Interprofessional education (IPE) underpins interprofessional collaborative practice (IPCP), which promotes safe and high-quality health care. Whilst IPE is known to improve healthcare student's individual collaborative competencies, less is understood about its impact on qualified health care professionals (HCPs) practice and organizational change. This review critically examines evidence of practice change, identified using Level 3 and Level 4a of Kirkpatrick's Modified Model of Learning, and barriers following IPE interventions. In February 2025 an integrated mixed methods systematic review was conducted following PRISMA guidelines. Six databases (PubMed, ProQuest, EBSCO/MEDLINE, EBSCO/ERIC, EBSCO/CINAHL, and EBSCO/PsycInfo) were searched using predefined criteria. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT), and data synthesized using the Johanna Briggs Institute (JBI) convergent integrated approach. Seventy-one studies were included. Four categories of practice change were identified: (1) improvements to clinical care provision, (2) improvements in team communication, (3) changes in teams and teamwork, and (4) increased professional development including research. The studies quality varied, with 56% meeting at least four out of five MMAT criteria. Studies revealed practice change is mostly self-reported (87%), at single time points (35%), and at an individual level (96%) by HCPs. Nine studies reported barriers in achieving practice changes following IPE. This paper provides evidence to support IPE for qualified HCPs to improve IPCP and the delivery of high quality and safe healthcare. The identified practice changes align with the Interprofessional Education Collaborative (IPEC) and the Canadian Interprofessional Health Collaborative (CIHC) IPCP frameworks. Further research is required focusing on whether changes are sustained long term and if more flexible evaluation methods such as a realist synthesis would be beneficial. This would allow a deeper understanding of practice changes, in particular how team behaviors change, and to explore the influence of healthcare decision makers on IPE and IPCP.

CONTEXT:Health consumer escalation of acute deterioration response systems are now widely available to help facilitate early recognition and response to acute deterioration in hospitals. Yet, a systematic synthesis of the literature on the signs and symptoms that health consumers consider representative of acute deterioration and the reasons for escalation has not been conducted. AIMS:(1) To identify the signs and symptoms that health consumers recognise as indicative of acute deterioration, and (2) describe the reasons that health consumers activate acute deterioration response systems in hospitals. METHODS:A systematic review was undertaken, informed by the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement and checklist. Five databases (Ovid Medline, Ovid Emcare, CINAHL Complete, Scopus and ProQuest Dissertations and Theses Global Database; January 2015-April 2025; English language) and Google Scholar were searched using a registered search strategy. Screening was undertaken in Covidence with all study designs that met the inclusion criteria included. The MMAT (Mixed-Methods Appraisal Tool) was applied to evaluate study quality. A convergent integrative synthesis was undertaken, incorporating thematic analysis. RESULTS:From 947 unique titles/abstracts and 27 full-text articles, 14 studies met the inclusion criteria. Health consumers can identify a variety of physiological, cognitive, behavioural and functional changes indicative of acute deterioration. Health consumers activate acute deterioration response systems for four reasons: (1) reassurance, (2) reassessment, (3) re-establishing control and (4) recognition and respect. CONCLUSIONS:Health consumers' ability to recognise acute deterioration varies, from clear, specific signs and symptoms to a non-specific sense that something is wrong. Health consumers activate acute deterioration response systems for multiple reasons. PROSPERO REGISTRATION NUMBER:CRD420251013545.

Background Nursing and allied health clinician-educators serve a vital function in bridging academic learning with clinical practice. Yet this role can be challenging as it requires shifting between clinician and clinician-educator identities throughout the day. Aim To explore how nursing and allied health clinician-educators navigate daily identity transitions from clinician to clinician-educator. Design A qualitative study employing a secondary analysis of interviews and longitudinal audio diaries (LADs). Settings We conducted this study in Australia with nursing and allied health professionals working in hospital, residential, rehabilitation, private and community workplace settings. Participants Twenty-five clinician-educators from ten different healthcare professions, with participants ranging from novice to experienced clinician-educators. Methods We collected and thematically analyzed data from entrance interviews, weekly LADs, and exit interviews. We used Social Identity Complexity Theory (SICT) to explore clinician-educators daily identity transition processes as intersection, dominance, compartmentalization, and/or merging. Results Dominance and compartmentalization explained the ways participants navigated their daily workplace identity transitions. Limited role clarity and confidence in educator tasks led to dominance of the clinician identity, particularly when participants perceived conflicting demands between educator and clinician roles. Participants also compartmentalized their identities; contextually activating either the clinician or educator identity. We found little evidence that participants daily identity transitions aligned with intersection and merging of identities. Conclusions Nursing and allied health clinician-educators face challenges when navigating their clinician and educator identities in clinical workplaces. Understanding these daily identity transitions is essential for designing supports to enhance education. We postulate that tailored induction programs incorporating identity transition theories, alongside organizational cultures valuing educational roles, could support clinician-educators to reconcile competing identities and cope with daily identity transitions.

