Magazine Issue

STRIDE: March 2021

The Australian Podiatry Association reserves the right to edit material for space and clarity and to withhold material from publication. Individual views expressed in this publication are not necessarily those of the Association and inclusion of product or service information does not imply Association endorsement unless specifically stated. STRIDE for podiatry is the official monthly publication of the Australian Podiatry Association Limited. STRIDE for podiatry is copyright and no part may be reproduced without written permission from the Australian Podiatry Association. ©2019 AUSTRALIAN PODIATRY ASSOCIATION, 89 Nicholson St, East Brunswick, VIC 3159, P (03) 9416 3111 W podiatry.org.au The Australian Podiatry Association would like to acknowledge the traditional custodians of the land. To pay respects to the past, present and future traditional Custodians and Elders of this nation and the continuation of cultural, spiritual and educational practices of aboriginal and Torres Strait islander peoples. We acknowledge the contribution of First Nations people to knowledge on health and appreciate the role feet play in connection to land and mobility between meeting places.

In this issue

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From the CEO & President

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Nello Marino, CEO

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Katrina Richards, President

Note from the editor

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Nello Marino, CEO

APodA advocacy update

COVID has shifted the landscape somewhat dramatically for aged care, prompting the Federal Government to reflect on the provision of allied health care services. Despite these good intentions, the latest round of funding has been disappointing for the podiatry profession.

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It’s always beneficial to reflect on who our members are, and how the APodA’s membership attrition and retention patterns are unfolding.

Here’s where our latest stats are at.

 

#1 Growth and retention of members

We all know that 2020 was an unpredictable year with the significant disruption to health services and the economy caused by COVID impacting businesses and individuals financially.

 

It was decided in March 2020 that the APodA would reduce the membership fee across all categories by 25% and provide the option to defer membership and insurance payments until October 2020 for members who required financial relief.

 

The combination of reduced fees and the increase in member communications and support at this time of crisis proved to be a successful strategy, with not only a solid retention of members (at 92%) for the year but also a growth in membership of 21%. This compares to the growth rate of the profession of 4.6% as reported by the Podiatry Board of Australia in the Annual Report 2019/2020.

 

#2 Supporting our new professionals

At the start of the membership renewal campaign in May 2020 we had 284 graduate members, of which 245 renewed as first-year professionals and nine professionals joined for the first time, making a total of 254 first-year professionals.

This represents 89% of graduates who upgraded their membership to the new professional category.

You may also be aware that 2020 was the first year of our second-tier reduced membership pricing structure for new professionals in their second year. Prior to the renewal campaign, we had 178 new professionals, of which 163 renewed to new professionals in their second year.

This represents 92% of new professional members who upgraded to the second year category.

 

#3 How our members work

 

  • 66% of members are full time
  • 15% of members are part time
  • 10% of members are new professional 1st year
  • 7% of members are new professional 2nd year
  • 2% of members are affiliate.

 

#4 Location, location

Here’s a big picture view of our members’ locations…

81% of our members live and work in metro locations while 19% of our members are classified as living and working in rural or remote regions.

 

StateMetroRural
ACT100%0%
NSW79%21%
NT100%0%
QLD82%18%
SA86%14%
TAS100%0%
VIC85%15%
WA80%20%

 

#5 Through the ages

Our membership is diverse when it comes to the age groups represented.

 

#6 Taking initiative

The most popular and positive initiatives in 2020 reported in the members survey were as follows.

 

  1. COVID relief – reduced membership fees
  2. The virtual conference
  3. COVID resources
Membership Update

By Natalie Policki

National Memberships Manager

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Communications Update

The member survey has spoken!

By Natalie Policki

National Memberships Manager

By Jo Nevin

National Marketing Manager

Looking deeper into our member survey; here is a summary of what we have learned overall, what we are doing well in, what can be improved, and where we are headed.

Most important reasons to join?

To recommend or not? 

  • 81% of respondents said they are likely to recommend APodA professional development events to a colleague.

 

Advocacy up close

 

  • Nearly 70% of respondents rated the APodA’s communication of advocacy activities to the membership as ‘excellent’ (69.4%).
  • The same percentage of respondents are not a registered NDIS provider (70%).

 

  • The top three most important areas of advocacy, as identified by members are:
    • Increased allied health visits under the Medicare Benefits Schedule MBS
    • Advocating podiatry services to health care professionals and;
    • Private health funds.

 

  • The top three areas that the Association should issue position statements on, as identified by members are:
    • Increased allied health visits under the (MBS)
    • The podiatrist’s role in vascular assessments for chronic disease and;
    • Prescription and fitting of orthoses.

 

The most challenging issue you face as a podiatrist?

 

 

What matters most to you

 

  • The most important initiatives for 2021 are identified as:
    • Structured specialist interest groups
    • Graduate support programs.

