Graduate Health Professionals Research Articles

Sociotechnical imaginaries in academic medicine strategic planning: a document analysis.

Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures.

Implementation of Educational Opportunities for Social Determinants of Health in Health Professions Education: A Scoping Review

Objective Health professions programs have recently increased their efforts to educate health care professionals about the social determinants of health (SDH); however, there seems to be a disconnect between graduate medical education and its applicability to other peer health professions. The current scoping review aims to map the literature that explores the implementation of educational opportunities focused on SDH in health professions education programs. Data Sources PubMed, CINAHL, ERIC, Education Source, and the Health Policy Reference Center were searched to identify relevant articles. Study Selection To be included in our review, articles had to have been published in the last 5 years and describe how material related to SDH was implemented into a graduate health professions education program. Outcomes were analyzed by thematic categories by type of curricular delivery (didactic, clinical education, service-learning experience, or reflection), timing of the implementation in the program, methods of implementation, and assessment after implementation. Data Extraction Our search identified 2006 articles that were reviewed by study authors; 36 were included in our full-text review. Information extracted included the study design, type of graduate education, aims of the studies, description of technique, timing of implementation, type of curricular delivery, and outcomes. Data Synthesis The majority (23, 63.9%) of studies used an observational design and used 2 or more (27, 75.0%) types of curricular delivery presented to medical students. Didactic (19, 52.8%) and small-group discussion (14, 38.9%) methods were used most often. Assessments were mostly student reflections or self-report items. Overall, students reported increased knowledge and satisfaction with activities. Conclusions Results of our scoping review indicated that various education opportunities related to SDH exist in graduate health professions education but are likely insufficient. More studies are necessary to investigate the purposeful implementation of SDH and the best methods to assess student knowledge of SDH. Future research should also investigate how to objectively assess student learning of SDH.

Undergraduate students' choices around community service and internship: A single faculty study.

The Internship and Community Service Programme (ICSP) places newly graduated health professionals for a compulsory training period. Universities adopt multiple strategies to encourage students to select rural placements for ICSP. This study describes ICSP choices among final-year MBChB and Health and Rehabilitation Science students at a South African university and the factors influencing their decisions. A cross-sectional qualitative descriptive study was conducted using a self-developed online questionnaire. Eighty-five final-year students were recruited. Most respondents (n = 38, 45.8%) chose the Western Cape (WC) as their first choice placement. There was a significant difference between MBChB and other health science students' choice of level of healthcare (χ = 10.39, p = 0.006), with MBChB less likely to choose primary healthcare (PHC) level placements. District and tertiary care options were perceived as better sites for learning and practice, while PHC and rural sites, considered underresourced and understaffed, were avoided. Although MBChB students indicated a lower preference for rural placements, this was not significant.Factors influencing ICSP application decisions included professional support, work environment, and social and personal considerations. Students' placement choices were based on their perceptions of clinical exposure, learning opportunities, mentorship and supervision. Placements closer to home were preferred. UG clinical exposure and rural background seem to have some impact on choice but need further investigation. Universities should continue to explore ways to improve students' readiness for practice in underresourced settings. Improved exposure to rural and PHC sites during training could encourage better uptake during ICSP placement.

0341 Navigating Sleep: Perceptions of Graduate Health Professions Students

0341 Navigating Sleep: Perceptions of Graduate Health Professions Students

Identifying the Needs of a Diverse Cohort and Engagement Opportunities That Foster a Sense of Belonging at a Hispanic-Serving Doctoral Program

ABSTRACT This mixed method study assessed the perceptions of health professional graduate students on a sense of belonging and evaluated the engagement experiences valued most in a graduate program across three domains of belonging, academics and diversity, equity and inclusion. Hispanic students valued building professional relationships with faculty and mentors more than non-Hispanic students while non-Hispanic students valued opportunities to discuss race relations outside the classroom. Belonging at the graduate level in health professional programs is distinct from undergraduate programs because of new expectations of developing into entry level clinicians. This study showed that Hispanic students significantly valued building connections with mentors, faculty and staff, identifying a need of continued supportive mentoring relationships within this population at the graduate level. Implications of these findings across the available literature are discussed.

