Jane Frost

Aim: Poor oral health is a common but often overlooked concern in palliative care, negatively impacting patients' quality of life. There is limited understanding of how palliative care providers (PCPs) approach oral health promotion in this context. This review synthesises evidence on the knowledge, attitudes and practices of PCPs regarding oral health care and strategies to support them in this area. Design: Integrative review. Data Sources: A systematic literature search was undertaken until January 2025 across multiple databases (MEDLINE, CINAHL, Cochrane, ProQuest, EMBASE and Scopus) and grey literature. Inclusion criteria focused on nurses, medical specialists and allied health professionals involved in palliative or end‐of‐life care, with no publication year restriction. Methods: This review followed Whittemore and Knafl's (2005) framework for integrative reviews. Study quality was assessed using appropriate tools for qualitative and quantitative studies, clinical guidelines and screening tools. A hybrid thematic synthesis approach was used for analysis. Results: Twenty‐five studies were included, mostly of moderate to high quality. Sample sizes ranged from 8 to 1339, with most participants being nurses and nursing assistants, followed by medical professionals. Findings revealed inconsistent knowledge, varied practices and limited prioritisation of oral health care. Barriers included system constraints, limited training and patient‐related challenges. Supportive strategies such as guidelines, screening tools and educational interventions were identified. Conclusion: A significant gap exists in PCP knowledge and practices regarding oral healthcare due to various barriers, with few supportive strategies documented in this field. Implications for the Profession and/or Patient Care: There is an urgent need for enhanced education, robust evidence‐based guidelines and tailored training for providers to advance and integrate oral health care in palliative care settings. Reporting Method: PRISMA Checklist. Patient or Public Contribution: No patient or public contribution.

Background: COVID-19 impacted higher education (HE) students studying health degrees with an embedded placement in a unique way. At the height of the pandemic AHPRA declared that health students completing placements were required to be vaccinated against COVID-19 and be competent at providing advice and information about the COVID-19 vaccine to the public. It is yet to be determined if there is hesitancy amongst students studying health degrees. This study aimed to determine if offering an evidence-based targeted educational intervention changes health student knowledge, attitudes, and willingness to have the vaccine. Methods: An evidence-based educational intervention was developed and delivered to students studying health. A purpose developed survey was designed to assess health students’ knowledge, and willingness to have the COVID-19 vaccine, before and after this targeted educational intervention. Results: A total of 290 students from eight health disciplines completed the intervention and pre- and post-surveys. Analyses demonstrated a statistically significant increase in participants’ willingness to receive the COVID-19 vaccine, and how confident participants felt about explaining Covid vaccines and their safety, with an increase in accuracy of knowledge about professional responsibility. Conclusion: This study shows that targeted educational intervention can positively influence HE health care students. Increasing the knowledge and confidence of our trainee health professionals is paramount to enable them to be sources of accurate information and advice in relation to Covid vaccination.

Social isolation and sedentary behaviour are common in residential aged care facilities (also known as nursing homes or long-term care). Use of new technologies such as virtual and augmented reality are currently under investigation for their potential to provide exciting and engaging activities for older people in residential aged care facilities. However, there is limited evidence on whether these technologies can promote physical activity in a small group setting for people with cognitive impairment. Using mixed methods, we examined the use of a virtual cycling experience in a sample of 10 participants with cognitive impairment living in residential aged care facilities. In a randomised crossover design, participants engaged in a 25-minute, self-paced, facilitated seated virtual cycling experience and a time-matched seated physical activity session in groups of five. All participants completed a brief pre- and post-intervention mood questionnaire. Video analysis was used for both conditions to compare levels of environmental stimulation, apathy and engagement using both the Person–Environment Apathy Rating Scale and the Engagement of a Person with Dementia Scale. A thematic analysis of semi-structured interviews following the virtual cycling experience was also performed. No differences were observed between conditions for all outcomes except for environmental stimulation, where there was a lower response in the intervention than the control condition (p = 0.032). This was primarily driven by lower scores for the virtual cycling experience than control in physical accessibility (p = 0.012). Participants reported the virtual cycling experience to be immersive and challenging and reminisced about cycling earlier in life. The activity manager observed that the virtual cycling experience was an overall positive experience and emphasised benefits of safety screening and preparation prior to the activities. The findings of this study support the use of the virtual cycling experience as an immersive and engaging alternative to usual activities, which might encourage higher levels of physical activity in residential aged care facilities.

