Competence Of Healthcare Professionals Research Articles

The Role of Medical Schools in Enhancing the Quality of Health Facility Services: A Doctoral Perspective: A Brief Review

This article explores the pivotal role of doctoral-level medical education in enhancing the quality of health facility services. Through a comprehensive examination of Doctoral programs, it underscores their significance in shaping competent healthcare professionals. Emphasizing clinical training, interprofessional education, research, and continuous professional development, Doctoral programs prepare doctors to deliver patient-centered, evidence-based care. The article suggests further research avenues including assessing learning methodologies' impact, evaluating healthcare service performance post-educational interventions, comparative analyses of international programs, examining emerging technology's influence, developing innovative curriculum models, and conducting cost-benefit analyses. These efforts aim to deepen understanding and advance healthcare delivery globally.

Implementation of a pharmacovigilance system to detect adverse events and improve medication appropriateness in a hospital in Indonesia

Background: The growing elderly population has led to an increased occurrence of adverse drug reactions (ADRs) due to the various drugs they are prescribed, posing the problem of potential drug interactions. The application of causality instruments combined with trigger tools and the competency of healthcare professionals has yielded better results in detecting ADRs. Objective: To evaluate the implementation of a pharmacovigilance system to detect ADRs, potentially inappropriate medications, and potential prescription omissions. Methods: An observational, descriptive, prospective study was conducted over six weeks at one of the largest hospitals in Indonesia. The pharmacist and the physicians collaborated in reviewing patient medication records using the pharmacovigilance system. Results: The study enrolled 144 patients. The 163 positive triggers identified helped detect 28 Adverse Drug Events (ADEs) caused by at least one high-alert medication. These ADEs occurred in 25 patients. Additionally, 62 potentially inappropriate medications and 41 potential prescription omissions were detected. Conclusion: The pharmacovigilance system could reduce the frequency of ADEs caused by medications used in elderly patients.

Transforming Healthcare with AI: Promises, Pitfalls, and Pathways Forward.

This perspective paper provides a comprehensive examination of artificial intelligence (AI) in healthcare, focusing on its transformative impact on clinical practices, decision-making, and physician-patient relationships. By integrating insights from evidence, research, and real-world examples, it offers a balanced analysis of AI's capabilities and limitations, emphasizing its role in streamlining administrative processes, enhancing patient care, and reducing physician burnout while maintaining a human-centric approach in medicine. The research underscores AI's capacity to augment clinical decision-making and improve patient interactions, but it also highlights the variable impact of AI in different healthcare settings. The need for context-specific adaptations and careful integration of AI technologies into existing healthcare workflows is emphasized to maximize benefits and minimize unintended consequences. Significant attention is given to the implications of AI on the roles and competencies of healthcare professionals. The emergence of AI necessitates new skills in data literacy and technology use, prompting a shift in educational curricula towards digital health and AI training. Ethical considerations are a pivotal aspect of the discussion. The paper explores the challenges posed by data privacy concerns, algorithmic biases, and ensuring equitable access to AI-driven healthcare. It advocates for the development of comprehensive ethical frameworks and ongoing research to guide the responsible use of AI in healthcare. Conclusively, the paper advocates for a balanced approach to AI adoption in healthcare, highlighting the importance of ongoing research, strategic implementation, and the synergistic combination of human expertise with AI technologies for optimal patient care.

PASIFIKA MOVING: A CO-DESIGNED AND CULTURALLY INCLUSIVE PHYSICAL ACTIVITY PROGRAM FOR PASIFIKA COMMUNITIES IN WESTERN SYDNEY

