Competent Health Professionals Research Articles

DAA-based IIT simulation model enhances the interprofessional collaboration and team efficiency competency of health professionals.

One of the ten recommendations of the commission on education of health professionals for the twenty-first century is the "promotion of interprofessional education that breaks down professional silos while enhancing collaborative relationships in effective teams." Continuously, the increasing prevalence of patients with complex chronic health issues challenges the staff's training strategy of healthcare institution. To ensure patient safety, the collaborative involvement of a team of health professional is necessary to delivery care to patients with complex health conditions and social disadvantage. Integrated interprofessional collaboration and team efficiency (IIT) is a competency that can optimize the multiple professional skills to provide well-coordinated, high-quality, and patient-centered care. IIT-based training is a way to improve team-based care through positive shared learning activities in a nonthreatening environment to respond to patient's needs. The describe, analysis, application (DAA) diamond is a debriefing method that provides different health professionals with valuable learning experiences through communication. Using advocacy-inquiry approach, DAA-based IIT simulation offers an effective platform for training IIT. Including all disciplines in the DAA-based IIT simulation process reinforces the unique role/contribution of each team member and provides a mechanism for the team to talk together for system improvements. Actually, good clinical care requires practitioner's ability to effectively resolve stress and conflict, improve job satisfaction/wellbeing, and enhance quality and safety of patient care. In our institution, regular DAA-based IIT simulation courses were held at various divisions and had been proved to improve the safety and quality of healthcare.

An Undergraduate Course Combining Interprofessional Education and Complementary Health Approaches Learning Objectives: Successful Integrative Learning that Improves Interest and Reduces Redundancy

Literature suggests interprofessional education (IPE) and education about complementary therapies for health sciences students may be effectively combined. A novel 30-hour, 10-week course for interprofessional undergraduate health sciences students combining IPE and complementary therapies learning objectives was developed and offered in 2012 (N = 71), 2013 (N = 120) and 2014 (N = 140). Pre-post mixed methods measurement occurred in three groups: one taking combined IPE-complementary therapies curriculum, and two control groups (one following non-specialized IPE curriculum, and one following combined IPE-continuing care curriculum). The students' attitudinal changes towards IPE and complementary therapies, and their comfort collaborating with students in other health sciences programs were measured using scales. Qualitative evaluation was conducted via content analysis of team-based reflective essays of their opinions towards what they learned about IPE and complementary therapies, and how it changed during the course. Quantitative results exhibited ceiling effects, revealing little change or difference between groups on all measures, with the exception of the Health Professional Collaborative Competency Perception Scale which indicated the students taking the IPE-complementary therapies course reported increased comfort collaborating in comparison with control groups. Qualitative results indicated students: increased their awareness and knowledge about complementary therapies, and were inspired to learn more, appreciated the need for collaboration and communication, desired to be more patient-centered, and wove concepts related to IPE and complementary therapies together. Combining IPE initiatives and basic complementary therapies education can save curricular time, and develop healthcare professionals who appear to be more ready to provide team-based, patient-centered care.

The perception of clinical risk among students of different health professions: a multicentre study.

the need for health care to be safe is increasingly guiding the development of policies to improve clinical practice and education; risk management and patient safety are essential competencies for health professionals. to examine how students working towards different degrees in Italy perceived their competence in clinical risk management and patient safety when learning in the classroom and the clinical setting. the Italian version of the H-PEPSS questionnaire was given to 154 students; 78 were studying for a nursing degree and 76 were on the cardio-circulatory pathophysiology and cardiovascular perfusion techniques (CPCPT) degree course. nearly half of the students (46.10%) did not feel confident about their competence in patient safety and risk management during clinical training. significant differences in confidence between the two types of students were found in many areas, including in critical aspects of clinical risk management. However, both types of students had similar levels of confidence in some essential areas.

Correlates of perceived death competence: What role does meaning-in-life and quality-of-life play?

