Introduction

Despite changes in legislation and increased funding and monitoring, there have been problems in Australia for several decades related to the quality of care in the aged care sector. An appropriately qualified aged care workforce is considered the key to improving aged care practices in the region and across the globe. Therefore, this study sought to understand the reasons for the ongoing problems in the aged care sector related to aged care education.

Since the 1990s, many studies have focused on care practices in nursing homes, now known as Residential Aged Care Services. The terms nursing homes and rest homes are still used in other countries. However, few studies examined the influence of aged care education on care practices. This paper reports on doctoral research that examined these issues within John Dewey's (1859–1952) conceptual framework of pragmatism.

Research questions

The study's research questions aimed to understand how aged care education prepares graduates to work effectively in the aged care sector and how this may relate to ongoing problems in aged care. Thus, the key reseach questions for this undertaking were: 1) How do managers and care workers in aged care perceive gaps in graduates' knowledge and skills? 2) What are the features of 'good' aged care training according to managers and care workers. 3) How does aged care training differ from what is specified in official regulation? 4) What gaps and/or deficiencies exist in the aged care curriculum?

Theoretical background

In this study, the theoretical concept, 'pragmatism,' provided an understanding of the practical application of education in aged care. Dewey's theory of pragmatism is particularly relevant to aged care education. First, the problematic situation is practice; care workers provide varying levels of quality of care to older adults. The inconsistent implementation of quality of care, inadequate monitoring of quality care, and differing interpretation of standards result in variability in standards of care; this is Dewey's 'problematic situation'.  Second, the problematic situation in aged care education expressed in 'variability in teaching quality,' may occur when individual student needs are not recognised, or when preservice students are not fully engaged with the subject matter being presented.

Pragmatism is about solving problems practically, dynamically, and sensibly rather than by fixed ideas. According to Dewey's pragmatist perspective, knowledge comes from actions and learning from these actions' experiences and outcomes (Dewey, 1938a; Morgan, 2014). Therefore, Dewey's works and ideas were particularly useful for applied studies in aged care education that sought to understand the variability of quality in aged care and aged care training quality.

In this study, a pragmatist stance of 'what works', was taken (Wells, 2000). Pragmatism emphasises action and learning from experiences (reflection) and fits this study's focus, which is about vocational aged care education and understanding its limitations in an observable, work context. This research has developed education pedagogical model that is theory and practice-based that emphasises experiential learning, mentorship, simulation, and work placements. The model is designed to impact the delivery of aged care education.

The conclusion presents a critical discussion of the results from a pragmatist perspective. It suggests a new pedagogical aged care education model entitled 'Democratic Experiential Learning Aged Care Education Model' that incorporates Dewey's writings on democracy and experiential learning. In this study, pragmatism focused on the problem of variability of quality in aged care logically and practically (Creswell & Plano Clark, 2007; Morgan, 2014). Pragmatism was appropriate to the study's focus because it enabled aged care to be conceptualised as a 'field of practice,' where knowledge of the field could be clarified and theorised from a practice-based perspective.

Methodology The framework employed a mixed-methods approach - qualitative data from interviews, quantitative data from an online survey and document analysis of published documents. The online survey was sent to 1,500 mangers and care workers, of which 360 who were currently working in metropolitan and regional care aged care services responded, 22 semi-structured interviews followed it. The interviews used open-ended questions and allowed the researcher to ask questions in a work setting and explore topics relevant to the participants (Creswell & Maietta, 2002). It provided a voice on sensitive issues that participants would not feel comfortable discussing in groups (Creswell, 2013). The qualitative research approach aimed to discover new insights into aged care education by interviewing participants in their natural setting—their work in Residential Aged Care Services (Creswell & Maietta, 2002). Semi-structured, open-ended interviews permitted participants to discuss in-depth their perceptions, experiences and responses to the research questions without imposing too much structure into the inquiry. Instead, the flexibility allowed participants to discuss their views and experiences, which made each interview unique. The interviews were thematically analysed to corroborate the descriptive analysis from the online survey and the content analysis from the published documents that included the Australian Department of Education and Training's aged care training packages, and the legislated Quality of Care Principles. The research findings from interviews with care workers and managers had concerns regarding gaps in aged care training packages and trainers ability to prepare them for the workforce. The results were presented in the context of aged care literature and current practices in aged care. Five main themes arose: (1) the need for consistent models of care; (2) the need for a better understanding of working within a legislative framework Quality Principles and education on the Accreditation Standards; (3) the need to broaden educational topics on chronic health conditions, documentation and elder abuse; (4) the development of skills to meet the challenges of working in an aged care environment; and (5) the need for an application of knowledge through simulation and experiential learning by qualified mentors with experience and expertise in aged care. The results established the need for a new pedagogical model of training. Therefore, Dewey's theoretical ideas and works influenced a proposed pedagogical model of 'Democracy and Experiential Learning for Aged Care Education' curriculum. Curriculum

Outcomes The research outcomes involved a critical discussion of the study's significant findings and results from a pragmatist perspective. Including, implications, recommendations for future work for aged care education; contributions of this study to existing knowledge; and a new aged care education 'Democratic Experiential Learning Aged Care Education Model.' The model was based on Dewey's works, mainly through his concepts of democracy in education, integrated knowledge and reflective practice and experiential learning. The research recommends that a new, innovative Democratic Experiential Learning Aged Care Education Model be implemented to evaluate its effect on aged care quality. This will fill the gaps in knowledge identified in the study by managers and care workers in aged care and break the cycle of the low quality of care. It is envisaged that this new model will help aged care graduates improve the delivery of aged care training and help with a sustainable aged care workforce. Moreover, the model will provide ongoing support for aged care graduates and a pathway to develop further knowledge and skills and offer challenges to those choosing to make aged care their long-term career. The research also sourced education concepts currently employed in Australian universities and internationally, for example, 'Work Integrated Learning' that can be adapted to the newly developed model. Therefore, the new Democratic Experiential Learning Model implemented in terms of the aged care curriculum in Australia, will establish a practice-theorising approach to teaching, learning and practice-based knowledge and lift the quality of care graduates' career pathways. Broad findings have already been presented to the Australian Royal Commission into residential aged care services, education and practices. While the innovative Democratic Experiential Learning model has emerged from the aged care sector in Australia, it has broad application for education in European settings and across similar sectors, internationally.

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