Competent Practitioners Research Articles

Core Content, Competencies, and Accreditation in US Global Health Fellowships: A Survey of Leaders' Perspectives.

The number of global health (GH) fellowships in the United States has increased over the past two decades. However, there are currently no standard requirements, shared core content, or widespread systems of accreditation. With the growth in programs, it is appropriate to consider these issues. We conducted a national survey to understand GH fellowship leaders' perspectives on the existence of core content and competencies and on the need for accreditation, including by the Accreditation Council of Graduate Medical Education (ACGME). We sent survey invitations to 123 fellowship leaders. Forty-five completed the survey (37%), representing seven specialties. Eighty-nine percent of respondents indicated that there is important core content for fellows to learn regardless of specialty; 30% indicated that accreditation would be "very" or "extremely" beneficial, whereas 21% indicated that it would be "not at all" beneficial. When asked what form of accreditation would result in training the most competent GH practitioners, 35% indicated that accreditation is unnecessary. Of those selecting a form of accreditation, the largest proportion (21%) selected accreditation from a professional society; 52% "disagreed" or "strongly disagreed" that ACGME accreditation is needed. More than 65% indicated that loss of training flexibility, funding restrictions, and increased administrative and fellow funding burdens are "very" or "extremely" important barriers. These results suggest that broad agreement on important core content exists across specialties, with a lack of consensus about the need for accreditation. More discussion with stakeholders, including international partners, is needed to understand their perceptions and build consensus before pursuing fellowship accreditation.

PSYCHOLOGICAL AND PEDAGOGICAL FEATURES OF ORGANIZING INDEPENDENT WORK OF STUDENTS IN HIGHER MEDICAL EDUCATION INSTITUTIONS DURING THE STUDY OF "OBSTETRICS AND GYNECOLOGY"

Modern medical education faces numerous challenges that require new approaches to student training. In the context of rapid changes in medicine and increasing demands on professionals, it is essential not only to transmit knowledge but also to foster students' ability to work independently and think critically. Psychological and pedagogical aspects of organizing independent learning activities become key to ensuring effective education. Research on motivation, psychological barriers, and innovative teaching methods opens new horizons for developing professional skills in students. The true goal of the educational process is to cultivate not only qualified but also adaptive medical professionals who can respond quickly to changes and challenges in contemporary practice.Aim of the study. To investigate the psychological and pedagogical features of organizing independent work of students in higher medical institutions when studying obstetrics and gynecology, focusing on motivational factors, psychological barriers, and effective teaching methods that promote the development of professional skills and readiness for practical activities.Material and methods. The impact of psychological and pedagogical aspects on organizing independent work of students in higher medical educational institutions during the study of obstetrics and gynecology has been examined, as well as the analysis of scientific articles and research that highlight effective approaches to improving the educational process in this field.Results. The Bologna Declaration emphasizes the importance of student activity and autonomy, making the organization of their independent work particularly relevant in modern conditions. The transition to a credit-module system of education ensures the individualization of the educational process, promoting self-development and active cognitive activity. This system changes traditional approaches to teaching, transforming the roles of instructors in the process. Students become more responsible for their own preparation, which increases their motivation to learn. As a result, independent work becomes a key element in forming professional skills and competencies of future medical practitioners, opening up new opportunities for their development.Conclusions. Independent work of students in the context of a credit-module system of education in a medical university occupies 29% to 42% of educational time and opens up broad opportunities for the development of students' cognitive independence. The main conditions for its effective implementation include motivating students towards this activity, taking into account the psychological characteristics of the youth collective, as well as organizing education with mandatory monitoring of the results of independent work.