INTRODUCTION & AIMS Pasifika migrant communities in Western Sydney, including Tongan, Samoan, Cook Islander, Fijian, and Māori face significant health disparities including higher rates of obesity, Type two diabetes and cardiovascular disease. Modifiable risk factors including physical inactivity are primary drivers. Previous lifestyle interventions have been unsuccessful due to inadequate community consultation. This study aims to work with Western Sydney’s Pasifika community to design and deliver a sustainable and culturally responsive physical activity program. METHODS The project comprises two phases. Phase A involved 2 co-design workshops or ‘Talanoas’, comprising community leaders, service users, caregivers, Pasifika practitioners, and Academics. Participatory research methods including mixed qualitative and quantitative methods were used to understand barriers, facilitators and preferences for a tailored physical activity program. Phase B, set to commence in 2024 includes the implementation of this program, which will be evaluated for its feasibility, acceptability, and effectiveness. RESULTS Phase 1 co-design included consultation with 24 individuals including; Pasifika community members, Pasifika community leaders, service users, Pasifika clinicians, and Academics. Results exposed essential cultural and practical considerations for the physical activity program. Pasifika Mothers were identified as a priority group considering their influential role within family structures and the broader Pasifika community. A focus on community-led, sustainable, accessible, and enjoyable group-based activity was evident. Co-design sessions were rated as highly acceptable. CONCLUSION The study not only lays the foundation for both Pasifika Moving, but also will inform future community health initiatives which target health disparities in under-served and culturally diverse communities. Pasifika Moving is an example of an initiative that is designed by, for, and led by the community. The outcomes from this study have broader implications to improve health equity and enhance the healthcare landscape by developing culturally competent healthcare professionals and services.

Entrustable Professional Activites for Clinical Competence

Aim: In recent years Entrustable Professional Activities (EPAs) have developed as an essential framework for competency-based medical education (CBME) implementation, which has become an important component of contemporary medical education. The need to close the gap between healthcare professional education, healthcare delivery, and societal demands motivates the transition to CBME. While the competencies describe the attributes that medical professionals should possess, the EPAs describe the practical activities that learners are expected to perform in their medical education and future careers. The difficulty of translating abstract abilities into clinical practice in the real world encouraged the development of EPAs, which are specific activities or responsibilities that may be delegated to learners upon demonstrating competency. With the introduction of EPAs, medical education programs have discovered a more effective means of assessing competencies that aligns them with the professional tasks that students are expected to perform. This alignment promotes a meaningful connection between intended competencies and real-world practice, which ultimately improves the readiness of future medical professionals. Methods: The article was prepared by the traditional review method. Results: This article highlights the particular features of EPAs and the significance of competency-based assessments being grounded in actual clinical situations. EPAs enable learners to advance progressively, fostering preparedness as well as responsibility over time. It is discussed how the incorporation of technology into EPAs has the potential to improve both teaching and learning. The use of technological support and mobile applications can make EPAs more applicable and comprehensible to both faculty and students. Conclusions: The integration of CBME and EPAs is a promising strategy for addressing concerns about medical education’s effectiveness. By actively engaging in real-world tasks, EPAs facilitate the internalization of competencies by learners. By providing a structured, adaptable, and context-specific approach to competency assessment, EPAs enable learners to assume responsibilities progressively, thereby facilitating their path to becoming competent and confident healthcare professionals. By recognizing the complementary nature of EPAs and competences, medical education programs can develop thorough and efficient training techniques that bridge the gaps between theoretical knowledge and practical clinical abilities.

Nutrition support practices in the intensive care unit of a tertiary hospital in Ghana

Background. Nutrition support is recognised as an important therapy for attenuating the catabolic effects of critical illnesses, including malnutrition prevention. However, variations in nutrition support practices make it difficult to achieve optimal outcomes in the intensive care unit (ICU). Objectives. To explore current nutrition support practices among healthcare professionals (doctors and nurses) in the ICU of a tertiary hospital in Ghana. Methods. Via a cross-sectional survey, the nutrition support practices and self-reported skills of 30 ICU healthcare professionals (23 nurses and 7 doctors) providing nutrition support were explored. Results are presented as themes with frequencies and proportions. Categorical data were analysed using Fisher’s exact test. Statistical significance was set at p<0.05. Results. Most of the respondents were young and had limited ICU experience. Almost half of the respondents were unaware of or were not familiar with the content of an in-house feeding protocol for both enteral nutrition (EN) and parenteral nutrition support, despite a majority reporting the feeding protocol as the main source of nutrition support information. There was a general lack of standardisation of execution of most nutrition support practices, especially with the pattern of EN delivery, usual method of optimising EN, and gastric residual volume threshold used to guide practice. Most respondents self-reported being average/satisfactory in the management of nutrition support. Conclusion. The study revealed that healthcare professionals in our ICU had varying nutrition support practices and competencies. There is a need for standardised and practical feeding protocols in accessible formats, ongoing education, and training in nutrition support to improve nutrition support practices and competencies of healthcare professionals providing nutrition support in the ICU setting.

