ResearchOnline@ND (University of Notre Dame)
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Working on scorched earth: Contemporary risks of higher education leadership critique through autoethnography
No full textOrganisational autoethnographers in higher education weave compelling stories to connect their personal experiences to phenomena, often to illuminate or challenge extant norms in the culture and leadership of universities. While much has been written about the strengths and limitations of this method, there are emerging risks that may be poorly understood. While some autoethnographies in higher education have already led to unfavourable professional consequences, the growing prevalence of non-disparagement clauses in higher education employment contracts and separation agreements, and the surge in civil defamation action in society more broadly, may pose significant risks for researchers in this space. This research article blends autoethnography with consideration of these emerging risks, and while there is a focus on implications for Australian academics, these risks are not unique to this context, holding international relevance. Scholars may need to liaise with university policy makers and legal professionals to develop a best practice model for autoethnography that can enable researchers to be open about their experiences without fear of reprisal. Where overarching codes, models or policies exist that have nationwide buy in, universities may need to be brought to account to engage more sincerely and comprehensively with them
A pilot multicentre randomised clinical trial to determine the effect of a pharmacist-partnered opioid tapering intervention before total hip or knee arthroplasty
No full textBackground: Opioid analgesic use before total hip or knee arthroplasty has been associated with worse postoperative outcomes. This pilot study aimed to examine the feasibility of a telehealth-based pharmacist-partnered opioid tapering intervention before elective primary hip or knee arthroplasty and its potential effectiveness compared with usual care.
Methods: This study was conducted at seven hospitals in New South Wales, Australia. Eligible patients were those aged ≥ 18 years, scheduled to undergo primary hip or knee arthroplasty for osteoarthritis and taking opioid analgesics pre-operatively. The intervention group participated in an opioid tapering telehealth service, a partnership between a pharmacist and general practitioner, for 3 months pre-operatively up to the day of surgery, while the control group received usual care. The primary outcomes of the study were to investigate the feasibility of the intervention (i.e. adherence to treatment) and potential effectiveness in decreasing baseline daily opioid dose by \u3e 50% before surgery.
Results: Between December 2021 and June 2023, 70 patients were recruited and assigned randomly to the intervention group (n = 35) or control group (n = 35). Baseline characteristics were similar between groups. Thirty patients in each group completed their allocated treatment. All patients allocated to the intervention group completed at least one appointment with a pharmacist, with the median (IQR [range]) being 2 (1–4 [1–6]) appointments. The number of patients who successfully decreased their baseline daily opioid dose by ≥ 50% before surgery was 27/30 in the intervention group compared with 5/30 in the usual care group (p \u3c 0.001).
Conclusions: The findings of this pilot study support the feasibility of a telehealth-delivered, pharmacist-partnered opioid tapering service for patients scheduled for primary hip or knee arthroplasty. A broader multicentre study to examine the effectiveness of this intervention on clinical outcomes is warranted
Artificial intelligence based assessment of minimally invasive surgical skills using standardised objective metrics – A narrative review
No full textIntroduction: Many studies display significant heterogeneity in the reliability of artificial intelligence (AI) assessment of minimally invasive surgical (MIS) skills. Our objective is to investigate whether AI systems utilising standardised objective metrics (SOMs) as the basis of skill assessment can provide a clearer understanding of the current state of such technology.
Methods: We systematically searched Medline, Embase, Scopus, CENTRAL and Web of Science from March 2023 to September 2023. Results were compiled as a narrative review.
Results: Twenty-four citations were analysed. Overall accuracy of AI systems in predicting overall SOM score of a procedure ranged from 63 % to 100 %. The most frequently used SOM by AI algorithms were Objective Structured Assessment of Technical Skills (OSATS) (8/24) and Global Evaluative Assessment of Robotic Skills (GEARS) (8/ 24).
