The creation of strategic alliances: the experience of the London Health Sciences Centre and southwestern Ontario.

This article describes the framework and strategies that the London Health Sciences Centre has developed to foster trusting and collaborative relationships with its regional partners in Southwestern Ontario. A four-phase approach was used to identify, implement and evaluate system-wide opportunities to improve the integration of clinical care in Southwestern Ontario. Specific case studies are illustrated that used this framework to improve both access to patient services and length of stay, while positively affecting operating resources.

An analysis of managerial skills for the current and future health care environment.

A survey questioned 503 experienced practitioners about managerial tasks and responsibilities of senior professionals in four allied health fields: physiotherapy, speech-language pathology, occupational therapy, and medical radiation science. Participants worked in a range of settings, including the private and public sectors, small and large departments/units, and community and hospital-based work sites. Factor analysis identified eight managerial areas of functioning: department running, staff relations management, legislative knowledge, career path management, implementation and change, quality assurance, management of future planning, and prioritizing work. The professional field of the practitioner influenced the importances attached to these areas, while work setting and gender of practitioner had minimal impact. Level of involvement in managerial tasks had no bearing on the importance attached to competency areas. Open-ended comments added depth to the results of the factor analysis. The findings are discussed with respect to the changing requirements being placed upon health service personnel.

Australian speech pathologists' views of what professional practices lead to successful outcomes of therapy.

The relative importance attributed to factors perceived by speech pathologists as contributing to successful levels of therapeutic outcomes were addressed in a survey of 372 practicing therapists in Australia. The survey consisted of 42 items derived from interviews with a sample of ten speech pathologists in Sydney. Therapists were asked to rate the importance of each item on a seven-point scale ranging from "not at all important" to "critically important." The findings indicate that the most important ingredients of successful therapy incorporate a mix of support and therapeutic activity outside the clinic; the clinicians' organizational skills and involvement in conducting therapy and their use of techniques; the positive therapeutic relationship between clinician and client; and, finally, the client's attitude to therapy. These findings suggest that speech pathologists, like other allied health professionals, endorse a humanistic or holistic approach to health care. The results provide insights into the practices that should be addressed and fostered in undergraduate speech pathology programs.

Impact of curricular change in an undergraduate program for speech pathologists on perceived preparedness for the workplace.

Recently, educational policymakers have emphasized the need for undergraduate programs to develop in their graduates generic skills and attributes beyond discipline-specific skills and knowledge. The generic skills and attributes should mesh with the requirements of the workplaces where the graduates will find employment. The present study examined the impact of curricular revisions to a program of study for speech pathologists on the perceptions of the graduates regarding their preparation in appropriate skill and knowledge domains. The curricular revisions sought to develop independent learning, critical thinking, research and evaluation skills, written and oral communication skills, and skills for seeking and providing support to peers. Seventy-eight graduates of the earlier program and 21 graduates of the revised program offered by the School of Communication Disorders at The University of Sydney completed a 52-item questionnaire concerning the extent to which the program had equipped them for the workplace. Eleven scales were derived from the questionnaire responses, reflecting skills endorsed by university educators and workplace supervisors of allied health professionals as being necessary for success in the workplace. The relative levels of perceived preparation on the 11 dimensions were similar across graduates of the revised program and those of the earlier program. Graduates of the revised program were significantly more positive about their preparation on five of the 11 dimensions, compared with earlier graduates of approximately equivalent age and experience. The dimensions where differences were observed generally reflected those targeted by the curricular revisions.

Health science graduates: preparation for the workplace.

The research reported in this article was undertaken to assess the perceptions of health science graduates in the fields of health information management, occupational therapy, orthoptics, physiotherapy, and speech pathology regarding their perceptions of the adequacy of undergraduate preparation in meeting the demands of a changing health care environment. An instrument was devised for use by graduates on the basis of the skills and workplace behaviours specified by experienced practitioners in the above fields as necessary in newly recruited graduates. A total of 527 health science graduates completed the 52 item instrument. The statistical analyses indicated that 11 factors define the adequacy of graduates' preparation for the workplace. Health science graduates perceived themselves to have been more thoroughly prepared on certain workplace dimensions than on others. Specifically, graduates perceived themselves to be ill-equipped on dimensions concerned with workplace management, knowledge of the health industry, and coping in the workplace. Graduates also perceived themselves to be inadequately prepared in terms of communicating with clients, health professionals, and the general public. The strengths of their courses were perceived to be in completing essential tasks, having confidence in the clinical role, in ethical practice, in pursuit and application of knowledge, and having a realistic expectation of the workplace role. The results are discussed in terms of the need to address curriculum changes.

Health personnel: perceived differences in professional relationships and work role.