A systematic review of large language models and their implications in medical education.

In the past year, the use of large language models (LLMs) has generated significant interest and excitement because of their potential to revolutionise various fields, including medical education for aspiring physicians. Although medical students undergo a demanding educational process to become competent health care professionals, the emergence of LLMs presents a promising solution to challenges like information overload, time constraints and pressure on clinical educators. However, integrating LLMs into medical education raises critical concerns and challenges for educators, professionals and students. This systematic review aims to explore LLM applications in medical education, specifically their impact on medical students' learning experiences. A systematic search was performed in PubMed, Web of Science and Embase for articles discussing the applications of LLMs in medical education using selected keywords related to LLMs and medical education, from the time of ChatGPT's debut until February 2024. Only articles available in full text or English were reviewed. The credibility of each study was critically appraised by two independent reviewers. The systematic review identified 166 studies, of which 40 were found by review to be relevant to the study. Among the 40 relevant studies, key themes included LLM capabilities, benefits such as personalised learning and challenges regarding content accuracy. Importantly, 42.5% of these studies specifically evaluated LLMs in a novel way, including ChatGPT, in contexts such as medical exams and clinical/biomedical information, highlighting their potential in replicating human-level performance in medical knowledge. The remaining studies broadly discussed the prospective role of LLMs in medical education, reflecting a keen interest in their future potential despite current constraints. The responsible implementation of LLMs in medical education offers a promising opportunity to enhance learning experiences. However, ensuring information accuracy, emphasising skill-building and maintaining ethical safeguards are crucial. Continuous critical evaluation and interdisciplinary collaboration are essential for the appropriate integration of LLMs in medical education.

Enhancing clinical management of neurological disorders: Feedback from the healthcare provider perspective

Objectives: Neurological disorders are a global health concern, and their management requires competent health-care professionals (HCPs). This study aimed to evaluate the current state of neurological case management among Indian HCPs by focusing on different aspects such as frequency of encounters, confidence, and upskilling preferences in managing neurological cases. Materials and Methods: A quantitative cross-sectional survey was conducted among 104 HCPs, including general practitioners (GPs) and consulting physicians (CPs). The survey gathered data on the frequency of encountering neurological cases, confidence levels, areas for improvement, preferred upskilling methods, and willingness to seek guidance from neurology experts. Results: Of the 104 HCPs surveyed, 69 (66.35%) HCPs frequently encountered neurological cases in their daily practice. Among them, 70.19% expressed a moderate level of confidence in managing such cases. Nearly, all HCPs (99.04%) showed a keen interest in upskilling their expertise in the field of neurology. The preferred approaches for upskilling included case-based learning (38.38%) and online webinars or lectures (38.38%). In addition, they showed a willingness to engage with neurology experts for guidance. Conclusion: Our study results highlight the high prevalence of neurological cases in the daily practices of HCPs. The findings reveal that HCPs are moderately confident in managing these cases, underscoring the necessity for targeted interventions to enhance their proficiency. Overall, the study emphasizes the importance of tailored neurological interventions to address the specific needs of Indian HCPs in managing neurological cases.

Transformation of Mandatory Physiotherapy Internship into A Structured Competency-Based Program: A Pilot Study.

Health professions education is challenging in terms of developing ways to construct and assess the amalgamation of knowledge, skills and attitudes that result in novice graduates to be self-aware and confident to practice without supervision. Currently, the Physiotherapy internship program in India does not have a comprehensive competency-based framework. With the current batch of interns facing the wrath of the COVID-19 pandemic during their undergraduate training, it is a matter of concern to ensure they have developed the required competencies to handle patients independently. This is a single-group interventional study using convenience sampling. A competency framework inclusive of a comprehensive assessment and training module was developed and introduced to 27 physiotherapy interns. Every intern underwent 10 training sessions along with 8 competency assessments during 6 months of internship training. A pre-post indigenous questionnaire was used to assess their self-perceived competency along with feedback questionnaire taken at the end of the module. Implementation of the competency framework revealed a statistically significant difference in the self-perceived competency (pre=84.36±10.98, post=98.55±8.74, p≤0.000). Having uniformity in assessment techniques among the faculty, being exposed to challenging cases during assessment, having training module at the beginning of the internship were some of the suggestions given by the participants. Competency based education offers to be an effective technique in health professional program. Incorporating a competency-based training would help the learners to understand their strengths and weaknesses that would go a long way to develop competent health-care professionals. Developing such framework in curriculum will emphasize standardization of learning outcomes, thereby resulting in quality education, further enhancing patient care, and improving the health outcomes worldwide.