 

  • The top three rated new services and initiatives from 2020 were:
    • The Foot Health Week campaign
    • The counselling service and;
    • Access to telehealth services.

 

  • The top three topics respondents would like to see in the CPD program are:
    • Clinical proficiencies
    • Dermatology and;
    • Exercise prescription.

 

  • When it comes to communication, email was identified as the most preferred method of APodA communication (98%) while Facebook was identified as the most used social media platform (64%).

 

COVID in focus

 

  • 72% of members supported the COVID relief package and took up the offer to access this package.

 

Online CPD or face to face?

When asked, ‘What are the major factors that would discourage you from attending an APodA event?’ 59% of respondents said location/distance. This was reflected in the creation of a new digital and online event program that launched last year, including our virtual symposium and conference.

 

Why attend APodA Events?

When asked ‘Why do you attend an APodA event?’

 

For the CPD opportunities (82%)To learn new skills and gain knowledge (81%)To gain insights on the latest research (67%)

 

  • 82% of respondents said they attend to gain CPD hours
  • 81% of respondents said they attend to learn new skills and gain knowledge in their field
  • 67% of respondents said they attend to gain insight into the latest research.

 

When asked ‘What topics/content would you most like to see from the APodA CPD program?’

 

  • 59% of respondents said ‘clinical proficiencies (i.e. general, physical, diagnostic examinations and treatments)
  • 53% said dermatology
  • 47% said orthotics/ orthoses
  • 42% said diabetes / high risk foot
  • 41% of responders placed equal emphasis on radiology and chronic disease complications.

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Conferences & Events Update

Conference corner: up for discussion

Phil_McShane
By Phil McShane
Business Development Manager
Join our three ambassadors in this video, as they reflect on the role of collaboration and innovation in podiatry.
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Here Dr Angela Evans AM, Prof Hylton Menz and Prof Joshua Burns discuss issues such as:

  • Non-communicable diseases globally relating to foot health
  • Developmental focus in children
  • Collection of data from patients including biometrics
  • Urban changes including scalability and how to deliver care on a broader scale through urban areas, as well as regional and remote areas
  • Opportunities for extending scope of practice, including through collaboration
  • New technologies to assist patient management and compliance including wearable sensors/tracking apps.

 

We hope to see you at the digital conference which runs between 3 to 17 July this year. Our ambassadors will continue to share their expertise by shining a light on the conference’s key take-outs at the end of each day.

 

See you there!

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When we think of Continuing Professional Development (CPD) it can be easy to think of webinars, research papers, conferences and symposiums. While this is just the tip of any CPD offering, understanding your own learning style can make a massive difference to your next CPD experience.

Depending on your mindset, CPD is either a tick box exercise that you automatically do without much thought (hopefully not!) or it represents an opportunity to expand your knowledge — not only in podiatry but also in areas that cover ‘soft skills’, such as communication skills or cultural awareness.

 

This is why your next CPD undertaking should factor in your personal learning style. Learning for the sake of learning is all well and good, but learning in a way that works for you can make all the difference.

 

So…which type of learner are you?

 

There is a raft of useful online quizzes designed to get to the heart of your learning profile, but as a brief overview, here are four main styles of learning.

 

N.B. It is worth noting that there are seven profile types all together once you factor in the lesser-known ‘logical’, ‘social’ and ’solitary’ styles of learning. For now, chances are, you will naturally gravitate towards one or two styles below. 

 

  1. Visual

Do you like to sketch out diagrams or flow charts? Then you may well be a visual learner. Visual learners tend to retain information when it is presented as a mental image, compelling presentations, drawings, or in a tangible handout. Research also shows that visual learners are likely to be fast talkers and have a tendency to interrupt!

 

  1. Auditory

The ear is a powerful tool for the auditory learner! Do you like to listen to people, as in really listen, and learn from them as they speak? Auditory learners learn by listening, whether this is through live discussions, podcasts or mentoring. Auditory learners are often tuned into the nuances behind any communication exchange such as the tone, pace and volume of a person’s speech.

 

  1. Read-write

Probably one of the more ‘traditional’ methods of learning, read-write learners prefer information to be displayed in writing  – whether this appears on a projector screen, in a textbook, research paper or on a website. Chances are, if you are this type of learner you found the traditional approach to classroom learning very suited to your style! Still unsure? Do you like to take endless notes? Then you may well be a read-write learner!

 

  1. Kinaesthetic

Last but by no means least, kinaesthetic learners learn through the power of movement. If you are a kinaesthetic learner you may have struggled to initially find your style of learning since this approach was not factored into more ’mainstream’ learning styles until relatively recently.

Perhaps you learn best when catching a ball or turning a study sequence into a physical pattern, or simply through the act of ‘doing’ such as clinical experience or hands-on workshops? If so, you may well be a kinaesthetic learner.

 

More information?

There is a tonne of interactive quizzes available alongside other useful resources. Here are just some to explore.

