Roger Dunston - Academia.edu (original) (raw)

Papers by Roger Dunston

Research paper thumbnail of The Patient’s Journey in the Emergency Department from Triage to Disposition

Communicating in Hospital Emergency Departments, 2015

Two main priorities guide emergency department care. The first is to determine a patient’s diagno... more Two main priorities guide emergency department care. The first is to determine a patient’s diagnosis . The second is to determine whether that patient can be safely treated within the emergency department and discharged home, or whether they need to be admitted for further treatment and supervision in another hospital ward or health-care facility. From the moment patients arrive at the emergency department to the point of their disposition, their care becomes organised systematically into a series of activities (what we refer to as ‘activity stages’—derived from Engestrom’s 2008 work on systems), each with their own short-term clinical goals, sequentially driven to achieve these outcomes.

Research paper thumbnail of The Context of Communication in Emergency Departments

Communicating in Hospital Emergency Departments, 2015

The way we use language is always shaped by and reflects the context in which we are communicatin... more The way we use language is always shaped by and reflects the context in which we are communicating. The communicative challenges and risks in emergency departments arise directly from the unique contextual demands of the emergency department environment. In this chapter, we begin our account of the communication demands of the emergency department by describing the characteristics and context of the emergency department, and how these directly affect the nature of communication.

Research paper thumbnail of Interprofessional health education in Australia: Three research projects informing curriculum renewal and development

Applied Nursing Research, 2014

This paper reports on three interrelated Australian studies that provide a nationally coherent an... more This paper reports on three interrelated Australian studies that provide a nationally coherent and evidence-informed approach to interprofessional education (IPE). Based on findings from previous studies that IPE tends to be marginalized in mainstream health curriculum, the three studies aspired to produce a range of resources that would guide the sustainable implementation of IPE across the Australian higher education sector. Method: Nine national universities, two peak industry bodies and a non-government organization constituted the study team. Data were gathered via a mixture of stakeholder consultations, surveys and interviews and analyzed using quantitative and qualitative methods. Results & Conclusion: An important outcome was a curriculum renewal framework which has been used to explore the implications of the study's findings on Australian nursing. While the findings are pertinent to all health professions, nursing is well placed to take a leading role in establishing IPE as a central element of health professional education.

Research paper thumbnail of Resource pack for the iTOFT (individual teamwork observation and feedback tool)

Resource pack for the iTOFT (individual teamwork observation and feedback tool) 10 Work-based ass... more Resource pack for the iTOFT (individual teamwork observation and feedback tool) 10 Work-based assessment of teamwork: an interprofessional approach

Research paper thumbnail of Curriculum renewal in interprofessional education in health: establishing leadership and capacity

The Curriculum Renewal for Interprofessional Education in Health: ‘Establishing Leadership and Ca... more The Curriculum Renewal for Interprofessional Education in Health: ‘Establishing Leadership and Capacity’ (ELC) project builds from a number of Australian and global studies and reports that address a range of critical issues associated with the development of interprofessional education (IPE) and interprofessional practice (IPP) within Australia and globally2. Informing the focus and design of the project was the view that Australian IPE had reached a point where a whole of system approach to development was now possible and required. This was talked about in terms of Australian IPE development having reached a ‘tipping point’; and Australian IPE now needing a new and scaled-up change focused methodology. There was also a sense that project based initiatives, whilst important, were unable to generate the momentum and system wide buy-in that was now seen as necessary. These views are not surprising as one of the most consistent findings from studies of IPE in Australia is that it has...

Research paper thumbnail of Using a Research-Informed Interprofessional Curriculum Framework to Guide Reflection and Future Planning of Interprofessional Education in a Multi-Site Context

Journal of Research in Interprofessional Practice and Education, 2015

Background: Over the past two years health educators in Australia have benefited from funding mad... more Background: Over the past two years health educators in Australia have benefited from funding made available from national organizations such as the Office of Learning and Teaching (OLT) and Health Workforce Australia (HWA). Funded research has been conducted into educational activities across the country that aim to promote integrated and sustainable interprofessional learning.Methods and Findings: A collaboration between multiple stakeholders led to theestablishment of a consortium of nine universities and interprofessional organizations. This collaboration resulted in a series of research studies and the development of a conceptual framework to guide the planning and review of interprofessional health curricula. A case study of the development of a suite of health education programs at a regional university in Australia is used to demonstrate how the framework can be used to guide curricular reflection and to plan for the future. Shedding a light on interprofessional health educa...