The profession of dietetics must continually adjust practice to address emerging issues such as creating sustainable food systems, decolonizing professional structures, and creating a workforce that represents the diverse communities served. While the dietetics professions in Australia and Canada share these priorities, regulatory approaches to addressing them have yet to be examined using a critical policy analysis approach. This approach scrutinizes the systems in which policy is developed and enacted, examines the ways policy reinforces or challenges the status quo, and identifies who benefits and who does not from policy measures. Canada and Australia share some historical, social, and health challenges and often look to each other for lessons learned. By comparing education and workforce readiness policies in the two countries, we suggest that both would benefit from a more critical review of policy approaches. We note that while both countries define similar scopes of practice for dietitians, ensuring competence to practice approaches vary. These variations create fertile ground to apply a critical policy approach that identifies historical contexts, evidence that informs current practice, and the potential for inequitable impact on different groups. We invite our dietetics colleagues to join us in using this approach to bring about profession-wide transformation.

Background Systems-based practice is crucial for health professionals. Our study aimed to explore systems-based practice within health professions competency standards in Australia, Canada and the United Kingdom.Methods We employed conceptual content analysis to review the extent to which systems-based practice is articulated within competency standards documents across 14 different health professions. Systems-based practice key word searches were undertaken across 38 documents, with frequency of terms counted and compared across professions and countries. The text surrounding the key word was analysed and categorised based on a systems-based practice framework into either knowledge (structural competencies), skills (structural action) or attitudes (social responsibility). Categories across professions were summarised and synthesised across professions for each of knowledge, skills and attitudes.Results The most common terms used across the professions and countries were 'quality' and 'system' with most phrases surrounding quality related to safe and effective patient care with only some references to improving care or quality improvement. Text surrounding the term 'system' mainly referred to health professions being able to navigate the systems in which they interact to provide care, with some standards describing competencies to affect systems that affect health, including bias, determinants of health, and access to care. The competency statements mostly focused on knowledge and skills with only some attitudinal capabilities described across the standards. All professions included systems-based practice competencies with some emphasising health system practice (paramedicine, midwifery, medicine, paramedicine, pharmacy, podiatry, radiography) and others including broader social systems (dietetics, nursing, physiotherapy, psychology, sonography, speech pathology, social work).Conclusions Systems-based practice is as a key competency for health professionals across Australia, Canada and the United Kingdom with a focus on health care systems and limited focus on competencies that challenge broader systems and prepare graduates to address the determinants of health.

Background: Health professionals have a responsibility to address planetary health. Consensus exists on the knowledge, skills and values required for planetary health education, yet optimal educational approaches for teaching how to include planetary health effectively in curricula are unclear. We aim to describe how we used design thinking to co-design planetary health curricula. Approach: Faculty (n = 8), health professionals (n = 8) and health professional students (n = 14) representing medicine, nursing, psychology, biomedicine, pharmacy and nutrition and dietetics participated in four, 90-min design thinking workshops over 2 months. Each workshop was followed by a 60-min reflection with eight academic staff. Audio recordings from both the workshops and faculty reflections were analysed using qualitative content analysis. Evaluation: Design thinking was valuable due to the multiple, diverse and rapid workable curriculum ideas and solutions that were generated across the three participant groups, while acknowledging aspects of complexity. Uncertainty and discomfort were generated and tolerated throughout the process, as faculty learned 'with' participants in the design process. This approach to design thinking created inclusive spaces that promoted participants' agency. Implications: Design thinking appears to be a feasible and useful tool to address complex curriculum challenges like planetary health, where health professions students and workforce voices are crucial for curricular relevance, effectiveness and timely responses.

