Background and interests
Lindsay Macdonald is a registered nurse with wide-ranging clinical interests.
Postgraduate study in linguistics and nursing led to an on-going interest in health communication, particularly in how clinicians and patients talk with each other.
Research activities
Lindsay Macdonald is a member of the Applied Communication in Health (ARCH) research group based in the Department of Primary Health Care and General Practice.
Communication in clinical practice, using video-recordings of actual consultations and day-to-day health practice activity, is the focus of her research. Wherever possible, participants (clinicians and patients) are partners in the research process.
Other current research interests include interprofessional practice and approaches to weight management.
Publications
Thompson, L., Dowell, A., Hilder, J., Macdonald, L., Stubbe, M., & Alchin, J. (2021). How do patients and General Practitioners talk about pain and negotiate empathy in consultations? A direct observational study. Health & Social Care in the Community, 29(5), e153-e162. doi: 10.1111/hsc.13259 Journal - Research Article
Stubbe, M., Macdonald, L., Tester, R., Gray, L., Hilder, J., Dew, K., & Dowell, T. (2020). Talking about diabetes and healthy lifestyle in primary healthcare: Translating research findings into practice. In L. Mullany (Ed.), Professional communication: Consultancy, advocacy, activism. (pp. 129-150). Cham, Switzerland: Springer Nature. doi: 10.1007/978-3-030-41668-3_7 Chapter in Book - Research
Hilder, J., Stubbe, M., Macdonald, L., Abels, P., & Dowell, A. C. (2020). Communication in high risk ante-natal consultations: A direct observational study of interactions between patients and obstetricians. BMC Pregnancy & Childbirth, 20, 493. doi: 10.1186/s12884-020-03015-6 Journal - Research Article
Stubbe, M., Dowell, A., Dew, K., & Macdonald, L. (2019). Interaction analysis of primary care consultations. In F. Goodyear-Smith & B. Mash (Eds.), How to do primary care research. (pp. 241-254). Boca Raton, FL: CRC Press. Chapter in Book - Research
Pullon, S., Ballantyne, A., Macdonald, L., Barthow, C., Wickens, K., & Crane, J. (2019). Daily decision-making about food during pregnancy: A New Zealand study. Health Promotion International, 34(3), 469-478. doi: 10.1093/heapro/dax098 Journal - Research Article
2021
Journal - Research Article
Thompson, L., Dowell, A., Hilder, J., Macdonald, L., Stubbe, M., & Alchin, J. (2021). How do patients and General Practitioners talk about pain and negotiate empathy in consultations? A direct observational study. Health & Social Care in the Community, 29(5), e153-e162. doi: 10.1111/hsc.13259
2020
Chapter in Book - Research
Stubbe, M., Macdonald, L., Tester, R., Gray, L., Hilder, J., Dew, K., & Dowell, T. (2020). Talking about diabetes and healthy lifestyle in primary healthcare: Translating research findings into practice. In L. Mullany (Ed.), Professional communication: Consultancy, advocacy, activism. (pp. 129-150). Cham, Switzerland: Springer Nature. doi: 10.1007/978-3-030-41668-3_7
Journal - Research Article
Hilder, J., Stubbe, M., Macdonald, L., Abels, P., & Dowell, A. C. (2020). Communication in high risk ante-natal consultations: A direct observational study of interactions between patients and obstetricians. BMC Pregnancy & Childbirth, 20, 493. doi: 10.1186/s12884-020-03015-6
2019
Chapter in Book - Research
Stubbe, M., Dowell, A., Dew, K., & Macdonald, L. (2019). Interaction analysis of primary care consultations. In F. Goodyear-Smith & B. Mash (Eds.), How to do primary care research. (pp. 241-254). Boca Raton, FL: CRC Press.
Journal - Research Article
Pullon, S., Ballantyne, A., Macdonald, L., Barthow, C., Wickens, K., & Crane, J. (2019). Daily decision-making about food during pregnancy: A New Zealand study. Health Promotion International, 34(3), 469-478. doi: 10.1093/heapro/dax098
2018
Chapter in Book - Research
Dew, K., Dowell, A., Macdonald, L., & Stubbe, M. (2018). Using conversation analysis. In M. Tolich & C. Davidson (Eds.), Social science research in New Zealand: An introduction. (pp. 307-316). Auckland, New Zealand: Auckland University Press.