Health professional graduate perspectives of practice education during the COVID-19 pandemic

Introduction: COVID-19 created a need to rapidly adapt practice education placements to minimise the impact on students’ progression to graduation. Physiotherapy and occupational therapy students at one university completed their final practice education placement between April and May 2020, during the period when health care was urgently adapting to the developing pandemic. 
 Aim: This study explored the impact of this final placement on new graduates, following their employment. 
 Method: 10 students took part in 3 online focus groups to share their experiences and perceptions of the impact on their preparedness for professional practice 
 Results: Four themes emerged from the analysis of transcripts including: 1. Coping with uncertainty, 2. Rising to the challenge, 3. Developing skills and competence and 4. Readiness for employment in the “new world” of practice. Overall, the study demonstrates the resilience of students in response to these unusual circumstances. Strategies including peer support, demonstration of learning, and client-centredness increased confidence and the development of professional identity. 
 Conclusion: Graduates identified both positive and negative experiences of placement during COVID-19, but overall felt proud that they had demonstrated resilience and developed skills relevant to their current employment as professionals.

Assessment of Awareness and Perceptions of Healthcare Professional Graduates Regarding the Use of Clear Aligners in Orthodontic Treatment.

Background Clear aligners have been one of the most recent advancements in the field of orthodontics. With an increasing demand for aesthetics, the use of clear aligners has progressed, but knowledge is still lacking among the population. Therefore, this study aims to evaluate the perception and awareness of health professional graduates regarding the use of clear aligners in orthodontic treatment. Materials and methods A draft questionnaire was formulated and validated consisting of eight open-ended questions assessing the perception of respondents and two close-ended questions assessing awareness of clear aligners. A web-based survey was performed. The sample (n=438) population included graduates of different health professions including medical (248), Ayurveda (114), nursing (18) and physiotherapy(58). A Google form was prepared and the link was circulated to all.The response was sought in terms of Likertscales. Results A total of 438 graduates responded to the questionnaire, of which 56% were from medical faculty, 26% from Ayurveda, 13.20% from physiotherapy, and 4.1% from nursing. On average, the awareness and perception of health professional graduates regarding the use of clear aligners in orthodontics was average to low. Among all the health professions, the graduates from the medical faculty showed maximum knowledge regarding clear aligners, whereas the awareness amongst the nursing students was the least. Conclusion On assessing the knowledge of health professional graduates from different faculties regarding clear aligners, statistically different results were found for responses from all faculties. Since it is one of the most recent advancements in the field of orthodontics, there is a need to bridge this knowledge gap among health professionals, which would help them guide their patients to seek the best treatment modality at the appropriate age.

How does COVID‑19 affect community-based clinical training for Undergraduate dental therapy programs?

Universities, in particular, the health professional graduates they produce, contribute significantly to a workforce that aim to meet the healthcare needs of societies. The core competencies for a newly graduated health professional include compassion and care, effective communication, awareness of multiculturalism in patient care, collaboration with other health professionals and leadership in change management.[1] To achieve this end, many institutions of higher education have integrated community-based education into their health sciences programs.

Graduate health professions education programs as they choose to represent themselves: A website review

Introduction: In an age of increasingly face-to-face, blended, and online Health Professions Education, students have more choices of institutions at which to study their degree. For an applicant, oftentimes, the first step is to learn more about a program through its website. Websites allow programs to convey their unique voice and to share their mission and values with others such as applicants, researchers, and academics. Additionally, as the number of health professions education (HPE) programs rapidly grows, websites can share the priorities of these programs. Methods: In this study, we conducted a website review of 158 HPE websites to explore their geographical distributions, missions, educational concentrations, and various programmatic components. Results: We compiled this information and synthesized pertinent aspects, such as program similarities and differences, or highlighted the omission of critical data. Conclusions: Given that websites are often the first point of contact for prospective applicants, curious collaborators, and potential faculty, the digital image of HPE programs matters. We believe our findings demonstrate opportunities for growth within institutions and assist the field in identifying the priorities of HPE programs. As programs begin to shape their websites with more intentionality, they can reflect their relative divergence/convergence compared to other programs as they see fit and, therefore, attract individuals to best match this identity. Periodic reviews of the breadth of programs, such as those undergone here, are necessary to capture diversifying goals, and serves to help advance the field of HPE as a whole.

