Professional Accountability Research Articles

Evaluation of Social Media Usage by Dental Practitioners of Pakistan for Professional Purposes - A Cross-Sectional Study.

BackgroundIn the past couple of years, the use of social media has been on a tremendous rise with greater attention in the field of healthcare, including dentistry. The use of social media for professional purposes is emphasized as unprofessional use can be detrimental. This study aims to evaluate the use of social media by dentists for professional purposes.Materials and MethodsThis cross-sectional study was carried out between December 2021 and March 2022. An online questionnaire was formulated using Google Forms and distributed to the dental professionals through various social media platforms such as Twitter©, Facebook©, Instagram©, Snapchat©, WhatsApp©, and Email©. The questionnaire consisted of two parts: demographic characteristics and questions about the use of social media for professional purposes. For data analysis, SPSS version 25.0 was used, where a multiple linear regression test was used to compare the responses of the participants with their demographic characteristics. A p-value of ≤0.05 was considered to be statistically significant.ResultsA total of 404 dentists participated in this study with a response rate of 89.7%. The majority of the 276 (68.3%) dentists believed to have a professional account to use social media for professional purposes. Most of the 280 (69.3%) dentists agreed social media improved knowledge and communication skills with the patients. About 248 (61.4%) dentists considered the use of social media for general purposes during clinical hours led to wastage of time. About 160 (39.6%) dentists considered connecting with patients on social media to be inappropriate.ConclusionThe use of social media is on the rise at a tremendous rate in different fields of work, including dentistry. Social media is a great tool for dentists to help expand and grow their clinical practice. However, the professional use and ethics whilst using social media should be considered by the dentists.

Level Of Professional Standards In Learning Delivery:Accounting To The Professional Commitment And Teaching Competence Of Secondary School Teachers

This study investigates on the teachers’ Professional Standards in Learning Delivery, accounting for professional commitment and professional accountability of 890 secondary school teachers in District 4 of Division of Quezon, which was determined through a stratified random sampling. A researcher-made survey questionnaire was used to gather data and was analyzed using the Regression analysis to test the hypothesis. Results disclosed that their level of professional standards is perceived as highly proficient in content knowledge and pedagogy, learning environment and diversity of learners, curriculum and planning, and assessment and reporting. Additionally, their professional accountability for teaching competence is perceived as very satisfactory regarding decision-making and professional judgment, instruction, and opportunities to learn. In contrast, research and experience were perceived to be satisfactory, which can be a basis for further investigations. Consequently, the study’s results that professional standards significantly affect the teachers’ professional commitment and teaching competence. Keywords: professional standards, professional commitment, teaching competence

Implementing Patient Falls Education in Hospitals: A Mixed-Methods Trial.

Patient education is key to preventing hospital falls yet is inconsistently implemented by health professionals. A mixed methods study was conducted involving a ward-based evaluation of patients receiving education from health professionals using a scripted conversation guide with a falls prevention brochure, followed by semi-structured qualitative interviews with a purposive sample of health professionals involved in delivering the intervention. Over five weeks, 37 patients consented to surveys (intervention n = 27; control n = 10). The quantitative evaluation showed that falls prevention education was not systematically implemented in the trial ward. Seven individual interviews were conducted with health professionals to understand the reasons why implementation failed. Perceived barriers included time constraints, limited interprofessional collaboration, and a lack of staff input into designing the research project and patient interventions. Perceived enablers included support from senior staff, consistent reinforcement of falls education by health professionals, and fostering patient empowerment and engagement. Recommended strategies to enhance implementation included ensuring processes were in place supporting health professional accountability, the inclusion of stakeholder input in designing the falls intervention and implementation processes, as well as leadership engagement in falls prevention education. Although health professionals play a key role in delivering evidence-based falls prevention education in hospitals, implementation can be compromised by staff capacity, capability, and opportunities for co-design with patients and researchers. Organisational buy-in to practice change facilitates the implementation of evidence-based falls prevention activities.

Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis.