MacDonald, L. (2018). Politics and ethics: Ethical research following the Canterbury earthquakes. In M. Tolich & C. Davidson (Eds.), Social science research in New Zealand: An introduction. (pp. 87-98). Auckland, New Zealand: Auckland University Press.
Journal - Research Article
Gray, L., Stubbe, M., Macdonald, L., Tester, R., Hilder, J., & Dowell, A. C. (2018). A taboo topic? How general practitioners talk about overweight and obesity in New Zealand. Journal of Primary Health Care, 10(2), 150-158. doi: 10.1071/HC17075
Dowell, A., Stubbe, M., Macdonald, L., Tester, R., Gray, L., Vernall, S., … Dew, K. (2018). A longitudinal study of interactions between health professionals and people with newly diagnosed diabetes. Annals of Family Medicine, 16(1), 37-44. doi: 10.1370/afm.2144
Conference Contribution - Published proceedings: Abstract
Stubbe, M., Tester, R., Macdonald, L., Hilder, J., Dowell, A., & Dew, K. (2018). Archiving and re-‐using heath interaction data in the ARCH Corpus: Challenges and solutions. Proceedings of the 5th International Conference on Conversation Analysis (ICCA). Retrieved from http://www.icca2018.org
Conference Contribution - Verbal presentation and other Conference outputs
Dowell, T., Hilder, J., Tester, R., MacDonald, L., Abels, P., & Stubbe, M. (2018, September). Observing communication about 'risk': The curious case of ante-natal care (aka Learning about research from other disciplines). Verbal presentation at the General Practice and Primary Care Research Weekend, Hanmer Springs, New Zealand.
2017
Chapter in Book - Research
Gray, B., Hilder, J., Macdonald, L., Tester, R., Dowell, A., & Stubbe, M. (2017). A New Zealand perspective on providing healthcare for patients with limited English proficiency. In E. A. Jacobs & L. C. Diamond (Eds.), Providing health care in the context of language barriers. (pp. 189-209). Bristol, UK: Multilingual Matters.
Journal - Research Article
McKinlay, E., Gallagher, P., Jones, B., Macdonald, L., & Barthow, C. (2017). Crossing professional cultures: A qualitative study of nurses working in a medical school. Contemporary Nurse, 53(6), 633-646. doi: 10.1080/10376178.2017.1416304
McKinlay, E. M., Morgan, S. J., Gray, B. V., Macdonald, L. M., & Pullon, S. R. H. (2017). Exploring interprofessional, interagency multimorbidity care: Case study based observational research. Journal of Comorbidity, 7(1), 64-78. doi: 10.15256/joc.2017.7.103
Ballantyne, A., Pullon, S., Macdonald, L., Barthow, C., Wickens, K., & Crane, J. (2017). The experiences of pregnant women in an interventional clinical trial: Research in Pregnancy Ethics (RIPE) study. Bioethics, 31(6), 476-483. doi: 10.1111/bioe.12361
Hilder, J., Gray, B., Dowell, A., Macdonald, L., Tester, R., & Stubbe, M. (2017). ‘It depends on the consultation’: Revisiting use of family members as interpreters for general practice consultations – when and why? Australian Journal of Primary Health, 23, 257-262. doi: 10.1071/PY16053
Gray, B., Hilder, J., Macdonald, L., Tester, R., Dowell, A., & Stubbe, M. (2017). Are research ethics guidelines culturally competent? Research Ethics, 13(1), 23-41. doi: 10.1177/1747016116650235
Morgan, S. J., Pullon, S. R. H., Macdonald, L. M., McKinlay, E. M., & Gray, B. V. (2017). Case study observational research: A framework for conducting case study research where observation data are the focus. Qualitative Health Research, 27(7), 1060-1068. doi: 10.1177/1049732316649160
Conference Contribution - Published proceedings: Abstract
Stubbe, M., Macdonald, L., Tester, R., & Dowell, T. (2017). Diabetes stories: What can we learn from patient experiences of communications with health providers? Proceedings of the Primary Health Care and General Practice Research Weekend. Retrieved from http://www.otago.ac.nz/wellington/departments/primaryhealthcaregeneralpractice/research/
Stubbe, M., Macdonald, L., Tester, R., & Dowell, T. (2017). Diabetes patients' experiences of communication with health providers: Empowerment, agency and mental wellbeing. Proceedings of the 7th Service User Academia Symposium. (pp. 13). Retrieved from http://www.otago.ac.nz/wellington/departments/psychologicalmedicine/suas/
2016
Chapter in Book - Research
White, S. J., Stubbe, M., Macdonald, L., Dowell, A. C., Dew, K., & Gardner, R. (2016). The referred consultation. In S. White & J. A. Cartmill (Eds.), Communication in surgical practice. (pp. 9-34). Sheffield, UK: Equinox.