Support mechanisms and obstacles for developing public health practitioners’ core competences

Abstract Community health needs assessment is one of the central activities for local governments in Estonia, specifically under the health promotion strategic planning, and this includes developing health and well-being profiles for evidence-based public health promotion. For effective implementation of the profile, sufficiently trained public health practitioners are needed. Therefore, analysis of the needs of the additional study programmes according to the core competences of professional standard for health promotion was carried out among public health practitioners and the leaders of local governments. The study was based on the 19 semi-structured interviews carried out in 2022-2023 with leaders (10) and public health practitioners (9) in Estonian local governments. Based on the local government’s size, status of the health and well-being profile and the employment and educational background of the public health practitioner three sub-groups were developed. The collected data was analysed using qualitative content analysis with focus on support mechanisms and obstacles of core competences of public health practitioners. The respondents indicated the need for training on communication (leadership and advocacy) and analytical skills (evaluation and research). Core competence training is however limited by resources (time, energy, motivation, funding), employer expectations (overload at work) and working full-time. Training is supported by personal motivation (e.g., wish to stay competent, understanding the need for training), employer support (including flexible work arrangements), and curriculum support (funding is covered). The results indicate there is a need for flexible education as the need for developing and maintaining core competences emerges in practical work. The results can be used for developing the public health curriculum, to assess and provide training for public health practitioners to better meet the needs of the labor market in the future. Key messages • Local government employees performing health promotion tasks feel the need to upgrade various core competences: e.g., communication, management, data analysis and assessment. • In health promotion, there is a growing need for flexible education, which creates challenges for higher educational institutions to meet the needs of the labor market.

The Sibling Sexual Behaviour Mapping Tool (SSBMT): Supporting practitioner confidence, planning and competency when responding to sexual behaviours between siblings

ObjectivesThis paper outlines the development and initial pilot of the Sibling Sexual Behaviour Mapping Tool (SSBMT). Building on the findings of the National Project on Sibling Sexual Abuse (King-Hill, McCartan, et al., 2023) and work by Yates and Allardyce (2023), the tool was devised with the aim of supporting frontline child-protection social workers during the initial stages of working with families where sibling sexual behaviours (SSB) may be present. MethodsThis paper explores the rationale for the SSBMT design, and preliminary findings from the first phase of resource evaluation. The evaluation process comprised a small pilot with social workers across seven local authorities in the United Kingdom (UK). The pilot study sought to assess the workability and effectiveness of the SSBMT within social work practice, providing stakeholder insight prior to its launch. The study employed mixed methods to gain feedback on the SSBMT design, accessibility, ease of use and compatibility with current child protection work processes, which included training of 50 practitioners, surveys with 20 professionals and two semi-structured interviews. FindingsThe findings suggest that the SSBMT increased practitioner confidence when working with SSB, and promoted holistic, whole-family approaches in the initial stages of work with children and families affected by SSB.

Evaluating the Incidence, Response, and Management Proficiency of Medical Emergencies in Dental Practices

Background: Dental professionals must be ready to respond quickly and effectively to medical emergencies that may arise in unexpected locations, such as dental offices. Given its sizable population and expanding dental sector, Pakistan is not exempt from such potential catastrophes. Objectives: The objective of this study was to determine the frequency of medical emergencies in dental outpatient departments (public and private). In addition, we aimed to pinpoint any inadequacies in procedures that impede efficient administration and offer ideas for enhancing the capacity to handle medical crises in dental offices. Methods: In a six-month cross-sectional study, dental professionals were given a reliable, closed-ended questionnaire to evaluate their attitudes, procedures, and level of expertise in handling medical emergencies. A total of 271 responses were evaluated. Results: Most instances recorded in medical crises were syncope (36%), followed by hypoglycemia (26%). The majority of reported medical situations (77.8%) were managed successfully within the hospital according to the findings of the study. Of the practitioners, approximately 55.9% adhered to all required guidelines for handling medical emergencies, while 34.8% only partially did so. Approximately 69.6% of practitioners did not follow the protocol when it came to using emergency equipment or drugs. Approximately 65% of practitioners stated that the most difficult aspects of handling medical emergencies were panic or disorientation and a lack of training. Dental professionals and personnel were trained in basic life support (39%), demonstration/lectures (21%), and addressing medical crises (figure 2). Conclusion: The fact that medical emergencies at dental offices are uncommon does not mean that a large percentage of dentists are well-equipped to manage these circumstances. By filling these gaps, the dental profession can improve patient safety and emergency practitioner competencies.

