Twelve tips for introducing E-Portfolios in health professions education.

Portfolios have been used in health professions for many decades as a means of documenting reflective practice that inform change, supports the understanding of professionals' development needs and changing care options for clients. Electronic versions of one's portfolio of evidence or E-Portfolios became more prevalent in the early 2000s as a repository to store evidence and reflections. However, in recent years E-Portfolios have evolved from a repository to an articulation of authentic learning and development. Introduction of a range of E-Portfolio technology options, hosting systems and increasing professional/ethical standards, has resulted in challenges and opportunities for academics and professionals to meet increasing requirements for teaching and support of students training for health professions. This paper explores twelve tips explained and justified in a Health Science context, designed to support students developing and using E-Portfolios to fulfil professional standards, show evidence of reflective practice and culminate in securing a job in their field.

Effects of a virtual group cycling experience on people living with dementia: A mixed method pilot study.

Social isolation and sedentary behaviour are common in residential aged care facilities (also known as nursing homes or long-term care). Use of new technologies such as virtual and augmented reality are currently under investigation for their potential to provide exciting and engaging activities for older people in residential aged care facilities. However, there is limited evidence on whether these technologies can promote physical activity in a small group setting for people with cognitive impairment. Using mixed methods, we examined the use of a virtual cycling experience in a sample of 10 participants with cognitive impairment living in residential aged care facilities. In a randomised crossover design, participants engaged in a 25-minute, self-paced, facilitated seated virtual cycling experience and a time-matched seated physical activity session in groups of five. All participants completed a brief pre- and post-intervention mood questionnaire. Video analysis was used for both conditions to compare levels of environmental stimulation, apathy and engagement using both the Person-Environment Apathy Rating Scale and the Engagement of a Person with Dementia Scale. A thematic analysis of semi-structured interviews following the virtual cycling experience was also performed. No differences were observed between conditions for all outcomes except for environmental stimulation, where there was a lower response in the intervention than the control condition (p = 0.032). This was primarily driven by lower scores for the virtual cycling experience than control in physical accessibility (p = 0.012). Participants reported the virtual cycling experience to be immersive and challenging and reminisced about cycling earlier in life. The activity manager observed that the virtual cycling experience was an overall positive experience and emphasised benefits of safety screening and preparation prior to the activities. The findings of this study support the use of the virtual cycling experience as an immersive and engaging alternative to usual activities, which might encourage higher levels of physical activity in residential aged care facilities.

Exploring the relationship between resilience and practice education placement success in occupational therapy students.

INTRODUCTION: Practice education is a fundamental component of health professional students' education and many personal, social and professional factors impact on students' performance. This study investigated the relationship between measures of resilience and practice education performance in occupational therapy students. METHODS: A quantitative cross-sectional study was used to collect the data. In all, 149 occupational therapy students completed a self-report questionnaire comprised of demographic questions and two standardised scales: Resilience at University (RAU) and Resilience Scale for Adults (RSA). Students' practice education performance was measured by the Student Practice Evaluation Form-Revised (SPEF-R). Multi-linear regression analyses with bootstrapping were completed to identify resilience factors that were predictive of occupational therapy students' practice performance. RESULTS: Overall, occupational therapy students reported high levels of resilience based on the RAU and RSA subscale scores. "Managing Stress," "Find Your Calling" and "Living Authentically" were strong predictors of a range of key fieldwork performance SPEF-R factors, including "Professional Behaviours," "Self-management Skills," "Co-worker Communication" and "Communication Skills." CONCLUSION: The resilience factors identified as being significant predictors of practice education performance outcomes in occupational therapy students represent notable findings. They suggest that students' capabilities in managing their stress levels, finding meaning in their chosen profession, and engaging self-care daily activities outside of the work environment that are meaningful, authentic and fit with one's personal values and beliefs can act as buffers against the challenges experienced by students who are completing practice education placements. The findings will assist academic and practice educators in identifying and targeting vulnerable students and strengthening resilience strategies through proactive pre-practice placement initiatives. Qualitative studies are recommended to further explore the relationship between resilience and practice education performance in occupational therapy students.

Factors determining eligibility and access to subacute rehabilitation for elderly people with dementia and hip fracture.

With hip fracture and dementia increasing in incidence in the global ageing population, there is a need for the development of specific procedures targeting optimal treatment outcomes for these patients. This paper looks primarily at the factors that limit access to subacute rehabilitation services as a growing body of evidence suggests that access to timely inpatient rehabilitation increases functional outcomes for patients both with dementia and without. Information was gathered by searching electronic data bases (SCOPUS, Medline, CINAHL, Health Source Nursing/Academic Addition, Psychinfo and the Cochrane Library) for relevant articles using the search terms dementia OR Alzheimer* AND hip fracture AND subacute rehabilitation OR convalescence for the period 2005-2015. Abstracts were scanned to identify articles discussing eligibility and access. A total of nine papers were identified that directly addressed this topic. Other papers discussing success or failure of rehabilitation and improved models of care were also reviewed. Barriers to access discussed in the literature include information management, management of comorbidities, attitudes, resource availability, and the quality of evidence and education. By identifying these factors we can identify strategic points of intervention across the trajectory of prevention, treatment and rehabilitation that may improve outcomes for this growing group of vulnerable patients. Emerging best practice for these patients is also discussed.

Views from health professionals on accessing rehabilitation for people with dementia following a hip fracture.

The literature reports that rehabilitation for elderly patients with mild-to-moderate dementia who have a hip fracture improves functional outcomes. However, access to rehabilitation may be difficult due to misconceptions about the ability of these patients to engage in and benefit from rehabilitation. Additionally, people who are admitted from residential care may not have the same options for rehabilitation as those admitted from home. This study sought to understand from expert clinicians how and why decisions are made to accept a person with dementia post-fracture for rehabilitation. In this Australian-based qualitative study, 12 health professionals across a state and territory were interviewed. These clinicians were the primary decision makers in accepting or rejecting elderly patients with dementia post-fracture into rehabilitation. Three key themes emerged from the data: criteria for accessing rehabilitation, what works well and challenges to rehabilitation. The participants were unanimous in the view that access to rehabilitation should be based on the ability of the patient to engage in a rehabilitation programme and not assessed solely on cognition. In terms of clinical care, a coherent rehabilitation pathway with integration of geriatric and ortho-geriatric services was reported as ideal. Challenges remain, importantly, the perception of some health care staff that people with dementia have limited capability to benefit from rehabilitation. Rehabilitation for this growing group of patients requires multiple resources, including skilled practitioners, integrated clinical systems and staff education regarding the capabilities of people with dementia. Future research in this area with patients with moderate-to-severe dementia in residential care is warranted.

Social capital, health, and elderly driver status.

Driving a car enables many people to engage in meaningful activities that, in turn, help develop and maintain personal social capital. Social capital, a combination of community participation and social cohesion, is important in maintaining well-being. This paper argues that social capital can provide a framework for investigating the general role of transportation and driving a car specifically to access activities that contribute to connectedness and well-being among older people. This paper proposes theoretically plausible and empirically testable hypotheses about the relationship between driver status, social capital, and well-being. A longitudinal study may provide a new way of understanding, and thus of addressing, the well-being challenges that occur when older people experience restrictions to, or loss of, their driver's license.