Formal Management Training Research Articles

Technology and the Roadblock. When Change Meets Organisational Culture

History shows us that success on the battlefield is not guaranteed to the side with the higher level of technological advancements. The competitive edge often resides with those who learn how to account for and integrate the required change that technology demands. This is more relevant now than ever before, given the nature of current global geo-political great power competitions. This study investigates how military leaders can manage technological changes within their organisations. Specifically, this research examines the utility of John Kotter’s Eight-Step change management theory as a potential framework. This research cross analyses a review of contemporary change literature with data from semi-structured questionnaires from current military leaders. Four main themes emerge from this primary research: 1.) Military change is constant and technology plays a vital part, 2.) Leaders influence organisational culture which impacts change, 3.) The military relies on a leader’s abilities and not a formalised process and 4.) Current military culture inhibits Kotter’s Eight-Step Model. The research findings further identify the potential positive implications for institutionalising formal change management training into professional military education to equip leadership with a roadmap to managing change and further enhancing current organisational culture.

Competencies and Development Needs of Physician Managers in Nigeria: A Case Study of selected hospitals in Ibadan City, Oyo State

The physician is traditionally the head of the medical team. To be an effective and efficient team leader is not innate but requires acquiring some competencies. The medical school curriculum was deficient in this regard hence the need for acquisition of these skills through training. Consequently, the present study aims to assess the influence of leadership competencies and Development Needs on the job performance of Physician Mangers. A cross-sectional survey was distributed among Physician Managers in various hospital types that were purposefully selected. Ten Physician Managers were also interviewed for in-depth information of skills they require to perform well. Descriptive and inferential statistics were used to summarize the items of the questionnaire at 5% level of significance and to determine if a significant difference existed between groups of Physician managers. Results show that possessing the competencies; communication and relationship management, leadership and business skills and knowledge do influence the job performance of Physician Mangers. There was a significant difference between physicians that had formal training in management and those that had none in the communication and professionalism domains. Seven Physician Managers from different types of hospitals were interviewed, two of them females. They had been in managerial positions from 6months to 34 years. They all emphasised communication and leadership skills as important competencies for every physician manager. They all also suggested that management training must be introduced either during undergraduate or postgraduate training and that physician as head of the medical team require regular management update training.

Laboratory Management for Cytopathology Fellows: Our Institution’s Curriculum

Abstract Introduction/Objective The cytopathology laboratory is one of the most highly regulated clinical laboratories. The Accreditation Council for Graduate Medical Education (ACGME) milestones include competencies in laboratory management. Additionally, many cytology fellows will be involved in laboratory management after finishing training. Therefore, it is imperative to incorporate formal laboratory management training for cytology fellows. Our cytopathology department implemented a formal laboratory management curriculum this year, with emphasis placed on the milestones (1.0 and 2.0) provided by the ACGME. Methods/Case Report The curriculum is divided into seven modules extending throughout the fellowship year (August-April). The modules include hand-off communication, process improvement, laboratory accreditation (introduction, intermediate, advanced) and error management (introduction, intermediate). Each module has two components: self-study of assigned reading materials and online courses, followed by an interactive session with faculty and/or laboratory personnel. Several engaging, high-quality resources are used including Institute for Healthcare Improvement Open School, modules from professional organizations, PubMed articles, National Quality Forum, departmental committees and mock inspections. Each module is followed by an interactive session to review policies, procedures and/or checklists. The fellows also spend time in the cytology laboratory preparation area and participate in Quality Improvement meetings. Results (if a Case Study enter NA) The fellowship director discusses the educational expectations at the start of each module. Evidence of compliance is demonstrated by uploading all of the completed assignments to MedHub (a web- based training management system) at the end of the module. All of the modules include self-assessment questions that are reviewed by the fellowship director. Conclusion Our cytopathology laboratory introduced a structured laboratory management curriculum. This curriculum fulfills some of the laboratory management competencies put forth in the ACGME milestones. This curriculum will also help to prepare fellows to confidently participate in cytology laboratory management as they enter the workforce.