AIM:This multi-method study explored dietetics graduates' preparedness for the landscape of private practice employment. METHODS:Qualitative, in-depth interview and audio-diary data were collected longitudinally in 2019 regarding dietetics graduates' experiences of private practice employability. Framework analysis of qualitative data prompted a quantitative survey of university representatives in 2021-2022 on the use of private practice placements. Survey data were analysed descriptively. Qualitative themes were reviewed alongside quantitative findings and were interpreted in the context of the sociocultural theory, landscapes of practice. RESULTS:Qualitative data from nine dietetics graduates (total 12 hours of audio data) indicated unpreparedness for this setting, with the following themes identified: 1) private practice skills were lacking; 2) making a living from private practice was challenging; and 3) support was needed. Quantitative data from 18 program directors of accredited universities (100% response) illustrated that private practice placement experiences varied from <10 to 40 days. Placements were most commonly elective (44%) and were not offered by four programs (22%). University program directors expressed concerns that private practice placements were challenging to organise and offered limited client contact hours. CONCLUSIONS:It is an educational priority to prepare graduates for available employment opportunities by providing learning experiences that traverse the dietetics landscape of practice. Co-designing placements with private practice business owners may support authentic experiences of appropriate durations, with ample opportunities for students to build skills to enhance preparedness for this growing employment setting.

AIM:This review aims to synthesise the evidence on supervision in dietetics and other health professions to (1) provide an evidence-based definition of supervision for dietetics and (2) translate this evidence to dietetics practice through developing a conceptualisation of the key components of supervision for dietitians. METHODS:A comprehensive narrative literature review was used to extract and synthesise supervision research data from (1) four bibliographic databases (Medline, CINAHL, ERIC, ProQuest), (2) two dietetic-specific journals, (3) the databases of two subject matter experts and (4) grey literature including position statements by Australian and international government health and professional governing bodies. The findings were synthesised by consensus between four authors, all supervision specialists. RESULTS:Fifty-one items of scholarship were reviewed and summarised as informing the evidence synthesis. A definition of supervision for dietetics is presented. The conceptualisation of the key elements of supervision includes (1) the supervisor, supervisee, supervisory alliance, and contracting; (2) supervision functions and outcomes; (3) frequency of supervision and (4) formats of supervision. CONCLUSION:Supervision should form a regular part of all dietitians' practice and commitment to ongoing learning. It is a core component of contemporary dietetic practice and is recommended as a key part of professional development across the professional career trajectory.

Worldviews influence research-from design to interpretation and reporting. Historically, psychometrics has been predominantly situated within a positivist paradigm, while social research has often aligned with interpretivist or critical paradigms. However, emerging perspectives in the philosophy-of-science are challenging this rigid alignment, inviting a more nuanced understanding of the relationship between worldviews and methodologies in the health professions. This article explores both historical and emerging worldviews related to psychometrics-asking readers to reconsider assumptions and preconceived ideas about which worldview applies to this field of research. Furthermore, this article challenges the psychometrics community to consider how the field can occupy seemingly competing worldviews and approaches, including those that have historically been more commonly associated with qualitative research-such as critical theory (under the broader umbrella of critical inquiry) and reflexivity. Using illustrative case examples applicable to the anatomical sciences and health professions, we discuss the evolution of perspectives on psychometrics and its relationship to worldviews through the lenses of classical test theory and item response theory to the contemporary paradigm of "critical psychometrics".

AIM:Evaluate assessment practices and outcomes for dietetic students and compare findings with those from a previous systematic review. METHODS:A systematic review was conducted whereby four databases (MEDLINE, Embase, Cumulative Index in Nursing and Allied Health Literature, and Education Resources Information Centre) were searched on 11 October 2023 with terms related to dietetics, students, and assessment. The search was repeated on 8 January 2025 to identify new publications. Eligibility criteria were primary research published after 1 June 2017 reporting at least one assessment method for dietetic students with an assessment-related outcome. Assessment practices and outcomes were evaluated using Miller's Pyramid, the New World Kirkpatrick's Hierarchy, and the principles of programmatic assessment. RESULTS:From 5701 search results, 22 were identified, revealing new assessment practices, including entrustable professional activities, e-portfolios, and programmatic assessment, localised to Australia and Singapore. Compared to publications prior to 2017, a greater proportion conceptualised assessment as part of a system (46% compared to 28%) with a sustained higher prevalence of does and shows levels of Miller's Pyramid. Evaluation continued to focus on reaction, learning, and behaviour. CONCLUSIONS:Findings indicate a transition towards programmatic approaches to systems of assessment within dietetics, though this shift was not observed globally. Such a shift is crucial for ensuring the profession's agility in responding to modern disruptors and maintaining the delivery of high-quality education.

