Introduction: Workforce development is a key strategy for building the capacity and capability of a workforce. Accordingly, rural and remote practising allied health professionals require relevant and accessible continuing professional development to enhance their knowledge and skills and improve consumer health outcomes. This study explored the impact of an online postgraduate allied health rural generalist education program, from the perspective of allied health professionals participating in the program and their supervisors and managers. Methods: A qualitative, exploratory descriptive study design was employed using semistructured interviews. This study formed the qualitative component of a larger convergent mixed-methods evaluation study aimed at evaluating the reach, quality and impact of an online rural generalist education program for allied health professionals in Australia. Allied health professionals from seven professions enrolled in an online postgraduate rural generalist education program, the rural generalist program (RGP). Their designated work-based supervisors and their managers who were responsible for the operational management of the study sites were invited to participate in the study. All participants were employed in rural and remote health services in 10 sites across four Australian states. Study participants' experience and perceptions of the impact of the RGP on themselves, the healthcare service and the broader community were explored using semistructured interviews. Data were thematically analysed site by site, then across sites using Braun and Clarke's (2012) systematic six-phase approach. Provisional codes were generated and iteratively compared, contrasted and collapsed into secondary, more advanced codes until final themes and subthemes were developed. Results: Semistructured interviews were conducted with 23 allied health professionals enrolled in the RGP and their 27 work-based supervisors and managers across the 10 study sites. Three final themes were identified that describe the impact of the RGP: building capability as rural generalist allied health professionals; recruiting and building a rural workforce; enhancing healthcare services and consumer outcomes. Conclusion: Allied health professionals working in rural and remote locations valued the RGP because it provided accessible postgraduate education that aligned with their professional and clinical needs. Integrated into a supportive, well-structured development pathway, the experience potentiated learning and facilitated safe clinical practice that met the needs of consumers and organisations. The findings demonstrate that effective work -integrated learning strategies can enhance the development of essential capabilities for rural practice and support early-career allied health professionals' transition to rural and remote practice. These experiences can engage allied health professionals in a way that engenders a desire to remain working in rural and remote contexts.

OBJECTIVE:To evaluate the development and implementation of the Allied Health Rural Generalist Program, a two-level online post-graduate education program, which includes Level 1, an entry-level non-award pathway program, and Level 2, a Graduate Diploma in Rural Generalist Practice.DESIGN:A convergent mixed methodology evaluation in two overlapping stages: a process evaluation on quality and reach, together with a mixed method case study evaluation on benefits, of the program.SETTING:Rural and remote Australia across ten sites and seven allied health professions: dietetics; occupational therapy; pharmacy; physiotherapy; podiatry; radiography; speech pathology.PARTICIPANTS:Process evaluation included 91 participants enrolled in all or part of the Rural Generalist Program. Case study evaluation included 50 managers, supervisors and Rural Generalist Program participants from the ten study sites.INTERVENTIONS:The Allied Health Rural Generalist Program.MAIN OUTCOME MEASURES:Process evaluation data were derived from enrolment data and education evaluation online surveys. Case study data were gathered via online surveys and semi-structured interviews. Quantitative and qualitative data were collected concurrently, analysed separately and then integrated to identify consistency, expansion or discordance across the data.RESULTS:The Rural Generalist Program was viewed as an effective education program that provided benefits for Rural Generalist Program participants, employing organisations and consumers. Key improvements recommended included increasing profession-specific and context-specific content, ensuring Rural Generalist Program alignment with clinical and project requirements, strengthening support mechanisms within employing organisations and ensuring benefits can be sustained in the long term.CONCLUSION:The Rural Generalist Program offers a promising strategy for building a fit-for-purpose rural and remote allied health workforce.

Interprofessional education (IPE), as preparation for interprofessional practice, is considered essential for quality, coordinated, outcome-focussed patient care. To develop capacity in our future healthcare practitioners, IPE needs to be developed within curricula, and opportunities provided to practise within the placement setting. The aim of this study was to examine the effect of a structured IPE placement program on students' perceptions of IPE within an authentic healthcare setting. This paper reports on changes in students' attitudes toward IPE, as measured by the SPICE-R2 instrument, in response to program involvement. Thirty-six students from six health professions participated in the study and reported significantly improved perceptions toward IPE, particularly in their understanding of roles and responsibilities, teamwork, and patient outcomes. The outcomes reinforce the importance of offering intentional and structured IPE activities during placement and the value provided to health students, preparing them for future collaborative practice.