IJCM_196A: Exploring the transition from medical students to interns: A leap into clinical practice

Background: The transition from medical student to independent doctor is a crucial phase, marked by a year-long clinical internship in India. Despite this, challenges arise, and stress is common among interns. This study aims to assess the preparedness of interns graduating under the present MBBS curriculum in India and understand the challenges they face during their internship. Methodologyology: This cross-sectional analytical study was conducted in teaching hospitals affiliated with Kasturba Medical College, Mangalore. Interns working in various departments of these hospitals were included in the study. Universal sampling was employed, approaching all available interns during the 14-day study duration. The sampling strategy was non-random, based on convenient sampling. Results: Out of 150 interns, 77 scored well in various aspects of clinical skills. However, discrepancies were observed in specific areas. While 84% demonstrated good history-taking skills, only 55% could effectively discuss medications with patients. Interns displayed lower competence in understanding drug interactions, with only 37 out of 150 scoring well. Communication and teamwork were strong points, with 82 interns effectively working in a multi-disciplinary team. On the contrary, clinical procedures and diagnostic skills showed dismal performance, especially in emergency situations and practical procedures. Conclusion: Interns exhibit strength in communication and teamwork but face challenges in diagnostic skills and clinical procedures. The findings emphasize the need for targeted interventions in specific areas, ensuring a well-rounded preparation for junior doctors. Addressing these challenges will contribute to a smoother transition from medical students to competent healthcare professionals.

Perception and Attitude Towards Academic Research among Undergraduate Students of Allied Health Sciences

Background: Research within healthcare education is pivotal for the evolution of evidence-based practice and the enhancement of patient care. Understanding undergraduate attitudes towards academic research is crucial for curriculum development and fostering a culture of inquiry. Objective: The objective of this study was to assess the perceptions and attitudes towards academic research among undergraduate students of Allied Health Sciences and to explore the implications of these perceptions for human healthcare. Methods: A descriptive cross-sectional survey was conducted over six months at the University of Lahore, Islamabad Campus. A sample of 300 students was derived using the Slovin formula, with a 95% confidence interval and a 5% margin of error. Data collection utilized a semi-structured, pretested questionnaire comprising 19 closed-ended questions. The questionnaire assessed students’ perceptions of research and its relevance to their education and professional futures. Data was analyzed using SPSS version 25 for descriptive and inferential statistics. Results: Out of 300 participants, 214 (71.3%) acknowledged an awareness of research, with 243 (81%) affirming its utility for professional development and 205 (68.3%) for daily life relevance. However, 195 (65%) perceived research as stressful, and 209 (69.7%) found it complex. Gender distribution showed 82 (27.3%) male and 218 (72.7%) female respondents. Conclusion: The study underscores the importance of research in healthcare education, indicating a strong student perception of its value for professional growth, despite associated stress and complexity. Educational strategies should emphasize research skills development to prepare competent healthcare professionals ready to engage in lifelong learning and evidence-based practice.

Evaluating the cross-cultural competence instrument for healthcare professionals (CCCHP) among nurses in Okinawa, Japan