CPD Insights

By Annette Harris

National CPD Manager

Sport

Podiatry, sport and exercise: where to from here?

By John Osborne | Section Editor

Certified Sports Podiatrist

John is a podiatrist in private practice in Melbourne, PhD candidate at La Trobe University and recently completed the Certified Sports Podiatrist pathway. If he could have an ideal day it would start with a nice coffee, include some reading and finish with a game of golf.

Certified sports podiatrist John Osborne explains why he thinks even more podiatrists need to become leaders in the management of lower leg conditions within the sporting world.

“Podiatry is in a fantastic position to establish ourselves as the leaders of foot and ankle pathology, especially in the world of sport and exercise.”

If you read people’s biographies, nearly every podiatrist mentions a love of sport, exercise or musculosketal medicine; something that is often reflected in education choices when it comes to Continuing Professional Development.

 

We are in this together

Our passion for sport should drive us to truly be the leaders and experts for the management of lower leg conditions. If we are all delivering consistent quality, that will drive the quality of podiatry care and our recognition as the experts for lower limb pathology.

 

The potential we share

We have a huge number of injuries that we can have influence on and we can use this passion and belief to deliver the best quality of outcomes for our patients. In fact, according to the National Collegiate Athletic Association injury surveillance system for 2000–20011, amongst collegiate soccer, field hockey, basketball, and lacrosse athletes the most common injury sites were the ankle, knee, and lower leg.

 

The most common injury types were muscle strains, ligament sprains, and contusions.  We know that there is a very clear need for our skills as leaders in this context and we now need to make sure this message is abundantly clear further afield.

 

Science comes first

However, if we are going to be experts, we need to be able to step up to that plate and engage with the science that has provided us with the opportunities that exist.

 

A short while ago, I was talking to a clinician about what makes a good specialist.

 

We reasoned that experts:

  • Possess the ability to synthesise the science …
  • Then apply it simply and without bias to our patient …
  • While simultaneously putting the patient’s global needs at the forefront of the decision-making process, and;
  • Incorporating our experience and understanding as part of this process.

 

Plans for 2021

As section editor for the Sports section in STRIDE there are lots of areas that I want to share with you over the coming year. I want to push for us to be experts and leaders when it comes to foot and ankle pathology.

 

We have made significant gains, and many would say that we have already achieved this outcome, yet I believe that there is more to be done.

 

 

"If you read people’s biographies nearly every podiatrist mentions a love of sport, exercise or musculosketal medicine; something that is often reflected in education choices when it comes to Continuing Professional Development."

Here’s what I want to achieve over the next year with you via STRIDE.

Inspire you
I want to deliver content that will provide all readers insight into sports and exercise podiatry practice and hopefully elevate everyone’s knowledge to make us all better podiatrists. I too, am always learning and I see any positive learning experience as a reciprocal undertaking.
Integrate the science
I want to see us, as podiatrists, better integrate the science into our practice. This starts with better understanding the pros and cons of any diagnostic pathway or choice of treatment. By translating the science in this way we can collectively ensure we are even practitioners; creating a path for us to truly be the leaders of foot and ankle pathology.
Be challenged
There can be progress in discomfort when it comes to challenging our own approach to how we diagnose and treat our patients so let’s embrace this over the year ahead.
Showcase the talents in podiatry
We have a diverse range of expertise and capabilities in our profession from the academic experts in biomechanical phenomena, foot orthoses, foot and ankle pathology to clinicians that have applied these resources practically and had incredible outcomes and experiences. I want to expose these talents in a variety of ways while attempting to help you synthesise the information.
Explore more
Together we can achieve a deeper understanding of the foot and ankle anatomy, pathology and management and I want to take the time to explore areas that we may otherwise not find the time to reflect on. It is my intention for this space in STRIDE to be a place for such exploration.

 

"I want to see us, as podiatrists, better integrate the science into our practice. This starts with better understanding the pros and cons of any diagnostic pathway or choice of treatment."

STRIDE magazine is the podiatry publication for podiatrists. With that in mind, if there is anything you want to see discussed, please contact me at john@theagilefoot.com.au or you can ‘social media’ me @theagilefoot. If you don’t ask for it, I can’t provide it.

 


 

Footnote

1. National Collegiate Athletic Association. Injury surveillance system. Washington: NCAA, 2002.

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The many facets of functional ability

The role podiatrists can have in enabling a person’s wellbeing is significant, taking a holistic perspective to explore the multiple factors which influence functional ability.

 

In doing so, we can influence the broader conversation around healthy ageing and directly delay a person’s need for ‘Aged Care’.

 

As podiatrists, we spend our time caring for people of all ages yet the majority of our time is probably spent with older people. This gives us the opportunity to be leaders in healthy ageing and assist people to develop and maintain their functional ability in their older age; directly enabling their wellbeing. 

