Background: This study aimed to assess and compare health literacy levels in a range of university-based health students. Methods: A survey containing the Health Literacy Questionnaire (HLQ) was administered to students enrolled in university-based medical, allied health or nursing degree programs. The HLQ scores and scale scores were compared across student groups. Results: In total, 374 students (24% response rate) with a median age of 25 years (range: 17–61 years), returned completed surveys. Three students who did not identify their degree programs were excluded from the final analysis which included 371 respondents; 242 graduate-entry medical students (65%), 67 allied health students (18%) and 62 nursing students (17%). Overall, the medical students had the highest score for seven of the nine HLQ scales; while the nursing students had the lowest score for all of the nine HLQ scales. Conclusion: These results show that health literacy profiles are different across student groups. In order to provide excellent patient-centred care, and to successfully look after their own health, a high level of health literacy is required by future health professionals. Health literacy training modules, tailored according to the different needs of the student groups, should therefore be included in university-based health professional degree programs.

Medical students at the University of Wollongong experience continuity of patient care and clinical supervision during an innovative year-long integrated (community and hospital) clinical clerkship. In this model of clinical education, students are based in a general practice ‘teaching microsystem’ and participate in patient care as part of this community of practice (CoP). This study evaluates patients’ perceptions of the clerkship initiative, and their perspectives on this approach to training ‘much-needed’ doctors in their community.

To build research capacity among graduating medical students, the teaching of research and critical analysis was integrated into the University of Wollongong (UoW) new, graduate-entry medical curriculum. This study examined whether the self-perceived research experiences of medical students, and consequent research capability, were influenced by exposure to this innovative research and critical analysis curriculum, which incorporated a 12-month community-based research project, and associated assessment tasks.

In keeping with its mission to produce doctors for rural and regional Australia, the University of Wollongong, Graduate School of Medicine has established an innovative model of clinical education. This includes a 12-month integrated community-based clerkship in a regional or rural setting, offering senior students longitudinal participation in a 'community of practice' with access to continuity of patient care experiences, continuity of supervision and curriculum, and individualised personal and professional development. This required developing new teaching sites, based on attracting preceptors and providing them with educational and physical infrastructure. A major challenge was severe health workforce shortages.

Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI) to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities. The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable. The prevalence of overweight or obesity was 79.2% (males) and 65.8% (females); increased with age to 74 years; and was higher in rural (74%) versus urban areas (71.4%) (p<0.001). Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001), obesity (p<0.0001) and overweight or obesity (p<0.0001) in women and obesity (p<0.0001) in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024) and overweight or obesity (p = 0.4896) in males. It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.

Particularly when undertaken on a large scale, implementing innovation in higher education poses many challenges. Sustaining the innovation requires early adoption of a coherent implementation strategy. Using an example from clinical education, this article describes a process used to implement a large-scale innovation with the intent of achieving sustainability. Desire to improve the effectiveness of undergraduate medical education has led to growing support for a longitudinal integrated clerkship (LIC) model. This involves a move away from the traditional clerkship of ‘block rotations’ with frequent changes in disciplines, to a focus upon clerkships with longer duration and opportunity for students to build sustained relationships with supervisors, mentors, colleagues and patients. A growing number of medical schools have adopted the LIC model for a small percentage of their students. At a time when increasing medical school numbers and class sizes are leading to competition for clinical supervisors it is however a daunting challenge to provide a longitudinal clerkship for an entire medical school class. This challenge is presented to illustrate the strategy used to implement sustainable large scale innovation. A strategy to implement and build a sustainable longitudinal integrated community-based clerkship experience for all students was derived from a framework arising from Roberto and Levesque’s research in business. The framework’s four core processes: chartering, learning, mobilising and realigning, provided guidance in preparing and rolling out the ‘whole of class’ innovation. Roberto and Levesque’s framework proved useful for identifying the foundations of the implementation strategy, with special emphasis on the relationship building required to implement such an ambitious initiative. Although this was innovation in a new School it required change within the school, wider university and health community. Challenges encountered included some resistance to moving away from traditional hospital-centred education, initial student concern, resource limitations, workforce shortage and potential burnout of the innovators. Large-scale innovations in medical education may productively draw upon research from other disciplines for guidance on how to lay the foundations for successfully achieving sustainability.