The first thing an American notices about driving in Australia is that, like Britain, Aussies drive on the left side of the road.
Pedals have the proper orientation, but shifting becomes a left-handed operation.
Even the turn signals and wiper stalks are switched to the other side of the steering wheel. Driving on the other side is by far the biggest adjustment to make. It takes months to be able to signal or wipe the windscreen without thinking which side is which. Once rolling on the correct side of the road things become a bit more familiar. Roads are mostly of good design and repair.