Radiography educator's perspective on advanced practice: A qualitative focus group study.

The organization Faculty for Undergraduate Neuroscience (FUN; www.funfaculty.org) was established in 1991 by a group of neuroscientists dedicated to innovation and excellence in undergraduate neuroscience education and research (Ramirez and Normansell, 2003 ). The founders experienced a need for a community of neuroscience educators because no formal division existed within the Society for Neuroscience (SfN; www.sfn.org) to support undergraduates or the faculty who focus on undergraduate neuroscience education. An educator's ability to incorporate current research and techniques in crowded undergraduate curricula becomes even more critical as our understanding of how nervous systems develop, function, adapt, and malfunction continues to expand. Teaching faculty must meet the significant challenges of communicating a broad and fast-paced discipline to a growing undergraduate audience. Moreover, as research experiences for undergraduates are increasingly encouraged and expected, providing undergraduates with meaningful research experiences is an additional, ongoing challenge for educators in the face of smaller budgets for research and education. To help undergraduate neuroscience faculty meet these challenges, FUN has emerged as a professional organization dedicated to the support and development of undergraduate neuroscience educators. The need for an organization that specifically supports excellence in undergraduate neuroscience has grown as an increasing number of interdisciplinary undergraduate neuroscience programs are formalized at colleges and universities. As evidence of the growing interest, FUN's membership has been increasing steadily and currently includes more than 500 individuals at more than 300 colleges and universities. FUN's members represent a broad range of scientific disciplines, including biology, psychology, chemistry, computer science, and philosophy; they work and teach at a variety of institutions, ranging from private, small liberal arts colleges to regional, state, and research universities.

There is a wealth of international evidence concerning the contribution post-registration master's level education makes to advancing the discipline of nursing. There are approximately 277 nurse practitioners registered in NZ, but they account for only a small portion of nurses who have undertaken master's level education. The additional contribution these nurses make to the work environment through advanced practice activities has not, hitherto, been documented. To report the extent of advanced practice nurse activity associated with various levels of nursing education in a sample of nurses working in clinical practice in New Zealand. A replication of recent Australian research was done via a national cross-sectional survey of 3255 registered nurses and nurse practitioners in New Zealand using an online questionnaire to collect responses to the amended Advanced Practice Delineation survey tool. In addition, demographic data were collected including position titles and levels of postgraduate education. A positive association was found between postgraduate education at any level and more time spent in advanced practice activities. Independent of level of postgraduate education, the role a nurse holds also effects the extent of involvement in advanced practice activities. There is an additional contribution made to the work environment by nurses with master's level education which occurs even when they are not employed in an advanced practice role. These findings are of significance to workforce policy and planning across the globe as countries work to sustain health services by increasing nursing capacity effectively within available resources.

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This paper reports on a survey of perceived problems in the provision of orthodontic education at the stages of undergraduate, postgraduate, and continuing professional education (CPE) in 23 European countries in 1997. A questionnaire, together with an explanatory letter, was mailed to all members of the EUROQUAL II BIOMED project. Answers were validated during a meeting of project participants and by further correspondence, when necessary. The topics covered in the questionnaire were adequacy of funding, numbers of orthodontic teachers, availability of equipment, regulations, training centres, numbers of orthodontists, availability of books, journals, and information technology. Completed questionnaires were returned by orthodontists from all 23 countries. Respondents from seven countries did not answer all questions. Respondents reported a perceived almost universal lack of adequate funding for postgraduate orthodontic training (from 18 out of 20 countries) and, to a lesser extent, at undergraduate (13 out of 20 countries) and CPE levels (17 out of 21 countries). Respondents from 12 of the 20 countries reported adequate numbers of qualified teachers at undergraduate level, but only seven out of 18 at postgraduate level and eight out of 19 for CPE. Lack of suitable equipment was reported as a more frequent problem by central and eastern European countries (six out of 20 countries at undergraduate level, eight out of 20 countries at postgraduate level, and 12 out of 19 at CPE level). Too few or too many regulations were only perceived to be a problem by the respondent from one country out of 19 at undergraduate level, by seven out of 19 at postgraduate level, and by eight out of 16 at CPE level). Lack of training centres was more frequently reported as a problem by respondents from central and eastern European countries, but was generally not perceived as a problem by respondents from west European countries. Respondents from seven countries reported a lack of training centres for CPE. Respondents from six countries reported that they perceived there to be too many orthodontists at postgraduate level, from seven countries that there were an appropriate number, and from seven that there were too few. A lack of books, journals, and information technology was reported to be a problem by respondents from four out of 19 countries at undergraduate level, eight out of 20 at postgraduate level, and 10 out of 20 at CPE level. At both undergraduate and postgraduate level, the majority of respondents from central and eastern European countries reported problems with books, journals, and information technology. The results of the survey confirmed many anecdotal impressions and provided an extremely useful background against which to formulate quality guidelines for orthodontic education in Europe.

