Enteric coated systems differ from conventional preparations, which disintegrate and release their drug loads in the stomach, so the time to onset for an enteric coated dosage form is longer, and dependent on its gastric residence time. This parameter varies widely, depending on the nature of the dosage form, the stomach contents, and any concomitant medication the patient may be receiving. Dosage form size has a major influence on emptying rate. Particles less than 1-2 mm in diameter are emptied rapidly during a meal, with the liquid phase. They also empty rapidly on an empty stomach with the liquid used to ingest the dose. Larger particles are retained during digestion, and empty during Phase 3 of the interdigestive period. Examination of the literature suggests that to overcome the variability in onset times, large tablets should be taken at least one or two hours before a meal, with a small amount of water, and pellet formulations should be taken with a large volume of water or a meal, unless food adversely affects the bioavailability of the drug.

Background: Despite attempts, there remains a theory practice gap for undergraduate nursing students transitioning to clinical practice on graduation, especially for specialty areas of clinical practice, such as palliative care, where there are limited opportunities to gain specialty knowledge and skills. As a result, undergraduate nursing students largely feel unprepared for end-of-life care in clinical practice. End-of-life care simulation is gaining momentum for helping prepare students to undertake this important care. However, little is known of whether end-of-life care simulation is a transformative learning strategy that can be transferred to clinical practice.

Aim: The aim of this paper is to report on undergraduate nursing students transformative learning through endof-life care simulation.

Design: A qualitative research design using narrative inquiry was used with data collected through semistructured interviews and analysed using Clandinin and Connelly's three dimensions of narrative inquiry.

Methods: Eighteen 3rd year undergraduate nursing students enrolled in a compulsory palliative care unit, at an Australian university participated in an immersive end-of-life care simulation. Data were collected through semistructured interviews and analysed using Clandinin and Connelly's three dimensions of narrative inquiry.

Results: This study revealed that transformative learning occurred through three disorientating dilemmas of: caring for a dying patient" approaching difficult conversations" and witnessing death for the first time. Knowledge of palliative care and clinical skills were also found to be transferred to clinical practice.

Conclusions: End-of-life care simulation can be an effective method of promoting transformative learning and can help to reduce the gap from nursing theory to clinical practice.

Given that the education landscape is continually evolving, to remain relevant Universities must reflect on and respond to changes in students’ needs and expectations. This project was sparked from UNE’s Academic Calendar Working Group which identified the opportunity to embed upskilling/achievement programs throughout the academic year, accessible to all students irrespective of level or course. One model proposed was a 6-week block called ‘Lean into Learning’. The UNE Advantage project set out to examine this purpose and provide recommendations for both generic, and discipline-specific activities that would increase students’ engagement, confidence, and academic success. This report provides an analysis of the current literature that addresses the student experience from national, international and UNE perspectives, and presents the findings of a mixed-method study that explored UNE staff and student perspectives about up-skilling/achievement programs as a way to enhance the student experience.

BACKGROUND/OBJECTIVES: Older people living in residential aged care facilities (RACFs) experience acute deterioration requiring assessment and decision making. We evaluated the impact of a large-scale regional Aged Care Emergency (ACE) program in reducing hospital admissions and emergency department (ED) transfers.

DESIGN: A stepped wedge nonrandomized cluster trial with 11 steps, implemented from May 2013 to August 2016.

PARTICIPANTS: Nine hospital EDs and 81 RACFs participated in the evaluation.

INTERVENTION: The ACE program is an integrated nurse-led intervention underpinned by a community of practice designed to improve the capability of RACFs man-aging acutely unwell residents. It includes telephone support, evidence-based algorithms, defining goals of care for ED transfer, case management in the ED, and an education program.

MEASUREMENTS: ED transfers and subsequent hospital admissions were collected from administrative data including 13 months baseline and 9 months follow-up.

RESULTS: A total of 18,837 eligible ED visits were analyzed. After accounting for clustering by RACFs and adjusting for time of the year as well as RACF characteristics, a statistically significant reduction in hospital admissions (adjusted incident rate ratio = .79" 95% confidence interval [CI] = .68–.92)" P = .0025) was seen (i.e., residents were 21% less likely to be admitted to the hospital). This was also observed in ED visit rates (adjusted incidence rate ratio = .80" 95% CI = .69–.92" P = .0023) (i.e., residents were 20% less likely to be transferred to the ED). Seven-day ED re-presentation fell from 5.7% to 4.9%, and30-day hospital readmissions fell from 12% to 10%.

CONCLUSION: The stepped wedge design allowed rigorous evaluation of a real-world large-scale intervention. These results confirm that the ACE program can be scaled up to a large geographic area and can reduce ED visits and hospitalization of older people with complex healthcare needs living in RACFs.

When considering health professionals' requirements and responsibilities, competence is a complex concept that extends beyond knowledge to encompass understanding, application, technical skills, problem-solving, and clinical judgment. Rural clinical placements provide a rich learning environment for students to improve their competencies, self-esteem, and preparedness for practice (PFP). This scoping review aimed to identify pre-registration health students' perspectives on rural placement regarding competency and skill development, and enablers and barriers to learning. The methodology outlined by the Joanna Briggs Institute was followed. Out of 1186 records (366 duplicates), 821 were screened by title and abstract, 59 underwent full-text screening and 18 studies were included. Over half the studies included medicine students (n=11). Reported competencies predominantly focused on self-assessed confidence regarding clinical skills. The reported barriers and enablers to learning highlighted the complexity of the placement experience and the importance of interpersonal factors, learner engagement and the supervisor's role. The review identified a gap in the literature pertaining to student perspectives of competencies and skills not assessed or experienced as well as a lack of standardised measures for PFP. The identified enablers and barriers provide suggestions for rural placement designand emphasise the importance of the student learning experience. Future research could include multiple health disciplines and specific methodologies to identify health students' perspectives regarding the development of competency, relatedness and autonomy, that is how to support health students to think, feel and act like health professionals.