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:Quality improvement partnerships between higher education and healthcare organizations are emerging as a valuable way to engage pre-licensure nursing students in this content. There are no agreed guidelines to assist with the establishment of these partnerships. AIM:To convene key stakeholders with the objective of reaching consensus on the following question: What needs to happen to establish quality improvement education partnerships between higher education and healthcare organizations? METHODS:A nominal group technique was used, adhering to the STROBE guidelines. Participants generated ideas to answer the question individually before sharing and discussing them within the group. Participants then independently voted and ranked the ideas in order of priority to reach consensus. RESULTS:Thirty-nine ideas were generated during the nominal group technique meeting by the five participants. A consensus was reached on ten priority areas required to establish quality improvement education partnerships. CONCLUSION:These priority areas can be used as a starting point for the establishment of quality improvement education partnerships for pre-licensure nursing students. The results can be used internationally to guide pre-licensure nursing and health professions academics towards the inclusion of quality improvement education partnerships in curricula to develop quality improvement knowledge and skills of students which they can apply on entering the workforce.

BackgroundQuality improvement partnerships between healthcare organisations and higher education require further research to explore their potential to provide a valuable education experience for pre-registration nursing students.AimsDevelop and validate a questionnaire for nurse academics to evaluate quality improvement content in pre-registration nursing curricula and the extent of partnership with higher education providers in developing this content. Conduct a pilot test of the questionnaire.Study designUse a content validity approach.MethodsThe Australian higher education sector was the setting and participants were nurse academics with knowledge of the quality improvement content taught in pre-registration nursing courses. The quality improvement collaboration (QuIC) questionnaire was informed by the literature and sent to ten quality improvement and higher education experts for content validation. Each question was scored on a Likert scale for relevance and clarity. The QuIC questionnaire was distributed by email to the 37 higher education organisations offering pre-registration programmes in Australia. Descriptive statistics were used to analyse the questionnaire data.ResultsEight experts completed the content validity questionnaire in full, with the QuIC questionnaire achieving an excellent content validity score of 0.94 for relevance and clarity. The QuIC questionnaire was completed by 24 participants. The results indicated that quality improvement education partnerships are only used occasionally in Australia. The education methods used to teach this content were case studies (online cases n = 11, 46%; patient cases n = 9, 38%) and the development of quality improvement education materials (n = 7, 29%).ConclusionsThe QuIC questionnaire demonstrates excellent relevance and clarity, and is the first in the literature to address the constructs of quality improvement education and partnerships. The pilot results provide insight into quality improvement education methods used in Australia and the presence of partnerships. These results may be used to assist in the implementation of quality improvement education partnerships into curricula across the health professions.

Background Quality improvement education partnerships occur when higher education and healthcare organisations collaborate to teach quality improvement. These partnerships have been used to increase pre-registration student engagement through experiential learning. However, there is limited evidence on the perspectives of higher education nursing academics and healthcare organisation participants in these quality improvement education partnerships. Aim To explore the experiences of quality improvement education and the use of partnerships to teach pre-registration nursing students, from the perspectives of higher education nursing academics and healthcare organisation staff. Design Qualitative interviews using reflexive thematic analysis. Setting and participants Higher education nursing academics and quality improvement healthcare organisation staff in Australia. Methods Semi-structured interviews were transcribed and transferred into NVivo software for coding. Reflexive thematic analysis was applied to determine main themes. Results Fourteen interviews were conducted and there were two thematic threads identified. The first described the current state of pre-registration quality improvement education in Australia and included three themes: 1) not valuing quality improvement, 2) the nebulous nature of quality improvement, and 3) quality improvement is for others. The second thread envisioned the future of quality improvement education through partnerships and included three themes: 1) creating quality improvement cultural change, 2) preparing a quality improvement ready workforce, and 3) increasing student engagement in quality improvement. Conclusion Quality improvement education partnerships are an innovative way to engage nursing students with this content. By drawing on these partnerships as a learning tool for new nurses, there is potential to change the culture of quality improvement across higher education and healthcare organisations settings. The results in this study could be used by other health professions educators internationally to establish future quality improvement education partnerships.

Aims and Objectives To describe what higher education and healthcare organisation partnerships can be identified in the published literature to teach pre-registration health professions students quality improvement and the impact of these partnerships. Background Quality improvement has been gaining traction in the Western world and has been incorporated in varying degrees into the curricula for pre-registration health professions students. Providing quality improvement education in partnership with healthcare organisations has been found to be a valuable experiential learning solution, but the impacts of higher education and healthcare organisation partnerships have not been explored. Design and Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was undertaken using the Ovid MEDLINE, Emcare, CINAHL, Scopus and Eric databases. Studies were subject to quality appraisal using the Critical Appraisal Skills Program validated tools and a thematic analysis and narrative synthesis was undertaken. Results Eight studies were included in this review. Features of existing quality improvement partnerships included experiential learning, time pressures and barriers to successful quality improvement partnerships. The impacts of quality improvement partnerships were demonstrated by an increase in quality improvement knowledge and understanding, students leading change and the implementation of quality improvement projects. Conclusion Several key elements were identified that may act as barriers or enablers to successful implementation of quality improvement partnerships. This review advances understandings of the need for a shift in focus that pays attention to the culture of teaching quality improvement in education partnerships and how this can be achieved in a mutually beneficial way. Relevance to Clinical Practice The development of quality improvement partnerships has been found to increase student knowledge and understanding, potentially improving patient outcomes, systems performance and professional development. More research is required on the establishment of quality improvement partnerships and the benefit these collaborations have on students, staff and patients.

eLearning may be part of the solution to manage the ongoing training needs of nurses in Australian hospitals. A focus on addressing a knowledge gap in the recognition of and response to the deteriorating patient provided an opportunity to develop an eLearning program. Human factors education was incorporated as an innovative key feature in the eLearning program. A self-study methodological approach was applied to simultaneously research the development process and to integrate an evaluation of the resulting eLearning program. Critical friends were consulted during the planning and development of the eLearning program to ensure that the final program was engaging while also being successful in supporting learning. The resulting eLearning program was evaluated with a cohort of nurses who participated in pre and post test questionnaires and focus group discussions. Nurses reported that the inclusion of a realistic, interactive case study game as a learning device was valuable and resulted in self reflection about experiences in managing deteriorating patients. These findings suggest that eLearning programs can be successful in increasing nurses' confidence in managing the deteriorating patient, reading the track and trigger charts, applying human factors education, and may result in improved in patient outcomes.