This study explored final year Baccalaureate nursing students’ perceptions of their ability to transfer learning from simulated experience to clinical practicum. There is an expectation that learning automatically transfers to real world settings.1A well-practiced skill can relatively easily be reproduced in a new situation if it is to be reproduced in very similar environment to that of initial learning.2The complex nature of current healthcare environments -which is where nursing students undertake clinical practicum-is often unlike the structured simulation setting.3A perceived disconnect from simulated to clinical setting may contribute to difficulty in the application of skills and knowledge in real world practice.4Questions about the transferability of knowledge and skills are very important,yet, the questions of ‘how’ and ‘what’ transfers from simulated learning remains relatively unexplored.

To aim of this study was to explore undergraduate nursing student (n = 256) perceptions of clinical reasoning ability and learning transfer after participating in either a standard post simulation debriefing or a debriefing based on transfer of learning principles. BACKGROUND:It is assumed that students will transfer what they have learned from simulation to real world practice, however, some students are unable to identify the relevance of simulated learning experiences if scenarios are dissimilar to clinical placement settings. The nature and extent what is able to be transferred from simulated to real settings is unclear, particularly in relation to complex processes such as clinical reasoning. Transfer of learning to a new situation involves deliberate cognitive effort, including reflection and mindful abstraction of central attributes of a problem. As reflection is a key element in learning transfer, the debriefing element of simulation was seen to be a platform for this study. METHOD:A convergent parallel mixed methods design used a pre-test, post-test survey and focus group interviews. RESULTS:No statistically significant difference in post-test clinical reasoning scores between groups was found. There was a statistically significant improvement in 12 out of 15 criteria among the control group and in 8 of the criteria among the intervention group. Qualitative findings provided some evidence that learning had transferred to clinical settings. Evidence of "near" transfer was more evident than "far" transfer. CONCLUSION:Positive findings included that all students perceived they had transferred the skills of patient assessment and effective communication during episodes of patient care. The concept of a "framework" being verbalized by many of the intervention group during practice is a promising finding and may be a useful direction for further research focusing on the instructional demonstration of explicitly promoting a level of abstraction of problems and prompting participants to search for conceptual connections. This may indicate retained idea or concepts from the debriefing which may be useful in future practice.

Well-developed clinical reasoning skills are central to the process of clinical judgement. However, the results of recent studies suggest that curricula and teaching approaches that support student nurses’ development of clinical reasoning skills have not yet been fully achieved. Cognitive apprenticeship offers a new approach to facilitate the development of complex thinking skills, for example, reasoning skills in making clinical decisions. This study examined the effect of an educational intervention utilizing principles of cognitive apprenticeship on students’ ability to apply clinical reasoning skills within the context of a purpose-built clinical vignette.A quasi-experimental, non-equivalent control-group design was used to evaluate the effect of the educational intervention on students’ accuracy, inaccuracy and self-confidence in clinical reasoning. Eighty-five undergraduate nursing students participated in the study. A purpose-built clinical vignette was utilised to collect data from study participants. Mixed-Design ANOVA with a significant level of p< 0.05 was employed. Both quantitative and qualitative data were collected. A statistically significant increase in students’ accuracy in clinical reasoning was found after the six-weeks educational intervention. Examination of the quantitative data at time 2 discovered a statistically significant higher accuracy in clinical reasoning score (p<0.00) of the intervention group as compared to the control group. Results from inaccuracy and self-confidence in clinical reasoning did not reach significance. Results from the qualitative data are reported separately. It is argued that interplay of small group discussion of domain specific case-scenarios and the provision of guided learning experience may play a role in achieving partially successful results. This study makes an important contribution to nursing education by providing evidence to understand how best to facilitate nursing students’ development of clinical reasoning.

Background: Utilizing expert panel in content validity evaluations of new constructed educational packages in the nursing context have not been described well.Objective: to describe the use of expert panel in a content validity evaluation of a new clinical reasoning educational package.Methods: Five senior nursing academics participated in the study. The prospective panellists were selected based on their relevant professional expertise, including teaching experience, relevant academic qualifications, and practice experience in the Indonesian context. The specifically constructed feedback instrument consisted of 31 items encompassing an overview of the educational-intervention model, the student’s workbook and the teacher’s guide. A Likert scale was used to evaluate the relevance, clarity and feasibility of the educational intervention package. The review was conducted over a period of approximately five weeks. Numerical data were analysed using the Content Validity Index (CVI) method. Both Item (I-CVI) and Scale (S-CVI) levels were calculated. An I-CVI of ≥.78 and an S-CVI of ≥.90 are determined. Panellists’ written comments were also sought. Thematic analysis was undertaken to analyse the qualitative data. Findings were used to inform decisions about whether to retain, modify or eliminate each item.Results: The I-CVI scores for each sub-scale (relevance, clarity and feasibility) was ≥.93.The S-CVI for the educational overview, teacher and student’s guides was ≥.95. Accordingly, the average proportion of expert agreement on the educational-intervention package was .98. The package as a whole (and the three individual components: overview, teacher’s and student’s guides) was shown to have excellent content validity. Comments from the panellists are focus on the teacher’s preparation before using the educational package. Thus, no further improvement on the educational package was required.Conclusion: Utilizing expert panel content validity and critically evaluating their recommendations can result in a more relevant, clear and feasible educational intervention, leading for a more effective clinical reasoning educational approach for student nurses. Acknowledgment: This study was supported by Indonesian Higher Education Department and Queensland University of Technology, Australia