BackgroundTo provide better quality healthcare services to patients with different linguistic and cultural backgrounds, the cross-cultural competence of medical professionals is important. However, assessing and improving the cross-cultural competence of healthcare professionals is difficult in Japan, as there is no standardized scale to measure the competence. This study’s purpose was to translate the Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP), which was developed and used in Europe, and to examine its reliability and validity among Japanese nurses.MethodsDuring June and July 2021, nursing staff were invited to take web- and paper-based surveys in Okinawa Japan. The CCCHP (five-factor model with 27 items across motivation, attitude, skills, emotion, and knowledge) was translated using a combination translation method, and a five-point Likert scale was used for responses. Exploratory and confirmatory factor analyses and known-group method were used to examine structural validity, while Cronbach’s alpha coefficient was used to test reliability.ResultsA total of 294 responses were analyzed; 77.2% had more than five years of experience. Since the fit index indicated that the five-factor model was not a good fit, it was modified to a four-factor model (J-CCCHP24) by moving three variables, removing the knowledge factor, and using the error covariance of the variables. The fit index after the modification was improved to comparative fit index (CFI) = 0.92, Tucker-Lewis index (TLI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, and standardized root mean square residual (SRMR) = 0.06, and Cronbach’s alpha was 0.85. The mean scores of J-CCCHP24 were significantly higher in the group with a history of overseas travel, higher foreign language skill, training in intercultural care, experience of foreign patient care, and intercultural interactions outside the workplace than in the group without these characteristics.ConclusionThis study confirmed the validity and reliability of the modified Japanese version of the CCCHP (four-factor model with 24 items). The results suggest that the exposure to different cultures on a personal level may help improve nurses' cross-cultural competence. Further refinement of this scale for practical use would encourage the implementation of necessary countermeasures to improve the cross-cultural competence of Japanese healthcare professionals.

Dynamically stabilized recurrent neural network optimized with Artificial Gorilla Troops espoused Alzheimer's disorder detection using EEG signals.

Alzheimer's disease is an incurable neurological disorder that damages cognitive abilities, but early identification reduces the symptoms significantly. The absence of competent healthcare professionals has made automatic identification of Alzheimer's disease more crucial since it lessens the amount of work for staff members and improves diagnostic outcomes. The major aim of this work is "to develop a computer diagnostic scheme that makes it possible to identify AD using the Electroencephalogram (EEG) signal". Therefore, Dynamically Stabilized Recurrent Neural Network Optimized with Artificial Gorilla Troops espoused Alzheimer's Disorder Detection using EEG signals (DSRNN-AGTO-ADD) is proposed in this paper. Here, Dynamic Context-Sensitive Filter (DCSF) is considered to eliminate the noise, and interference from the EEG signal. Then Adaptive and Concise Empirical Wavelet Transform (ACEWT) is utilized to separate the filtered signals from the frequency bands, and to feature extraction from the EEG signals. Signal's characteristics, like logarithmic bandwidth power, standard deviation, variance, kurtosis, mean energy, mean square, norm are combined to ACEWT method to create feature vectors and enhance diagnostic performance. After that, the extracted features are fed to Dynamically Stabilized Recurrent Neural Network (DSRNN) for task classification. Weight parameter of DSRNN is enhanced using Artificial Gorilla Troops Optimization Algorithm (AGTOA). The proposed DSRNN-AGTOA-ADD algorithm is activated in MATLAB. The metrics including accuracy, specificity, sensitivity, precision, computation time, ROC are examined for AD diagnosis. The performance of the proposed DSRNN-AGTOA-ADD approach attains 12.98%, 5.98% and 23.45% high specificity; 29.98%, 23.32% and 19.76% lower computation Time and 29.29%, 8.365%, 8.551% and 7.915% higher ROC compared with the existing methods.

Medical informatics and biophysics in medical universities of European countries: A systematic review and meta-analysis

<b>Aims:</b> This systematic review aims to assess the prominence of medical informatics and biophysics in European medical schools, recognizing the growing importance of technology in healthcare.<br /> <b>Methodology:</b> A comprehensive search of Medline and PubMed databases was conducted by employing MeSH terms and relevant keywords following PRISMA guidelines.<br /> <b>Results:</b> The review reveals limited body of research on this topic, with 41 relevant studies identified. These studies underscore the value of medical informatics and biophysics in medical education. They emphasize the necessity of certification and reveal variations in curricula and training across European nations.<br /> <b>Scientific novelty:</b> This study contributes to existing literature by highlighting the scarcity of research on subject.<br /> <b>Conclusions:</b> The findings emphasize the significance of incorporating medical informatics and biophysics into medical education across European nations. Standardization, international guidelines, and accreditation procedures are imperative to ensure the competence of healthcare professionals in utilizing technology and information systems effectively.