Advanced Practice Radiation Therapist (APRT) roles are expanding globally, yet educational preparation approaches vary significantly across jurisdictions. This study synthesized key multidisciplinary interest-holder perspectives to identify essential considerations for APRT preparation. Focus group interviews were conducted via videoconferencing, including practicing APRTs, gatekeepers, educators, and institutional radiation oncology leaders. Semi-structured discussions explored educational content, clinical training, assessment methods, and implementation factors. Data underwent inductive thematic analysis utilizing Braun and Clarke's six-step approach, followed by concept mapping to organize findings into an integrated thematic structure. Four focus group sessions involving 33 participants from ten countries across North America, Europe, Asia, and Australia were conducted between October 2024 and January 2025. Five interconnected themes representing key considerations for APRT preparation emerged: (1) content of educational preparation including the four APRT pillars of clinical practice, research, leadership, and education; (2) aligning preparation outcomes with the intended scope of practice, particularly autonomous decision-making and critical thinking; (3) integrating diverse learning processes combining traditional knowledge acquisition with experiential clinical training; (4) key requirements for preparation, including master's-level education and structured clinical apprenticeship under direct supervision; and (5) critical influence of broader system context on transportability and sustainability across healthcare environments. Participants endorsed master's-level academic preparation combined with extensive clinical experience, drawing parallels to physician training where apprenticeship builds specialist competencies beyond formal academics. This internationally derived, multidisciplinary interest-holder synthesis provides foundational guidance for APRT curriculum development, competency standards, and professional credentialing. While these findings offer important direction for standardizing preparation approaches, future research involving broader multidisciplinary interest-holder groups, implementation studies, and outcomes evaluation is necessary to validate and extend these preliminary findings.

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IntroductionAlthough the notion of advanced practice (AP) has been widely accepted and implemented in some countries, for example, the United Kingdom, in Canada it is has yet to be widely tested as a model of working. Currently it has been implemented and evaluated in Ontario, but this approach is not widespread across the country. To date in British Columbia (BC), there are no advanced practitioners and no research has been conducted regarding the opinions and attitudes of radiation therapists (RTs) in BC towards the implementation of AP. Understanding RTs attitudes and perceptions towards AP may be important when considering the acceptance and implementation of new roles. The research objectives were to explore the attitudes and opinions of RTs and establish what the term AP means to BC RTs, and also to discover what they consider to be benefits, and barriers to implementing AP.Materials and methodsA quantitative approach was utilised and an on-line questionnaire was sent to 266 RTs that currently practice in BC. Likert and demographic questions were used to explore the definition of AP and ascertain opinions about the barriers and benefits of implementing AP in BC.ResultsA total of 183 questionnaires were completed for a response rate of 69%. The majority of respondents agreed with the Canadian Association of Medical Radiation Technologies (CAMRT) and the literature's definition of AP. Cost, time, lack of support and training and issues of medical dominance were cited as barriers. Job satisfaction, autonomy, and increased recruitment and retention of staff were considered benefits.ConclusionsAlthough RTs believe there are obstacles to be overcome regarding the adoption and implementation of AP, these are outweighed by the potential benefits such as enhanced patient care due to increased levels of professional knowledge and development that can lead to increased levels of job satisfaction. These are seen as important drivers for creating the AP role in BC.

