The role of dietetics accreditation standards in supporting practice-ready graduates - a policy analysis.

BACKGROUND: Despite clear evidence that accreditation has the potential to shape the future of graduate outcomes and health professions, little research has examined accreditation policy within dietetics and whether it achieves its aims. This study aimed to interpret the purpose and positioning of dietetic accreditation standards internationally. METHODS: This study drew on Yanow's interpretive policy analysis approach. Countries with similar dietetics education and accreditation systems were selected for inclusion in this study, including Australia, Canada, New Zealand, the United Kingdom and the United States. A purposive sample of participants involved in the accreditation process were identified and invited to participate in semistructured interviews. Accreditation standards from all countries were collected. Coding of text for purpose and meaning was undertaken. Codes were then grouped into categories and then themes, in line with the interpretive policy analysis approach that aims to seek meaning from the policy and identify conflicts. RESULTS: A total of 8 interviews and 11 accreditation standard documents were analysed from across the five countries. The analysis of data showed that the purpose of accreditation was protecting public safety by producing safe and effective dietetic graduates and supporting universities to achieve this. Focusing on input- versus outcome-based education was a key conflict. CONCLUSIONS: There is a unified purpose of accreditation internationally which may support global mobility of the dietetics workforce. Focusing more on outcome-based standards may support the development of dietetics graduates better equipped to meet future needs.

Policymakers' perspectives on designing school-based health initiatives for Victorian adolescents.

Initiatives based on the Health Promoting Schools (HPS) framework have previously been successful in improving health and well-being yet there is little evidence of how these findings translate into policy. This study therefore aimed to analyse the political considerations that underpinned policymakers' decisions for the design and implementation of a programme based on HPS in middle and high schools in Victoria, Australia. Interpretive policy analysis was undertaken using interviews with a purposive sample of government and non-government policy actors. Interviews explored factors influencing programme design and implementation and were analysed using thematic analysis. Ten in-depth interviews, including 11 participants, were conducted. The analysis revealed four themes. The Achievement Program was designed through (i) the establishment of strategic collaborations and good governance, involving people that made valuable and diverse contributions to the design process while acknowledging their (ii) positions of power, (iii) ensuring careful attention was paid to evidence-informed programme design and (iv) incorporation of real-time feedback from other settings. Policymakers believe this approach has the potential to improve policy adoption. There is a need to explore if this approach to policy development influences adherence and improves health outcomes.

Clinical educators' skills and qualities in allied health: a systematic review.

BACKGROUND: The skills and qualities of effective clinical educators are linked to improved student learning and ultimately patient care; however, within allied health these have not yet been systematically summarised in the literature. AIMS: To identify and synthesise the skills and qualities of clinical educators in allied health and their effect on student learning and patient care. METHOD: A systematic search of the literature was conducted across five electronic databases in November 2017. Study identification, data extraction and quality appraisal were performed in duplicate. Qualitative and quantitative data were extracted separately but analysed together using a thematic analysis approach whereby items used in quantitative surveys and themes from qualitative approaches were interpreted together. RESULTS: Data revealed seven educator skills and qualities: (i) intrinsic and personal attributes of clinical educators; (ii) provision of skillful feedback; (iii) teaching skills; (iv) fostering collaborative learning; (v) understanding expectations; (vi) organisation and planning; and (vii) clinical educators in their professional role. Across all themes was the concept of taking time to perform the clinical educator role. No studies used objective measurements as to how these skills and qualities affect learning or patient care. DISCUSSION AND CONCLUSION: Despite much primary evidence of clinical educator skills and qualities, this review presents the first synthesis of this evidence in allied health. There is a need to examine clinical education from new perspectives to develop deeper understanding of how clinical educator qualities and skills influence student learning and patient care.

A guide to policy analysis as a research method.