 

In working towards this goal it is important to consider the many facets of ‘functional ability’, as identified by the World Health Organisation and shared later in this article.

 

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How podiatrists can shine: screening for peripheral artery disease

Podiatric screening for peripheral artery disease (PAD) provides a non-invasive clinical assessment opportunity to flag the likelihood of vessel disease, a disease that is likely to exist in more than one vascular bed.

 

People at risk are putting their feet in podiatrists’ hands. However, screening for PAD is often conducted only on people with symptoms or visual signs.

 

This needs to change.

Australasian Council of Podiatry Deans

Fascinating pharmacology: why it matters

By Caroline Robinson

Associate Professor

Associate Professor Caroline Robinson is the Associate Head of School of Community Health (SCH) and Discipline Lead Podiatry at Charles Sturt University (CSU). She moved to Australia from the United Kingdom in 2005, where she completed her fellowship in Podiatric Surgery and Masters in Pharmacology. Caroline teaches across the podiatry program and has a particular interest in healthy ageing, the Indigenous curriculum, and pharmacology. She leads curriculum development in the SCH and is working to enable pathways into podiatry, particularly for Aboriginal students. Her research work in partnership with Aboriginal and non-Indigenous colleagues focuses on developing Indigenous cultural capabilities for allied health students and staff.

While Endorsement for Scheduled Medicines (ESM) may be achieved through one of two pathways1, any podiatrist or podiatric surgeon who wants to demonstrate the required prescribing competencies to ensure safe practice2 must have a sound understanding of pharmacology. So, why do so few practitioners take up this challenge (and opportunity)?

Associate Professor Caroline Robinson, a member of the Australasian Council of Podiatry Deans (ACPD), explores this issue.

“The question remains: how can we inspire current practitioners to consider the value of studying pharmacology?”

Pharmacology has a reputation for being a challenging area of study and I suggest that this is true for both undergraduate students and podiatry practitioners. In fact, the December 2020 podiatry registrant data makes for interesting reading, with only 152 (2.7%) of the 5691 registered practitioners holding endorsement for scheduled medicines.

 

Why is this the case? A range of reasons might explain this, yet it is interesting to consider this issue from the perspective of ‘barriers to changing professional practice’.

 

These barriers have been categorised as:

 

  • The organisational context
  • The awareness, knowledge and attitudes of the professional, and;
  • The patient as a service user and consumer.

 

It is also possible that a practitioner’s perceived knowledge of pharmacology, and their attitude towards this field of biomedical science, may be a large enough barrier to deter further study.

 

The benefits to be gained

Yet there are multiple benefits to be gained from such study. In my teaching practice, I see first-hand the impact of studying pharmacology and applying theory to podiatry practice. A student with the capability to critically evaluate a client’s history in order to propose a drug prescription demonstrates a high level of clinical reasoning; the inverse similarly holds true.

 

By developing a deeper knowledge of pharmacodynamics and pharmacokinetics3, it extends a practitioner’s understanding of their client’s medical status and overall wellbeing. This is one reason why institutions are working to embed ESM within the podiatry curriculum, so we should see the number of endorsed prescribers increase over the next decade.

 

The need for change

For now though, the question remains: how can we inspire current practitioners to consider the value of studying pharmacology?

 

Not only is this study a means to gain endorsement but also – and perhaps more importantly – application of this knowledge enriches podiatry practice.

 

Pharmacology really is fascinating and can provide a fresh perspective on the least complex of clients. In fact, pharmacology knowledge is intrinsic to the first three prescribing competency areas:

 

  • Assessment: Understands the patient and their clinical needs
  • Treatment options: Understands the treatment options and how they support the patient’s clinical needs
  • Shared decision-making: Works in partnership with the person to develop and implement a treatment plan.

 

Over to you

With only 2.7% of currently registered podiatrists holding endorsement for scheduled medicines, the opportunity for professional development is there to pursue; despite the perceived barriers in place.

 

Perhaps you may be interested in studying pharmacology to deepen your understanding of your clients’ clinical needs, and enable richer conversations to inform shared decision-making?

 

Increasing the number of endorsed podiatrists is important to build capacity and raise our professional profile, and we can all play a role in this if we choose to.

 

More information?

"In my teaching practice, I see first-hand the impact of studying pharmacology and applying theory to podiatry practice."

