Background: Across the Western world, demographic changes have led to healthcare policy trends in the direction of role flexibility, challenging established role boundaries and professional hierarchies. Population ageing is known to be associated with a rise in prevalence of chronic illnesses which, coupled with a reducing workforce, now places much greater demands on healthcare provision. Role flexibility within the health professions has been identified as one of the key innovative practice developments which may mitigate the effects of these demographic changes and help to ensure a sustainable health provision into the future. However, it is clear that policy drives to encourage and enable greater role flexibility among the health professions may also lead to professional resistance and inter‐professional role boundary disputes. In the foot and ankle arena, this has been evident in areas such as podiatric surgery, podiatrist prescribing and extended practice in diabetes care, but it is far from unique to podiatry.Methods: A systematic review of the literature identifying examples of disputed role boundaries in health professions was undertaken, utilising the STARLITE framework and adopting a focus on the specific characteristics and outcomes of boundary disputes. Synthesis of the data was undertaken via template analysis, employing a thematic organisation and structure.Results: The review highlights the range of role boundary disputes across the health professions, and a commonality of events preceding each dispute. It was notable that relatively few disputes were resolved through recourse to legal or regulatory mandates.Conclusions: Whilst there are a number of different strategies underpinning boundary disputes, some common characteristics can be identified and related to existing theory. Importantly, horizontal substitution invokes more overt role boundary disputes than other forms, with less resolution, and with clear implications for professions working within the foot and ankle arena.

The interprofessional education (IPE) literature abounds with examples of IPE and their evaluations, invariably demonstrating improved outcomes for collaborative care. The aim of this research was to identify models of IPE in health curricula reported in the literature to clarify key characteristics of the models. Searches were conducted in Pubmed (Ebsco), CINAHL (Ebsco), Cochrane Library, PsychINFO (Ebsco), Scopus, Web of Science, and Google Scholar databases for articles describing models of IPE. A total of 25 papers met the inclusion criteria. Models fell broadly into: (a) extra-curricular activities or partially integrated models (28%), and (b) integrated models, that is, models where IP activities were embedded across the whole curriculum (72%). A total of 40% of included papers presented phased models designed to incrementally develop interprofessional capability. However, major barriers exist to fully integrated interprofessional curricula: they require a major curriculum restructure, and a willingness on the part of health professionals to reconsider their professional identities. A curriculum that focuses on the patient and on ways to deliver the most appropriate personalized care is proposed. In such a curriculum, the focus can shift from profession-based care to expertise-based care that is likely to be delivered by a team of skilled health professionals.

Introduction: A greater understanding of Australian healthcare professionals' perceptions of artificial intelligence (AI) is needed to identify the challenges ahead as this new technology finds its way into healthcare delivery.Objective: The aim of this study was to identify healthcare professionals' perceptions of AI, their understanding of this technology, their education needs and barriers they perceived to its implementation.Design: Healthcare professionals in eight local health districts in New South Wales Australia were surveyed using the Shinners Artificial Intelligence Perception (SHAIP) tool.Findings: The study surveyed 176 participants from regional (59.5%), rural (36.4%) and metropolitan (4.0%) healthcare districts in Australia. Only 27% of all participants stated they are currently using AI in the delivery of care. The study found that Age, Discipline, Use of AI and Desire for Education had a significant effect on perceptions of AI, and that overall healthcare professionals believe AI will impact their role and they do not feel prepared for its use. The study showed that understanding of AI is varied and workforce knowledge is seen as the greatest barrier to implementation. More than 75% of healthcare professionals desire education about AI, its application and ethical implications to the delivery of care.Conclusion: The development of education is needed urgently to prepare healthcare professionals for the implementation of AI.

Increasingly, health workforces are undergoing high-level ‘re-engineering’ to help them better meet the needs of the population, workforce and service delivery. Queensland Health implemented a large scale 5-year workforce redesign program across more than 13 health-care disciplines. This study synthesized the findings from this program to identify and codify mechanisms associated with successful workforce redesign to help inform other large workforce projects.

Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand clinical reasoning in osteopathy from the perspective of osteopathic clinical educators and the extent to which it was similar or different from clinical reasoning in other health professions. This study was informed by constructivist grounded theory. Participants were clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. According to participants, clinical reasoning in osteopathy is different from clinical reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic reasoning models that are based on the relationship between structure and function in the human body. Clinical reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. The use of diagnostic reasoning models that are based on the relationship between structure and function in the human body differentiated clinical reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that clinical reasoning in osteopathy is distinct from clinical reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary decision-making and potentially enhance the quality of patient care. Where commonalities exist in the clinical reasoning processes of osteopathy and other health professions, shared learning opportunities may be available, including the exchange of scaffolded clinical reasoning exercises and assessment practices among health disciplines.