Stubbe, M., White, S. J., Macdonald, L., Dowell, A. C., Gardner, R., & Dew, K. (2016). Do surgeons want to operate? Negotiating the treatment plan in surgical consultations. In S. White & J. A. Cartmill (Eds.), Communication in surgical practice. (pp. 124-152). Sheffield, UK: Equinox.
Journal - Research Article
Pullon, S., Morgan, S., Macdonald, L., McKinlay, E., & Gray, B. (2016). Observation of interprofessional collaboration in primary care practice: A multiple case study. Journal of Interprofessional Care, 30(6), 787-794. doi: 10.1080/13561820.2016.1220929
Morris, C., Macdonald, L., Stubbe, M., & Dowell, A. (2016). "It's complicated": Talking about gout medicines in primary care consultations: A qualitative study. BMC Family Practice, 17(1), 114. doi: 10.1186/s12875-016-0515-y
Barton, J., Dew, K., Dowell, A., Sheridan, N., Kenealy, T., Macdonald, L., Tester, R., … Gray, L., & Stubbe, M. (2016). Patient resistance as a resource: Candidate obstacles in diabetes consultations. Sociology of Health & Illness, 38(7), 1151-1166. doi: 10.1111/1467-9566.12447
Macdonald, L. M. (2016). Expertise in everyday nurse–patient conversations: The importance of small talk. Global Qualitative Nursing Research, 3. doi: 10.1177/2333393616643201
2015
Journal - Research Article
Barthow, C., Jones, B., Macdonald, L., Vernall, S., Gallagher, P., & McKinlay, E. (2015). Researching in the community: The value and contribution of nurses to community based or primary health care research. Primary Health Care Research & Development, 16, 224-234. doi: 10.1017/s1463423614000097
Conference Contribution - Published proceedings: Abstract
Pullon, S., Morgan, S., McKinlay, E., Macdonald, L., & Gray, B. (2015). Observation of interprofessional collaboration in NZ general practices. In J. Young (Ed.), Proceedings of the Annual General Practice and Primary Care Research Weekend. (pp. 16-17). Dunedin, New Zealand: Department of General Practice and Rural Health, University of Otago. [Abstract]
Stubbe, M., Dowell, T., Macdonald, L., Kenealy, T., Sheridan, N., Dew, K., Tester, R., Docherty, B., Hall, D.-A., Gray, L., & Vernall, S. (2015). 'I understand what it is but I didn't expect to get it': Justifications in the accounts of newly diagnosed type 2 diabetes patients. In J. Young (Ed.), Proceedings of the Annual General Practice and Primary Care Research Weekend. (pp. 8-9). Dunedin, New Zealand: Department of General Practice and Rural Health, University of Otago. [Abstract]
Pullon, S., Morgan, S., McKinlay, E., Macdonald, L., & Gray, B. (2015). Observation of collaboration in primary care practice. Proceedings of the Primary Health Care Research Conference. (pp. 88). Retrieved from http://www.phcris.org.au/conference/2015/index.php
2014
Journal - Research Article
Claridge, R., Gray, L., Stubbe, M., Macdonald, L., Tester, R., & Dowell, A. C. (2014). General practitioner opinion of weight management interventions in New Zealand. Journal of Primary Health Care, 6(3), 212-220.