Conclusions: Stratifying for AI studies which employed SOMs to assess surgical skill did not reduce heterogeneity of reported reliability. Our study identifies key issues within the current literature, which, once addressed, could allow more meaningful comparisons between studies
Logic modelling as hermeneutic praxis: Bringing knowledge systems into view during comprehensive primary health care planning for homelessness in Australia
No full textLogic modelling is used widely in health promotion planning for complex health and social problems. It is often undertaken collaboratively with stakeholders across sectors that hold and enact different institutional approaches. We use hermeneutic philosophy to explore how knowledge is ‘lived’ by – and unfolds differently for – crosssectoral stakeholders during comprehensive primary healthcare service planning. An Organisational Action Research partnership was established with a non-government organisation designing comprehensive primary health care for individuals experiencing homelessness in Adelaide, Australia. Grey literature, stakeholder input, academic feedback, a targeted literature review and evidence synthesis were integrated in iterative cycles to inform and refine the logic model. Diverse knowledge systems are active when cross-sectoral stakeholders collaborate on logic models for comprehensive primary health care planning. Considering logic modelling as a hermeneutic praxis helps to foreground and explore these differences. In our case, divergent ideas emerged in how health/wellbeing and trust were conceptualised; language had different meanings across sectors; and the outcomes and data sought were nuanced for various collaborators. We explicate these methodological insights and also contribute our evidence-informed, collaboratively-derived model for design of a comprehensive primary health care service with populations experiencing homelessness. We outline the value of considering cross-sectoral logic modelling as hermeneutic praxis. Engaging with points of difference in cross-sectoral knowledge systems can strengthen logic modelling processes, partnerships and potential outcomes for complex and comprehensive primary health care servic
Understanding \u27predatory\u27 journals and implications for guiding student and client information seeking
No full textWhile library professionals working in academic contexts are likely to have knowledge of ‘predatory’ journals and related implications for guiding student information seeking, school and public library professionals may be less familiar with this phenomenon. This article draws on a broad body of research to explore the factors that enable predatory journals to thrive, some of which arise from inequities in current ‘legitimate’ academic publishing practices. While this article highlights the complexities involved when guiding students and clients to make robust information seeking choices in relation to predatory journals, some key implications for professional practice emerge from the research
Refresh of a clinical skills assessment for physician trainees
No full textPurpose: The Royal Australasian College of Physicians (RACP) oversees physician training across Australia and Aotearoa New Zealand. Success in a written examination and clinical skills assessment (known as the clinical examination) at the mid-point of training is a requirement to progress from basic to advanced training. The clinical examination had evolved over many years without a review process. This paper describes the approach taken, the changes made and the evaluation undertaken as part of a formal review.
Methods: A working party that included education experts and examiners experienced in the assessment of clinical skills was established. The purpose of the clinical examination and competencies being assessed were clarified and were linked to learning objectives. Significant changes to the marking and scoring approaches resulted in a more holistic approach to the assessment of candidate performance with greater transparency of standards. Evaluation over a 2-year period was undertaken before the adoption of the new approach in 2019.
Results: In 2017 testing of a new marking rubric occurred during the annual examination cycle which confirmed feasibility and acceptability. The following year an extensive trial utilising the new marking rubric and a new scoring approach took place involving 1142 examiners, 880 candidates and 5280 scoresheets which led to some minor modifications to the scoring system. The final marking and scoring approaches resulted in unchanged pass rates and improved inter-rater reliability. Feedback from examiners confirmed that the new marking and scoring approaches were easier to use and enabled better feedback on performance for candidates.
Conclusion: The refresh of the RACP clinical examination has resulted in an assessment that has clarity of purpose, is linked to learning objectives, has greater transparency of expected standards, has improved inter-rater reliability, is well accepted by examiners and enables feedback on examination performance to candidates
Exploring intersections of climate justice and tourism through Indigenous perspectives
Get PDFBobbie will share insights and stories from her postdoctoral research journey over the last year that has focused on the intersection of Indigenous communities, tourism and climate justice. Since 2023, Bobbie served as the lead author and researcher for a report released in July 2024 entitled, Climate Justice and Tourism: An Introductory Guide. This project brought together an international research team and canvassed voices of tourism stakeholders impacted by climate crises from diverse areas of the globe. Key insights from this report, including a focus on fairness and equity in both emissions and adaptation within tourism contexts, will be shared. The second part of Bobbie\u27s talk will address the more critical lens that Bobbie has brought to understandings of climate justice by focusing on the impacts of transition metal mining on Indigenous communities and tourism. Based on fieldwork, workshops and visits across Bolivia, Chile, and Panama, Bobbie shares insights about how the drive to extract \u27transition\u27 minerals that are key for decarbonizing technologies is actually putting at risk Indigenous relationships to Country, culture and plans for community tourism