Progress reports on projects that received ANZAHPE Research Grants in 2019.

Developing resilience and positive mental health strategies in health professional students
Project Lead: Ben Milbourn

“Talk to Me” – Improving mental health and suicide prevention for young adults

A scoping review of the literature on suicide prevention programs has been carried out and submitted for peer review. The “Talk to Me” mass open online course (MOOC) has been developed as an online suicide prevention intervention created to address the growing mental health needs of university students. The program contains 6 modules covering positive mental health strategies, suicide and self-harm awareness, crisis communication skills, and current interventions. Key skills include suicide crisis planning and response strategies, as well as ways to improve your own or others’ mental health. Funds from the grant were used to develop video resources using actors to create a narrative of a person experiencing mental health distress. Lived experience educators consulted on the scripts of the scenarios. A pilot of two of the modules was carried out late November 2019. A consumer reference group and non-government organisations working in community mental health have consulted on the MOOC content, providing valuable feedback.  The project will now move to the next phase and commence roll out the MOOC using randomised control group methodology for approximately 250 health university students in March 2020. 

Enhancing feedback literacy in the workplace: a learner-centred approach
Project lead: Christy Noble

Junior doctors in emergency departments (ED) have reported dissatisfaction with feedback in this setting (Chaou et al., 2017; Yarris et al., 2009). Medical educators and supervisors often conceptualise feedback as information transmission (i.e. from the supervisor to the learner). With this prevailing view of feedback, it is not surprising that junior doctors’ active role in feedback can be overlooked when developing professional capabilities. Moreover, working in busy fast-paced environments, such as emergency departments, can make it challenging for supervisors to balance patient care with feedback (Chaou et al., 2017). Heightening junior doctors’ skills in feedback, as seekers, processors, and users of performance information may support their learning experiences, transitions between terms, and ongoing capacity to learn through work.

This ongoing design-based research study aims to explore how junior doctors engage with feedback processes, after participating in a feedback literacy program during their emergency medicine term at Gold Coast Health. We have conducted five feedback literacy sessions with 80 interns.  Each iteration has been evaluated through focus groups interviews (n=5) with the interns (n=30) and through educator reflections.  Based on these data, the sessions were refined to enhance intern feedback literacy.  

Our thematic analysis is ongoing, however based on our initial analysis, interns suggested that the literacy sessions contributed to their understanding of effective feedback practices in ED. They described using a range of new strategies such as priming the supervisors for feedback, and sharing their evaluative judgments to facilitate their engagement in feedback conversations. They noted that these strategies may be transferable to other terms and felt more confident to seek feedback. We have found it is important for interns to have structured tools, such as  written feedback, to prompt feedback conversations, yet it is the conservation that has most impact on their learning. The interns also described ongoing challenges when engaging in feedback in ED including lacking time to follow up, and  feeling exhausted and non-receptive to feedback. Overall, our analysis suggests that a key feature of being feedback literate is being able to read cues about performance from the environment and interpret these in a meaningful way.  For further research, there would be value in conducting observational studies to understand the interplay between context and feedback literacy.

References

Chaou, C.-H., Monrouxe, L. V., Chang, L.-C., Yu, S.-R., Ng, C.-J., Lee, C.-H., & Chang, Y.-C. (2017). Challenges of feedback provision in the workplace: A qualitative study of emergency medicine residents and teachers. Medical Teacher, 39(11), 1145-1153. doi:10.1080/0142159X.2017.1366016

Yarris, L. M., Linden, J. A., Gene Hern, H., Lefebvre, C., Nestler, D. M., Fu, R., . . . Brunett, P. (2009). Attending and Resident Satisfaction with Feedback in the Emergency Department.16(s2), S76-S81. doi:doi:10.1111/j.1553-2712.2009.00592.x

An innovative gender-focused education intervention for health professional students: A pilot study 
Project  Lead: Frances Doran

Sexual harassment, bullying, and discrimination based on gender occurs across a range of health care settings with frequent complaints made to Health Professional Registration Boards of Australia and the Australian Health Practitioner Agency.   Undergraduate health professional education provides an ideal opportunity to not only initiate a change in attitudes about gendered violence but also equip graduates on how to deal with it, prevent it, and become safe and ethical clinical practitioners. This is an area that is often overlooked in undergraduate curriculum.

To meet this gap in education, ANZAHPE funded an innovative gender-focused education intervention which incorporated a bystander component, delivered to students enrolled in the Master of Osteopathic Medicine students at Southern Cross University. The goal was to enhance knowledge and awareness of the gendered drivers of violence and facilitate attitudinal and behavioral change.

Progress to date

• Ethics approval gained 
  
• Gender-focused primary prevention educational intervention, developed in consultation with an expert in gender-based violence
  
• Workshops delivered to two groups of students enrolled in the Master of Osteopathic Medicine at Southern Cross University
  
• Students completed pre- and post-education surveys
  
• Statistical data analysis complete (preliminary analysis indicates statistically significant changes in some attitudes and knowledge)
  
• Follow-up interviews/surveys to be completed 
  
• Final report and publication to the ANZAHPE journal in preparation

The results are applicable to a broad range of people interested in gender-inclusive health professional education

Analysis of Leadership activities and strategies in Interprofessional Learning using a cultural-historical activity theory (CHAT) approach 
Project Lead: Helena Ward

This research study focuses on leadership activities and strategies in interprofessional learning (IPL) using Cultural Historical Activity Theory (CHAT) to analyse the links between the actions that leaders take to promote learning, their everyday activities and their longer-term strategies.   

The outcomes of this study will add to the body of knowledge on IPL and inform design, implementation, and evaluation of IPL programs.

The research questions are:

• How are leaders building capacity in IPL?
• How can these findings be applied to other IPL contexts?

Using a Leading for Learning Reflection tool, participants were asked to record examples of their actions that were aimed at fostering interprofessional learning in everyday activities and how these actions related to their overall goals for IPL.  Participants were interviewed to explore how they are build capacity in interprofessional learning and their views on leadership and learning.

In 2019, we conducted a pilot study with the reflection tool and follow up interviews. This led to some changes in the reflection tool and data collection process.  Through a separate IPL balanced scorecard project last year, we have identified academic staff within the Faculty of Health and Medical Sciences who have a leadership role in IPL.  We are currently focusing on participant recruitment during the first half of 2020, to be followed by interviews.

Development of an Evidence-Based Practice Learning and Assessment Framework for academics, workplace learning supervisors, and students: An action research project  
Project Lead:  Kylie Murphy

Since receiving an Australian and New Zealand Association for Health Professional Educators (ANZAHPE) research grant in July 2019, the research team has developed resources informed by feedback from academics, placement-experienced students, and placement supervisors from a range of health disciplines.

The initial draft framework was informed by a review of relevant literature and the combined expertise of the research team in relation to Evidence-Based Practice (EBP) education. Preliminary feedback from placement supervisors suggests that a summarising poster, a more detailed booklet, and checklists, available to download from a website, would best meet supervisor needs. Since then, feedback from the stakeholder groups—received through focus groups, interviews, and email exchanges—has informed the refinement of these resources. 

The formative evaluation, involving iterative cycles of feedback, reflection, and further refinement, is now complete. The team is currently finalising the resources for publication and summative evaluation. The resources will be made freely available on a website that will include a link to a brief evaluation survey.  This website will be launched in April 2020. 

If you know clinical placement coordinators and/or supervisors who may be interested in receiving the resources and contributing to the survey, please encourage them to email kmurphy@csu.edu.au