 


Footnotes

1 There are two pathways for endorsement for scheduled medicines:
- Pathway A – approved qualification pathway.
- Pathway B – supervised practice pathway for registered practitioners.
2 The NPS MedicineWise Prescribing Competencies Framework describes the competencies that health professionals require to prescribe medicines judiciously, appropriately, safely and effectively in the Australian healthcare system.
3 Difference between Pharmacokinetics and Pharmacodynamics (pharmaeducation.net)

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An introduction to APERF

By Dr. Shan Bergin

Chair, APERF

Dr Shan Bergin completed her Podiatry degree in 1991 at La Trobe University. From there, she worked almost exclusively in the area of the high-risk foot across acute, sub-acute and community health settings. In 2009, she was awarded a PhD in Health Services Research from Monash University and her thesis was on: 'Community-based models of care for management of diabetes-related foot complications: current and future models of care'. To this day, Dr Bergin is still very active in the research sector, and her current interests include the influence of psychosocial elements on outcomes for chronic disease; including diabetes-related foot disease. Dr Bergin also has a strong background in clinical education and quality and risk management and she is currently working as a lecturer in the discipline of Podiatry at La Trobe University, and part-time in the disability sector as a risk management investigator.
The Australian Podiatry Education and Research Foundation (APERF) is delighted to become a monthly contributor to STRIDE. As members of the APodA community, you may already be familiar with the role of APERF, however, we thought we would use our first column to provide some background information you may not be aware of.

 

Over the coming months, we look forward to highlighting research-related issues that are relevant to the podiatry workforce, as well as keeping you up to date on the progress and impact of APERF funded research. However, for this first issue, we want to set some context around APERF.

 

What is APERF?

APERF was established in 1991 and exists to advance research into the causes, prevention, and treatment of foot problems. APERF is a charitable trust that is currently overseen by seven trustees, who are all experienced podiatrists and/or researchers.

 

What are some outcomes?

Australia has produced some of the world’s leaders in podiatric research, and APERF funding has been instrumental in nurturing the early careers of a number of these internationally acclaimed podiatrists. APERF has a vital role in supporting podiatry research that informs education, improves clinical care, and extends podiatry’s scope of practice, with the end result being research outcomes that have the greatest benefit to patients and the profession.

 

How is APERF funded?

APERF’s ongoing capacity to fund podiatric research relies heavily on the continued support and generous donations from the podiatry community, industry partners, medical suppliers and patients. With both the fundraising and research funding landscapes becoming increasingly competitive, financial sustainability is one of APERF’s greatest challenges.

 

Despite these funding challenges, APERF is committed to supporting an increase in the evidence base for podiatry; increasing the number of podiatrists who are research active and promoting collaboration and partnership. APERF is also committed to increasing the diversity of research funded and continues to look for opportunities to fund larger, more complex research studies.

 

The impact of APERF

Since 1991, APERF has supported 81 research projects and awarded $495,000 in research grants. Funded projects have examined the epidemiology of podiatric conditions, explored different elements of clinical practice, developed educational resources, and investigated issues affecting the podiatry workforce.

 

Though it is difficult to evaluate patient-related outcomes – due to the size of both awarded grants and the resultant studies – APERF funded research has:

 

  • Provided career development opportunities for podiatrists
  • Supported clinical and academic podiatrists to move into senior leadership roles
  • Resulted in changes to clinical guidelines, and;
  • Promoted collaboration between organisations, health professions and individuals.

 

As a national program, APERF has awarded research funds across five of the seven states, with the majority of funds distributed to podiatrists in NSW, Victoria and Queensland. Organisationally, La Trobe University and Queensland University of Technology are the most predominant funding recipients, followed by Western Sydney University and the University of Sydney. Health care organisations are also represented with Royal Perth Hospital, The Royal Prince Alfred Hospital, Alfred Health, Monash Health and Peninsula Health all past recipients of APERF funding.

 

For more information

For more information about APERF please visit our website.

Women in surgery: the story so far

The Royal College of Surgeons and Royal Australasian College of Surgeons have created a mentoring program as part of a Women in Surgery initiative. The ACPS is also set to formalise a broader initiative to attract more women to podiatric surgery. To understand why this issue is so very important today...

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JFAR Update

Explore-worthy Australian studies

Andrew_Buldt

Curated by

Andrew Buldt | Section Editor

The team at the Journal of Foot and Ankle Research (JFAR) are back in STRIDE with three clinically relevant studies for members to read every quarter. Each of the following studies has been produced by an Australian research group!

Culturally safe student placements improves knowledge and treatment of first nations people

Study #1 - Effect of a culturally safe student placement on students’ understanding of, and confidence with, providing culturally safe podiatry care. West, M., Sadler, S., Hawke, F., Munteanu, S.E., Chuter, V. J Foot Ankle Res 14:9 (2021)

 

What happened - The aim of the study was to evaluate the effect of undertaking clinical placement in a culturally safe podiatry service for Aboriginal and Torres Strait Islander Peoples on podiatry students’ understanding of, and confidence with, providing culturally safe podiatry care. Final year podiatry students at the University of Newcastle attended a culturally safe Aboriginal and Torres Strait Islander student clinic. The clinics are designed to create an environment that is considerate of the spiritual, physical, social and emotional world view of Aboriginal and Torres Strait Islander People. During the clinic sessions, students provided podiatry assessments and management, patient education about strategies to maintain good foot health, and participated in pre- and post-appointment yarning circles with clinic clients.