Understanding factors that are associated with more adaptive death attitudes and competencies can inspire future health-promoting palliative care strategies and inform approaches to training and development for health professionals. The potential importance of meaning, purpose, quality, and values in life for promoting adaptive death attitudes has been highlighted, but there is limited research in this area, particularly in relation to death competence. The purpose of this cross-sectional study was to develop an understanding of demographic and life-related factors associated with perceived death competence, such as meaning in life and quality of life. During the course enrollment period of a Massive-Online-Open-Course about death and dying, 277 participants completed questionnaires on death competence, meaning in life, quality of life, and sociodemographic background. Findings indicated that greater presence of meaning in life, quality of life, age, death experience, and carer experience were each statistically significant unique predictors of death competence scores. Life-related variables were more strongly associated with death competence than demographic variables. Bereavement experience and experience caring for the dying was associated with greater death competence, but there were no differences on death competence between health professionals and the general community. Above all other factors, the presence of meaning in life was the strongest predictor of higher perceived competence in coping with death. The findings demonstrate important interconnections between our attitudes about life and death. Knowledge of factors associated with poorer death competence may help identify those at risk of greater distress when facing death, and might prove useful additions to bereavement risk assessments. Understanding factors associated with greater death competence in health professionals and volunteers may help predict or prevent burnout and compassion fatigue, and help identify who would benefit from additional training and support. Future longitudinal studies including both health professionals and the general community are needed to determine the effect adaptive attitudes toward meaning in life can potentially have on bolstering subsequent adaptive coping and competence regarding death and dying.

Integrating Transracial Adoption Themes into the Counseling Core Curriculum

This paper presents an overview of professional counseling competencies for mental health professionals working with members of the adoption kinship network and discusses examples of how competencies for counseling members of the Transracial Adoption Kinship Network (TrAKN) can be woven into a graduate counseling program.

Expected professional and personal characteristics of clinical mentors: Differences between physiotherapy and social gerontology students

Background: Clinical mentors play an important role in the development of knowledge and the acquisition of competencies of different health professionals. The success of the entire mentoring process also depends on the professional and personal characteristics of the clinical mentor. The purpose of this study was to identify which professional and personal characteristics of clinical mentors are relevant to physiotherapy (PHT) and social gerontology (SG) students.
 Methods: The web survey was performed between January 20 and May 15, 2018, using the adapted version of the nursing clinical teacher effectiveness inventory. The final sample consisted of 100 PHT and SG students from one of the Slovenian Universities.
 Results: The competencies “explains clearly” (p ˂ 0.001) and “takes responsibility of own actions” (p = 0.023) were statistically significantly more relevant to PHT students than to the SG students. The competencies “explains clearly” (p ˂ 0.001), “demonstrates clinical skill and judgment” (p = 0.033), “takes responsibility of own actions” (p = 0.023), and “is self-critical” (p = 0.023), were statistically significantly more relevant to PHT than to the SG students, while the statements “discusses current development in his/her field” (p = 0.002), “communicates expectations of students” (p = 0.029), “demonstrates empathy” (p = 0.037), “demonstrates enthusiasm” (p = 0.005), and “has a good sense of humor” (p = 0.005) were statistically significantly more relevant to SG students.
 Conclusion: The contrast in responses reflects the differences in the nature of both professions: The predominantly instrumental nature of PHT and the predominantly expressive nature of SG.

Factors associated with cultural competence in health and social care professionals in Finland

Factors associated with cultural competence in health and social care professionals in Finland

Elements constituting a grid of key competences of health professionals in the public hospitals of Yaoundé in Cameroon: The weight of socio-cultural barriers

Researchers on skills management insist on the need to have a context-based approach. We highlight the components of a grid of key skills of health professionals in public hospitals of different categories in the city of Yaoundé in Cameroon. In order to have a global vision of the design, implementation, evaluation and practices around the key competencies of health professionals, 43 semi-directive interviews were validated with actors with different functions and positions. The data were the subject of an inductive qualitative study and a thematic content analysis. The competence of health professionals and the resulting practices are based on their ability to overcome socio-cultural barriers (values and beliefs of users, traditional practices, national regulation, tribalism, corporatism, high level of corruption and favoritism leading to subjectivity in their evaluation) and structural barriers (material, infrastructural, financial and human resources deficiencies) in order to bring them as close as possible to universal health accreditation standards such as those of the World Health Organization. This leads to a medical practice of culturally acceptable quality. Skill assessment is one of the vital issues for public hospitals because it plays a fundamental role in strategies of distinction, rankings, selection processes and orientation in the professional life of health professionals. It goes through the development of a skills grid specific to these professionals and must be based on objective practices.

