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Practice placements are a substantive component of allied health student curriculum that are critical for developing allied health professional competence. Students are situated in practice settings during placement, where their learning opportunities are opportunistic, and shaped according to population, industry, and policy needs: which change over time and in relation to each other as well as external forces. Allied health practice-placements must respond and adapt to the complex and evolving landscapes of practice; and evidence about the processes and products of such innovation is critical. Realist thinking enables consideration of practice placements as open systems that occur within broader open systems – emerging dynamics of industry, workforce and policy. This helps to expose and explore the changing factors that enfold practice placements and render them workable for service providers who manage competing priorities. We contribute a realist-informed exploration of placement models developed for allied health learning during profound transition of the Australian disability sector: from government- to recipient-controlled funding. In the context of declining placement offerings and reports of practitioner fatigue and administrative load, we facilitated an action-research workforce project with university and placement providers of allied health services to develop and trial quality placement education amidst transitional policy implementation. Our investigation seeks to understand innovative placement models that ‘worked’ for placement providers and students during a time of policy and industry turbulence. We apply layered inferential techniques to synthesise qualitative data collection with 40 students, practitioners, educators and placement facilitators about the process/es of innovating student placements ( n  = 50 instances); novel placement features co-designed during the project; and the role of placement facilitation within processes of co-design. Our key findings show that a collaborative approach to practice-placement education supports reflection about novel models, and helps the needs of students and service recipients to become more visible in the relevant context/s of service provision. We further show the importance of developing reciprocity and partnerships for quality placement outcomes, without the need for resource-intensive placement facilitation approaches. This evidence is useful for promoting quality allied health education as the professions continue to expand and evolve, amidst open systems of policy and industry that influence practice and education.

Introduction Clinicians within public healthcare organisations, including allied health professionals are becoming increasingly research active. Townsville Hospital and Health Service (THHS) employed an embedded Research Fellow in 2010 to build the capacity and capability under a state-wide initiative resulting in increased activity over time. A Research Capability Framework (RCF) was introduced in 2018 with intent of having a briefer measure of activity than the previously used research ‘spider’. This study measures and explores the growth in research capacity and capability over 12 years. Methods A mixed methods triangulation design compared two ways of measuring research capacity including interviews and self-rating of the RCF objectives by Discipline Directors (DD), and a survey of allied health professionals to measure their level of research experience and knowledge of health services research methods. The interviews were themed and quantitative data was analysed descriptively. Results 12 DDs, 5 Team Leaders and 105 clinicians participated. Four major themes were identified from the interviews: clinical practice provides a rich environment for quality improvement and research activity, influence of health service managers on research culture, prioritising clinical care over research, and the effect of collaborations on research. High levels of research participation were noted, and varying levels of methods knowledge were evident. Discussion Similar results in consuming and producing research activity by both instruments suggest the shorter RCF could replace the more onerous research spider. Qualitative data collected simultaneously with the Objective ratings can be used to plan the future direction of capacity building efforts. The high levels of experience in quality improvement skills but limited knowledge of research translation methods suggest this knowledge gap may be a barrier to the translation of allied health research.

Background Engaging health services in research is important for ensuring a strong practice-relevant evidence base. To achieve this, health service staff must be equipped with the necessary research capabilities. Despite growing research engagement by Allied Health (AH) professionals within services, career frameworks that enable staff to map research capabilities are currently lacking. Pre-existing frameworks focus largely on research capabilities within the academic context, and do not adequately capture the specific capabilities required of AH research roles in health services. Equally, existing frameworks assume a career progression that moves from clinical practice, through a PhD and then onto a research academic path, and hence have limited relevance for other types of research roles that exist within health services. Hence, this study aimed to develop a research career capability framework for AH research careers within health services, using the specific setting of Queensland Health, a state-wide Australian public health service. Methods This research involved four sequential phases: 1) A rapid review to identify potential capabilities for inclusion in the framework; 2) Refinement of the rapid review findings into an initial set of capabilities and domains by a Project Reference Group (PRG); 3) An e-Delphi survey with a broad range of stakeholders to gain consensus on included capabilities; and 4) A survey of and consultation with the PRG to refine capabilities and develop final framework elements. Results Twelve articles yielding 2,125 capability statements were identified in the rapid review. These were synthesized into 73 capabilities by the PRG, which went forward to a 2-round e-Delphi with 48 participants. The resulting framework consisted of 61 capabilities under five domains: Research knowledge and skills; Research impact and translation; Clinical and healthcare research context; Research leadership and strategy; and Research capacity building and mentorship. Conclusions Using a multi-phase approach, a research capability framework which represented the diversity of AH research careers within health services was developed. The framework can be used to guide professional development of AH researchers and to support their career development processes. Although developed within a specific health context, the work has application to other locations, as well as professions outside Allied Health.