Research paper thumbnail of The times are changing: workforce planning, new health-care models and the need for interprofessional education in Australia

Journal of Interprofessional Care, 2019

Following a history of the Australian health system and funding models, we outline workforce issu... more Following a history of the Australian health system and funding models, we outline workforce issues, in particular, the lack of health professionals in regional locations. The role of the Australian government health departments in workforce planning is discussed. We describe research funded by the Commonwealth government focussing on the development of interprofessional education (IPE) for collaborative practice. New models of interprofessional care have been introduced to help tackle the population needs: in the Australian Capital Territory (ACT); HealthOne in New South Wales; health-care homes nationally; and partnerships between pharmacists and general practitioners in Victoria. Changes in care delivery necessitate innovations in health education, however how IPE is embedded in Australian health professional education still varies. There is a growing sense of an IPE community complemented by an interest in IPE from peak policy and workforce bodies. There are changes underway in health professional registration and accreditation that are likely to regulate shared and common learning to enable the continuous development of a flexible, responsive and sustainable health workforce. We conclude that there are significant opportunities for further development of IPE and collaborative practice as key strategies for adding to the ability of health systems to address individual needs in conjunction with aiming for optimal and universal health coverage.

Research paper thumbnail of Communicating in The Emergency Department: Executive Summary Report for Gosford Hospital

Research paper thumbnail of Emergency Communication: Report for Prince of Wales Hospital

Research paper thumbnail of Communicating in Hospital Emergency Departments

Research paper thumbnail of Building evidence-informed practice capacity

Research paper thumbnail of Co-Production and Health System Reform - From Re-Imagining To Re-Making

Australian Journal of Public Administration, 2009

There is growing interest in the application of citizen participation within all areas of public ... more There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of postneoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required.

Research paper thumbnail of Sustaining practice innovation in child and family health: report to partners

Research paper thumbnail of Reciprocal learning in partnership practice: an exploratory study of a home visiting program for mothers with depression

Studies in Continuing Education, 2012

Research paper thumbnail of Curriculum Renewal for Interprofessional Education In Health

Five deliverable areas were specified: Deliverable 1 Focuses on developing a future orientated cu... more Five deliverable areas were specified: Deliverable 1 Focuses on developing a future orientated curriculum framework, the 'Four Dimensional Curriculum Framework' (4DF) (Lee et al. 2013). The 4DF has been used across the three studies as a way of organising, analysing and communicating about the studies-see Sections 1 and 2. In the remainder of the Introduction we provide summary details of the CRS study. For completeness we also provide a brief summary of the three studies mentioned above. Following the introduction, we present CRS recommendations-five national development and capacity building recommendations. We also propose a national forum to be held in 2014. Each of the recommendations and the national forum proposal are discussed in detail in Section 8, the final section of the report.

Research paper thumbnail of Arrangements of co-production in healthcare: Partnership modes of interprofessional practice

Research paper thumbnail of The use of self-care practices and products by women with chronic illness

Women’s Health and Complementary and Integrative Medicine, 2018

Research paper thumbnail of Delivering On The Promise of Human Rights — Where Are We And Where Do We Need To Be?

Australian Journal of Human Rights, 1997

This schism between promise and reality is one of the most well developed and consistent themes o... more This schism between promise and reality is one of the most well developed and consistent themes of human rights literature. For instance, Philip Alston, in discussing the reality as opposed to the promise of economic and social rights implementation, remarks " ... there is not a single important indicator that would show anything other than the relative neglect, and often also the absolute neglect, of economic, social and cultural rights in practice"

Research paper thumbnail of The establishment of Cancer Australia: an historical perspective

Research paper thumbnail of Repositioning interprofessional education from the margins to the centre of Australian health professional education ? what is required?

Australian health review : a publication of the Australian Hospital Association, Jan 16, 2018

This paper examines the implementation and implications of four development and research initiati... more This paper examines the implementation and implications of four development and research initiatives, collectively titled the Curriculum Renewal Studies program (CRS), occurring over a 6-year period ending in 2015 and focusing on interprofessional education (IPE) within Australian pre-registration health professional education.The CRS was developed as an action-focused and participatory program of studies. This research and development program used a mixed-methods approach. Structured survey, interviews and extensive documentary analyses were supplemented by semi-structured interviews, focus groups, large group consultations and consensus building methods. Narrative accounts of participants' experiences and an approach to the future development of Australian IPE were developed.Detailed accounts of existing Australian IPE curricula and educational activity were developed. These accounts were published and used in several settings to support curriculum and national workforce devel...