Oral cancer – Current knowledge, practices and implications for training among an Irish general medical practitioner cohort

Diabetes is a global health emergency, affecting more than 420 million people worldwide, but care gaps persist. Patient engagement (PE) in research may address these gaps, but meaningful engagement with representative populations of diverse race, language, and socioeconomic status is lacking. Power imbalances and tokenistic engagement are common. Our aim in this study was to understand what diverse patient-partners (PPs) who live with diabetes need to participate in research and how to integrate and engage them meaningfully. A purposive sampling strategy was used to recruit PPs from the Diabetes Action Canada (DAC) research network. A semistructured focus group guide was used to conduct focus group sessions. Sessions were audio-recorded and transcribed verbatim. Data analysis and synthesis involved Braun and Clarke's reflexive thematic analysis to develop patterned meanings across the data set. Thirty-five PPs participated in 13 focus groups (9 English, 4 French). PPs had a mean age of 55 years, were living with type 2 (46%) or type 1 (37%) diabetes, identified as female/woman (77%), and resided in Ontario (47%) or Québec (40%); 34% identified as racialized. Themes were developed across 3 broad domains: 1) enablers; 2) opportunities for improvement (challenges and recommendations); and 3) diabetes-specific considerations, highlighting distinct challenges and enablers related to participants' lived experiences with diabetes. We used these data to codesign research-stage-specific recommendations to optimize patient integration and engagement in research. Our focus group study identified enablers and opportunities for improvement to integrate PP perspectives into the DAC research network more meaningfully.

Advanced practice is not a new concept in Irish healthcare, having been established in nursing for decades. However, there is limited clinical career progression for radiation therapists as advanced practice roles have not been formalised within radiotherapy. The same factors driving other jurisdictions worldwide to implement advanced practice roles in radiotherapy are the reasons for change in Ireland today: an ageing population, new technology, recruitment, retention, task-shifting, and optimisation of patient-centred care. A national framework in Ireland has not yet been established. To identify the key barriers and enablers of implementing advanced practice in radiotherapy in Ireland, a qualitative study was undertaken, which consisted of semi-structured interviews of 10 key senior stakeholders. The key themes identified were: training/education, professional development, governance and workplace culture. Ethics approval and participant consent were sought in advance. Participants across both public and private sectors acknowledged the potential of advanced practice in radiation therapy roles to tackle recruitment and retention issues, enhance patient care and optimise service efficiency. Key findings included the need for funded education in addition to frustration around slow implementation despite widespread clinical support. The recommendations based on the study findings are:-Creation of an Irish AP implementation steering group-Create a specific APRT guidance framework document.-Recognition of master's level education requirement for the role to be undertaken and completed in post in a candidacy style.

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By the year 2000 it is estimated that approximately two million Europeans per year will be afflicted by cancer and that the annual death rate will be of the order of one million. Despite the numerical extent of the problem, the high mortality and the very considerable morbidity associated with uncontrolled cancer, it is the general view of experts in the field that the teaching of oncology to undergraduates remains extremely unsatisfactory in many medical schools. In recent years there has been substantial progress in cancer research and in the management of cancer patients due to developments in diagnosis and treatment. It is clear that, with available knowledge and technology, screening programmes designed to detect cancers at an earlier stage and programmes of public education aimed at prevention could substantially contribute to a reduction of our present cancer problem. If the newly-qualified doctor is to be provided with the necessary knowledge and skills to participate as a nonspecialist in the prevention, early diagnosis and management of malignant disease, it is essential that attention is focused on the development of a satisfactory curriculum for undergraduate education. The problem of an integrated undergraduate oncology training programme in Europe was reviewed by a UICC Regional Conference in Oncology held in Cracow in 1972 (1) and subsequently by a UICC/WHO meeting in 1981 (2). The objective of the Education Branch of the EORTC is to identify requirements for cancer education in Europe at both the undergraduate and postgraduate level. The Education Branch, which was set up in 1986, has directed its attention initially to the problem of undergraduate oncology education and, as a basis for making recommendations, in 1987 carried out a survey by questioning 165 deans of medical schools in Europe. Of 124 responses received by July 1987, 94 were considered valid, since 30 were either double-registered from the same university or did not concern undergraduate education. The information obtained from 94 medical schools in 14 countries (UK, France, Netherlands, Italy, Germany, Spain, Denmark, Belgium, Portugal, Ireland, Switzerland, Greece, Iceland, Sweden) is summarized in Fig. 1. As shown, approximately 60% of the centres have a course in oncology and a chair in oncology. In some institutions the courses were of a very short duration whereas optional in others. Only 41% of schools reported that they had a curriculum in oncology. Less than 50% had a pre-degree training period (that is a specific allocation of time for oncology in the final clinical year). Only one-third of the schools had an examination in oncology. It is of interest to examine the schools’ preferences for the future evolution of undergraduate education in ontology. Of the universities without corresponding facilities, 86% indicated that they would like a specific course in oncology, 81 % a chair in oncology, and 70 % a curriculum in oncology. A common European curriculum would be favoured by 95 % of all universities (Fig. 2). A striking finding of the inquiry was the wide variation in educational practice between different universities in the same country (Table). Approximately only 50 % of the medical schools in the United Kingdom, Germany, Spain and Denmark, for example, had courses in oncology. There were also substantial differences between individual countries. Thus all 16 French medical schools responding to the inquiry reported a course in oncology, whereas none of the 12 Italian medical schools had such a course. However, the Italian Government has recently approved