ABSTRACT Background Despite clear needs to prepare allied health professionals to work in aged care to meet community needs, student placements in residential aged care are not commonplace. There is limited evidence that explores allied health students' attitudes to aged care placement learning experiences. Objective This work aims to examine the attitudes, experiences and impact of a residential aged care placement on allied health professional students. Methods The study employed an exploratory qualitative approach within an interpretative philosophy. Participants were 14 dietetics, occupational therapy and speech pathology students who had a placement experience in residential aged care in Australia. Students completed a demographics questionnaire, and either an online interview before and after their placement, or a group online interview after their placement. Verbatim transcripts were analysed thematically using an inductive approach. Results Students acknowledged the usefulness of placement in ‘Building Skills,’ and proposed how they could translate these skills to future acute setting placements. However, the ‘Legitimacy of the Learning Environment’ was a concern given the limited in situ role modelling from their own profession. Students clearly identified how they had and could make a meaningful ‘Contribution to Care’ of the older person. Conclusions Placement experiences in residential aged care are a legitimate learning opportunity for allied health professional students to develop their capabilities to work with older people; however, the student sense of fit within the workplace was disconnected. Supporting effective student learning in the aged care setting is important to enable students to be prepared to enter the aged care workforce.

BACKGROUND:Best practice evidence for identifying and managing professional behaviour lapses in a multidisciplinary context is lacking. This study aimed to evaluate multidisciplinary educators' attitudes and perceptions of the ProFESS (Professional standards, Ethical Behaviour and Student Support) framework and its companion Fitness for Practice model, designed and implemented at a large Australian university to address this using a behaviour change approach. METHODS:A 72-item survey based on the Context, Input, Process, Product evaluation framework was completed by 92 multidisciplinary faculty educators and analysed using descriptive and inferential statistics. Content analysis of open text responses occurred. FINDINGS:ProFESS and Fitness for Practice were found to be acceptable irrespective of the discipline using them, providing a supportive, transparent, consistent approach for identifying and managing a professional behaviour lapse. Other key strengths of the framework included its student-centredness and fostering a sense of safety for respondents with potential to improve student-educator relationships. DISCUSSION:Our findings suggest that ProFESS enhances educators' confidence in managing professional behaviour lapses and that its structural flexibility and adaptability underpin its acceptability for multidisciplinary educators. Many of its positive attributes address the failure to fail barriers. The ProFESS method provides opportunities for greater consistency of application as it does not require individual interpretation of behaviour but does require education and training to apply consistently. CONCLUSIONS:The acceptability of the ProFESS/FfP framework in a multidisciplinary healthcare education context is promising for integrating support and standards, fostering a safety culture for educators and reducing 'failure to fail' barriers.

INTRODUCTION:Forecasting how workforces will meet projected challenges faced by future populations is essential to future-proof professions. This paper aims to describe the specific actions required for nutrition professionals (nutrition scientists, nutritionists, dietitians) to realise the professions' workforce development vision of the future. METHODS:A qualitative interpretive approach was employed. Individual interviews were conducted with nutrition leaders and external thought leaders. Focus groups were also conducted with experts within the nutrition and dietetics professions, academic dietetics educators and students/recent nutrition science and dietetics graduates (total sample n = 68). Key nutrition-related issues and challenges, drivers for change and potential future roles of the profession were explored. This paper documents the actions required to achieve these outcomes. Data were analysed using a team-based thematic analysis approach. RESULTS:Analysis and interpretation of participant interviews identified five key actions to strengthen the profession: 'Enhance and harness the diversity of the profession'; 'Develop a cohesive profession with a strong identity'; 'Decolonise teaching and practice'; 'Retain science as the fundamental basis of the profession with trans-systems knowledge integration'; and 'Build opportunities for an agile nutrition workforce'. CONCLUSIONS:Future-proofing the nutrition profession rests on mobilising current strengths and embracing growth and change. There will be confronting challenges for members of the profession and for a united profession. Individual professionals, professional associations, educators and education institutions need to work together to instigate change towards a more equitable future to support optimal health and wellbeing for individuals, communities and populations.

AIMS:Concept-based approaches to curricula have been proposed as a solution to this issue, and 56 concepts have been proposed for dietetics curricula. This study aimed to develop a framework for a dietetic concept-based curriculum. METHODS:A pragmatic approach was employed by a team of nine experienced Australian dietetic educators. Iterative processes of idea generation, reflection, group discussion, and consensus formation were applied by seven of the academics in a two-day face-to-face workshop and four online meetings to further develop the 56 curriculum concepts previously identified for dietetics by Tweedie et al. The discussions were supported by document analysis and critical discussion with two other academics as a reference group. The finalised set of concepts were conceptualised into a curriculum framework. RESULTS:The original 56 concepts were expanded to 63, with seven concepts added in response to developing workforce demands. The 63 concepts were arranged into a framework of 19 core and 44 supporting concepts. Two exemplars were developed to show how five core concepts could be taught. The research team's processes and experiences provide a method for renewing curricula using concepts to guide others wishing to take this approach. CONCLUSION:This study used an evidence-based approach to develop the first concept-based curriculum framework for dietetics. This paper provides a guide and practical tools for dietetics curriculum developers willing to apply a different approach. These findings have implications for curriculum renewal in other competency-based credentialing programs.