ObjectiveLack of clarity regarding effective communication behaviors in chronic pain management is a barrier for implementing psychologically informed physical therapy approaches that rely on competent communication by physical therapist providers. This study aimed to conduct a systematic review and meta-synthesis to inform the development of a conceptual framework for preferred communication behaviors in pain rehabilitation.MethodsTen databases in the health and communication sciences were systematically searched for qualitative and mixed-method studies of interpersonal communication between physical therapists and adults with chronic pain. Two independent investigators extracted quotations with implicit and explicit references to communication and study characteristics following Standards for Reporting Qualitative Research and Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Methodological quality for individual studies was assessed with Critical Appraisal Skills Programme, and quality of evidence was evaluated with GRADE-CERQual. An inductive thematic synthesis was conducted by coding each quotation, developing descriptive themes, and then generating behaviorally distinct analytical themes.ResultsEleven studies involving 346 participants were included. The specificity of operationalizing communication terms varied widely. Meta-synthesis identified 8 communication themes: (1) disclosure-facilitating, (2) rapport-building, (3) empathic, (4) collaborative, (5) professional accountability, (6) informative, (7) agenda-setting, and (8) meta-communication. Based on the quality of available evidence, confidence was moderate for 4 themes and low for 4 themes.ConclusionThis study revealed limited operationalization of communication behaviors preferred by physical therapists in chronic pain rehabilitation. A conceptual framework based on 8 communication themes identified from the literature is proposed as a preliminary paradigm to guide future research.ImpactThis proposed evidence-based conceptual framework for preferred communication behaviors in pain rehabilitation provides a framework for clinicians to reflect on their own communication practices and will allow researchers to identify if and how specific communication behaviors impact clinical outcomes.

The Green Accounting Application as a strategic Mechanism In Sustainable Development Achievement: a field study on sample of accounting professionals

This study aimed to highlight the role of green accounting application, with its two pillars, environmental costs measurement and disclosure in sustainable development dimensions achievement (the economic, the social and the environmental dimension). To achieve the goal of the study, a questionnaires were distributed to a sample of accounting professionals (accountants, auditors, and university professors of accounting).where Green accounting is the method by which a judgment are made on economic institutions environment responsibility commitment extent by providing information about the costs incurred in this area, that it can considered like an effective system for environmental performance controlling . The results of this study revealed that There is a higher awareness of the importance of green accounting application in economic institutions by the members of the syudy. Also,there is a statistically significant effect of green accounting on sustainable development, where the finding show a positive correlation between the two variables, amounting 71%.

Clinical Hand Over: A neglected domain in our Health Care

Clinical handover or shift handover refers to “the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis1. It is considered a vital and valuable affair in healthcare pathway in a clinical practice. In fact, it is a complex domain in advanced communication skills in medical sciences, which is being recognized increasingly to enhance patient care and safety. It involves the effective communication of high‑quality clinical information while transferring the patients care responsibility to other person or clinical team or at change of shift or any time or transferring to another hospital2. In clinical practice, if relevant clinical information’s were not shared timely and accurately, may results delay in diagnosis, delayed or inappropriate treatment, any adverse events or omission of care. To overcome this, an effective and accurate clinical handover is very crucial in promoting health care continuity and patient safety3. The World Health Organization, Association of American Medical Colleges and Joint Commission4 has also recognized the importance and emphasize the need to improve handovers quality. These organizations have declared it a core entrustable professional activity and issued a mandate by emphasizing the health care institutes to standardize the handovers process and incorporate handover training of their employees in order to improve the consistency and minimize the vulnerability to errors5,6. It is estimated that in USA over 300 million, in Australia more than 40 million and in UK above 100 million clinical handovers are conducted each year7. Arguably, this number is making this practice most frequent and significant process in communication between clinicians and paramedical staff in providing safe patient care. Due to increasing emphasis on person-centered medical care all over the world, a change from traditional to structured handover’s practices is being developed. Literature is now favoring the use of a structured handover framework and advocates patient’s placement at the centre of their care. It is purely a communicative event which can only be achieved through linguistic exchange, by clinicians or paramedics discussion and writing which is conducted between outgoing and oncoming staff at the time of shift change or during patient hand over. This acts a key tool in ensuring the continuity of patient’s information’s which in turns are very important for the continuity of care8. For better outcome technological support like templates, internet, computers, soft wares etc are also used to enhance the effectiveness and safety of this process5,7. To meet the colleague, organizational and patients’ requirements, the staff and doctors should be made aware about its importance and trained to deliver an effective handover9,10. It is also imperative that doctors and paramedical staff should identify any potential barriers encountered during handovers to effectively address these obstacles. As a part of Good Medical Practice, it is recommended and expected that all health professionals should learn and practice excellent handover skills, in order to ensure effective communication between each other of important patients’ clinical information, to ensure patient safety and enable inter-professional collaboration10. It has been reported in literature that the poorly conducted shift handovers, most likely threaten patient’s quality of care, safety and continuity of care2.