The aim of this study was to explore perceptions and attitudes of Australian paediatric pharmacists about advanced pharmacy practice and to identify suitable methods of assessment for this level of practice. Four focus groups (with 31 participants) were held in 2012 with Australian hospital pharmacists who work with children. Written notes and audio recordings were used to produce verbatim transcriptions and extract themes. There was consensus across groups that formal recognition of advanced pharmacy practice was valuable to the profession and to individuals. Elements should include a strong grounding in clinical practice, commitment to education, research and service improvement outside the department and institution. A framework for career development should be used to describe the levels of practice leading to advanced practice. Assessment should involve multiple separate criteria, and incorporate direct observation, peer review and a professional portfolio. Postgraduate qualifications are desirable but not considered essential. Different knowledge and skills are required in paediatrics; however, the definition of advanced practice remains the same. Recognition of advanced practice is valuable for the profession and for individuals. Multiple methods of assessment should be used. Specialty areas such as paediatrics can be defined and assessed similar to other specialties, with acknowledgement of the specific paediatric knowledge and skills required.

The quality and safety of medicines use is as important in paediatrics as in adult medicine, and closely linked to the skills, knowledge, attitudes and behaviours of health professionals responsible for patient care. The aim of this research was to investigate advanced paediatric pharmacy practice; how to develop and assess advanced skills; and how these skills improve outcomes for children.Prevention of adverse medication events (AMEs) is the most researched pharmacy impact on patient outcomes. However, there is limited evidence in paediatrics. The first phase of this research investigated AMEs in children, with the hypothesis that: Voluntary reports of AMEs can be used to identify trends over time in response to safety improvement initiatives, and identify associated skills required of health practitioners.The first component of this phase reviewed six months of potential and actual AMEs identified from three databases: clinical incident reports, pharmacist intervention reports and administrative coding using the International Classification of Diseases 10th Revision (ICD-10). Analysis identified 447 individual AMEs. Little duplication between data sources was found. ICD-10 coding identified the most cases of harm, and intervention and incident reports identified the most cases of error. ICD-10 events rarely involved error and were time-consuming to retrieve, hence this method was not used in subsequent research.The next component reviewed eight years of voluntary reports of medication related events (MREs). 10,865 MREs were investigated. Two categories were reviewed in detail: chemotherapy prescribing and potassium errors. Potassium errors reduced from 6.3 to 2.2 per 10,000 occupied bed days from 2008 to 2012. Chemotherapy prescribing errors decreased from 4.2 to 1.1 per 100 oncology separations from 2005 to 2012, particularly errors in chemotherapy protocols. Education alone did not produce sustained change. System changes including forcing functions, executive endorsement and strong multidisciplinary engagement resulted in most improvement. Health practitioners required advanced skills in education, change and risk management, communication, teamwork, leadership, and research methodology.The second phase of research tested the hypothesis that: Paediatric hospital pharmacists value formal recognition of advanced pharmacy practice, can describe the characteristics of advanced practitioners and identify preferred methods of assessment of advanced practice.Four focus groups, involving 31 Australian paediatric pharmacists, concluded that advanced practice should be formally recognised, and include a foundation in clinical practice, together with education, research and service improvement outside the institution. Multiple methods of assessment were recommended; most preferred were direct observation of practice, peer review and portfolio review. Knowledge of paediatric diseases and drug handling, and skills in communication with children and families, were important.The third phase of the project reviewed two existing datasets to test two hypotheses, the first of which was: Pharmacist interventions can document progression to advanced