This chapter outlines the skills and attributes people need to develop in order to put nutrition science into action. Well trained nutrition professionals are able to integrate foundational knowledge of human and nutrition science with detailed knowledge of diets and eating patterns, food composition and nutrient value and to apply this across different cultural and population groups in different contexts. ‘Community nutrition’, although a largely superseded term, has been described as public health nutrition at the local level or with smaller population reach. Key attributes of an effective nutrition workforce include its competence to meet the health needs of the communities it is working within. Science has contributed to knowledge through inquiry based on observable and measurable evidence according to the principles of reasoning and experimentation. It requires the formulation and testing of hypotheses via the collection of data through observation and experimentation.

AIMS:This study aimed to identify and synthesise the evidence on factors influencing the incorporation of Entrustable Professional Activities into assessment in nutrition and dietetics education. METHODS:A systematic review was conducted with a narrative synthesis and was undertaken and reported in accordance with the PRISMA guidelines. Six electronic databases were searched (MEDLINE, CINAHL, SCOPUS, PsycINFO, Web of Science, and EMBASE) on 9 September 2024. Methodological quality was assessed using the Critical Appraisal Skills Program checklists. Key patterns identified from the narrative synthesis of the included manuscripts were labelled as themes and represented in a figure. RESULTS:Across the international literature, six articles were identified revealing six main and interconnected themes related to factors influencing the incorporation of Entrustable Professional Activities in nutrition and dietetics. In summary, development and review processes for Entrustable Professional Activities require key stakeholder engagement in addition to ensuring they are linked to assessment structures and existing frameworks. Furthermore, technology platforms and applications appeared to support Entrustable Professional Activity incorporation, and training is an important part of integration. CONCLUSIONS:Further research on factors influencing incorporation is occurring and is suggested to continue, especially given Entrustable Professional Activities seemingly offer a tangible option to simplify the intricacy of competency-based assessment in work-based practice. However, further research to enhance understanding of whether Entrustable Professional Activities support nutrition and dietetics learners and assessors in undertaking high-quality assessment with utility is warranted.

Preparedness for practice (P4P) encompasses experience, knowledge, confidence, self-awareness, accountability, resilience, and competency, and is crucial to improved patient outcomes, healthcare team dynamics and doctor wellbeing. This study aimed to investigate graduating medical students’ perceptions of P4P. Graduating medical students from the class of 2022 at an Australian University were invited to voluntarily participate in the study. The cross-sectional exploratory study was developed using co-design (co-creation with faculty and medical students) and employed through a 69-question survey. The survey measured eight key competency areas using 5-point Likert confidence scales and 34 open-ended questions. Quantitative data was analysed using descriptive statistics. Text responses were analysed with qualitative description which drew upon thematic analysis and coding. A total of 365 graduating Doctor of Medicine students completed the survey (83

AIM:To develop evidence-informed propositions for implementing whole-of-program assessment across dietetic education settings, in response to emerging education theory, technological advances such as generative artificial intelligence, and the need for meaningful learning and trustworthy progression decisions. METHODS:A four-stage multiple methods study, grounded in pragmatism, was conducted. Initial propositions were developed through a systematic scoping review of programmatic assessment literature. Thematic analysis was used to identify patterns, which were iteratively refined into themes and then preliminary propositions. These were further refined through workshops with dietetic educators, who provided feedback based on their expertise. A repeated systematic scoping review incorporated recent research to ensure currency, with findings integrated into the propositions. In the final stage, feedback from external reviewers was used to enhance clarity and practical relevance. RESULTS:Nine propositions for evidence-informed practice in dietetic student assessment were developed. These propositions focus on aligning assessment with program learning outcomes, using varied learning tasks to generate trustworthy learning evidence, developing feedback literacy among education partners, involving expert assessors in progression decisions, and providing intermediate reviews to monitor student progress. The propositions emphasise the importance of student agency and recognise the influence of institutional structures and culture on assessment. CONCLUSIONS:The propositions provide a practical, whole-of-program approach to assessment that promotes learning and trustworthy progression decisions. The approach is recommended as the common assessment process across the dietetics profession. By aligning assessment practices across the curriculum and profession, these propositions seek to enhance educational outcomes and address the evolving challenges in dietetic student education.