Evaluation of cross-cultural competence among German health care professionals: A quasi-experimental study of training in two hospitals

Sociocultural diversity in the German health care system is increasingly reflected in multicultural teams and the diversity of patients. To ensure successful collaboration in a multicultural environment and effective care to diverse patients the importance of cross-cultural competence training is growing. There is a lack of evidence-based training approaches for the German health care system, and it is unclear how the theoretical-conceptual promotion of cross-cultural competence can be achieved sustainably. The aim of the study is to evaluate the effectiveness of cross-cultural competence training for German health care professionals. A quasi-experimental evaluation study in two German hospitals was conducted. Cross-cultural competence was examined in an intervention and a control group (n = 196) using the self-reported instrument Cross-Cultural Competence of Healthcare Professionals (CCCHP) and analyzed with SPSS Statistics 25. Cross-cultural training had a cognitive level impact on knowledge, awareness, and attitudes and showed a highly significant reduction in social desirability. On an affective level, cross-cultural motivation and curiosity initially increased at t1 and decreased at t2. Cross-cultural emotion and empathy increased slightly. On a behavioral level, cross-cultural skills decreased after the training. For sustainable effects, cross-cultural training should focus more on practical skills in addition to theoretical content. Training interventions should be long-term. The results show that more needs to be done in the German health care sector to meet the increasing diversity and demands.

Risks in the analogue and digitally-supported medication process and potential solutions to increase patient safety in the hospital: A mixed methods study.

In hospital medication errors are common. Our aim was to investigate risks of the analogue and digitally-supported medication process and any potential solutions. A mixed methods study including a structured literature search and online questionnaires based on the Delphi method was conducted. First, all risks were structured into main and sub-risks and second, risks were grouped into risk clusters. Third, healthcare experts assessed risk clusters regarding their likelihood of occurrence their possible impact on patient safety. Experts were also asked to estimate the potential for digital solutions and solutions that strengthen the competence of healthcare professionals. Overall, 160 main risks and 542 sub-risks were identified. Main risks were grouped into 43 risk clusters. 33 healthcare experts (56% female, 50% with >20 years professional-experience) ranked the likelihood of occurrence and the impact on patient safety in the top 15 risk clusters regarding the process steps: admission (n = 4), prescribing (n = 3), verifying (n = 1), preparing/dispensing (n = 3), administering (n = 1), discharge (n = 1), healthcare professional competence (n = 1), and patient adherence (n = 1). 28 healthcare experts (64% female, 43% with >20 years professional-experience) mostly suggested awareness building and training, strengthened networking, and involvement of pharmacists at point-of-care as likely solutions to strengthen healthcare professional competence. For digital solutions they primarily suggested a digital medication list, digital warning systems, barcode-technology, and digital support in integrated care. The medication process holds a multitude of potential risks, in both the analogue and the digital medication process. Different solutions to strengthen healthcare professional competence and in the area of digitalization were identified that could help increase patient safety and minimize possible errors.

Recognizing Stereotypes and Their Impact on Health: A Transformative Learning Activity for Undergraduate Health Science Students

Stereotypes are simplified generalizations that act as mental shortcuts which help us understand the world. However, these oversimplifications fail to capture the diversity within groups and communities. This is particularly adverse in healthcare settings as stereotypes are cognitive frameworks from which implicit biases emerge—affecting how individuals and groups are perceived, evaluated, and treated. Specifically, stereotypes linked to race, ethnicity, gender, and sexuality exert profound and detrimental influence on healthcare access, quality, and decision-making for marginalized populations. Thus, recognizing and understanding stereotypes are crucial for combatting health disparities prevalent in our society. Accordingly, it is essential that students receive instruction and training that allows them to understand the impact of stereotypes, acknowledge implicit biases, and advocate for equitable and unbiased healthcare for all. Health science instructors can facilitate this growth through the implementation of transformative education and learning. Transformative education is an approach to learning that aims to create profound personal and societal changes by fostering critical thinking, self-awareness, and social responsibility. The transformative learning activity presented in this manuscript seeks to enhance students’ understanding of stereotypes’ role in perpetuating health disparities and their impact on marginalized communities. By fostering critical reflection, open dialog, and collaborative problem-solving, the activity equips students to comprehend the multifaceted dimensions of stereotypes in healthcare and prepares them to address the challenges of an increasingly diverse and socially complex world. Through transformative education, students are nurtured to become competent healthcare professionals who champion equitable and unbiased care and bridge understanding and empathy across communities.