Background: To introduce and evaluate a university vaccination training program, preparing final year Bachelor of Pharmacy (BPharm) and Master of Pharmacy (MPharm) students to administer vaccinations to children and adults in community pharmacy and offsite (mobile and outreach) settings. Methods: Final year BPharm and MPharm students were trained to administer intramuscular vaccinations to adults and children. The education program embedded in pharmacy degree curriculum was congruent with the requirements of the Australian National Immunisation Education Framework. The training used a mix of pedagogies including online learning; interactive lectures; and simulation, which included augmented reality and role play. All pharmacy students completing the program in 2019 were required to carry out pre- and post-knowledge assessments. Student skill of vaccination was assessed using an objective structured clinical assessment rubric. Students were invited to complete pre and post questionnaires on confidence. The post questionnaire incorporated student evaluation of learning experience questions. Results: In both cohorts, student vaccination knowledge increased significantly after the completion of the vaccination training program; pre-intervention and post-intervention mean knowledge score (SD) of BPharm and MPharm were (14.3 ± 2.7 vs. 22.7 ± 3.3; p < 0.001) and (15.7 ± 2.9 vs. 21.4 ± 3.2; p < 0.001) respectively. There was no difference between the BPharm and MPharm in the overall knowledge test scores, (p = 0.81; p = 0.95) pre and post scores respectively. Using the OSCA rubric, all students (n = 52) were identified as competent in the skill of injection and could administer an IM deltoid injection to a child and adult mannequin. Students agreed that the training increased their self-confidence to administer injections to both children and adults. Students found value in the use of mixed reality to enhance student understanding of the anatomy of injection sites. Conclusion: The developed vaccination training program improved both student knowledge and confidence. Pharmacy students who complete such training should be able to administer vaccinations to children and adults, improving workforce capability. Mixed reality in the education of pharmacy students can be used to improve student satisfaction and enhance learning.

The aim of this study was to explore the contemporary application, inclusive of advantages and challenges, of mixed reality (MR) technology in the education of nursing students and, its contribution to enhanced learning. A descriptive evaluation design was undertaken to explore the learning experience of second year students enrolled in a 3 year Bachelor of Nursing programme. One hundred per cent of the students stated that the experience assisted them in their learning. The key themes of engagement in learning, and developing clinical judgement emerged from students’ responses, and demonstrated ways in which students felt MR enhanced their learning. This emerging technology has the potential to assist in enhancing clinical judgement and developing skills in noticing physical cues in patients. The implementation of MR may also enhance student motivation and engagement with learning.

Assistive technology including virtual reality and augmented reality has gained interest as a novel intervention in a range of clinical settings. This technology has the potential to provide mental stimulation, a connection to autobiographical memory through reminiscence, and enhanced quality of life (QoL) to people living with dementia (PLWD) and mild cognitive impairment (MCI). In this mini-review, we examine the available evidence from studies reporting on the potential benefits of virtual and augmented reality to provide enjoyable, leisurely activities that may promote QoL and psychological well-being and facilitate social interaction. In total, 10 studies of varying study designs and durations (5 min to 6 months) using virtual (n = 9) and augmented reality (n = 1) were examined in PLWD (n = 6) and MCI (n= 3), in addition to 1 study that included participants with both conditions. Overall, the virtual experiences were enjoyed by the participants, improved their mood and apathy, and were preferred when compared with nonvirtual experiences. However, small sample sizes and variations in study design limit the generalizability of the results. Nevertheless, the use of virtual and augmented reality technology for PLWD and MCI is a novel and emerging method which may provide cognitive stimulation and improve well-being. Future research should explore the potential application of this technology to promote social interaction in both the community and aged care settings. We suggest future studies in PLWD and MCI assess the effects of more sustained use of virtual and augmented reality technology on psychological outcomes including QoL, apathy, and depressive symptoms, with the incorporation of physiological biomarker outcomes.