White, S. J., Stubbe, M. H., Macdonald, L. M., Dowell, A. C., Dew, K. P., & Gardner, R. (2014). Framing the consultation: The role of the referral in surgeon-patient consultations. Health Communication, 29(1), 74-80. doi: 10.1080/10410236.2012.718252
Conference Contribution - Published proceedings: Abstract
Stubbe, M., Hilder, J., MacDonald, L., Tester, R., Dowell, T., & Gray, B. (2014). Negotiating role boundaries and shifts in interpreter-mediated consultations. Proceedings of the 9th Australasian Institute of Ethnomethodology and Conversation Analysis (AIEMCA) Conference. (pp. 21-22). Retrieved from http://aiemca.net/
Stubbe, M., MacDonald, L., Gray, B., Hilder, J., Tester, R., & Dowell, A. (2014). Negotiating role boundaries in interpreter-mediated consultations: Processes and perceptions. Proceedings of the European Association for Communication in Healthcare (EACH) International Conference. (pp. 70-71). Retrieved from http://www.each-conference.com/
Gray, L., Dowell, T., Macdonald, L., Tester, R., & Stubbe, M. (2014). Getting TabOO issues on the table: Talking about overweight and obesity in New Zealand General Practice. Obesity Research & Clinical Practice, 8(Suppl. 1), (pp. 41-42). doi: 10.1016/j.orcp.2014.10.075
Gray, B., Hilder, J., Stubbe, M., Tester, R., Macdonald, L., & Dowell, T. (2014). Communication in interpreted consultations. Proceedings of the Royal New Zealand College of General Practitioners (RNZCGP) Conference for General Practice: Making Connections: Are You Plugged In? Retrieved from http://www.conference.co.nz/gp14/programme
2013
Journal - Research Article
Macdonald, L., Stubbe, M., Tester, R., Vernall, S., Dowell, T., Dew, K., Kenealy, T., Sheridan, N., Docherty, B., Gray, L., & Raphael, D. (2013). Nurse-patient communication in primary care diabetes management: An exploratory study. BMC Nursing, 12(20). doi: 10.1186/1472-6955-12-20
Dowell, A., Stubbe, M., Scott-Dowell, K., Macdonald, L., & Dew, K. (2013). Talking with the alien: Interaction with computers in the GP consultation. Australian Journal of Primary Health, 19(4), 275-282. doi: 10.1071/PY13036
White, S. J., Stubbe, M. H., Dew, K. P., Macdonald, L. M., Dowell, A. C., & Gardner, R. (2013). Understanding communication between surgeon and patient in outpatient consultations. ANZ Journal of Surgery, 83(5), 307-311. doi: 10.1111/ans.12126
Conference Contribution - Published proceedings: Abstract
Stubbe, M., MacDonald, L., Hilder, J., Tester, R., Gray, B., & Dowell, T. (2013). Negotiating role boundaries and alignment in interpreter-mediated general practice consultations. Proceedings of the 4th New Zealand Discourse Conference. Retrieved from http://www.aut.ac.nz/research/research-institutes/icdc/conferences/NZDC4
Stubbe, M., Macdonald, L., Gray, B., Hilder, J., Tester, R., & Dowell, T. (2013). Negotiating role boundaries in interpreter-mediated consultations. Proceedings of the Eleventh Communication, Medicine and Ethics (COMET) Interdisciplinary Conference. Retrieved from http://www.comet2013.unimelb.edu.au/
Dowell, T., Stubbe, M., Scott-Dowell, K., Macdonald, L., & Dew, K. (2013). Talking with the alien: Interaction with computers in the GP consultation. Proceedings of the Eleventh Communication, Medicine and Ethics (COMET) Interdisciplinary Conference. Retrieved from http://www.comet2013.unimelb.edu.au/
Conference Contribution - Verbal presentation and other Conference outputs
Gray, L., Stubbe, M., Macdonald, L., Tester, R., & Dowell, T. (2013, August). Taboo: Talking about overweight & obesity. Verbal presentation at the 21st International Union for Health Promotion and Education (IUHPE) World Conference: Best Investments for Health, Pattaya, Thailand.
2012
Chapter in Book - Research
Dew, K., Stubbe, M., Dowell, A., & Macdonald, L. (2012). Side effects talk in general practice consultations. In B. R. Bates & R. Ahmed (Eds.), Medical communication in clinical contexts. (pp. 95-126). Dubuque, IA: Kendall Hunt.
Journal - Research Article
Moriarty, H. J., Stubbe, M. H., Chen, L., Tester, R. M., Macdonald, L. M., Dowell, A. C., & Dew, K. P. (2012). Challenges to alcohol and other drug discussions in the general practice consultation. Family Practice, 29(2), 213-222. doi: 10.1093/fampra/cmr082
Conference Contribution - Verbal presentation and other Conference outputs
Barthow, C., Jones, B., Macdonald, L., Vernall, S., Gallagher, P., & McKinlay, E. (2012, November). Research nurses in community based research: Transferring evidence of effectiveness. Verbal presentation at the New Zealand Nurses Organisation (NZNO) Nursing Research Section Conference, Nelson, New Zealand.