Conflict resolution and negotiation in pediatric surgery

Conflict is pervasive in pediatric surgery – it is experienced during patient care, in the operating room and between colleagues. The ethical principles of autonomy, beneficience, non-maleficience and justice are firmly anchored in any discourse regarding conflict in the setting of healthcare. The authors review key features of conflict in healthcare including the effect on patient outcomes as well as implications for the ability of the surgeon and the medical team to function appropriately and safely when conflicts arise. Although most pediatric surgery fellowship programs have no formal training in conflict management, much has been written about strategies to teach and utilize techniques of conflict mitigation and negotiation. In this article, the authors discuss common areas of conflict in the medical environment and suggest useful tools for the practicing pediatric surgeon to aid in the resolution of conflict.

Assessment of Relationship Between Hospital Resource Management Capacity and Characteristics of Hospitals and Managers

Objective: The purpose of the study is to investigate the relationship between hospital resource management capacity and hospital and manager characteristics.
 
 Methods : The study was conducted on 41 hospitals affiliated to the Ministry of Health of Turkey in Istanbul and Ankara and 232 hospital managers working in these hospitals. Primary and secondary data sources were used as data collection methods. In the first part of the survey, which is used as the primary data source, the questions related to the duties of the managers, gender, total management time, the period of management in the hospital, formal management training, organizational and professional commitment and identification levels and hospital capacity management levels were included, which is used as the primary data source. As the secondary data source, hospital statistics were applied and data related to the characteristics of the hospitals. 
 
 Results: Exploratory factor analysis was performed to determine whether the questions used to evaluate the resource management capacity of the hospitals were structurally valid. As a result of exploratory analysis, a three-factor structure consisting of equipment, workforce and facility dimensions was reached, and the confirmatory factor analysis conducted to test the accuracy of this structure was found to be acceptable for the goodness of fit values. As a result of the structural equation model used in the study, the type of hospitals and the number of medical specialties, and the gender of the managers have significant effects on the resource management capacity of hospitals (p 0.05).
 
 Conclusion: According to the findings, resource management capacities of specialty hospitals are at a better level than general hospitals. This result shows that the type of service and the scope of service in specialty hospitals are clearly defined. Even if the number of medical specialties becomes more complex in the findings, the resource management capacity of the hospitals is managed more successfully. In the last findings, it was concluded that female managers are more successful in evaluating resource management capacity.

Primary trauma care course: Alternative basic trauma course in developing countries. "The Need Of The Hour".

Low- and middle-income countries account for over 90% of all road traffic injury deaths. Despite this, formal training in trauma management is not widely adopted in these countries. No specific training was available in prehospital or emergency department for life support before primary trauma care (PTC) course. This study was conducted to assess the effectiveness of the PTC course in the improvement of knowledge and skills of trauma management among participant in Pakistan. Two days of PTC courses were organised and conducted in various regions of Pakistan, participants per course comprising medical students, doctors, house officers, residents, and paramedics. The course comprises lectures of 5hours and 30minutes, skills workshops for 3hours and discussion and multisystem trauma scenarios for 3hours. Trauma management knowledge and clinical confidence of candidates were assessed using a predetermined multiple-choice questionnaire of 30 MCQs both at pre- and post-course, and using clinical scenarios, confidence matrix was assessed. A total 7852 of participants were trained, an average of 2 courses per month and 302 total courses. Mean score of pre-course MCQs was 60% and mean score of post-course MCQs was 82%. Among the participant postgraduate trainees, average in trauma knowledge and trauma clinical confidence were significantly higher in both pre- and post-course. The mean score of pre-course confidence matrix was 70% and the mean score of post-course confidence matrix was 93%; at the end of course, all participants showed a high level of confidence in managing trauma mock scenarios. A total of 5889 (75%) participants had a ≥78.5% post-workshop knowledge score. However, only 1963 (25%) participants had a trauma skill score with ≤75 marks. PTC workshop could be an alternative and cost-effective flexible course for gaining knowledge and clinical skills of initial trauma management and strengthening the capacity of trauma management training in developing countries with minimal resources for saving the life of trauma victims.

