Medical Education - Research Publications
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ItemContinuing Professional Development programmes through the lens of Habermas’ Knowledge-Constitutive Interests: a novel approach to evaluating and (re)designing CPD(AMEE, 2024)Background: Clinician-educators are usually experienced clinicians seeking information and strategies to improve their teaching. Continuing Professional Development (CPD) programmes can address a range of learning requirements for clinician-educators if they can respond to the particular educational and contextual needs of participants. A critical review of a one-day postgraduate course was conducted. It focused on how the course was tailored to the learning needs and interests of participants and drew on the early work of Jürgen Habermas and his Knowledge-Constitutive Interests schema in its analysis. Habermas describes technical, practical and emancipatory interests. For clinician-educator CPD, ‘teaching tips that work’ align with the technical interest, while learning why certain teaching techniques suit specific situations or learners is a practical interest. Understanding the material so attendees can flexibly apply it in their context aligns with the emancipatory interest in autonomy. Summary of Work: Examination of the course through the lens of Habermas' interests was conducted by asking: What type of interest does each session target? How does it do this? How could the teaching method shift from fostering technical or practical knowledge towards meeting the participants' emancipatory interests?
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ItemMeeting Halfway: Engaging Clinician-Educators(ANZAHPE, 2024)Introduction/Background: Clinician-educators form a significant component of the health professional education workforce and deliver a substantial amount of teaching and supervision, especially in placement sites. There are many challenges clinician-educators face in contributing to educational activities such as programme development, evaluation and educational research and scholarship, yet experience in these areas can be critical to their professional development. Are health professional education programmes doing enough to encourage the contribution of their clinician-educator workforce? Methods: In this PeArLS, I will briefly introduce the issue outlined in the Introduction and then engage the participants in a discussion across several questions listed below in ‘Issues or questions for exploration’. These questions will explore the experience of participants in working with clinician-educators outside of their usual teaching or supervisory activity and the ways in which those educators might best be utilised to enhance the programmes into which they teach. Strategies for engaging clinician-educators will form an important part of this discussion and will focus on ways in which participants have successfully overcome barriers to clinician-educator contribution. Results/Evaluation: This session will be a success if both the presenters and participants identify ways to engage their clinician-educator staff in broader participation in their educational programmes. These could be in areas such as programme design, evaluation, faculty development or scholarship. Insights from participants who have successfully developed professional development programmes or scholarly collaborations with their clinician-educator workforce will be particularly valuable. Discussion: Opportunities for shared understanding and problem-solving are critical to the ongoing development of health professional education programmes and practitioners. Greater involvement of clinician-educators in the academic programmes to which they contribute will be of benefit to all health professional education practitioners.
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ItemNo Preview AvailableMalignant pleural effusion management: An audit of current practice(Wiley, 2024)Introduction/Aim: Malignant pleural effusion (MPE) is a complication of advanced cancer that can result in limited life expectancy and significant morbidity. Recurrence of MPE is common and definitive management with either pleurodesis or indwelling pleural catheter (IPC) insertion is often required. This study aimed to review the management of MPE at two tertiary hospitals to identify potential areas for improvement with an emphasis on the hospital length of stay, frequency of non-definitive pleural procedures and frequency of unplanned pleural related admissions. Methods: Retrospective audit of all patients diagnosed with MPE at Western Health over a 3-year period. Results: Of 79 patients with MPE were identified during the time period (mean age 66.1 years, 59% female). 25 patients (13.1%) had a non-definitive pleural procedure following diagnosis, including 16 (38.1%) of the 42 patients who subsequently went on to have a definitive procedure. The median hospital length of stay for pleural effusion related hospitalisations was 9 days. 22 of the 42 pleural effusion-related admissions occurred after a presentation via the emergency department (ED). When compared with planned admissions, those who presented via ED had a higher rate of non-definitive procedures (77% vs 25%) and a longer length of stay (12 vs 7 days). Conclusion: The pleural effusion-related hospital length of stay was in line with previously published Australasian data. Despite this, our data suggests that there might still be scope for improvement. In particular, our data has suggested that interventions to reduce the number of unplanned admissions via ED might result in a reduced rate of non-definitive procedures and a reduced hospital length of stay. Future research could assess the impact of interventions such as the introduction of dedicated pleural clinic or a streamlined admissions pathway on these measures.
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ItemNo Preview AvailablePrescribing oxygen: An audit of prescribing and delivery practices at two tertiary hospitals in Melbourne, Australia(Wiley Online Library, 2021)Background and Aims: Over-oxygenation in COPD patients can result in adverse outcomes. The use of specific oxygen saturation targets in COPD has been associated with less acidosis, a lower requirement for assisted ventilation, and reduced mortality. Our study reviews current practices of both oxygen prescription and delivery for patients admitted at two tertiary hospitals with an exacerbation of COPD. Methods: This retrospective audit included all admissions at two tertiary hospitals with a primary diagnosis of exacerbation of COPD over 6 months (April to September 2020). Medical records were reviewed to determine how many had documented target SpO2 ranges and how concordant these were with the Thoracic Society of Australia and New Zealand guidelines (SpO2 range 88% to 92% in COPD). For those with documented SpO2 ranges, we determined the percentage of recorded SpO2 levels that were below, above and within the target range. Results: 312 admissions for exacerbation of COPD were reviewed. Target SpO2 goals were documented for 57% of admissions (N=178), of which 77% (N=137) were consistent with current guidelines. Of those with a documented SpO2 range, only 75.4% of recorded SpO2 readings were within range, with 2.3% falling below and 22.3% above range. Conclusions: Our results highlight underutilisation of SpO2 targets in patients with COPD, as well as frequent over-oxygenation despite documented targets.
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ItemNo Preview AvailableTheory into Practice: Scholarship and the Clinician-Educator(Australian & New Zealand Association for Health Professional Educators, 2023-06-06)
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ItemNo Preview AvailablePregnancy planning in a woman with diabetes secondary to familial partial lipodystrophy due to a rare PPAR gamma gene variant(International Association of the Diabetes and Pregnancy Study Groups, 2022)
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ItemNo Preview AvailableDiabetes Digital Phenotyping to Improve Documentation of Diabetes in Hospital Inpatients(Australian Diabetes Society, 2022)
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