This study questions the validity of the assumption that the workplace culture and experiences of health personnel are largely similar. The study compares nurses, occupational therapists, physiotherapists and speech therapists concerning their perceptions of professional issues within their own profession, and their perceptions of professional issues within the medical profession. Respondents completed a questionnaire containing 55 items referring to their own profession, and 55 items referring to the medical profession. Six scales were derived from the large survey instrument addressing issues regarding status/cohesiveness of the profession, professional relationships, and the role of the patient in health delivery in the respondent's profession, and in the medical profession. Nurses emerged as different to other health personnel on most dimensions. Few differences emerged among allied health professionals. Physiotherapists were more positive than occupational therapists about the status/cohesiveness of their profession, and regarded the contributions of the patient to health delivery as less important. Speech therapists did not differ significantly from occupational therapists on any dimension.

Australian physiotherapists' and occupational therapists' views on professional practice.

The extent to which physiotherapists and occupational therapists endorse a humanistic, holistic approach to health care was addressed in a survey of attitudes of practicing occupational therapists (N = 378) and physiotherapists (N = 558). A 22-item questionnaire including aspects of therapist's knowledge and techniques, holistic approach, client characteristics, client/therapist relationship, and approaches to professional practice was employed. The findings indicate that the professional practices reflecting the new public health model prevailed. This model emphasizes client/therapist interaction, the client's own ability to change and improve, and holistic attitudes towards health care, along with the therapist's knowledge and skills. However, comparative analyses of the two therapy groups reveal that although both groups support a humanistic approach to client care, occupational therapists promote the client's resources and coping skills to a greater extent, place more emphasis on the client in terms of the client's capacity for recovery and coping abilities, were more involved with the social, personal, and psychological problems of the client, and place less emphasis on treatment methods and techniques than physiotherapists. Demographic variables including gender, age, and workplace setting (public/private) were found to be significantly related to views of professional practice. Recommendations for the training of therapists and the implications for practitioners are made and suggestions for further research are given.

The impact of perceived medical dominance on the workplace satisfaction of Australian and British nurses.

Current literature on the sociology of health views medical dominance as a structural feature of the health division of labour, and a body of literature has developed exploring the structural components contributing to the subordination of the allied health professions. In this paper, nursing literature describing the nature and source of nurses' perceptions, complaints and dissatisfactions with their profession, and sociological analyses of the position of nurses within the structure of the health care delivery system, were employed to provide a framework for assessing the degree to which structural medical dominance of the nursing profession impinges on nurses' perceptions of dominance and how these perceptions affect nurses' workplace satisfaction. A 69-item questionnaire covering aspects of doctor-nurse, doctor-patient, nurse-patient and nurse-hospital administration relationships was developed. One-hundred and thirty-three Australian nurses and 108 British nurses completed the questionnaire, in which they ranked their own level of professional satisfaction and the level of satisfaction they perceived doctors to experience. Results indicated that Australian and British nurses were not only dissatisfied with many aspects of their work environment, such as their pay and working conditions, but also experienced dissatisfaction with their professional status while perceiving the medical profession to be highly satisfied. British nurses were significantly more dissatisfied with their own profession and perceived the medical profession to be more authoritarian than did Australian nurses. No difference between Australian and British nurses' perceptions of degree of medical autonomy was found. The implications of nurses' perceived discrepancy in workplace satisfaction between nurses and doctors in the delivery of health care are discussed in terms of the structural barriers created by medical dominance. Recommendations for the training of nurses and the implications of the findings for nurse practitioners are made, together with suggestions for further research.

Gender differences in allied health students' knowledge of disabled women and men.

Disabled women experience greater handicaps than disabled men do. A survey of 907 students in six allied health professions indicated that the majority lacked knowledge of 13 sex differences in frequency of occurrence of physical disabilities and handicaps. Female students revealed greater unawareness. Students who recognized sex differences in frequency of disabilities were more likely to correctly identify predominantly male disabilities but tended to incorrectly attribute predominantly female disabilities to men. This trend was stronger among male subjects. Beliefs regarding sex differences in handicaps suggest that disabled men are perceived as coping more effectively with disability. Results are a matter of concern given that health practitioners' knowledge and expectations influence rehabilitation outcomes.

Crafty birds and fitness fiends: relationships of professional and leisure activities.

Stereotypes of therapists were found to contain a 'kernel of truth' in a survey comparing the active and passive leisure pursuits of female physiotherapy (N = 100) and occupational therapy (N = 107) graduates and undergraduates. Physiotherapists had relatively more active leisure patterns as adolescents and undergraduates. Occupational therapists had relatively passive leisure patterns that persisted after graduation. These findings support the spillover hypothesis of a work-leisure relationship. Following graduation physiotherapists adopted more passive leisure pursuits which supports the compensation theory of leisure. However, physiotherapy graduates felt deprived of sport and experienced less leisure satisfaction than occupational therapists.