practice.Six hundred interventions recorded by four pharmacists from one paediatric hospital were retrospectively reviewed over three separate periods from 2005 to 2012. Skills demonstrated in these interventions were rated using a pilot scale from 1 to 5, representing skills typical of intern pharmacists through to advanced practice. Skills increased over time, with more Level 3-5 interventions recorded in the later time periods, and mean skill level increasing from 1.9 to 2.6 (p<0.01).The second hypothesis in this phase was: Training and development priorities in paediatric pharmacy can be identified by direct observation of pharmacists working in clinical practice.This study retrospectively reviewed six years of paediatric pharmacist competency assessments using the General Level Framework (GLF). Fifty assessments were retrieved from ten Queensland hospitals, including specialist and general hospitals. Ethics, confidentiality, legal compliance and appropriate dosages were performed consistently well. However, assessment of patients’ understanding of illness and treatment, and assessment of adherence, were not performed well. This study demonstrated that the GLF could be used to evaluate competency and identify training needs in the paediatric setting.The final phase of the research tested the hypothesis that: Advanced level paediatric pharmacy practice is most reliably evaluated using multiple assessment methodsThirty-six pharmacists were recruited from four Australian paediatric hospitals. Six assessment methods (direct observation of practice, peer review, portfolio review, viva voce, knowledge assessments and self-assessment) were tested over 12 months. Each method was scored against the Paediatric Advanced Level Framework. Qualitative and quantitative analysis of scores, ranking, and participant and evaluator feedback found the most reliable methods were portfolio review, peer review and oral viva. Postgraduate qualifications, CPD records, and direct observation of practice using the GLF or shpaclinCAT, provided less reliable scores and were not preferred by participants or evaluators.This research project demonstrates the value of advanced practice to Australian paediatric pharmacists as a career pathway; the importance of advanced skills to safe medication use in paediatrics; and the importance of using a combination of assessment methods to evaluate advanced practice. Future work includes development of an electronic portfolio, a paediatric curriculum linked to accessible training, and formal credentialing of advanced pharmacy practitioners.

The intent of the exercise was to have a comprehensive status paper on Environmental Justice (EJ) education available on one hand and desirable on the other to be prescribed in graduate and undergraduate levels of university education in Nepal. The present evaluation reports results of a review of existing syllabi of environmental science and environmental management taught at the three major universities namely Tribhuwan University (TU), Pokhara University (PU) and Kathmandu University (KU) at Undergraduate (UG) and Postgraduate (PG) levels. A simple evaluation scheme was designed to assess the representation of topics and subtopics under the selected categories of Environmental Justice. This central information of the report is supplemented by introductory account of EJ in Nepal as an academic discipline and review account of courses provided by other universities and other considerations in design and development of EJ curriculum. Notable among the conclusions are firstly to conceive and frame the syllabi affixing EJ as an independent subject of 3 credits each or in total about 50 hours of teaching in UG and PG levels; while the UG course should be more oriented towards theoretical inputs related to scope, philosophy, definitions etc., the PG course should focus on national and international perspectives and issues along with policies and plans. A professional approach in framing PG level syllabus is suggested with a provision to take up dissertation work related to EJ. In Nepal, it is time to sustain the participatory-based judicial dispensation with an intention of effective and useful implementation of policies by stakeholders. There is an essentiality of introducing the issues related to international environmental which are not only contextual but also futuristic. The report concludes by reiterating to consider the opinion and expertise to judicial officials at the time of framing the syllabi for teaching at graduate and undergraduate levels facilitating inclusion of essential components in an adequate and appropriate measure.