Background While allied health plays a central role in healthcare, workforce challenges are straining the sector. Challenges are shaped by population changes, emerging models of care, and educational limitations, and were exacerbated by COVID-19. This study aimed to identify drivers of recruitment and retention for allied health clinicians in an Australian metropolitan setting. Identifying and addressing these factors is essential to the design and implementation of tailored, evidence-informed workforce strategy and policy. Methods This cross-sectional, online survey explored workplace attraction, job seeking behaviours, and workplace perceptions. 29 Likert-scale statements informed by the existing literature examined factors influencing allied health retention. Allied health employees from a single Australian metropolitan health network were invited to participate. Descriptive statistics, logistic regression, and deductive content analysis were undertaken. Results 42.6% ( n  = 593) of those invited participated in the survey, with 45.7% ( n  = 271) of participants having been with the organisation for six or more years. 35% ( n  = 197) of respondents to a question about intention to leave agreed that they aimed to leave their current role within six months. Variables associated with intention to leave were not feeling a sense of satisfaction with their role (odds ratio [OR] 1.51, 95% CI 1.22–1.85), not being recognised and rewarded by the team manager (OR 1.37, 95% CI 1.12–1.67), not working in the preferred clinical area (OR 1.56; 95% CI 1.25–1.95), and feeling burned out by the job (OR 1.44; 95% CI 1.16–1.78). Qualitative findings support the centrality of aspects of the job (job characteristics), the organisational context (rewards offered; climate; organisational support) and person-context interface (peer/group relations; work-life conflict) to attraction, retention, and attrition in roles. Conclusion This study identifies factors affecting recruitment, retention, and attrition of allied health professionals in a metropolitan setting. Findings are impacted by the personal and professional effects of the COVID-19 pandemic response. Results provide a baseline upon which the impact of interventions can be measured, while informing the prioritisation and design of tailored workforce strategies. Further, findings may inform local policy responses to improve the allied health workforce and ensure excellent care for the community.

Background Health professionals working in health services are uniquely placed to carry out research to improve health service provision. Improving research capacity and culture in health organisations benefits patients, health professionals, health services and society more broadly. This cross-sectional observational study aimed to evaluate the current research capacity and culture within the Allied Health workforce in the publicly funded, non-metropolitan Northern New South Wales (NNSW) Local Health District (LHD). Additionally, the study aimed to explore whether Allied Health staff have undertaken research with Aboriginal and Torres Strait Islander Peoples, and if so, whether the research was conducted in a culturally safe and responsive way. Methods The validated Research Capacity and Culture tool was administered to the Allied Health workforce in NNSWLHD to evaluate the research capacity and culture, within and across three domains (Organisation, Team and Individual), including research involvement, perceived barriers and motivators for undertaking research, and participants’ experience in conducting research with Aboriginal and Torres Strait Islander Peoples. Quantitative data were analysed descriptively, and median responses between domains were compared. Qualitative data were obtained through two open-ended questions and thematically analysed. Results A total of 147 Allied Health professionals from 15 disciplines completed the survey. Participants reported low-to-moderate levels of skills and success across all three domains. Most participants were not currently involved in research. Motivators for undertaking research included encouragement by managers, research mentoring, and a problem identified that needs changing, whilst barriers were lack of time, other work roles take priority, lack of suitable backfill, and staff shortages. Few participants reported having ever contributed to a research project involving Aboriginal and Torres Strait Islander Peoples. Conclusions Research capacity building strategies within Allied Health in NNSWLHD should utilise a “whole of system” approach, including research career pathways, funding, backfill, mentoring, opportunities to upskill in research writing and develop skills to conduct research in a culturally safe and responsive way. Supporting Aboriginal and Torres Strait Islander clinicians to build research capacity can shape the health research agenda, inform health policies, support evidence-led clinical care, and in turn, the well-being of Aboriginal and Torres Strait Islander People.