Finding the roots: experimentation in innovation project management

PurposeProject management practices have been losing its central place in innovation processes within the companies due to its excessive control-oriented phased approach. Hence, the purpose of this paper is to propose and examine the project management practitioners' experiences on the systematic use of an experimentation framework to manage innovation projects.Design/methodology/approachThree case studies were carried out in three different Brazilian companies for a ten month period. The authors have chosen these companies for the following reasons: they were all in an innovation context; they have never carried out a project based on experimentation and they had previous experience with project management traditional tools.FindingsThe findings have shown that our framework can contribute to the project management available toolkit; once the rigid experimentation process, the authors’ proposed made it easier for project management practitioners to adapt to more flexible approaches. Nonetheless, stakeholders' involvement has shown to be a key success factor on the deployment of the framework.Practical implicationsManagers still need to add expertise in flexible methods into their managerial skills, so they are able to deal with innovation just as they deal with traditional processes they were trained to. This suggestion can also be extended to the business schools.Originality/valueThe case studies have shown that traditional project management practices can also be applied in innovation projects. So despite of generally being the opposite of an experimentation process, those practices are relevant in project management discipline, which means that formal project management training is still a good ally to project management practitioners.

The 3Ds – Discussion, diagnosis and direction: Elements for effective obesity care by healthcare professionals

BackgroundThe care of people with obesity is often suboptimal due to both physician and patient perceptions about obesity itself and clinical barriers. Using data from the ACTION-IO study, we aimed to identify factors that might improve the quality of obesity care through adoption of the 3D approach (Discussion, Diagnosis and Direction [follow-up]) by healthcare professionals (HCPs). MethodsAn online survey was completed by HCPs in 11 countries. Exploratory beta regression analyses identified independent variables associated with each component of the 3D approach. ResultsData from 2,331 HCPs were included in the statistical models. HCPs were significantly more likely to initiate weight discussions and inform patients of obesity diagnoses, respectively, if (odds ratio [95% confidence interval]): they recorded an obesity diagnosis in their patient's medical notes (1.59, [1.43–1.76] and 2.16 [1.94–2.40], respectively); and they were comfortable discussing weight with their patients (1.53 [1.39–1.69] and 1.15 [1.04–1.27]). HCPs who reported feeling motivated to help their patients lose weight were also more likely to initiate discussions (1.36 [1.21–1.53]) and schedule follow-up appointments (1.21 [1.06–1.38]). By contrast, HCPs who lacked advanced formal training in obesity management were less likely to inform patients of obesity diagnoses (0.83 [0.74–0.92]) or schedule follow-up appointments (0.69 [0.62–0.78]). ConclusionSpecific actions that could improve obesity care through the 3D approach include: encouraging HCPs to record an obesity diagnosis; providing tools to help HCPs feel more comfortable initiating weight discussions; and provision of training in obesity management. Clinical trial registrationNCT03584191.

Physician's experience on managing asthma in adolescents: results of the International AMADO (Asthma Management in ADOlescents) survey.

BackgroundWorldwide prevalence of asthma seems to be increasing in adolescents, but limited data is available regarding the management of asthma in this age group.ObjectiveTherefore, we conducted an international survey focused on physicians who manage asthma in order to understand how Asthma Management in ADOlescents (AMADO) is currently performed.MethodsThe AMADO survey is a web-based global survey of physician's attitudes towards the management of asthma in adolescents, circulated for 17 weeks. The survey had an anonymous and voluntary standard. The questionnaire consisted in 27 questions covering the training background of respondents, difficulties in diagnosis, and in management of asthma in adolescents.ResultsTwo hundred forty-four responses were received from 46 countries, from all continents. Most (65%) of participants indicated allergy as being their main specialty. The majority of participants (62%) had more than 5 years of clinical practice, but 62% have no formal training in management of adolescents with asthma. Most of participants (96%) indicated having at least one case of asthma in adolescents per month. 60% of respondents mentioned that the asthmatic adolescents only had the consultation due to the family imposition. All respondents mentioned having difficulties in the management of asthma in adolescents due to patient poor adherence. Overall, 44% of participants have no specific health care resources for adolescents in their departments. Main suggestions from the participants were: optimization of time and personalized communication to these cohort, and standardization of multidisciplinary actions to improve adherence to asthma control treatment.ConclusionManagement of asthma in adolescents is still a challenge in clinical practice. The results from this survey helped us to identify the key issues to improve clinical outcomes in the future. This survey is the first step of the international AMADO initiative, which intends to optimize diagnosis and control of asthma and prevent avoidable deaths.