Empathic Patient-Oriented Communication in Cancer Care Course: Program Design and Evaluation

There is a lack of effective training for health professional (HP) in approaching and managing challenging communication. The purpose of this study was to evaluate the impact of a blended curriculum in communication on HP competence and knowledge. Following a needs assessment using a 1-5 Likert scale on perceived competence in various aspects of communication, an interprofessional, blended curriculum was developed to advance competence and training in challenging conversations in cancer. The blended curriculum consisted of 5 eLearning modules: communication styles, speaking in plain language, principles of breaking bad news, principles for incident disclosure and fundamentals of resilience and coping. Two patient experience videos were recorded. A reflective practice forum was created for the video vignettes to foster resilience skills. Following this asynchronous training a 3-hour in-person, facilitated, skills development session with standardized patients was held. Trainees participated in 4 standardized scenarios. A pre/post evaluation design was used to evaluate self-perceived competence (4-items) and knowledge acquisition (13-items). The McNemar-Bawer Chi Squared test was used to compare self-assessed competency scores and paired T-Tests were used to compare knowledge acquisition scores pre and post course. Learner satisfaction was collected post course. Sixty-one interprofessional trainees completed the needs assessment. The overall perceived competence for breaking bad news was 2.3 (1-5) and the importance was 3.7 (2-4), for incident disclosure was 2.2 (1-4) and importance 3.6 (2-4) and for highly emotional encounters 2.5 (1-5) and importance 3.6 (2-4). The top needs identified were greater knowledge in these areas and opportunities for simulation. Thirty-one trainees completed the pre and 18 the post assessment. There was a significant increase in self-perceived competency following course completion in 2 of 4 competency domains: disclosing an incident to patient/family (p-value=0.046), and breaking bad news (p-value=0.011). There was a trend towards a significant difference in knowledge acquisition scores pre (M=7.47, SD=2.36) and post ((M=6.50, SD-2.31); t(14)=2.12, p=0.053). Course satisfaction was high with 79% (26/33) (reporting that they were ‘confident’ to”totally’ confident that they have mastered the techniques in difficult conversations. 79% (26/33) reported they ‘likely’ to ‘definitely’ intend on using these techniques in their work. 93.76% (30/33) stated they ‘intend to’ ‘are likely to’ or will ‘definitely’ continue to practice communication skills after the training. Overall, 100% said they would recommend this course to a colleague. A blended curriculum offered to advance HCP competence and training in challenging conversations in cancer can build HCP perception of competence and knowledge.

Supporting Aboriginal and Torres Strait islander cultural educators and cultural mentors in Australian general practice education