Research paper thumbnail of The Patient’s Journey in the Emergency Department from Triage to Disposition

Communicating in Hospital Emergency Departments, 2015

Two main priorities guide emergency department care. The first is to determine a patient’s diagno... more Two main priorities guide emergency department care. The first is to determine a patient’s diagnosis . The second is to determine whether that patient can be safely treated within the emergency department and discharged home, or whether they need to be admitted for further treatment and supervision in another hospital ward or health-care facility. From the moment patients arrive at the emergency department to the point of their disposition, their care becomes organised systematically into a series of activities (what we refer to as ‘activity stages’—derived from Engestrom’s 2008 work on systems), each with their own short-term clinical goals, sequentially driven to achieve these outcomes.

Research paper thumbnail of The Context of Communication in Emergency Departments

Communicating in Hospital Emergency Departments, 2015

The way we use language is always shaped by and reflects the context in which we are communicatin... more The way we use language is always shaped by and reflects the context in which we are communicating. The communicative challenges and risks in emergency departments arise directly from the unique contextual demands of the emergency department environment. In this chapter, we begin our account of the communication demands of the emergency department by describing the characteristics and context of the emergency department, and how these directly affect the nature of communication.

Research paper thumbnail of Interprofessional health education in Australia: Three research projects informing curriculum renewal and development

Applied Nursing Research, 2014

This paper reports on three interrelated Australian studies that provide a nationally coherent an... more This paper reports on three interrelated Australian studies that provide a nationally coherent and evidence-informed approach to interprofessional education (IPE). Based on findings from previous studies that IPE tends to be marginalized in mainstream health curriculum, the three studies aspired to produce a range of resources that would guide the sustainable implementation of IPE across the Australian higher education sector. Method: Nine national universities, two peak industry bodies and a non-government organization constituted the study team. Data were gathered via a mixture of stakeholder consultations, surveys and interviews and analyzed using quantitative and qualitative methods. Results & Conclusion: An important outcome was a curriculum renewal framework which has been used to explore the implications of the study's findings on Australian nursing. While the findings are pertinent to all health professions, nursing is well placed to take a leading role in establishing IPE as a central element of health professional education.

Research paper thumbnail of Resource pack for the iTOFT (individual teamwork observation and feedback tool)

Resource pack for the iTOFT (individual teamwork observation and feedback tool) 10 Work-based ass... more Resource pack for the iTOFT (individual teamwork observation and feedback tool) 10 Work-based assessment of teamwork: an interprofessional approach

Research paper thumbnail of Curriculum renewal in interprofessional education in health: establishing leadership and capacity

The Curriculum Renewal for Interprofessional Education in Health: ‘Establishing Leadership and Ca... more The Curriculum Renewal for Interprofessional Education in Health: ‘Establishing Leadership and Capacity’ (ELC) project builds from a number of Australian and global studies and reports that address a range of critical issues associated with the development of interprofessional education (IPE) and interprofessional practice (IPP) within Australia and globally2. Informing the focus and design of the project was the view that Australian IPE had reached a point where a whole of system approach to development was now possible and required. This was talked about in terms of Australian IPE development having reached a ‘tipping point’; and Australian IPE now needing a new and scaled-up change focused methodology. There was also a sense that project based initiatives, whilst important, were unable to generate the momentum and system wide buy-in that was now seen as necessary. These views are not surprising as one of the most consistent findings from studies of IPE in Australia is that it has...

Research paper thumbnail of Using a Research-Informed Interprofessional Curriculum Framework to Guide Reflection and Future Planning of Interprofessional Education in a Multi-Site Context

Journal of Research in Interprofessional Practice and Education, 2015

Background: Over the past two years health educators in Australia have benefited from funding mad... more Background: Over the past two years health educators in Australia have benefited from funding made available from national organizations such as the Office of Learning and Teaching (OLT) and Health Workforce Australia (HWA). Funded research has been conducted into educational activities across the country that aim to promote integrated and sustainable interprofessional learning.Methods and Findings: A collaboration between multiple stakeholders led to theestablishment of a consortium of nine universities and interprofessional organizations. This collaboration resulted in a series of research studies and the development of a conceptual framework to guide the planning and review of interprofessional health curricula. A case study of the development of a suite of health education programs at a regional university in Australia is used to demonstrate how the framework can be used to guide curricular reflection and to plan for the future. Shedding a light on interprofessional health educa...

