed in curriculum-aligned ways to develop and combine content mastery, self-directed, collaboration and, perhaps most importantly, creative endeavour in high school science, especially in low income school communities.

The collection and analysis of analytics incorporated into serious games provides researchers with objective data on player behavior related to serious game design elements and learning. Such analytics offer insights about play-learners engagement that is not possible to capture through traditional techniques. Visualization of learning behavior data can allow for a comparison between the pedagogical intent of the game design and the play-learners actual behavior within the serious game. This paper describes the use of game-play logs to identify pathways through gaming content in a serious game app for literacy improvement. The paper describes the technical aspects of processing game-play logs and their transformation into visualizations, and considers how these visualizations can be used to explore play-learner behavior in relation to the pedagogical intent of activities embedded in the serious game app.

There is increasing interest in the application of serious games for learning. Growth in the take-up of digital devices, e.g. smartphones and tablets, and their use for gaming provides new opportunities for mobile learning (m-learning). A serious game m-learning app for improving adult learners' apostrophe usage, called Apostrophe Power, has been developed. The research team, which consisted of software engineers and educationalists, encountered a number of discipline spanning issues while designing and developing this m-learning app. This paper overviews the issues encountered, the recommendations from recent literature and how the issues were ultimately addressed, exemplified in a case study. These lessons learnt offer insight for serious game development and highlight practical solutions for m-learning apps involving interdisciplinary teams.