Summary: The question being addressed by this project is whether, and in what way/s, an M-Learning solution based on connected learning principles might enhance student learning outcomes. A prototype app has been developed and piloted. Quantitative and qualitative feedback highlight several issues for curriculum development and app refinement. Content Outline: Introduction o Emergence of mobile devices and connected learning as important trends in higher education o Potential to enrich nursing and allied health education, particularly within the clinical practice context o Question being addressed by this project

Background: Simulation is an integral component of health care education. Research suggests a positive relationship between simulation and learning outcomes. Kirkpatrick's framework is a four-level model based on the premise that learning resulting from training programs can be classified into four levels: reaction, learning, behavior, and results. Evaluation of educational impact provides valuable feedback to educators that may assist with development and improvement of teaching methods. Method: This review is based on the PRISMA guidelines for conducting a systematic review. Inclusion criteria included articles (a) written in the English language, (b) published between 2000 and 2016, (c) describing a debriefing intervention after high-fidelity patient simulation, and (d) based in health care. Results: Thirteen studies met criteria for inclusion in the review. Conclusion: Results indicated a paucity of studies at the highest levels of evaluation, indicating an area where future research is needed to assist with the development and improvement of simulation education. [ J Nurs Educ . 2018;57(7):393–398.]

The use of technology to facilitate connected learning is currently receiving an increasing amount of attention in higher education. Connected learning can be described as a set of design principles that aim to engage, empower and equip students to learn effectively, purposefully and continuously throughout their lives (Connected Learning Alliance, 2016). It enables learners to uniquely integrate personal connections, in-class and out-of-class experiences, collaborations and resources of all kinds resulting in a deeper learning experience that better addresses learners' specific needs. In workplace learning contexts where students are placed for clinical practice in their respective discipline areas this is all the more important because these are particularly challenging learning environments for students. Given the potential of mobile technologies to enable social interactions, our question was whether, and in what way/s, an mLearning solution designed to facilitate student collaboration in the workplace might complement the supervisory guidance being received in the workplace and enhance the overall quality of student learning. This paper reports on our work in progress to develop a mobile app designed to enhance the learning experience of health professional students undertaking clinical placements in a variety of health facilities. A key aim of the project is to provide a real-time means by which students from multiple health disciplines can meaningfully connect with each other during the course of a placement in order to share insights, pose questions, receive feedback and store reflections on their learning. Principles of connected learning have been used to underpin the design of the prototype app. Sixteen students from the disciplines of nursing, social work and nutrition and dietetics volunteered to participate in the pilot which was conducted during 2016. A short briefing session about the aims of the project and how to use the app were provided prior to the commencement of the pilot. Evaluative feedback was collected using an online survey and a faceto- face focus group discussion. Quantitative and qualitative data indicate that students value the opportunity to connect with their multidisciplinary peers whilst on placement in the workplace. However, analysis of their online dialogue and comments during the focus group discussion highlight several issues which have important implications for their engagement with the app and consequent realisation of learning benefits. Outcomes from the pilot are being used to refine the initial prototype app for testing on a wider scale in the early part of 2017.

Background: Little is known about the effectiveness of students' transfer of simulation learning to "real-world" contexts. This study was an initial exploration of third-year nursing students' perceptions regarding the transfer of high-fidelity simulation learning to clinical practice.& para;& para;Method: A series of semistructured focus group discussions were undertaken with final year under graduate nursing students (n = 25).& para;& para;Result: Three themes emerged from the analysis of data: But it's not the same on "real" clinical practice, Having opportunities to apply what we've learned, and Making better connections.& para;& para;Conclusions: The findings highlight that transfer of simulation learning to practice should not be assumed, particularly when students' clinical placements are in settings that are dissimilar to the high-fidelity simulation scenarios they have experienced. (C) 2017 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.