Research paper thumbnail of The times are changing: workforce planning, new health-care models and the need for interprofessional education in Australia

Journal of Interprofessional Care, 2019

Following a history of the Australian health system and funding models, we outline workforce issu... more Following a history of the Australian health system and funding models, we outline workforce issues, in particular, the lack of health professionals in regional locations. The role of the Australian government health departments in workforce planning is discussed. We describe research funded by the Commonwealth government focussing on the development of interprofessional education (IPE) for collaborative practice. New models of interprofessional care have been introduced to help tackle the population needs: in the Australian Capital Territory (ACT); HealthOne in New South Wales; health-care homes nationally; and partnerships between pharmacists and general practitioners in Victoria. Changes in care delivery necessitate innovations in health education, however how IPE is embedded in Australian health professional education still varies. There is a growing sense of an IPE community complemented by an interest in IPE from peak policy and workforce bodies. There are changes underway in health professional registration and accreditation that are likely to regulate shared and common learning to enable the continuous development of a flexible, responsive and sustainable health workforce. We conclude that there are significant opportunities for further development of IPE and collaborative practice as key strategies for adding to the ability of health systems to address individual needs in conjunction with aiming for optimal and universal health coverage.

Research paper thumbnail of Communicating in The Emergency Department: Executive Summary Report for Gosford Hospital

Research paper thumbnail of Emergency Communication: Report for Prince of Wales Hospital

Research paper thumbnail of Communicating in Hospital Emergency Departments

Research paper thumbnail of Building evidence-informed practice capacity

Research paper thumbnail of Co-Production and Health System Reform - From Re-Imagining To Re-Making

Australian Journal of Public Administration, 2009

There is growing interest in the application of citizen participation within all areas of public ... more There is growing interest in the application of citizen participation within all areas of public sector service development, where it is increasingly promoted as a significant strand of postneoliberal policy concerned with re-imagining citizenship and more participatory forms of citizen/consumer engagement. The application of such a perspective within health services, via co-production, has both beneficial, but also problematic implications for the organisation of such services, for professional practice and education. Given the disappointing results in increasing consumer involvement in health services via 'choice' and 'voice' participation strategies, the question of how the more challenging approach of co-production will fare needs to be addressed. The article discusses the possibilities and challenges of system-wide co-production for health. It identifies the discourse and practice contours of co-production, differentiating co-production from other health consumer-led approaches. Finally, it identifies issues critically related to the successful implementation of co-production where additional theorisation and research are required.

Research paper thumbnail of Sustaining practice innovation in child and family health: report to partners

Research paper thumbnail of Reciprocal learning in partnership practice: an exploratory study of a home visiting program for mothers with depression

Studies in Continuing Education, 2012

Research paper thumbnail of Curriculum Renewal for Interprofessional Education In Health

Five deliverable areas were specified: Deliverable 1 Focuses on developing a future orientated cu... more Five deliverable areas were specified: Deliverable 1 Focuses on developing a future orientated curriculum framework, the 'Four Dimensional Curriculum Framework' (4DF) (Lee et al. 2013). The 4DF has been used across the three studies as a way of organising, analysing and communicating about the studies-see Sections 1 and 2. In the remainder of the Introduction we provide summary details of the CRS study. For completeness we also provide a brief summary of the three studies mentioned above. Following the introduction, we present CRS recommendations-five national development and capacity building recommendations. We also propose a national forum to be held in 2014. Each of the recommendations and the national forum proposal are discussed in detail in Section 8, the final section of the report.

Research paper thumbnail of Arrangements of co-production in healthcare: Partnership modes of interprofessional practice

Research paper thumbnail of The use of self-care practices and products by women with chronic illness

Women’s Health and Complementary and Integrative Medicine, 2018

Research paper thumbnail of Delivering On The Promise of Human Rights — Where Are We And Where Do We Need To Be?

Australian Journal of Human Rights, 1997

This schism between promise and reality is one of the most well developed and consistent themes o... more This schism between promise and reality is one of the most well developed and consistent themes of human rights literature. For instance, Philip Alston, in discussing the reality as opposed to the promise of economic and social rights implementation, remarks " ... there is not a single important indicator that would show anything other than the relative neglect, and often also the absolute neglect, of economic, social and cultural rights in practice"

Research paper thumbnail of The establishment of Cancer Australia: an historical perspective

Research paper thumbnail of Repositioning interprofessional education from the margins to the centre of Australian health professional education ? what is required?

Australian health review : a publication of the Australian Hospital Association, Jan 16, 2018

This paper examines the implementation and implications of four development and research initiati... more This paper examines the implementation and implications of four development and research initiatives, collectively titled the Curriculum Renewal Studies program (CRS), occurring over a 6-year period ending in 2015 and focusing on interprofessional education (IPE) within Australian pre-registration health professional education.The CRS was developed as an action-focused and participatory program of studies. This research and development program used a mixed-methods approach. Structured survey, interviews and extensive documentary analyses were supplemented by semi-structured interviews, focus groups, large group consultations and consensus building methods. Narrative accounts of participants' experiences and an approach to the future development of Australian IPE were developed.Detailed accounts of existing Australian IPE curricula and educational activity were developed. These accounts were published and used in several settings to support curriculum and national workforce devel...