Challenges and strategies for navigating Australian healthcare access: experience from Chinese international students.

BACKGROUND: Australia hosts over 680,000 international students, contributing $47.8 billion to the Australian economy in 2023, and Chinese students rank first among all nationalities. However, despite their considerable numbers, research focusing on their access to healthcare services is scant. This study aimed to explore barriers and supports regarding the utilisation of healthcare services among Chinese international students studying in Australia. METHODS: Semi-structured interviews were conducted in Chinese between October and December 2023 with 25 Chinese international students (age range, 19-30; female/male, n = 18/7; undergraduate/postgraduate/doctoral, n = 1/18/6) enrolled in three Australian universities to understand the healthcare challenges they encountered and the coping strategies they recommended. These interviews were recorded, and thematic analysis was applied to the interview data. An adapted social-ecological model was used to identify barriers and pragmatic strategies to deal with the challenges at different levels. RESULTS: Chinese international students in Australia faced healthcare barriers at different levels. Individual barriers included language and cultural disparities, lack of knowledge about the healthcare system, and reluctance to seek help. Institutional barriers involved high costs, difficulties regarding appointments, and procedures related to the referral system. Policy barriers included insurance coverage and reimbursement issues. The students interviewed for this study proposed individual-level strategies, such as trying various methods to reduce language barriers, seeking information online, and using online resources and consultations. A central appointment platform and multilingual medical service were recommended from students to medical institutions, while medical service guidance and psychological support were suggested to education institutions. Higher-level strategies were also reported, which were mainly pertaining to insurance terms and coverage for overseas students and improving the accessibility of medical information. CONCLUSIONS: Our study identifies barriers to healthcare access for Chinese international students in Australia, including culture-specific challenges. To mitigate these issues, we recommend self-directed health promotion, targeted support by education institutions, enhanced cross-cultural communication and expanded telemedicine by hospitals, and attention to insurance coverage. Future research should explore optimising these approaches to improve support systems and policy frameworks.

Specialty preferences of studying-abroad medical students from low- and middle-income countries.

BACKGROUND: This study explored the specialty preferences of China-educated international medical students (IMSs), who are mainly from low- and middle-income countries (LMICs) and constitute a potential medical workforce both for their home countries and foreign countries, and the influence of migration intentions on their specialty preferences. METHODS: A cross-sectional, questionnaire-based survey was conducted at 5 universities in China. The questionnaire link was distributed electronically among the IMSs at the 5 universities via emails. The questionnaire enquired IMSs' demographic information, migration intentions and their specialty preferences. The Chi-square test was applied to determine the influence of the respondent's gender, intention to practise in the home country and intention to practise in a high-income country on their specialty choices. The Chi-square test was also applied to determine the influence of the respondent's gender, year of study and country of origin on their preferences for generalist-orientated or non-generalist orientated specialties. RESULTS: Altogether, 452 IMSs returned their responses, yielding a response rate of 64.1%. Approximately half of the IMSs planned to not return to their home country. The most selected specialty was general surgery and the least selected specialty was physical medicine and rehabilitation. No significant differences were evident in most specialty preferences between those who intended to return home and those who intended to stay abroad. Among the IMSs having intentions of returning to their home country, male students tended to choose a generalist-orientated specialty, while female students tended to choose a non-generalist-orientated specialty. CONCLUSION: China-educated IMSs could play important roles in the primary care services as well as other shortage specialties both for their home countries or foreign countries. Therefore, it is recommended that governments in these countries plan migration and recruitment policies that cater for these studying-abroad medical students from LMICs, especially in this challenging time during the COVID-19 pandemic.

Teachers' and students' verbal behaviours during cooperative and small-group learning.

BACKGROUND: Teachers play a critical role in promoting interactions between students and engaging them in the learning process. This study builds on a study by Hertz-Lazarowitz and Shachar (1990) who found that during cooperative learning teachers' verbal behaviours were more helpful to and encouraging of their students' efforts while during whole-class instruction, their verbal behaviours tended to be more authoritarian, rigid, and impersonal. AIM: This study seeks to determine if teachers who implement cooperative learning engage in more facilitative learning interactions with their students than teachers who implement group work only. The study also seeks to determine if students in the cooperative groups model their teachers' behaviours and engage in more positive helping interactions with each other than their peers in the group work groups. SAMPLES: The study involved 26 teachers and 303 students in Grades 8 to 10 from 4 large high schools in Brisbane, Australia. METHODS: All teachers agreed to establish cooperative, small-group activities in their classrooms for a unit of work (4 to 6 weeks) once a term for 3 school terms. The teachers were audiotaped twice during these lessons and samples of the students' language, as they worked in their groups, were also collected at the same time. RESULTS: The results show that teachers who implement cooperative learning in their classrooms engage in more mediated-learning interactions and make fewer disciplinary comments than teachers who implement group work only. Furthermore, the students model many of these interactions in their groups. CONCLUSIONS: The study shows that when teachers implement cooperative learning, their verbal behaviour is affected by the organizational structure of the classroom.