Background Radiology is a multidisciplinary specialty, combining the medical specialism of radiologists with the clinical expertise of diagnostic radiographers. Radiographers are skilled in performing imaging procedures such as X-Rays, ultrasound and computed tomography scans to diagnose and monitor conditions within a wide range of patient pathways, and they are assisted by support workers who enable service delivery by providing patient facing and ancillary activities. Imaging service demands in the United Kingdom continue to outpace growth in the radiographer workforce, and there is an urgent need to explore the potential for developing the capability and capacity of the imaging support workforce. A multi-centre mixed methods study investigated the determinants for the utilisation of the radiography support workforce in England, presenting the findings in a maturity matrix. A maturity matrix is an actionable tool which aims to facilitate practice improvements, presented as a series of distinct, iterative steps that showcase the desired developmental path towards an effective service. Methods The mixed methods study employed an explanatory sequential, multi-stage advanced framework design, involving six consecutive workstreams. The final workstream synthesised and integrated findings from the previous workstreams to identify the key factors that contribute to best practices in imaging support workforce deployment. Documentation of critical determinants and articulation of quality indicators were modelled into a maturity matrix to be used by imaging managers to review and plan the development of their support workforce. Results The Imaging Support Workforce Maturity Matrix is constructed as a means of tackling workforce improvements and tracking progress over time at service level. Fifteen critical determinants within three themed categories (evidence-based workforce planning; deployment; development and progression) were embedded within the matrix. Each determinant is presented for self-assessment against four levels of service maturity (Emerging, Developing, Maturing, and Thriving). These support assessment and action-planning towards the goal of fully developing the role and progression route for the support workforce. Conclusion The Imaging Support Workforce Maturity Matrix is presented. The actionable tool was reviewed with service managers in a first stage of validation and further research will be undertaken to implement appropriately across other allied health professions.

Purpose Allied health student placements in healthcare settings are complex, constantly evolving, and tailored to real-life environments. The value of student placements in acute and primary healthcare settings is reflected in enhanced student learning, improved service delivery, and positive patient outcomes. This review aims to synthesise the effects of allied health student placements in primary healthcare settings, particularly focusing on older clients’ health outcomes and satisfaction with care. Materials and methods A systematic integrative review was conducted. The five-step integrative review approach, established by Whittemore and Knafl was used to allow the inclusion of diverse research methodologies. Five major databases, i.e., Medline-EBSCO, PubMed, PROQUEST, CINAHL, and SCOPUS were searched. The CLUSTER model was used to track additional references. Data were extracted as suggested by Whittemore and Knafl and then thematically synthesised. Results Eleven papers were reviewed. Despite a lack of rigorous methodologies, five mixed-methods studies, four quantitative studies, one qualitative study, and one cost–benefit analysis were identified exploring the possible effects of allied health student placements for older clients. From these papers, four main themes were identified: student integration in service delivery, older clients’ health outcomes, satisfaction with care, and insights into mechanisms to achieving health and well-being outcomes. Conclusion This review suggests that integration of allied health students into service delivery can provide additional healthcare support for older clients, but further high-quality research is needed to confirm.

Background An allied health research capacity building initiative at a regional Australian public health service has increased research activity significantly. To demonstrate the value of allied health research activity a short one-page narrative was developed to communicate the impact of allied health research. This paper evaluates the use of the narrative at this healthcare organisation. Methods A multiple case study design was used for the evaluation. Three cases written as narratives were chosen and one comparison case without a narrative. The cases were investigated via organisational document review, policies, or guidelines, and published journal articles, plus semi-structured interviews were conducted with relevant stakeholders. Analysis was conducted in four stages: case context and description, within-case analysis, cross-case analysis and interpretation and evaluation using thematic analysis. Results Document analysis revealed the rationale and evidence for the practice change, the instigator of change and enablers. Cross-case analysis identified commonalities such as an expanded scope of practice, clinician-led change, and the inclusion of salient stakeholders to ensure that translation occurred. Differences included the timing of funding and the reach of change. Conclusion The one-page narrative (named Evidence Brief) effectively describes a change in clinical practice because of allied health research or quality improvement projects. Evidence Briefs have potential to act as a research measure with each Evidence Brief acting as a unit of change so that over time, accumulated Evidence Briefs may be used to measure clinical practice change resulting from research. Future research by this team will obtain feedback from management to determine the value of Evidence Briefs as a communication tool and to evaluate the extended use of them across other disciplines and healthcare organisations. Keywords: case study, evaluation, communication, clinical practice change, research impact