Working around: Job crafting in the context of public and professional accountability

Professionals are expected to justify their actions to clients, disciplinary committees and courts in multiple accountability systems. Although developed to reflect professional standards, is it possible that these systems induce proactive behaviours that counteract their goals and instead serve to protect the professional? This article examines the types of stimuli professionals acquire from the public and professional accountability contexts and how these stimuli motivate engagement in specific proactive behaviours. An interpretive grounded theory study was conducted; it included 31 in-depth interviews with physicians from eight hospitals. The study revealed that accountability systems trigger and motivate professionals to engage in self-serving, proactive job-crafting behaviours. Professionals simultaneously manage their perceived accountability pressures and their personal interests. Context-specific factors that motivate individuals to craft their jobs are identified, and we reveal four distinct stimuli–motivation–job-crafting patterns that are linked to specific performance episodes (i.e. work stages). Our findings emphasize the importance of taking specific work contexts (i.e. accountability) and work stages into account when studying job-crafting behaviours. This study contributes to understanding professionals’ motivations and behaviours in the context of accountability, which is essential, as the quality and safety of their work are matters of public concern.

A Hospital's Roadmap for Improving Nursing Excellence Using AACN's Healthy Work Environment Standards.

A Hospital's Roadmap for Improving Nursing Excellence Using AACN's Healthy Work Environment Standards.

From performative to professional accountability: re-imagining ‘the field of judgment’ through teacher professional development

ABSTRACT The rise of performative culture in education and intensifying forms of test-based accountability have subjected teachers to a ubiquitous ‘field of judgment’ through which they are held to account. Within this context, professional development is consistently deployed as a key solution to stagnant or declining student outcomes. In this paper, we examine how accountability might be reimagined through one approach to professional development known as Quality Teaching Rounds (QTR). We draw on Foucault’s notion of panopticism and Ball’s influential writings on performativity to analyse interviews with 21 educators from 14 schools in New South Wales, Australia, conducted during a 2014–2015 randomised controlled trial. Participants highlighted the pervasiveness of testing and test results in shaping their experience of teaching in a system of perpetual surveillance where numbers bite deep into practice. By contrast, participation in QTR afforded teachers rare spaces of freedom within the structure of performativity to collaboratively focus on pedagogy. We argue meaningful professional development can alter the field of judgment and enable teachers to reclaim accountability on their own terms, while maintaining a clear focus on student outcomes.

Professional Responsibility in the Field of Intellectual and Developmental Disabilities: Its Definition, Application, and Impacts.

This article addresses the need to clearly understand professional responsibility and the critical role it plays in the lives of individuals with intellectual and developmental disabilities (IDD), in shaping professions for the better, and in enhancing the functioning of society for the benefit of all. Understanding professional responsibility is especially timely during the current transformation that is occurring in the field of IDD. To that end, the article discusses what is a profession, who is a professional, and what is professional responsibility. Using a logic model framework, the article describes the components of professional responsibility that include its building blocks such as respect for the person, professional ethics and standards, critical thinking skills, and clinical judgment; its use of nine professional practices including empowerment, evidence-based practices, individualized supports, and person-centered outcome evaluation; its outcomes in terms of mutual trust, the improved effectiveness of clinical functions, and professional accountability; and its impacts regarding individual benefit, professional integrity, and societal enhancement.