 

Outcome - Students completed a cultural awareness and capability survey before and after their clinical placements. The results found a significant improvement in the understanding of factor including culture, history and interrelationship with health and health care delivery. Improvements were also apparent for confidence in providing culturally appropriate and safe podiatric care. The study provides foundation evidence of the role that culturally safe placements have on developing students’ cultural capability in a tertiary health care setting, and will help inform future curricula development at both educational institutions and health services.

Diabetes-related foot disease may be underestimated in Australia

Study #2 - Diabetes-related foot disease in Australia: a systematic review of the prevalence and incidence of risk factors, disease and amputation in Australian populations. Zhang, Y., van Netten, J.J., Baba, M., Cheng, Q., Pacella, R., McPhail, S.M., Cramb, S., Lazzarini, P.A. J Foot Ankle Res 14:8 (2021)

 

What happened - The aim of the systematic review was to investigate the prevalence or incidence of risk factors for DFD (neuropathy, PAD, previous ulcer, previous amputation, foot deformity), of DFD (ulcers and infection), and of diabetes-related amputations (total, minor and major amputation) in Australia. A total of 20 articles were included for data extraction. The data suggest that within people with diabetes in Australia, there is a relatively high proportion that have risk factors for developing DFD. While only a low proportion develop DFD, a high proportion of these appear to be hospitalised for DFD or undergo amputations.

 

Outcome - It is possible that there is an underestimation of DFD prevalence in Australia in the few limited studies, given the high incidence of hospitalisation and amputation because of DFD. The study also found high amputation rates were higher in Indigenous and geographically remote populations with lower access to DFD treatment.

People with chronic ankle pain have lower quality of life

Study #3 - Quality of life, function and disability in individuals with chronic ankle symptoms: a cross-sectional online survey. Al Mahrouqi, M.M., MacDonald, D.A., Vicenzino, B., Smith, M.D. J Foot Ankle Res 13:67 (2020)

 

What happened - The aim of the study was to compare self-reported pain, function, ankle instability, physical activity, and QoL between individuals with and without chronic ankle symptoms. The study used an online survey of 270 individuals with and 124 without ankle pain or stiffness for longer than 3 months duration. The survey captured information relating to pain and stiffness, quality of life, function, pain and disability, ankle instability and physical activity.

 

Outcome - The data indicated that individuals with chronic ankle symptoms reported higher BMI and disability and lower QoL, function and ankle stability than asymptomatic controls. The data also showed a strong association between the Foot and Ankle Ability Measure activities of Daily Living subscale and QoL. This suggests that the management of individuals with chronic ankle symptoms should specifically target improving function.

Footscape: behind the scenes

Many members may already know of Footscape, an Australian charity that assists disadvantaged individuals and communities predisposed to debilitating foot pathology. We have invited its founder and Chief Executive Officer, Anthony Lewis, to share more about the workings of Footscape. Each month Anthony will share Footscape’s recent experiences against the broader backdrop of foot health issues that affect people who experience disadvantage.

Download more of Steph’s illustrations at her website, The Comical Anatomist.

Cartoon Anatomical Insights
Steph

By Steph Cooper

Podiatrist Steph Cooper is based in Western Australia and as a visual learner, she now uses this skill to help educate fellow future health professionals in a fun and engaging way. Steph's drawings making anatomy fun through whimsical illustrations caricaturing the human body. You can find her at The Comical Anatomist (the web link is next to her latest drawing!)
Idea to Impact: An innovator’s roadmap

The inventor’s mindset: the power of ‘yet’

By Ben Lindsay – section editor

Managing Director, Solushin

Ben Lindsay is the inventor of the Solushin medical device and program manager of INCUBATE. You can find Ben's details at the bottom of the article.
Do you have an invention or idea that could change podiatry as you know it? Are you unsure where to start? While this column may not appeal to all podiatrists (in fact I am sure it won’t) I am willing to guess that there are plenty of podiatrists who have considered creating a product to make their patient’s lives, or even their role, easier. If this sounds like you, then this monthly column could help you to scratch that entrepreneurial itch through the sharing of advice on how to take an idea and turn it into a commercial product that can truly make a difference.

Where to start?

Navigating your product’s design, manufacture and commercialisation can feel overwhelming, but it doesn’t have to be. Throughout 2021, I will share tips that I utilise myself (as a medical device entrepreneur) and also teach others at Australia’s leading start-up accelerator.

 

Together, we are going to start making your idea a reality. So let’s start at the very beginning.

 

As a podiatrist you treat various injuries and ailments, and likely use hundreds of different tools. Logic follows that you might question why a particular problem still exists.

 

Perhaps you are sick and tired of how a certain tool doesn’t quite hit the mark? You are not alone. In fact the question in your mind is probably, ‘Why haven’t these problems been addressed?!’