“Examining the Incorporation of Islamic Values in Concept Mapping and Curriculum Design for Medical Education: A Holistic Perspective”

Medical education is an ever-evolving realm, continuously striving for innovative methods to improve learning outcomes and nurture competent healthcare practitioners. Concept mapping has emerged as a valuable tool in this drive, aiding in the organization and synthesis of intricate information. This review delves into the infusion of Islamic teachings into concept map teaching and curriculum development within medical education. By drawing on Islamic principles related to knowledge acquisition, ethics, and comprehensive healthcare, this examination offers strategies for integrating Islamic perspectives into concept mapbased teaching approaches. Through harmonizing educational practices with Islamic ethos, medical educators can cultivate an environment that is culturally attuned and ethically rooted, fostering the development of healthcare professionals who embody compassion and integrity in serving their communities. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 984-992

Core competencies for healthcare practitioners and clinics providing gender-affirming care from the patient perspective: An international qualitative study

Core competencies for healthcare practitioners and clinics providing gender-affirming care from the patient perspective: An international qualitative study

The need to identify anatomy-related competencies in medical education.

A profound grasp of anatomy is indispensable for shaping competent and safe medical practitioners. This knowledge acquisition is pivotal in the early stages of medical education and remains crucial throughout clinical training. However, the evolving landscape of medical education has ushered in changes to the anatomy curriculum, marked by a reduction in contact hours and a streamlined content structure to accommodate novel subjects and teaching methodologies. This transformation has precipitated a quandary in defining the essential scope and depth of anatomical knowledge to be imparted. Traditionally, surgeons assumed the role of anatomy instructors until Flexner's recommendations catalyzed the integration of trained anatomists. Nevertheless, the varied backgrounds of anatomists and the heterogeneity in anatomy curricula across institutions have introduced potential disparities in the quality of graduates. Addressing these challenges mandates the identification of key anatomy competencies tailored for undergraduate medical students. The imperative lies in ensuring that these competencies span cognitive, psychomotor, and affective domains, offering not only comprehensiveness but also direct applicability to clinical practice. Hence, this viewpoint highlights the necessity of adopting a systematic approach that includes gathering input from various stakeholders in developing and implementing a universal anatomy core competency framework, ensuring graduates are equipped for the multifaceted demands of clinical practice. Overall, the manuscript provides a comprehensive overview of the challenges and opportunities in anatomy education, with a clear call to action for a transformative approach to meet the evolving needs of medical practice.

Adapting seasonal beekeeping patterns in western Norway

This paper is about how Western Norway beekeepers synchronise their practices to perceived patterns of seasonal rhythms and adapt their timings and ways of working as they sense shifts in these rhythmic seasonal patterns associated with climatic and environmental (and social) change. It contributes to work on adaptation governance with an emphasis on the time sensitivity of adaptive action in institutions – the importance of taking the right action at the right time – and that this timing is coordinated at the convergence of multiple temporalities across human and more-than-human worlds, within temporal assemblages. The research was conducted in close collaboration with beekeepers over the 2021/2022 seasons and found them to be temporally literate practitioners that are capable of gauging shifts in temporalities, drawing on diverse temporal frameworks (both formal and informal), and recalibrating. Recalibration came both in small incremental micro-manoeuvres to maintain synchrony in a seasonal pattern, or collective efforts to fundamentally adapt or reconfiguring seasonal patterns when patterns fail to ‘hold’. From this perspective, the paper centres and elevates temporal synchronisation in adaption, with attention to the institutionalised capacity of temporally competent practitioners to make use of and recraft the cultural frameworks governing timings.