Measuring text similarity and its associated factors in electronic nursing progress notes: A retrospective review.

To measure text similarity in electronic nursing progress notes and determine factors associated with text similarity. Electronic clinical notes with redundant information masks clinically relevant information, increases clinicians' cognitive burden and undermines patient safety. Retrospective review of electronic medical record nursing progress notes. The study was conducted between November 2018 and February 2019 in two Australian Paediatric Intensive Care Units. De-identified, randomly selected inpatient data were extracted from the network's database. Manually classified shift summary progress notes for each admission were sequenced from admission to discharge. Text similarity was calculated for consecutive pairs of nursing progress notes. Linear regression was undertaken to determine the association between the similarity scores and variables of interest: note word count, total number of notes and unit. The STROBE checklist was used for reporting. 921shift summary nursing progress notes were analysed. Similarity scores were widely distributed with a median of 10.37%. Only 17.2% (n=144) of the notes have similarity scores above 20%. Of these, 5% (n=47) were above 50% similar in comparison with a previously written note. Similarity above 50% was observed as early as the first note pair in the course of a patient's admission. A significant difference was found between the similarity scores of Unit 1 and Unit 2. Hospital unit was the only variable of interest significantly associated with similarity scores. Text similarity among electronic nursing progress notes in Australian Paediatric ICUs is minimal; however, notes with >50% similarity have been identified. Text analytics provides measurable data and insights about electronic clinical documentation to inform future nursing practice, research and eMR design. Findings have implications for nursing practice in the way that nursing staff are educated to maintain data quality, professional accountability and effective communication in electronic documentation and to avoid unnecessary repetition of text.

Doctors as Resource Stewards? Translating High-Value, Cost-Conscious Care to the Consulting Room.

After many policy attempts to tackle the persistent rise in the costs of health care, physicians are increasingly seen as potentially effective resource stewards. Frameworks including the quadruple aim, value-based health care and choosing wisely underline the importance of positive engagement of the health care workforce in reinventing the system-paving the way to real affordability by defining the right care. Current programmes focus on educating future doctors to provide 'high-value, cost-conscious care' (HVCCC), which proponents believe is the future of sustainable medical practice. Such programmes, which aim to extend population-level allocation concerns to interactions between an individual doctor and patient, have generated lively debates about the ethics of expanding doctors' professional accountability. To empirically ground this discussion, we conducted a qualitative interview study to examine what happens when resource stewardship responsibilities are extended to the consulting room. Attempts to deliver HVCCC were found to involve inevitable trade-offs between benefits to the individual patient and (social) costs, medical uncertainty and efficiency, and between resource stewardship and trust. Physicians reconcile this by justifying good-value care in terms of what is in the best interest of individual patients-redefining the currency of value from monetary costs to a patient's quality of life, and cost-conscious care as reflective medical practice. Micro-level resource stewardship thus becomes a matter of working reflexively and reducing wasteful forms of care, rather than of making difficult choices about resource allocation.

Beyond “best practices”: Centering equity in teacher preparation evaluation

Over the last decade, there have been multiple recommendations for evaluating, assessing, or holding teacher preparation accountable. This article analyzes recent policy proposals regarding “best practices for evaluating teacher preparation programs” by critiquing 19 major reports explicitly focused on evaluation. The analysis revealed that the reports’ primary goal was identifying preferred evaluation metrics using rigorous criteria for accuracy and utility. The majority of reports did not position equity as a central goal of evaluation and actually said little about equity explicitly, although some assumed equity was a by-product of rigorous evaluation systems. Building on previous efforts to focus on equity in teacher education, the article advocates an equity-centered approach to teacher preparation evaluation that acknowledges long-standing inequities in educational opportunity and attainment in the United States. Rejecting the idea of “best practices,” which are by definition decontextualized and inattentive to local contexts, the article offers 11 guiding principles for researchers, policymakers, and practitioners, to make strong equity the center of evaluation. These recommendations include: making equity an explicit goal during the entire process of evaluation and working at a systems/structural level; utilizing assessment models and tools that focus on equity; including all stakeholders, especially those from the minoritized communities served by programs, in decisions about evaluation criteria; and, supporting internal professional accountability.