Gray, L., Stubbe, M., Macdonald, L., Tester, R., & Dowell, T. (2012, August). TAbOO: Getting 'fat' on the table (brief intervention pilot). Verbal presentation at the Primary Care and General Practice Research Weekend, Martinborough, New Zealand.
2011
Journal - Research Article
Gardner, J., Dew, K., Stubbe, M., Dowell, T., & Macdonald, L. (2011). Patchwork diagnoses: The production of coherence, uncertainty, and manageable bodies. Social Science & Medicine, 73(6), 843-850. doi: 10.1016/j.socscimed.2010.12.010
Conference Contribution - Verbal presentation and other Conference outputs
Stubbe, M., Tester, R., Macdonald, L., Dew, K., & Dowell, T. (2011, June-July). Evolution by design: Creating a multimedia corpus for health interaction research. The ARCH Corpus of Health Interactions [Colloquium]. Verbal presentation at the Ninth Interdisciplinary Communication, Medicine & Ethics (COMET) Conference, Nottingham, UK.
2010
Journal - Research Article
Dew, K., Stubbe, M., Macdonald, L., Dowell, A., & Plumridge, E. (2010). The (non) use of prioritisation protocols by surgeons. Sociology of Health & Illness, 32(4), 545-562. doi: 10.1111/j.1467-9566.2009.01229.x
Journal - Research Other
Dew, K., Stubbe, M., Macdonald, L., Dowell, A., & Plumridge, E. (2010). How useful are clinical priority assessment tools? [Research Gems]. Journal of Primary Health Care, 2(2), 174-175.
Conference Contribution - Poster Presentation (not in published proceedings)
Macdonald, L., & Stubbe, M. (2010, September). ″It can be a bit overwhelming″ Nurse-patient communication in diabetes management. Poster session presented at the International Conference on Communication in Healthcare, Verona, Italy.
Conference Contribution - Verbal presentation and other Conference outputs
Stubbe, M., Tester, R., & Macdonald, L. (2010, November). Evolution by design: Creating a multimedia corpus for health interaction research. Verbal presentation at the GP Research Weekend, Dunedin, New Zealand.
Stubbe, M., Tester, R., & Macdonald, L. (2010, November). Evolution by design: Creating a multimedia corpus for health interaction research. Verbal presentation at the 12th New Zealand Language and Society Conference, Auckland, New Zealand.
Stubbe, M., & Macdonald, L. (2010, September). Preventing illness and promoting wellness: Lifestyle talk in GP consultations. Verbal presentation at the International Conference on Communication in Healthcare, Verona, Italy.
2009
Conference Contribution - Published proceedings: Abstract
Stubbe, M., Dew, K., Macdonald, L., & Dowell, T. (2009). Tracking patient-professional interactions through an episode of care: What are the implications for practice? Proceedings of the Royal New Zealand College of General Practitioners Annual Scientific Conference: Myths and Realities of Primary Care. RNZCGP. Retrieved from http://www.rnzcgp.org.nz/rnzcgp-conference-2009/
Other Research Output
Macdonald, L., Vernall, S. & Hill, N. (May, 2009). ARCH: Applied research on communication in health. Otago Wellington Nurses Network, Wellington, New Zealand. [Research Presentation].
2008
Journal - Research Article
Dew, K., Dowell, T., Stubbe, M., Plumridge, E., & Macdonald, L. (2008). 'Treating' patients differently: A qualitative study of how clinical and social factors shape interactions between doctors and patients. New Zealand Family Physician, 35(6), 282-386.
Dew, K., Plumridge, E., Stubbe, M., Dowell, T., Macdonald, L., & Major, G. (2008). 'You just got to eat healthy': The topic of CAM in the general practice consultation. Health Sociology Review, 17(4), 396-409.
Stubbe, M., Dowell, T., Plumridge, L., MacDonald, L., & Dew, K. (2008). Antibiotics: Prescribing dilemma: Do our GPs say one thing while doing another? New Zealand Pharmacy, 28(3), 30362.