 

The very beginning

The hardest thing about inventing a new product is often not knowing the next steps. This fear of the unknown can be overwhelming, paralysing, and even embarrassing. In fact it’s one of the most common reasons that people don’t pursue an idea.

 

“I have an idea but I don’t know what to do next,” is a common refrain. To overcome this, I want to empower you with one word that will change how you approach all the information that gets thrown at you. Including the articles I will write for you in STRIDE this year.

 

That word is: ‘yet.’

 

“I don’t know what to do … yet.”

 

With that simple word, we are turning what you don’t know into something you will learn. I have witnessed the power of ‘yet’ firsthand; the ability for people to accept what they don’t know and are willing to find out.

 

So, if you have an idea, then these monthly STRIDE contributions are for you.
Each month I will share tips specifically for podiatrists that will help you to:

 

  • Navigate your product’s design and manufacturing
  • Develop its brand identity and;
  • Even sell and market it.

 

These are all things you might not know… yet.

 

You can contact him via ben@solushin.com or on LinkedIn.

 

 

APodA HR Advisory Service

Can employees cash out their ‘long service leave’?

By Joseph McHardy

APodA HR Advisory Service

The team at the APodA HR Advisory Service has recently received a number of enquiries from members regarding the ‘cashing out’ of long service leave (LSL). Specifically, this involves being paid out LSL as a financial sum rather than actually taking time off. This article will discuss the provisions around cashing out LSL in each state and territory*.

Employees typically derive their entitlements to LSL from the long service leave or industrial relations acts specific to each state or territory.

Here’s a summary of where each state and territory stands on the issue of ‘cashing out’ long service leave.

 

New South Wales

In NSW, most workers derive their entitlement from the Long Service Leave Act 1955 (NSW). The NSW legislation does not contain any provisions that allow an employee to be paid for their LSL without actually taking some time off. For this reason, cashing out LSL in NSW is prohibited, regardless of the fact that it may be to an employee’s benefit.

 

Victoria

In Victoria, most employees derive their entitlement from the Long Service Leave 2018 (VIC). Going farther than NSW, it constitutes an offence under the law in Victoria for an employee to ‘cash out’ their LSL. Employers and employees who do so may be subject to civil and criminal penalties.

 

Australian Capital Territory (ACT)

In the ACT, the Long Service Leave Act 1976 (ACT) provides employees with their entitlement to LSL. An employee must actually take the period as leave and may not receive a payment in lieu. In other words, employees in the ACT cannot cash out their LSL.

In NSW, most workers derive their entitlement from the Long Service Leave Act 1955 (NSW).

In Victoria, most employees derive their entitlement from the Long Service Leave 2018 (VIC).

In the ACT, the Long Service Leave Act 1976 (ACT) provides employees with their entitlement to LSL.

Queensland

In Queensland, most employees derive their entitlement to LSL from the Industrial Relations Act 2016 (QLD).

 

In this state, employees may be eligible to cash out their LSL if:

 

  • The award, enterprise agreement or certified agreement allows them to do so; or
  • They make an application to the Queensland Industrial Relations Commission for an order allowing them to do so.

 

The Health Professionals and Support Services Award 2020 does not contain any such provisions. Therefore, the only option available to employees in Queensland is to make an application to the Queensland Industrial Relations Commission. Such applications may only be made on compassionate grounds or on the grounds of financial hardship and can only be submitted once an employee has gained access to the entitlement.

 

To submit an application, an employee must complete a form F13, available from the Queensland IR Commission.

 

 

South Australia

For the majority of workers, the entitlement to LSL in South Australia comes from the Long Service Leave Act 1987 (SA). Under the Act, an employer and employee may make an agreement for the employee to receive a payment in lieu for some or all of their entitlement. In other words, employees in SA can cash out their LSL. Such an agreement must be recorded in writing and kept on an employee’s file.

 

Western Australia

In Western Australia, the bulk of employees derive their entitlement to LSL from the Long Service Leave Act 1958 (WA). In the state, an employer and employee may make an agreement for the employee to receive a payment in lieu of some or all of their entitlement. In other words, employees in WA can also cash out their LSL. Such an agreement must be recorded in writing and deliver a benefit to the employee.

In Queensland, most employees derive their entitlement to LSL from the Industrial Relations Act 2016 (QLD).

For the majority of workers, the entitlement to LSL in South Australia comes from the Long Service Leave Act 1987 (SA).

In Western Australia, the bulk of employees derive their entitlement to LSL from the Long Service Leave Act 1958 (WA).

 

Northern Territory

In the NT, the Long Service Leave Act 1981 (NT) is the piece of legislation that governs the entitlement for the majority of workers. Employees are not permitted to receive a payment in lieu of taking their LSL.

 

Tasmania

The Long Service Leave Act 1976 (TAS) provides the entitlement for LSL for Tasmanian workers.