How Effective is Clinical Supervision in Nursing? A Systematic Review

Background: Clinical Supervision (CS) is a process of learning and professional support for nurses and developing nursing practice through regular discussions with experienced and skillful colleagues. However, it remains challenging to ensure the effectiveness of its implementation across all healthcare organizations. This systematic review study aims to answer the question: What are the effects of CS on nurses’ perceptions and performance?. Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and using a mixed method. The search was conducted in the online databases including PubMed, ScienceDirect, Cochrane library, Wiley Online Library, and ProQuest for studies related to effectiveness of CS published from 2000 to 2021. Additional studies were also added by reference/citation tracking. Methodological quality of the included studies was assessed using the McMaster Critical Review Form for both quantitative and qualitative studies (Version 2.0). Their risk of bias was assessed independently by two authors using the Cochrane Collaboration’s risk of bias assessment tool. The studies were qualitatively analyzed by the classification of their main findings, study design, and CS methods/models. Results: Of 1041 potentially relevant studies, 237 were removed due to being duplicates. After screening the titles and abstracts of the remaining, 793 removed and finally 11 studies that met the inclusion criteria were entered into the review process. The design of the studies was quasi experimental (n=3), randomized controlled trial (n=1), cross-sectional (n=5), and qualitative (n=2). All the included studies showed the significant effectiveness of CS presented in various methods used such as one-on-one CS and group CS. The CS increased nurses’ peer support and stress relief (restorative function), professional accountability (normative function) and skills and knowledge (formative function). Conclusion: CS is significantly effective in nursing practice. There is a growing need in the future for more experimental studies, taking into account the use of more appropriate methodologies.

Responding to Recommended Changes to the 2020-2021 Residency Recruitment Process From a Diversity, Equity, and Inclusion Perspective.

In May 2020, the Coalition for Physician Accountability's Work Group on Medical Students in the Class of 2021 Moving Across Institutions for Post Graduate Training (WG) released its final report and recommendations. These recommendations pertain to away rotations, virtual interviews, Electronic Residency Application Service opening for programs and the overall residency timeline, and general communications and attempt to provide clarity and level the playing field during the 2020-2021 residency application cycle. The WG's aims include promoting professional accountability by improving the quality, efficiency, and continuity of the education, training, and assessment of physicians. The authors argue the first 3 WG recommendations may disproportionately impact candidates from historically excluded and underrepresented groups in medicine (HEURGMs) and may affect an institution's ability to ensure equity in the selection of residency applicants and, thus, warrant further consideration. The authors examine these recommendations from a diversity, equity, and inclusion (DEI) perspective. For each of the first 3 WG recommendations, the authors highlight new opportunities created by the recommendations and detail challenges that programs must carefully navigate to ensure equity for all candidates. The authors also recommend solutions to guide programs as they address these challenges, meet new common program requirements, and attempt to promote equity for HEURGMs. Finally, the authors recommend that after the 2020-2021 recruitment cycle, the medical education community evaluate DEI-related outcomes of both the WG's and the authors' recommendations and incorporate the findings into future application cycles.

