Aims and Objectives:To evaluate a rapid response student telehealth placement experience implementing interRAI assessments of community-dwelling frail older people during the COVID-19 pandemic. To identify lessons to inform future telehealth clinical placements.Background: New Zealand undertakes assessment of older people with disabilities using the interRAI contact assessment tool for less complex conditions and home care assessment tool for complex needs. New Zealand entered lockdown in March 2020 in response to COVID-19. New Zealand's most vulnerable community members required urgent needs assessment. Design: A clinical placement whereby 3rd year undergraduate nursing students trained by interRAI-NZ educators worked remotely from home delivering telehealth assessment for 'at risk' older people across the Waikato District, New Zealand. This represented the first telehealth experience within an undergraduate nursing program approved by the New Zealand Nursing Council. Methods: A case study evaluation utilising mixed method questionnaire and qualitative techniques within an interpretive paradigm. 19 third year students in the fifth semester of a Bachelor of Nursing program and 5 nursing staff members engaged in delivery of the initiative completed pre-and post-placement short answer questionnaires. Reflective diaries were maintained by students on placement. Post-placement interviews and focus group discussions provided in-depth data. COREQ guidelines informed analysis and reporting. Results: Student and tutor responses showed consistent themes: tackling COVID-19; implementation requirements; nursing competencies; provider relationships; and community insights. These provide insight and highlight lessons learnt from this initiative. Conclusions: Student confidence in therapeutic engagement and clinical assessment and interest in aged care was increased, confirming the viability and importance of this inaugural telehealth student placement initiative.
Background Student-led clinics have gained increasing attention as a mechanism for students across various health professions to gain authentic interprofessional clinical placement experience during their educational programme. Purpose This scoping review is designed to identify and describe experiences relating to student-led clinics in Aotearoa New Zealand. Methods The review involved five key steps: 1) identifying the research question; 2) identifying relevant studies; 3) study selection; 4) charting the data; and 5) collating, summarising and reporting the results. Discussion Student-led health clinics present invaluable educational opportunities for authentic collaborative practice and capacity to improve population health and well-being, especially in marginalised and disadvantaged communities. Clinic establishment and operation require consideration of a complex set of factors. Conclusion Community consultation (including with Indigenous populations) should precede establishment of clinics. There is scope for more reporting and objective evaluation to ensure best practice is being determined, developed, and achieved.
Background Student-run clinics (SRCs) offer an innovative approach to expand healthcare access and equity and increase clinical placement opportunities for students. However, research on the health benefits and/or outcomes of such clinics is currently fragmented. Methods An integrative review was conducted to capture and synthesize findings across a range of study types involving varied student disciplines, student delivered intervention types, and health conditions addressed or care areas of focus. Only published and peer reviewed studies were included. Studies needed to report outcomes in a defined study group measured over time, or report SRC data with explicit comparisons to non-SRC settings. Data were analyzed using inductive content analysis to identify major themes and natural clustering of health outcomes measured. Results Fifty-one articles were selected for review based on the eligibility criteria. Studies were predominantly from the United States, and most (n = 34, 67%) adopted a case review methodology for measuring outcomes. Health outcomes were evaluated in relation to a range of health conditions that, for the purposes of this review, were considered to naturally cluster into eight categories: diabetes, hypertension, functional health/quality of life, depression, hospital utilization, substance use, weight, health screening/vaccinations, and others. Conclusion This integrative review sought to evaluate the health outcomes accrued by patients in student-run health clinics. Taken as a whole, the literature suggests positive health outcomes resulting from student-run clinics across a range of health conditions. Greater confidence in care-related findings would be achieved from future research utilizing more robust and prospective study designs.
Student-run clinics (SRCs) offer unique opportunities for students to engage in healthcare delivery, but the student learning outcomes of such clinics have not yet been systematically examined in a comprehensive manner. The purpose of this review was to appraise and synthesize existing literature pertaining to student learning outcomes associated with participation in SRCs. A systematic review was undertaken using PubMed, CINAHL, and Web of Science databases. The quality of articles that met inclusion criteria articles was appraised using the Mixed Methods Appraisal Tool (MMAT). Study details, such as learning outcomes, were also extracted. Ninety-two studies met inclusion criteria. Most studies were conducted in North America (n = 73, 79.3%), and related to clinics involving solely medical students (n = 35, 38.0%) or multi-professional clinics (n = 34, 37.0%). Demonstrated learning outcomes of SRC participation include clinical skills, interprofessional skills, empathy/compassion for underserved patients, and leadership. SRC participation had little apparent impact on students’ future career directions. Quality appraisal via the MMAT found mixed levels of research quality amongst reviewed studies. In summary, while SRC participation appears to offer benefits for student learning, improved study design and research outside of North American contexts would further advance knowledge.
Numerous scholars have examined how governments in particular times and places have classified their populations by ethnicity, but studies that are both cross-national and longitudinal are rare. Using a unique database of census questionnaires, we examine state practices of ethnic enumeration over a 50-year period (1965-2014) in the 24 countries and areas that comprise Oceania. The region's extraordinary linguistic and cultural diversity, combined with its complex colonial history and indigenous politics, make it an ideal site for comparative analyses. We find a shift from biological conceptions of difference to a more cultural understanding of group identity, exemplified by a sharp rise in language questions and the decline of race-based inquiries. While local identity labels have largely displaced colonial categories, the imprimatur of previous regimes still lingers, particularly in Melanesia. These shifts in official constructions of ethnoracial differences reflect a gradual lessening of colonial influences on demographic practices.
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