 

Section 10 of the Act outlines that an employee may elect to receive a payment in lieu of taking a period of LSL by agreement with their employer. Any such agreement must be recorded in writing, including the dates the payment is intended to cover.

 

So, there you have it. In NSW, Victoria, the ACT, and the NT, employees may not cash out their LSL. In Queensland, South Australia, Western Australia and Tasmania, employees can cash out their LSL – provided they meet the relevant criteria.

In the NT, the Long Service Leave Act 1981 (NT) is the piece of legislation that governs the entitlement for the majority of workers. Employees are not permitted to receive a payment in lieu of taking their LSL.

The Long Service Leave Act 1976 (TAS) provides the entitlement for LSL for Tasmanian workers.

More information?

If you are considering the option of cashing out LSL, we recommend you contact one of our friendly team for advice in relation to your specific circumstances.

 

There are three ways you can do this.

 

*An employee’s entitlement to LSL is generally derived from state/territory legislation.

If you are fitting out a new podiatry practice, updating an existing practice or even just considering this as part of your longer-term goal, then you may want to reflect on the following tips for a hassle-free process (and happy patients in your waiting room!)

Tip #1 Get into the headspace of your patient

This requires you to carve out some time and really consider how your patient feels from before they step into your practice.

 

How did they find out about you? What method did they use to book? Were they notified of their appointment in advance by text, email or phone? Is it easy (and affordable) for them to park nearby or to catch public transport?

 

Then think about how you want them to feel when they step inside. Do you want them to immediately feel happy and alert or relaxed and calm? Elements such as lighting, furniture placement, temperature control, choice of interior style and colours, music and other soundscapes can all play a significant role.

 

Don’t be afraid to be creative, it will not only help your brand to stand out but it may bring a much-needed smile to your clients’ faces.

 

Tip #2 Ditch the dust (and other practicalities)

It goes without saying (though we will say it here!) that podiatrists have infection control procedures to comply with and dust should not exist in a podiatry practice (not even in the waiting room). Likewise, window dressings need to repel dust from gathering and since curtains can trap pathogens in the air they are a major no-no. Think window dressings that can be wiped down instead.  Check also that your waiting room has easy wipe down surfaces; and now that we have ditched magazines and toys in waiting rooms, perhaps consider installing a digital screen to entertain and inform waiting patients, family members or carers with a medical information channel. Then there is the power of the indoor plant or flower arrangement to consider. While potentially therapeutic and relaxing, ensure this is hypoallergenic and regularly wiped down to remove dust particles. The short answer here is that wipe down surfaces are invaluable!

 

Tip #3 Be guided by restrictions

In the era that is COVID, this advice now takes on a whole new meaning. Not only are there practical COVID-related considerations but these government-mandated restrictions are ever-changing. It is worth ‘COVID-proofing’ your practice as much as possible from the outset, which can involve a range of measures such as using telehealth, safeguarding your patients and colleagues from potential contaminants, or managing your space to support social distancing.

 

One way to safeguard patients and colleagues from such contaminants is by installing a perspex screen. If you do this, remember the following points, which are expanded on further in the Safe Work Australia website:

 

  • It’s essential to consult with workers about installing perspex screens.
  • Appropriate staff training must be given if you do choose to install them.
  • The screen needs to be fitted to suit your practice requirements and dimensions to ensure it protects everyone from droplet spray.
  • A risk assessment can assist you in deciding what type of screen is best for your workplace. And bear in mind that installing a perspex screen may result in other WHS risks to consider.

 

Outside of COVID, it’s important to consider issues such as any physical restrictions or limitations that require accessibility into your practice and around the internal space itself. This includes access to areas like the reception desk, toilet, car park or waiting room. How can you accommodate these elements into the design of your practice?

 

Tip #4 Insulate and separate

There is no worse noise for a nervous client than the sound of a machine whirring loudly in the treatment room. Likewise, patients don’t want to hear the details of fellow clients who are perhaps sharing with the reception staff, or their podiatrist, all the details of their toenail infection.

 

Invest in good soundproofing to insulate unwanted sounds (and also minimise the transfer of any odours between rooms), and ensure the reception desk and treatment rooms are positioned in a way that supports confidential conversations when needed.

 

More information?

For more tips and links to a range of resources, download APodA’s guide, ‘Design and fit-out a clinic’.

Business Insights

By Natalie Policki

National Memberships Manager

Thank you!

…And that wraps up STRIDE’s first digital issue! The roll out of STRIDE as a digital entity is an iterative process and our editorial team and external contributors are learning as we go. A lot of passion and hard work has been poured into every single article, and we hope you enjoyed STRIDE’s leap into this digital space. As always, please feedback any comments to our editor Siobhan Doran at siobhan.doran@podiatry.org.au

 

Have a great month (and don’t forget to search back on any of these articles whenever you need to!)

Editor, STRIDE

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