Public Health Officials and COVID-19: Leadership, Politics, and the Pandemic.

Public Health Officials and COVID-19: Leadership, Politics, and the Pandemic.

Mentoring each other: Creating a community of practice for aspiring and current library managers

Integrating formal management training into library school curriculum has been a topic of discussion for years, with varying progress. And in our experience, librarians are rarely given formal training on the job before becoming managers. We need to find ways to support new managers, helping them to acquire skills to handle the interpersonal, economic, and political challenges. Human Resources departments can provide valuable training in policy and procedures of the organization, but libraries have unique management challenges that may not exist elsewhere on campus. Librarians may be asked to manage faculty, staff, and student workers. They may need to arrange for coverage for service points, as well as work as an academic department. They work on projects with people from all parts of campus. Sometimes only other librarians understand the different dynamics of our situation. But when you’re a manager, it can be awkward to discuss specific management concerns with colleagues in your organization. Meeting with librarians from other institutions provides a comfortable level of anonymity.

The current state of biosecurity and welfare of ornamental fish population in pet fish stores in Chiang Mai Province, Thailand

Aquaculture has undergone extensive development in recent decades due to its use as a source of protein for human consumption, as models for scientific research, and as pets. The purpose of this study was to survey ornamental fish stores in Chiang Mai province, Thailand to identify practices which affect life quality and welfare of pet fish including general management, biosecurity management, and knowledge about fish disease and drug usage of ornamental fish store owners. The results show that most pet fish stores have poor husbandry in terms of fish health based on the observed incidence of skin erosion and fin rot (92.86%) and white spots on the skin (78.57%) in store fish. Moreover, treatment of these health conditions were performed by experienced people working in the stores without consulting a veterinarian. The top three drugs used for treatment included malachite green oxalate, trichlorfon, and formalin. Interestingly, oxytetracycline and chlortetracycline were also used frequently to treat fish disease. Despite a lack of formal training in fish management, fish health, and drug usage in ornamental fish, the knowledge of owners about fish disease and antibacterial agent usage was determined to be of an intermediate level based on testing. The information gained from this study can be used in future studies to identify stressors that affect pet fish welfare and to investigate biosecurity and ornamental fish welfare in the other sectors of the ornamental fish trade supply chain.

The Current State of Snakebite Care in Kenya, Uganda, and Zambia: Healthcare Workers' Perspectives and Knowledge, and Health Facilities' Treatment Capacity.

Snakebites continue to be a public health concern in sub-Saharan Africa, where availability of appropriate medical treatment is rare, even though death and disability can be prevented with timely intervention. A challenge is the lack of sociopolitical studies to inform health policies. This study aimed to identify snakebite patient profiles, healthcare workers' (HCWs) knowledge of snakebite, and facilities' snakebite treatment capacity in Kenya, Uganda, and Zambia to inform interventions to improve access to appropriate treatment. The research comprised a cross-sectional key informant survey among HCWs from health facilities in Kenya (n = 145), Uganda (n = 144), and Zambia (n = 108). Data were collected between March 2018 and November 2019. Most of the HCWs suggested that the number of snakebite incidents was similar between the genders, that most patients were aged 21-30 years, and most people were bitten when farming or walking. Overall, only 12% of HCWs had received formal training in snakebite management. Only about 20% of HCWs in each country said their health facility had the medicines needed to treat snakebites, with antivenom available in 0-34% of facilities across the sectors and countries, and snakebites were not systematically recorded. This research shows that an integrative approach through policies to increase resource allocation for health system strengthening, including community education, HCW training, and improved access to snakebite treatment, is needed. Part of this approach should include regulations that ensure antivenoms available in health facilities meet quality control standards and that snakebites are accommodated into routine reporting systems to assess progress.