Mapping ward managers' core competencies using the Balanced Scorecard model.

Nurse ward managers have a crucial role in the effective functioning of hospital wards and in organising the work of the nursing team. The Balanced Scorecard model is a management framework that enables strategy to be translated into action by setting goals that lead to measurable outcomes. Few studies have used the Balanced Scorecard model to map the competencies of healthcare professionals. To use the Balanced Scorecard model to map the core competencies of nurse ward managers and determine relevant key performance areas (KPAs) and key performance indicators (KPIs). This mixed-methods study was conducted in the surgical department of an Italian hospital using a qualitative and quantitative exploratory sequential approach. For the quantitative part, the authors asked a convenience sample of various clinical staff to rate a list of nine competencies in terms of their importance for the work of nurse ward managers. For the qualitative part, two focus group discussions were held with nurse ward managers. Responses to the questionnaires showed that all nine competencies were important to respondents, with no statistically significant differences between roles. Findings from the focus group discussions broadly confirmed the relevance and importance of the nine competencies. Based on these findings, the authors formulated a strategic map of the nurse ward manager role, with core competencies and associated objectives mapped against the four dimensions of the Balanced Scorecard model. A strategic map of the nurse ward manager role informed by the Balanced Scorecard model can help measure nurse ward managers' performance and provide a benchmark for them to improve their competencies.

Kalıpyargı Tehditinin Kardiopulmoner Resüsitasyon Performansı Üzerine Etkisi: Bir Randomize Kontrollü Manken Çalışması

Objective: Stereotype threat (ST) can lead to decreased performance when individuals face the possibility of confirming negative stereotypes associated with their group. During the Coronavirus disease 2019 (COVID-19) pandemic, non-Intensive Care Unit physicians (non-ICUp) were assigned to work in ICUs. However, social media emphasized the inadequacy of knowledge and skills among these physicians. Given the negative judgments, the study aimed to evaluate the cardiopulmonary resuscitation (CPR) performances of these physicians and investigate the effect of ST. Methods: A total of 63 non-ICUp and 53 Intensive Care Unit physicians (ICUp) physicians working in COVID-19 ICUs were randomly assigned to control and experimental groups. In the experimental group, ST was manipulated by presenting the study’s aim as measuring the difference in CPR performances between ICUp and non-ICUp physicians. The control group received no information. Participants were videotaped while performing a standard CPR scenario and evaluated by independent instructors and mannequin scores. Results: Overall CPR scores were higher among ICUp. Non-ICUp performed better in the ST condition regarding effective chest compression (p=.02) and correct compression rates per minute (p=.02) compared to the control condition. However, ICUp had lower scores for correctly placing chest compressions in the ST condition (p=.03). Conclusion: The higher CPR performance among ICUp was expected. However, the hypothesis suggesting lower performance for non-ICUp under ST conditions was not supported. Inconsistent results regarding the ST effect could be influenced by moderating factors such as task difficulty, knowledge about the existing stereotype, and motivation to perform well. The interaction between the physicians’ specialty and situational factors highlights the importance of creating realistic training environments that simulate high-pressure situations, ultimately contributing to the development of competent and confident healthcare professionals. Future research should further explore the impact of ST-based training on interactions and performance among different healthcare professionals. Keywords: Stereotype threat, intensive care unit, cardiopulmonary resuscitation, CovId-19

Call for an interprofessional, experiential, performance-based model for health professions education

Medical errors are cited among the leading causes of death in the United States, resulting in devastating consequences for patients and their families, besides adding substantial costs to healthcare. Communication within and between teams is cited as a major contributing factor to patient deaths due to preventable medical errors. Although Universities and Academic Health Centers aim to graduate competent healthcare professionals who are effective healthcare team members, the importance and degree of emphasis given to interprofessional education (IPE) across health professions accreditation organizations is variable. To ensure a highly skilled, efficient and confident health professions workforce, an interprofessional, experiential, performance-based model for health professions education is proposed. This transformational model must be relevant for this high-risk, data-driven and increasingly technological medical era. Finally, it must revolve around patient safety and well-being as patients traverse through the levels of the healthcare system and upon the safety and well-being of professionals providing them care.