Moss, C., Walsh, K., Jordan, Z., & Macdonald, L. (2008). The impact of practice development in an emergency department: A Pluralistic evaluation. Practice Development in Health Care, 7(2), 93-107. doi: 10.1002/pdh.252
Conference Contribution - Published proceedings: Abstract
Stubbe, M., Plumridge, E., Dowell, T., Dew, K., & Macdonald, L. (2008). Negotiating prescribing dilemmas: The use of evidence in antibiotic discussions. Proceedings of the 15th World Congress of Applied Linguistics. AILA. Retrieved from http://www.aila2008.org/symposiaindividual-papersposters.html
Conference Contribution - Verbal presentation and other Conference outputs
ARCH Group includes, Dowell, T., Stubbe, M., & MacDonald, L. (2008, February). The language of adherence: Exploring interactions in a medicine use consultation. Verbal presentation at the PHARMAC Seminar Series, Wellington, New Zealand.
ARCH Group includes, Dowell, T., Stubbe, M., & MacDonald, L. (2008, April). The language of adherence: Exploring interactions in a medicine use consultation. Verbal presentation at the PHARMAC Seminar Series, Wellington, New Zealand.
2007
Journal - Research Article
Dowell, A., Macdonald, L., Stubbe, M., Plumridge, E., & Dew, K. (2007). Clinicians at work: What can we learn from interactions in the consultation? New Zealand Family Physician, 34(5), 345-350.
Conference Contribution - Verbal presentation and other Conference outputs
ARCH Group includes, Stubbe, M., Plumridge, L., & MacDonald, L. (2007, March). The language of adherence: Exploring interactions in a medicines use consultation. Verbal presentation at the PHARMAC Seminar Series, Wellington, New Zealand.
Stubbe, M., Dew, K., Plumridge, E., Macdonald, L., & Dowell, T. (2007, September). Inside the black box: Tracking patient-professional interactions. Verbal presentation at the Research Symposium: Using interaction data in Health Research, Wellington, New Zealand.
Stubbe, M., Dew, K., Macdonald, L., Plumridge, L., & Dowell, T. (2007, June). Persuasion and resistance in general practice referral talk. Verbal presentation at the Fifth Interdisciplinary Conference on Communication, Medicine and Ethics, Lugano, Switzerland.
Dew, K., Stubbe, M., Plumridge, L., Macdonald, L., & Dowell, T. (2007, June). Patient-initiated side effects talk: Interactional dilemmas in the general practice consultation. Verbal presentation at the Fifth Interdisciplinary Conference on Communication, Medicine and Ethics, Lugano, Switzerland.
2006
Conference Contribution - Verbal presentation and other Conference outputs
Dew, K., Stubbe, M., Plumridge, E., MacDonald, L., & Dowell, T. (2006, November). Side effects talk: Interactional dilemmas in the general practice consultation. Verbal presentation at the Sociological Association of Aotearoa New Zealand Conference, Hamilton, New Zealand.
Stubbe, M., Dowell, T., Dew, K., Plumridge, E., & Macdonald, L. (2006, August). Interaction under the microscope: Talk at work in the general practice consultation. Verbal presentation at the Royal New Zealand College of General Practitioners Conference, Auckland, New Zealand.
Dew, K., Stubbe, M., Plumridge, E., Macdonald, L., & Dowell, T. (2006, August). Is clinical decision making rational? An analysis of surgeon-patient interactions. Verbal presentation at the 10th New Zealand Language and Society Conference, Christchurch, New Zealand.
Stubbe, M., Dowell, T., Macdonald, L., Dew, K., & Plumridge, E. (2006, August). ″You'll be persuaded?″ The discursive construction of referral decisions in general practice consultations. Verbal presentation at the 10th New Zealand Language and Society Conference, Christchurch, New Zealand.
Plumridge, L., Stubbe, M., Dew, K., & Macdonald, L. (2006, October). Taking a closer look. Verbal presentation at the PHARMAC Seminar Series, Wellington, New Zealand.
2005
Conference Contribution - Verbal presentation and other Conference outputs
Walsh, K., Moss, C., Allbon, C., & MacDonald, L. (2005, September). Pluralistic evaluation of practice development in an emergency department. Verbal presentation at the 5th International Clinical Practice Development Conference: Implementation, Evaluation, Sustainability, Hamilton, New Zealand.