Upon completion of undergraduate nursing courses, new graduates are expected to transition seamlessly into practice. Education providers face challenges in the preparation of undergraduate nurses due to increasing student numbers and decreasing availability of clinical placement sites. High fidelity patient simulation is an integral component of nursing curricula as an adjunct to preparation for clinical placement. Debriefing after simulation is an area where the underlying structure of problems can consciously be explored. When central principles of problems are identified, they can then be used in situations that differ from the simulation experience. Third year undergraduate nursing students participated in a pilot study conducted to test a debriefing intervention where the intervention group (n=7) participated in a simulation, followed by a debriefing based on transfer of learning principles. The control group (n=5) participated in a simulation of the same scenario, followed by a standard debriefing. Students then attended focus group interviews. The results of this pilot test provided preliminary information that the debriefing approach based on transfer of learning principles may be a useful way for student nurses to learn from a simulated experience and consider the application of learning to future clinical encounters.

Identifying and stabilising deterioration in a child with significant clinical compromise is both a challenging and necessary role of the paediatric critical care nurse. Within adult critical care research, high fidelity patient simulation (HFPS) has been shown to positively impact learner outcomes regarding identification and management of a deteriorating patient; however, there is a paucity of evidence examining the use of HFPS in paediatric nursing education. The aim of this study was to investigate the effect of HFPS on nurses' self-efficacy and knowledge for recognising and managing paediatric deterioration. Further, participants' perceptions of the learning experiences specific to the identification and management of a deteriorating child were also explored. Registered nurses working in a tertiary-referral paediatric critical care unit were recruited for this quasi-experimental study. Using a pre-test/post-test control-group design, participants were assigned to one of two learning experiences: HFPS or standard instruction. Following the learning experience, nurses were also invited to participate in semi-structured interviews. 30 nurses participated in the study (control n=15, experiment n=15). Participants in the HFPS intervention were most likely to demonstrate an increase in both perceived self-efficacy (p=<0.01) and knowledge (p=<0.01). No statistically significant change was observed in control group scores. The mean difference in self-efficacy gain score between the two groups was 5.67 score units higher for the experiment group compared to the control. HFPS also yielded higher follow-up knowledge scores (p=0.01) compared to standard instruction. Ten nurses participated in semi-structured interviews. Thematic analysis of the interview data identified four themes: self-awareness, hands-on learning, teamwork, and maximising learning. The results of this study suggest that HFPS can positively influence nurses' self-efficacy and knowledge test scores specific to the recognition and management of paediatric deterioration.

•HFPS training can lead to improved learner outcomes in PICU nursing education•HFPS can positively influence both technical and non-technical skill acquisition•Scant studies provide high quality empirical evidence to support HFPS use in PICU

Peer review of teaching is recognized increasingly as one strategy for academic development even though historically peer review of teaching is often unsupported by policy, action and culture in many Australian universities. Higher education leaders report that academics generally do not engage with peer review of teaching in a systematic or constructive manner, and this paper advances and analyses a conceptual model to highlight conditions and strategies necessary for the implementation of sustainable peer review in higher education institutions. The model highlights leadership, development and implementation, which are critical to the success and formation of a culture of peer review of teaching. The work arises from collaborative research funded by the Office for Learning and Teaching to foster and advance a culture of peer review of teaching across several universities in Australia.

Teaching is a core function of higher education and must be effective if it is to provide students with learning experiences that are stimulating, challenging and rewarding Obtaining feedback on teaching is indispensable to enhancing the quality of learning design, facilitating personal and/or professional development and maximising student learning outcomes. Peer review of teaching has the potential to improve the quality of teaching at tertiary level, by encouraging critical reflection on teaching, innovation in teaching practice and scholarship of teaching at all academic levels. However, embedding peer review within the culture of teaching and learning is a significant challenge that requires sustained commitment from senior leadership as well as those in leadership roles within local contexts.