Obesity Management in Primary Health Care: Front-Line Providers’ Experiences and Views

As in the rest of the world, obesity in Oman has increased and according to World Health Organization (WHO) data, prevalence of obesity in 2008 and 2016 were 20.9% and 27% respectively. This study explores primary care physicians’ current strategies and management of obesity, attitude and perceptions towards obesity, educational needs, and their views on long-term follow up.
 Methods: A cross sectional study was conducted where practicing family medicine physicians from different governorates were invited to participate in an online questionnaire-based survey. Participant were invited via email and responses were kept anonymous. Responses were collected over three weeks in April 2019 and only responses that met inclusion criteria were analyzed with SPSS v22.
 Results: 77 complete responses met inclusion criteria and female were the majority (67.5%). Half of participants had less than 10 years of experience. Weight and BMI were recorded routinely by two-thirds of participants whereas waist- hip ratio was recorded by only 12%. Weight reduction medications were prescribed by 5.2% and 24% would refer an obese patient to Bariatric center. Main barrier to obesity management and referral was inadequate obesity specialist centers followed by short consultation times. The pathophysiology mechanism of obesity and related hormones was only known by 40.8%. Almost all participants agreed that formal obesity management training should be integrated as part of residency training.
 Conclusion: Despite the significant number of comorbidities related to obesity and its complications, weight, BMI and other anthropometric measures were not routinely performed. Nationally, the rate of referral to bariatric centers for evaluation is low. Boundaries and challenges do exist and need to be addressed. Obesity and weight management need to be integrated as part of Family Physicians Training Program.

Assessment of the Understanding of Concussion and Care Protocols Amongst Student Athletes and Coaches: A Qualitative Study.

Background: Pediatric sports-induced concussions have become a topic of interest and concern in the scientific community. Already, the literature is rich with studies that have identified numerous short-term and long-term consequences of childhood sports-induced concussions. However, there are very few studies that have identified how well the students who participate in concussion-prone sports and their coaches understand these consequences and how they can be avoided. This study aimed to explore student athletes' and their coaches' understanding of the concept of concussion and how it is managed both immediately after the injury occurs and during long-term recovery.Methods: This study utilized a qualitative design. The study was conducted in local and international schools in Singapore. Participants were recruited through purposive sampling. 42 student athletes aged 13–18 who participated in rugby, softball, football, cricket, volleyball, and/or water polo were recruited. Fourteen coaches who coached these same sports were also recruited. Four focus groups and three semi-structured interviews were conducted. Data collected were then analyzed with thematic analysis. Risk factors were assessed through four domains of focus: understanding of what concussion is; attitudes toward concussion; existing protocols for treating concussion; and return-to-school and return-to-play protocols. As this is a qualitative study, outcome measures were not identified.Results: Analysis of the data revealed four themes for each group. For student-athletes these included: limited understanding of concussion; non-reporting of injuries; variable supervision of athletes; and a lack of established return-to-school and return-to-play guidelines. For coaches these included: variable understanding of concussion; insufficient formal training in concussion management; limited medical support in managing injuries; and lack of understanding and adherence to return-to-school and return-to-play protocols.Conclusions: Of the themes identified, the most pressing was a lack of clearly defined return-to-play guidelines. This is an urgent issue that needs to be jointly addressed by healthcare professionals and schools with evidence-based guidelines.

A Call for Leadership and Management Competency Development for Directors of Medical Services-Evidence from the Chinese Public Hospital System.

Background: A competent medical leadership and management workforce is key to the effectiveness and efficiency of health service provision and to leading and managing the health system reform agenda in China. However, the traditional recruitment and promotion approach of relying on clinical performance and seniority provides limited incentive for competency development and improvement. Methods: A three-component survey including the use of a validated management competency assessment tool was conducted with Directors of Medical Services (n = 143) and Deputy Directors of Medical Services (n = 152) from three categories of hospital in Jinan, Shandong Province, China. Results: The survey identified the inadequacy of formal and informal management training received by hospital medical leaders before commencing their management positions and confirms that the low self-perceived competency level across two medical management level and three hospitals was beyond acceptable. The study also indicates that the informal and formal education provided to Chinese medical leaders have not been effective in developing the required management competencies. Conclusions: The study suggests two system level approaches (health and higher education systems) and one organization level approach to formulate overall medical leadership and management workforce development strategies to encourages continuous management competency development and self-improvement among clinical leaders in China.