Background Paramedicine is undergoing a transformative shift as practitioners seek recognition beyond traditional emergency response roles toward being fully integrated healthcare professionals. Central to this evolution is the process of professionalisation, marked by efforts to expand scope of practice, formalise education and regulation, and achieve greater systemic integration. Despite these developments, significant barriers remain. Purpose This study explores key barriers to the professionalisation of paramedics across five developed healthcare systems, highlighting shared and context-specific challenges. Methods A qualitative study underpinned by a critical theory paradigm was conducted using semi-structured interviews. Over a five-month period (Dec 2022–Apr 2023), 15 expert stakeholders from clinical, educational, policy, and leadership roles in paramedicine and pre-hospital emergency care were recruited across five countries. Interviews were conducted via Microsoft Teams, transcribed verbatim, and analysed thematically with a reflexive and interpretive approach. Results Four main themes were developed: Current Barriers to Expansion– including outdated legislation, inconsistent regulatory frameworks, limited funding, workforce shortages, and insufficient integration within healthcare systems. Elevating Professional Status– focusing on the need for protected titles, standardised education, credentialing, and a stronger professional identity. Impact of COVID-19– participants reflected on the profession’s temporary visibility during the pandemic, followed by policy and funding shifts that diluted that momentum. Future Continuing and Emerging Barriers– encompassing structural and cultural resistance, lack of leadership pathways, and challenges in sustaining innovation and collaboration. Conclusion The study highlights persistent barriers to paramedic professionalisation, including fragmented regulation, uneven educational standards, and systemic underinvestment. Although COVID-19 demonstrated the adaptability and potential of the profession, sustaining progress requires targeted policy reform, stronger regulatory frameworks, investment in education and leadership, and commitment to workforce development. Recognising paramedics as integral healthcare providers is essential to advancing the profession and improving patient care.

Background Incorporating occupational therapists (OTs) into primary care requires adapting services to patient needs and depends on how colleagues within the multidisciplinary team perceive the OT roles and collaborate in daily practice. This study explored the feasibility, impact on the care team, and challenges of incorporating an OT into the home-based care service of a Spanish primary healthcare center. Methods A two-phase sequential exploratory mixed-methods study was conducted. First, structured interviews and a stakeholder focus group were conducted over the six months following the introduction of the OT. Thematic analysis identified factors that hindered or supported integration. Second, a cross-sectional study described patients who received OT care within 12 months of service implementation. The electronic health records provided patient profiles and OT interventions. Descriptive statistics and the Kruskal–Wallis tests were used to examine the associations between the study and patient characteristics. Results Six themes emerged: introduction of the OT role, team coordination, impact on team functioning, impact on patient and caregiver, contributions of the OT, and structural limitations and challenges. OT integration improved interdisciplinary collaboration and patient-centered care; however, initial role ambiguity and a lack of referral criteria were challenges. Over 12 months, 248 patients were visited (mean age, 88.2 years; 70.9% women), with an average of 11.1 chronic conditions. Overall, 45.6% had severe or total dependency in activities of daily living, and 43.2% reported at least one fall in the past year. OT interventions focused on risk assessment (65.6%) and home adaptation (52.5%). Patients with moderate-to-severe functional dependency received more risk assessment activities (median: 2; p  = 0.005). No significant associations were found between intervention frequency and fall history or other functional domains. Conclusions Integrating an OT into a primary health care team appears feasible and valuable. Sustainable implementation may require clear patient profiles, defined professional roles, structured integration processes, robust evaluation frameworks, and service standardization-based workforce planning.