Rural Australian health services face significant challenges such as aging populations, access and retention of services and health practitioners as well as difficulties with staff training due to geographic isolation. Educational pedagogy, through a 'flipped' or 'flipped' classroom method has become popular in nursing literature whereby discussion surrounding its effectiveness, ability to increase performance, address learning outcomes and resolve the education-clinical practice divide is currently being explored. Several reviews that look specifically at the validity and implementation of the flipped classroom pedagogy into nursing education demonstrate a need for further scientific research. Current literature examines the in-class on campus implementation of the methodology but rarely does it consider the advantages or ways of implementing such a method in a rural off campus nursing learning environment. The use of technology is not the solution unless supported by interaction to develop practical situational skills. The authors consider advantages and disadvantages and identify central problems for the effective implementation of 'flipped' in off-campus rural nursing education.

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Informal care-givers play an important role, with health-care systems relying on the billions of hours of care they provide. Care-givers experience high levels of psychological distress and isolation; however, the efficacy of what support is the best for care-givers is unclear. The primary aim of this systematic review is to determine the effect of group creative arts interventions on informal care-givers of adults. The secondary aim is to understand the impact of group type, the primary outcomes and how they are measured. Given the heterogeneous nature of the included studies, a narrative synthesis approach was taken. Database searches identified 2,587 studies, 25 of which met the full inclusion criteria. Studies included group creative arts interventions for either care-givers only (N = 8) or for care-giver/cared-for dyads (N = 17). The majority of the participants in the studies were older Caucasian females. Group creative arts interventions are beneficial for care-givers and for the person being cared for; however, benefits differ depending on whether the group is for care-givers only or for care-giver/cared-for dyads. Future research will benefit from care-givers being involved in the design of the creative arts intervention to provide input regarding group type and relevant outcome measures. Future research should consider targeting their intervention to care-givers with a low baseline score to increase the ability of the study to demonstrate a significant difference.