BackgroundPromoting cultural competence of health professionals working with Aboriginal and Torres Strait Islander communities is key to improving health outcomes. Cultural Educators and Cultural Mentors (CE/ CMs) have critical roles in Australian general practice training, yet these are not well understood.MethodsGuided by a CE/CM Network, our research team including experienced CE/CMs, used surveys and semi-structured interviews to explore these roles and investigate best practice in employment and support. Participants sampled from stakeholders involved in general practice education across Australia included CE/CMs, Medical Educators, General Practice Supervisors and Registrars, and representatives of Regional Training Organisations, Indigenous Health Training Posts and other key organisations. We undertook thematic analysis using a framework approach, refined further in team discussions that privileged views of CE/ CM members.ResultsParticipants comprised 95 interviewees and 55 survey respondents. We organised our findings under three overarching themes: understandings about cultural education and mentoring; employment and support of CE/CMs; and delivery and evaluation of cultural education and mentoring. Our findings supported a central role for Aboriginal and Torres Strait Islander CE/CMs in face-to-face Registrar education about culture and history and related impacts on health and healthcare. Cultural education was reported to provide base-line learning as preparation for clinical practice whilst cultural mentoring was seen as longitudinal, relationship-based learning. Mentoring was particularly valued by Registrars working in Aboriginal and Torres Strait Islander communities.Challenges described with employment and support included difficulties in finding people with skills and authority to undertake this demanding work. Remuneration was problematic, particularly for CMs whose work-time is difficult to quantify, and who are often employed in other roles and sometimes not paid. Other improved support recommended included appropriate employment terms and conditions, flexibility in role definitions, and professional development. Recommendations concerning implementation and evaluation included valuing of cultural education, greater provision of mentoring, partnerships with Medical Educators, and engagement of CE/CMs in rigorous evaluation and assessment processes.ConclusionsOur research highlights the importance of the unique CE/CM roles and describes challenges in sustaining them. Professional and organisational support is needed to ensure delivery of respectful and effective cultural education within general practitioner training.

Overlooked Ethical Problems Associated With the Research and Practice of Evidence-Based Treatments

Proponents of evidence-based treatments (EBTs) have directed complaints of potential unethical practice against psychotherapists who refrain from using EBTs as first-line interventions for a range of psychiatric disorders on the grounds that these treatments should be given priority because of their exceptional scientific backing. This article counters these claims and highlights core ethical concerns associated with the research and practice of EBT itself; namely, the appropriateness of saturating the field with short-term models of psychotherapy and the questionable assumption that these can yield meaningful and lasting change; the uncertain relevance of the results of EBT investigations for psychotherapists working with real-world clients; the foreclosure of opportunities to address clients’ unmet developmental needs and self-fragility posed by the directive/didactic therapeutic stance inherent in EBTs; and, the reduced quality of psychotherapy offered to the public at large and threats to the clinical competence of early-career mental health professionals caused by overemphasizing training in EBTs over the acquisition of relational skills in graduate schools and postgraduate training sites.

Assessing students’ and health professionals’ competency learning from interprofessional education collaborative workshops

ABSTRACTInterprofessional education (IPE) is a key element in preparing current and future health professionals to function in a collaborative practice-ready workforce. California State University, Fresno’s College of Health and Human Services and Valley Children’s Healthcare have partnered together to create an IPE collaborative that organizes and provides interagency-sponsored workshops that align learning objectives of relevant healthcare topics with 2016 IPEC core competencies for university students and health professionals. Using a pre/post design with the IPEC Competency Self-Assessment Tool, two cross-sectional studies were conducted to measure whether interprofessional learning of core competencies improved after participation in IPE workshops, and if such improvements were different between students and health professionals. In Study 1, 67 participants attended a Pediatric Head Injury IPE workshop. Of these, 19 students and 22 health professionals consented to participate and complete the IPEC survey. In Study 2, 99 participants attended an Error Disclosure IPE workshop. Of these, 26 students and 29 health professionals consented to participate and complete the IPEC survey. This investigation showed that the IPEC Competency Self-Assessment Tool discriminated competency ratings between students and health professionals in both studies and demonstrated a positive impact of IPE workshops on students’ and health professionals’ self-assessment of interprofessional competencies.

Race Dialogues in Group Psychotherapy: Key Issues in Training and Practice

ABSTRACTGrowing racial and ethnic diversity in the United States and globally requires culturally competent mental health professionals who can address ongoing racial tensions and experiences of racism and xenophobia. Attending to racial and ethnic issues and infusing race and ethnic dialogues in group psychotherapy can play a major role in addressing mental health problems, promoting racial harmony, and healing deep psychological wounds and trauma that are the result of racial tensions. This article describes seven key issues necessary to effectively address race and ethnicity in group psychotherapy.

Cross-cultural validation of the Brazilian version of the spiritual care competence scale.