Policy analysis provides a way for understanding how and why governments enact certain policies, and their effects. Public health policy research is limited and lacks theoretical underpinnings. This article aims to describe and critique different approaches to policy analysis thus providing direction for undertaking policy analysis in the field of health promotion. Through the use of an illustrative example in nutrition it aims to illustrate the different approaches. Three broad orientations to policy analysis are outlined: (i) Traditional approaches aim to identify the 'best' solution, through undertaking objective analyses of possible solutions. (ii) Mainstream approaches focus on the interaction of policy actors in policymaking. (iii) Interpretive approaches examine the framing and representation of problems and how policies reflect the social construction of 'problems'. Policy analysis may assist understanding of how and why policies to improve nutrition are enacted (or rejected) and may inform practitioners in their advocacy. As such, policy analysis provides researchers with a powerful tool to understand the use of research evidence in policymaking and generate a heightened understanding of the values, interests and political contexts underpinning policy decisions. Such methods may enable more effective advocacy for policies that can lead to improvements in health.

The utility of an interprofessional education framework and its impacts upon perceived readiness of graduates for collaborative practice. A multimethod evaluation using the context, input, process, product (CIPP) model.

BACKGROUND: Frameworks in higher education can support strategic curriculum change in complex systems. The impact of these frameworks in achieving their stated purpose is less known. An interprofessional education (IPE) framework and related multi-activity curriculum designed to develop health profession graduates with the requisite skills for collaborative care, was introduced in a large university, across eleven health professions. OBJECTIVE: To determine the utility of an interprofessional framework and impact upon perceived work readiness for collaborative practice. METHOD: A multimethod design using the context, input, process, product (CIPP) evaluation model was selected taking a social constructivist theoretical stance. Data collection included staffing allocation to IPE, curriculum audit, and reflections from representatives of all health professions courses offered at the institution. Data was analyzed using framework analysis. PARTICIPANTS: Interviews or focus groups were undertaken with academic Faculty (n = 13), recent graduates (n = 24) and clinical supervisors/employers of recent graduates (n = 17). RESULTS: The framework assisted the systematic implementation of interprofessional curriculum across the different health courses at the university. Collaborative work-ready learning outcomes were identified in graduates where targeted curriculum had been implemented across all four domains of the framework. Gaps identified in framework implementation were consistent with gaps identified in graduate knowledge and skills related to collaborative practice. The combination of formal university-based IPE and informal workplace learning as part of clinical placements contributed to achieving the desired learning outcomes. CONCLUSIONS: These findings offer insights into the use of shared frameworks to drive specific learning activities related to collaborative practice.

A Systematic Review of the Impact of Multi-Strategy Nutrition Education Programs on Health and Nutrition of Adolescents.

OBJECTIVE: To update evidence on the impact of multi-strategy nutrition education interventions on adolescents' health and nutrition outcomes and behaviors. DESIGN: Systematic review of randomized controlled studies of multi-strategy interventions encompassing nutrition education published from 2000 to 2014 guided by the Preferred Reported Items for Systematic Reviews and Meta-analyses statement. SETTING: Secondary schools in developed countries. PARTICIPANTS: Adolescents aged 10-18 years. MAIN OUTCOME MEASURES: Anthropometric and dietary intake. ANALYSIS: Systematic search of 7,009 unduplicated articles and review of 11 studies (13 articles) meeting inclusion criteria using qualitative comparison. RESULTS: Four studies reported significant changes in anthropometric measures and 9 showed significant changes in dietary intake. Type of nutrition education varied. Components of the interventions that showed statistically significant changes in anthropometric and dietary intake included facilitation of the programs by school staff and teachers, parental involvement, and using theoretical models to guide the intervention's development. Changes in canteens, food supply, and vending machines were associated with significant changes in dietary intake. CONCLUSIONS AND IMPLICATIONS: Multi-strategy interventions can have significant impacts on nutrition of adolescents when the nutrition education is theoretically based and facilitated by school staff in conjunction with parents and families, and includes changes to the school food environment.