An Exploratory Analysis of Social Science Graduate Education in Data Management and Data Sharing

Effective data management and data sharing are crucial components of the research lifecycle, yet evidence suggests that many social science graduate programs are not providing training in these areas. The current exploratory study assesses how U.S. masters and doctoral programs in the social sciences include formal, non-formal, and informal training in data management and sharing. We conducted a survey of 150 graduate programs across six social science disciplines, and used a mix of closed and open-ended questions focused on the extent to which programs provide such training and exposure. Results from our survey suggested a deficit of formal training in both data management and data sharing, limited non-formal training, and cursory informal exposure to these topics. Utilizing the results of our survey, we conducted a syllabus analysis to further explore the formal and non-formal content of graduate programs beyond self-report. Our syllabus analysis drew from an expanded seven social science disciplines for a total of 140 programs. The syllabus analysis supported our prior findings that formal and non-formal inclusion of data management and data sharing training is not common practice. Overall, in both the survey and syllabi study we found a lack of both formal and non-formal training on data management and data sharing. Our findings have implications for data repository staff and data service professionals as they consider their methods for encouraging data sharing and prepare for the needs of data depositors. These results can also inform the development and structuring of graduate education in the social sciences, so that researchers are trained early in data management and sharing skills and are able to benefit from making their data available as early in their careers as possible.

Perspective of United States Judo Coaches on Concussion: A National Survey

Concussions among athletes in contact sports are a prevalent health concern in the United States. There are few studies that have assessed concussion from the perspective of judo coaches. This is a descriptive study of a survey sent to 1,056 United States judo coaches assessing their attitudes, knowledge, and practices toward concussion. The survey had a response rate of 21%, with 215 total responses. Though most coaches could accurately identify common symptoms of concussion from a case presentation, many also misidentified nonconcussion and red flags (e.g., facial droop) as symptoms of concussion. A minority of coaches reported any formal training in concussion management. USA Judo coaches are receptive to and would benefit from a sport-specific standardized concussion training program.

Developing senior hospital managers: does \u2018one size fit all\u2019? \u2013 evidence from the evolving Chinese health system

BackgroundTo improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency.MethodsA cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n = 498) from three categories of hospital in Jinan, Shandong Province, China.ResultsThe survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate. The core competencies identified in the Australia context were applicable to the management roles in Chinese hospitals. In addition, the senior executives had low levels of confidence in their management competence. Furthermore, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence.ConclusionsThe study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management.

Exploring the link between management training and organizational performance in the small business context

PurposeThis study aims to explore the impact of management training on organizational performance in the small business context to evaluate whether formal management learning interventions bring organizational benefits to small enterprises.Design/methodology/approachA qualitative approach was adopted consisting of 100 interviews with small firm owners/managers and employees working in 50 Greek small enterprises operating in the manufacturing and services sectors. Participant firms consisted of 25 small enterprises (9 manufacturing firms and 16 firms in the services sector) whose owners/managers have completed various formal training interventions (i.e. accredited seminars and workshops, business and management courses, etc.,) and 25 small enterprises (16 manufacturing firms and 9 firms in the services sector) whose owners/managers have not completed any sort of formal business training and have never attended formal management courses.FindingsThe findings revealed that management training in small businesses had a positive impact on organizational performance. In particular, those respondents that completed formal training interventions argued that their firms achieved increased profitability during 2017 and 2018; improved staff productivity; very low staff turnover rate; and enhanced staff satisfaction and motivation compared with the less-trained owners of small firms in the same sector. The participants pointed out that their formal education in business and management has enabled them to realize the importance of employee learning and job design for staff motivation, whereas it has helped them to manage change more effectively.Practical implicationsThe present findings have major implications for practitioners (i.e. small firm owners/managers), as they point to a positive link between management training and organizational performance, thus encouraging them to invest in their self-development.Originality/valueThe existing evidence around the impact of management training on firm performance has been based mostly on quantitative research in large organizations. However, the available empirical studies fail to explore in-depth how formal management training can help smaller enterprises achieve improved organizational performance. Against this background, the present study sheds new light on this area.