Validation of Emergency Nurse Practitioner Competencies: Patient Complexity and Clinical Decision Making

IntroductionOver the past 15 years, the emergency nurse practitioner has been recognized as a nursing specialty role with dedicated scope and standards of practice. However, a paucity of objective data exists to validate the actual practice of emergency nurse practitioners in the emergency care setting. The purpose of this pilot study was to describe the initial acuity of patients assigned to emergency nurse practitioners, actions, decisional complexity, and disposition decisions of advanced practice nurses as they function in emergency departments in a single system. MethodsThis descriptive exploratory study used retrospective chart data to gain understanding. ResultsThe most common Emergency Severity Index level seen by emergency nurse practitioners was Emergency Severity Index 3. Of 8513 encounters with Emergency Severity Index level data, 21% were triaged at Emergency Severity Index 2, 56% at Emergency Severity Index 3, 21% at Emergency Severity Index 4, and only 2% at Emergency Severity Index 5. Half of encounters resulted in a Current Procedural Terminology code of 99825 or higher and 94% were coded at 99824 or higher. There were a high percentage of admissions including intensive care unit admissions. DiscussionAlthough descriptive, this study is highly illustrative of the broad scope of complex skills and clinical decision making required to perform as an advanced practice nurse in the emergency department. Further examination of education and training is warranted.

Disrupting deliberation? The impact of the pandemic on the social practice of deliberative engagement

The coronavirus pandemic disrupted established ways of doing democracy. This was particularly the case for citizens’ assemblies that have been increasingly commissioned by public authorities to help tackle complex policy problems. The social restrictions adopted in response to the coronavirus pandemic disrupted the ‘deliberative wave’, making the in-person participation of citizens’ assemblies unviable. It forced deliberative practitioners to rethink their standard mode of operation. In this paper, we adopt social practice theory to make sense of how the meanings, competencies and materials associated with the practice of deliberative mini-publics were challenged and, at times, reformulated as practitioners were forced to adapt to digital delivery. Our findings highlight that while aspects of deliberative practice such as inclusivity were rethought, the established identity and competencies of practitioners played a constraining role in the choices and applications of technology.

Current and Future Opportunities and Challenges in Continuing Pharmacy Education: A 2024 Update

Following a 2015 conference on the future of continuing pharmacy education (CPE), the Accreditation Council for Pharmacy Education’s Board of Directors ratified recommendations to address two key questions: (1) “What next steps should the profession take to ensure practitioner competence based on marketplace and regulatory changes in the next 10 to 15 years?” and (2) “How can the value of CPE be optimized over the next 10 to 15 years?” In this article, we describe how these recommendations have been addressed since the 2015 conference, highlighting advancements in technology and the adoption of continuing professional development, and describe future directions and additional opportunities to optimize CPE.

Collaborative framework to assess achievement of American Association of Colleges of Nursing and National Organization of Nurse Practitioner Faculties patient-centered competencies using evolving case studies

BackgroundThe American Association of Colleges of Nursing (AACN) and National Organization of Nurse Practitioner Faculties (NONPF) emphasize the role of clinical reasoning in nurse practitioner (NP) competencies. Evidence-based clinical reasoning is vital to patient safety. Collaborative technology tools can aid in assessing progress towards achieving clinical reasoning competency. Purpose/aimsThe purpose of this article is to describe an electronic, collaborative learning framework to teach and assess second year NP students in systematically selecting and eliminating diagnoses and forming treatment plans. Design/methodsPost gap analysis, the collaborative learning framework was created. This visual, collaborative resource was scaffolded across two sequential advanced NP second year clinical synthesis courses and embedded with evolving case studies. Students identified pertinent positives and negatives from the history, physical, and diagnostic findings. Each student developed a unique differential diagnosis and plan of care and critiqued their peers. Result/findingsThe tool exceeded expectations. Faculty were able to visualize data, provide clarification on interpretation of data and pharmacology, and grade in small groups. ConclusionThe collaborative learning framework provided real-time visualization of students' work in clinical reasoning. It was easy to use and integrate into second year NP courses to meet learning objectives and assess clinical reasoning competency.