AIMS This paper reports on the implementation of a research project that trials an educational strategy implemented over six months of an undergraduate third year nursing curriculum. This project aims to explore the effectiveness of ‘think aloud’ as a strategy for learning clinical reasoning for students in simulated clinical settings. BACKGROUND Nurses are required to apply and utilise critical thinking skills to enable clinical reasoning and problem solving in the clinical setting [1]. Nursing students are expected to develop and display clinical reasoning skills in practice, but may struggle articulating reasons behind decisions about patient care. For students learning to manage complex clinical situations, teaching approaches are required that make these instinctive cognitive processes explicit and clear [2-5]. In line with professional expectations, nursing students in third year at Queensland University of Technology (QUT) are expected to display clinical reasoning skills in practice. This can be a complex proposition for students in practice situations, particularly as the degree of uncertainty or decision complexity increases [6-7]. The ‘think aloud’ approach is an innovative learning/teaching method which can create an environment suitable for developing clinical reasoning skills in students [4, 8]. This project aims to use the ‘think aloud’ strategy within a simulation context to provide a safe learning environment in which third year students are assisted to uncover cognitive approaches that best assist them to make effective patient care decisions, and improve their confidence, clinical reasoning and active critical reflection on their practice. MEHODS In semester 2 2011 at QUT, third year nursing students will undertake high fidelity simulation, some for the first time commencing in September of 2011. There will be two cohorts for strategy implementation (group 1= use think aloud as a strategy within the simulation, group 2= not given a specific strategy outside of nursing assessment frameworks) in relation to problem solving patient needs. Students will be briefed about the scenario, given a nursing handover, placed into a simulation group and an observer group, and the facilitator/teacher will run the simulation from a control room, and not have contact (as a ‘teacher’) with students during the simulation. Then debriefing will occur as a whole group outside of the simulation room where the session can be reviewed on screen. The think aloud strategy will be described to students in their pre-simulation briefing and allow for clarification of this strategy at this time. All other aspects of the simulations remain the same, (resources, suggested nursing assessment frameworks, simulation session duration, size of simulation teams, preparatory materials). RESULTS Methodology of the project and the challenges of implementation will be the focus of this presentation. This will include ethical considerations in designing the project, recruitment of students and implementation of a voluntary research project within a busy educational curriculum which in third year targets 669 students over two campuses. CONCLUSIONS In an environment of increasingly constrained clinical placement opportunities, exploration of alternate strategies to improve critical thinking skills and develop clinical reasoning and problem solving for nursing students is imperative in preparing nurses to respond to changing patient needs. References 1. Lasater, K., High-fidelity simulation and the development of clinical judgement: students' experiences. Journal of Nursing Education, 2007. 46(6): p. 269-276. 2. Lapkin, S., et al., Effectiveness of patient simulation manikins in teaching clinical reasoning skills to undergraduate nursing students: a systematic review. Clinical Simulation in Nursing, 2010. 6(6): p. e207-22. 3. Kaddoura, M.P.C.M.S.N.R.N., New Graduate Nurses' Perceptions of the Effects of Clinical Simulation on Their Critical Thinking, Learning, and Confidence. The Journal of Continuing Education in Nursing, 2010. 41(11): p. 506. 4. Banning, M., The think aloud approach as an educational tool to develop and assess clinical reasoning in undergraduate students. Nurse Education Today, 2008. 28: p. 8-14. 5. Porter-O'Grady, T., Profound change:21st century nursing. Nursing Outlook, 2001. 49(4): p. 182-186. 6. Andersson, A.K., M. Omberg, and M. Svedlund, Triage in the emergency department-a qualitative study of the factors which nurses consider when making decisions. Nursing in Critical Care, 2006. 11(3): p. 136-145. 7. O'Neill, E.S., N.M. Dluhy, and C. Chin, Modelling novice clinical reasoning for a computerized decision support system. Journal of Advanced Nursing, 2005. 49(1): p. 68-77. 8. Lee, J.E. and N. Ryan-Wenger, The Think Aloud seminar for teaching clinical reasoning: a case study of a child with pharyngitis. J Pediatr Health Care, 1997. 11(3): p. 101-10.

This project is a two phase design working in partnership with five universities to develop, implement and systematically embed a distributive leadership model that aims to embed peer partnership (review, development) within the culture of teaching and learning excellence. This presentation will posit a ‘prototype’ peer review leadership model based on ongoing research that brings together both the fundamentals of peer review with the broader importance of context and persons. It will be argued that essential to teaching development is a need to address not only the implementation of peer partnership programs but also strategies to influence and change both the contexts of teaching and the advantages for colleagues. Peer review as a strategy to develop excellence in teaching needs to be considered from a holistic perspective encompassing all elements of the teaching environment. The emphasis is on working to foster the type of conditions needed for leadership and change to begin and be sustained. The work has implications for policy, research, leadership development and student outcomes and has potential application world-wide. Phase 1 has collected focus interview and questionnaire data to inform the research and is being analysed using a thematic qualitative approach and statistical analysis. Evidence is emerging currently as the project is ongoing.