Practitioners’ Understanding Of Sociological And Medical Models Of Mental Illness When Working With Ethnic Minority Victims/Survivors Of Child Sexual Abuse (CSA)

Being unaware of the pros and cons of a sociological versus medical approach to the treatment of mental illness as a result of child sexual abuse (CSA) risks abuse of gendered power in the clinical setting and disengagement from ethnic minority clients who already traverse steep barriers to help-seeking. To address this, an education/training program was developed, delivered, and evaluated in Australia over six months using mixed-methods (T1 n=112, T2 n=44). At T1 and T2, hardly any participants thought a sociological approach – which squarely names sexism – was not useful or effective. However, they were mostly social workers and counsellors, and therefore centrally aware of social justice issues. Replication with medical practitioners is required to see how findings compare. The results also speak of ethnic minority practitioners becoming feminists against highly valued traditional gender roles in collectivist cultures, and of Anglo practitioners not judging highly patriarchal societies to demonstrate respect for difference. The results contribute new and innovative data, including about practitioners’ commitment to social justice when faced with forced choice questions about it. This study provides a platform for future participatory research with victims/survivors and medicos, so patriarchy outside the clinical context is held to professional account and not repeated within it.

Factors contributing to maternal health inequalities for women who are not white British in the UK

Background Women of non-white British ethnicity have a higher maternal mortality risk for reasons not yet fully understood, and report significant concerns about stereotypes, racism and overall dissatisfaction in care. This study aimed to examine what midwives perceive to be contributing factors to ethnic disparity in maternity care. Methods A systematic search of the literature was conducted to find contemporaneous, relevant studies which were appraised for inclusion and quality. Four qualitative studies were included. Results Midwives spoke about practical, cultural and logistical concerns that contribute to health inequalities; none mentioned racism. Three themes emerged: relationship barriers, logistical barriers and a sense of us vs them. Three areas of us vs them were explored: ‘incongruent expectations’, ‘structural racism, stereotypes and implicit bias’ and ‘culture vs professional accountability’. Conclusions Further research into the impact of implicit bias is needed to adequately address health inequalities for non-white British women. A national strategy could be used to set expectations for women accessing UK maternity services early in pregnancy. Midwives need to be empowered and supported to thoroughly document women's choices so that their professional responsibilities are met.

Accountability and the Quality of Regulatory Judgment Processes. Experimental Research Offering Both Confirmation and Consolation

The quality of judgment by regulatory professionals is key to good regulatory governance yet also a potential problem. Psychological studies have shown that individuals easily make judgment errors and that feeling accountable—expecting to have to explain and justify oneself—improves one’s judgments. This paper explores to what extent felt accountability improves regulatory judgment processes in more realistic settings than the traditional laboratory study. It does so in an experimental design inspired by a classic study. Samples of professional regulators and students were given a judgment task with conflicting and incomplete information under varying conditions of accountability and in a context of ambiguity. Results confirm that accountability improves professional regulators’ judgment processes in terms of decision time, accurate recall of information and absence of recency bias. However, professional regulators were significantly more accurate in their judgments than students. Our results suggest that it is important to devise appropriate forms of operational accountability for regulatory professionals that stimulate their cognitive efforts and guard against biases.

Greater accountability in nursing handover.

Nursing handover exemplifies both the nurse's professional ethics and the profession's integrity. The article by Yetti et al. acknowledges the critical role of structure and process in handover implementation. At the same time, they emphasised the fundamental necessity to establish and update handover guidelines. I assert that effective patient handover practices do not simply happen; instead, nurses require pertinent educational support. It is also pivotal to develop greater professional accountability throughout the handover process. The responsibility for ensuring consistent handover quality should be shared between nurse managers and those who do the actual handover practices.

Development of Instrument to Assess Influence of Extension Conference on Intended Outcomes

The Annual Conference for Mississippi State University Extension is the sole event at which the majority of Extension personnel gather for networking, organizational updates, recognition of efforts, and professional development. Extension leaders plan this conference with intended outcomes but without ever evaluating those outcomes beyond attendee satisfaction. We developed an evaluation instrument to determine how certain conference events influence participants’ critical psychological states and ultimately, their perceived motivation, professional enrichment, opportunities for networking, professional accountability, and organizational awareness. Rather than simply assessing attendee satisfaction, this instrument may help inform planning for successive Extension conferences and other professional development events.