Reliability of the Mental Health Nurse Competency Assessment Tool (ECOEnfSM): A pilot study

AimTo evaluate the reliability of the ECOEnfSM scale as a tool to assess the professional competencies of Mental Health Nurse Practitioners (MHNP) in their clinical practice. MethodA pilot study, observational, descriptive and cross-sectional, focuses on MHNP who have completed their Specialized Health Training Program (SHTP) in Spain. The data were collected by general and collaborators mentors of the Multiprofessional Teaching Units (MTUs). The Mental Health Nursing Competency Assessment Tool (ECOEnfSM) was used, which consists of three subscales and eight Competence Units (CU). A reliability and validity analysis were conducted (Cronbach's alpha and Spearman's correlation coefficient). ResultsThe Rotation Assessment subscales showed excellent reliability (r > 0.90) with high and very high correlations (r > 0.6) in all UCs with high levels of significance (P < .01). The Annual Assessment subscale showed good reliability (r > 0.80) with a medium and very high correlation (r > 0.4) with high levels of significance (P < .01). All UCs showed a good to excellent consistency (r > 0.80). The “Home Visits” assessment criterion showed heterogeneity of data due to there are few MTUs that fully develop it. ConclusionThe ECOEnfSM scale showed very high reliability in MHNP during their training program in Spain. The ECOEnfSM is considered the only objective tool in Spain to assess the professional competencies in this population.

Exploring the literature on racism and health practitioner regulation: a scoping review protocol

IntroductionRacism in healthcare leads to significant harm to healthcare professionals and the clients, families and communities they serve. Increasingly, health practitioner regulators—responsible for protecting the public and ensuring practitioner competence—are...

Continuing education in sport psychology: a survey of where we are and where we need to go

ABSTRACT A fundamental competence for psychology practitioners is to practice according to ethical standards and principles. One way to achieve these standards includes continuing education (CE). Sport psychology practitioners (SPPs) have frequently noted the importance of engaging in CE to improve professional practice, yet more research is needed on the effectiveness of the CE available to SPPs and what SPPs think they desire in terms of CE. In this exploratory study, a multinational sample of 291 (female = 158; male = 128) SPPs at different levels of professional development participated in an online survey to gather information about their CE opportunities and their perceived effectiveness. Most SPPs (n = 223) reported that CE was mandated by their professional organizations, believed in its importance, and had experienced eight CE events on average in the previous 12 months, which were generally focused more on service delivery-related issues. Participants also offered their views on the effectiveness of the CE programmes they attended and their hopes for future topics offered by CE programmes (e.g., ethics, EDI, effective service delivery). Based on the results from this study, we share some reflections on the current status quo of CE within the sport psychology profession and offer recommendations to support professional organizations to provide effective CE opportunities to their members.

Student Perceptions of Clinical Instructor Characteristics Affecting Clinical Experiences: a Systematic Review

Objective: The aim of the study is to investigate how students perceive the characteristics of clinical instructors that have an impact on their clinical experiences and aid programs in improving clinical education, and to evaluate the effectiveness of clinical instructor characteristics. Design: Study of a systematic review. Data sources: From three online web databases including PubMed, EBSCOhost (CINAHL), and Science Direct. In addition, searches for key article references were carried out. Review studies that were published from 2017 to 2022. Review methods: A five hundred sixty-two extracted literature from databased articles published in no more than five years, the PRISMA flowchart clarifying the data collection procedure which was manually reviewed, and the study included 19 documents for further analysis. Results: Through the investigation of 19 studies that met the criteria: nine qualitative studies, eight quantitative studies, and two mixed methods. The majority of these studies were cross-sectional descriptive studies while one of them was a quasi-experimental design a pretest-posttest. Two studies from quantitative design utilized the same instrument as a standardized tool used to measure the Nursing Clinical Teacher Effectiveness Inventory (NCTEI) survey tool developed by Knox and Mogan (1985). Conclusion: The experiences and opinions of many students’ nurses, faculties, and clinical instructors about the characteristics of CI is an ongoing and fluctuating process according to their perceptions of them. However, clinical instructors are crucial in helping student nurses develop the skills necessary to be effective and competent practitioners.