This study describes the cross-cultural validation and psychometric evaluation of the Spiritual Care Competence Scale - Brazilian Portuguese version. This reliable and valid instrument is recommended in the literature to measure the outcomes of the education process in the development of spiritual care competences. This is a cross-sectional validation study following the stages proposed by Beaton et al.: translation into Portuguese, back translation into English, expert committee review for semantic equivalence, assessment of the clarity of the pre-final version, and evaluation of the psychometric properties of the final version in Portuguese. Health professionals working at a public hospital in South Brazil participated in the different stages of this study.ResultRegarding internal consistency, total Cronbach's alpha was 0.92 and the mean inter-item correlation was 0.29. The test-retest procedure showed no statistically significant differences in the six subscales. The intraclass correlation coefficient ranged from 0.67 to 0.84, demonstrating the stability of the scale.Significance of resultsThe results support the psychometric quality of the scale and indicate that the adapted instrument is a valid and reliable scale with good internal consistency for measuring spiritual care competencies of health professionals in Brazilian healthcare settings.

Identifying social entrepreneurship competencies of managers in social entrepreneurship organizations in healthcare sector

In spite of paying much attention to social entrepreneurship in academia, such is not the case in social entrepreneurship organizations. Although to fulfill economic and social missions, managers are required to possess economic and social competencies, only few studies investigated this important subject. The present study aims to identify the social entrepreneurship competencies of managers in social entrepreneurship organizations in the field of healthcare. Purposive sampling was used in the population of managers of social entrepreneurship organizations in the field of treatment and prevention of specific diseases (such as cancer, MS, thalassemia, etc.) and also social entrepreneurship organizations in the field of treatment and empowerment of the disabled. Eight managers in this field were interviewed and data was analyzed by open and axial coding using ATLAS.ti software. In total, 42 competencies have been identified in 10 categories and 5 main dimensions including communication competencies, personal competencies, managerial competencies, social competencies and health professional entrepreneurial competencies.

Advance care planning for patients with chronic kidney disease

A crucial part of caring for someone with end-stage kidney disease is ensuring their wishes at the end of life are documented, understood and acted on. Peter Ellis explores the different tools that can be used by trained and competent health professionals for the purpose of advance care planning. He suggests that kidney care professionals should at the very least be able to signpost to these resources.

Diet 3.0: practical issues in everyday life

Internet and the new technologies have changed the way of obtaining information of all kinds; also, information related to food and health. The sources of information and content generators have multiplied Doctors followed by other health professionals are the professional's citizens trust most to consults their doubts regarding health, food and nutrition, but the internet and social networks are increasingly used. The information on food, nutrition and health available on the net comes from very different sources and areas; from scientific journals, academic institutions, health organizations, scientific societies, professional, consumer or other kind of associations, companies from an array of sector who offer information and sell their products, or individuals with different profiles, who may or may not be qualified and present personal opinions, either independent or interested. The fact that when searching the internet for health issues citizens can access together with contrasted sources, other sites which publish information of uncertain quality has worried competent bodies and health professionals. A number of initiatives have been promoted to develop systems that allow the identification of websites that offer trusted quality health content, useful for patients and consumers. It is necessary that qualified health professionals contribute to the dissemination of quality information, easy to understand, in the internet and facilitate access to reliable information sources through directories. Citizens-active patients- active consumers need trusted information a reach in order to adopt informed decisions related to food consumption, own care or that of their families as well as to be able to participate in community actions.

Implications for faculty development for emerging clinical teachers at distributed sites: a qualitative interpretivist study.