Direct observation of procedural skills evaluation of suturing skills in surgical interns: A comprehensive analysis

Background: The internship period in medical education serves as a critical phase for students transitioning from theoretical learning to practical application within clinical settings. Surgical specialties, in particular, demand a high level of skill and competence from interns due to the inherent risks associated with surgical procedures. However, there is often a gap between the theoretical knowledge gained in medical college and the practical skills required in surgical practice. Aims and Objectives: Therefore, keeping all the above facts in mind, the present study was undertaken to implement direct observation of procedural skills (DOPS) as a method for evaluating the suturing skills performance in interns. Materials and Methods: This study focused on an intern in the Department of Surgery, aiming to assess their suturing skills using the DOPS method. A structured workshop was conducted to provide interns with hands-on training in suturing techniques. Subsequently, interns were divided into groups and assessed by assigned assessors using the checklist. Feedback was provided to interns after each assessment session. Data were collected through self-administered questionnaires distributed to interns and assessors, and statistical analysis was performed using SPSS software. Results: Analysis of the data revealed a significant improvement in suturing skill scores among interns following the implementation of DOPS assessments. Mean scores increased substantially from the initial to subsequent attempts, indicating enhanced proficiency in suturing skills. Interns expressed positive perceptions of the DOPS methodology, highlighting its effectiveness in driving learning and improving confidence in performing surgical procedures. Conclusion: DOPS not only facilitates skill development but also promotes confidence and competence in interns, preparing them for clinical practice. Overall, DOPS emerges as a valuable approach for evaluating and improving suturing skills among interns, contributing to their professional development as competent health-care practitioners.

The manager’s digital competencies in education system: a systematic review

This paper systematically reviews 34 WoS and Scopus studies, identifies and gives full detail of stakeholders, levels, models, educational technologies, and research prospects in formation and development of digital competencies of practitioners and future managers in education system. The six research questions put forward aim at data analysis. The results have shown that (a) pre-COVID-19 pandemic studies were of a more general, extensive nature; (b) during the COVID-19 pandemic and the post- COVID period, there has been an increase in scientific attention to formation of managers’ digital competencies; (c) there is not enough research on issues related to development of digital competencies of future managers; (d) the analysis revealed an insufficient number of studies of such a significant digital competence as Safety; (e) DigComp structure is applicable as a universal basis for professional development of digital competencies of managers; (f) the analyzed papers lack detailed study of such important digital competencies as Information and Data Literacy, Safety, and Problem Solving; (g) analyzed articles lack detailed study of important technologies for the development of digital competencies of the DigCompOrg structure for current managers. A number of practical recommendations are given for the education system in forming and developing digital competencies of managers.

Supporting practitioners to talk about sexual wellness and pleasure during radiotherapy for gynaecological cancer

IntroductionRadiotherapy treatment for gynaecological cancer has significant negative effects on sexual wellness and pleasure (1–3). Patients undergoing radiotherapy for gynaecological cancers have more sexual dysfunction and experience more sexual and depressive symptoms than those who undergo surgery alone (4). The World Health Organization defines sexual health as a crucial part of health and wellbeing and recognizes the importance of positive and respectful approaches to sexuality, alongside safe and pleasurable sexual experiences free from violence and coercion (5). MethodsTaking a sex critical approach to sexual wellness and pleasure, this project aimed to support practitioners to have improved and impactful conversations with people receiving radiotherapy treatment for gynaecological cancers. A series of three professional development workshops were held to explore language, unpack assumptions and develop key competencies for practitioners. A fourth workshop involved co-development of resources for use by other practitioners. ResultsThe group united, sharing insights, learning, and developing practices through reflection developing critical awareness about damaging silences around sexual wellness and pleasure. Co-created resources included conversation cards and a poster. ConclusionThe project aimed to build and extend research findings to develop practitioner skills in supporting sexual wellness and pleasure for people receiving gynae-radiotherapy. The study shows the benefits of discussing norms and harms associated with biomedically focused conversations in gynae-radiotherapy to acknowledge diversity and validate concerns about sexual wellbeing and pleasure. Implications for practiceA sex critical approach to sexual wellness and pleasure should be considered a core principle of care for patients during their treatment for gynaecological cancers. Conversations are a key (free) resource within the practitioner-patient relationship that can address and improve patients’ psychosocial wellbeing.