Medical faculties have the responsibility to graduate competent health professionals and a consequent obligation to assure the quality and effectiveness of their students' clinical teaching. Many institutions are responding to rural workforce needs by extending clinical training from the traditional academic teaching hospital to include rural and remote sites distributed away from the central training institution. It is incumbent upon medical schools to consider how this might impact on the faculty development of these clinicians as teachers. The research reported here sought to develop an understanding of how clinicians working at distant resource-constrained and new training sites view their early experiences of having been delegated the task of clinical teaching. This was with a view to informing the development of initiatives that could strengthen their role as teachers. Qualitative research using an interpretive approach was used to reach an understanding of the views and subjective experiences of clinicians taking on the role of clinical teaching. Participants were emerging clinical teachers at distant peri-urban, rural and remote sites in South Africa. They were deemed to be emerging by virtue of either having recently taken on the role of clinical teacher, or working at sites newly used for clinical teaching. In-depth interviews were conducted with all nine clinicians meeting these criteria. The interviews were coded inductively looking for underlying meanings, which were then grouped into categories. The findings clustered into three inter-related themes: relationships, responsibilities and resources. The clinicians take pleasure in developing learning relationships that enable students to have a good experience by participating actively in the clinical environment, value what students bring from the medical school in terms of clinical advances and different perspectives, and in the contribution that they feel they are making to creating a more appropriately trained future healthcare workforce. However, they yearn for a closer relationship with the medical school, which they think could acknowledge the contributions they make, while also offering opportunities for them to become more effective clinical teachers. They also feel that they have a role to play in both curriculum re-alignment and student evaluation. These clinicians felt that the medical school has a responsibility to let them know if they are doing 'the right thing' as clinical teachers. Interestingly, these participants see trusted clinical colleagues and mentors as a resource when needing advice or mentorship concerning clinical teaching. This study adds to an understanding around designing faculty development initiatives that meet the needs of clinicians at distant sites that take on the role of clinical teaching. There remains the need to impart particular strategies to support the learning of particular kinds of knowledge that is commonly dealt with in faculty development. However, there may be an additional need for faculty developers to embrace what is known about rural doctor social learning systems by overtly designing for incorporation of the foundational three Rs: relationships, responsibilities and resources.

Developing a Palliative Care Competency Framework for Health Professionals and Volunteers: The Nova Scotian Experience.

In 2014, Nova Scotia released a provincial palliative care strategy and implementation working groups were established. The Capacity Building and Practice Change Working Group, comprised of health professionals, public advisors, academics, educators, and a volunteer supervisor, was asked to select palliative care education programs for health professionals and volunteers. The first step in achieving this mandate was to establish competencies for health professionals and volunteers caring for patients with life-limiting illness and their families and those specializing in palliative care. In 2015, a literature search for palliative care competencies and an environmental scan of related education programs were conducted. The Irish Palliative Care Competence Framework serves as the foundation of the Nova Scotia Palliative Care Competency Framework. Additional disciplines and competencies were added and any competencies not specific to palliative care were removed. To highlight interprofessional practice, the framework illustrates shared and discipline-specific competencies. Stakeholders were asked to validate the framework and map the competencies to educational programs. Numerous rounds of review refined the framework. The framework includes competencies for 22 disciplines, 9 nursing specialties, and 4 physician specialties. The framework, released in 2017, and the selection and implementation of education programs were a significant undertaking. The framework will support the implementation of the Nova Scotia Integrated Palliative Care Strategy, enhance the interprofessional nature of palliative care, and guide the further implementation of education programs. Other jurisdictions have expressed considerable interest in the framework.

Factors Causing Contraceptive Acceptors Drop Out

Family planning program has a very strategic, comprehensive and fundamental meaning in creating a healthy and prosperous Indonesian human being. However, recently the incidence of drop out is quite high for several reasons. This study was conducted to determine the influential factors that cause acceptors to drop out. It is descriptive research. The populations in the study were contraceptive acceptors who dropped out for 3 consecutive months, and not being pregnant. The numbers of sample were 100 people. The data collection employed closed and open questionnaires; data presented in descriptive form. Influential factors of drop out contraceptive acceptors due to side effects were 38%, wanting children 18%, others (changing the method/ expired) 14%, without husband support in using contraception 22%, and others 22%. The period of using contraception after dropout 34% (3-10 years); express unlimited time (one day later) and unwilling to use contraception anymore after dropping out 23%. It is suggested that health professionals can increase the handling of family planning side effects, improve counseling, information and education related to the choice of short term non-hormonal contraceptive devices related to the selection of contraceptives for pre-menopausal age so that the decision making can be taken more appropriately, increase the competence of health professionals, increasing husband support, improving mentoring and monitoring acceptors who have dropped put to use contraceptives again willingly.