Barriers and opportunities for promoting health professions careers among African American students in the Midwest

The purpose of our study is to examine the barriers and facilitators for urban African American students interested in pursuing health professions careers in the Midwest. In our analysis of the key informant interviews and focus groups, we identified four barriers (lack of preparation, lack of funding, lack of support/isolation, and perceived discrimination) and three facilitators (early preparation, support/mentorship, funding). We provide recommendations for how to leverage these facilitators and address the barriers to increase the representation of African Americans in the healthcare workforce. Novel future directions for this work should include comprehensive interventions tailored to URM students that span the health professions education pipeline and begin as early as elementary school. Interventions that engage mentors should take place at high school, undergraduate, and graduate health professions school levels.

Belonging in Graduate Health Professions Education- Implications for Occupational Therapy Education: A Scoping Review

Belonging in Graduate Health Professions Education- Implications for Occupational Therapy Education: A Scoping Review

Leadership behaviours in interprofessional student teamwork

BackgroundEffective leaders support high-quality patient care and improve patient safety by embodying a collective leadership style. Training in leadership skills needs to be integrated longitudinally throughout a clinician’s career. Models of leadership drawn from organisational theories can provide a conceptual framework for cultivating student leadership qualities during teamwork and the evaluation of emergent outcomes. Using the conceptual framework of Situational Leadership Theory, we sought to explore the leadership qualities identified by students of their team members, during a large scale interprofessional learning activity.MethodsIn 2018, 1674 students from 11 health disciplines were required to participate in the “Health Collaboration Challenge” (HCC). The HCC required students to work in small interprofessional teams of five or six students. Following team activities, students were required to provide constructive written feedback to their team members. Peer feedback data were coded and categorised into themes using the conceptual framework of Situational Leadership Theory. Data were then quantified within each theme.ResultsA total of 1282 comments were analysed. The most frequent comments related to ‘delegating’ (456/1282, 36%) and ‘supporting’ (402/1282, 31%). This was followed by comments categorised as ‘directing’ (244/1282, 19%), and ‘coaching’ (180/1282, 14%) leadership styles. Notably, a total of 1112/2597 (43%) of comments were unconstructive. A total of 298 comments provided by students informed their peers of areas for self-improvement. The most frequent comments were recommendations relating to ‘active team member contribution’ (111/298; 37%), followed by ‘communication’ (83/298; 28%), ‘interprofessional practice’ (77/298; 26%), and ‘disciplinary knowledge’ (27/298; 9%).ConclusionAlthough most students demonstrated a reasonable ability to display leadership behaviours appropriate to teamwork, further development is needed through training. Leadership skills are an expectation of health professional graduates, and should be explicitly taught and vertically integrated within interprofessional education curricula. Further research is warranted in how students contribute to and understand the requirements of leadership within interprofessional teams.

Statistical consulting in the healthcare professions: A model of student‐led consulting services

Statistical consulting is a common and vital activity undertaken by those with advanced statistical training but may not be widely available to health professionals and trainees without access to dedicated statistical consulting cores. Here, we present a novel model of statistical consulting used by a student chapter of the American Statistical Association housed in a graduate health professions university. This student‐led organization provides statistical consulting services for faculty, staff and students university‐wide. Information on the methods of advertising consulting services, the role of a professional statistician faculty advisor, resources available to consultants and university community members and the ways in which consulting services were adapted to address the barriers introduced by the COVID‐19 pandemic are addressed. Data from 108 consults performed over the past two and a half years with 88 different consultees are analysed and discussed. This article outlines an innovative model of student‐led statistical consultation for healthcare professionals and trainees and aims to provide a template for future student‐led organizations who similarly aim to perform university statistical consultations.

Interprofessional Education And Student Understanding of Their Future Roles and Responsibilities as Health Professionals

<h3>Research Objectives</h3> To investigate student perceptions regarding their own roles/responsibilities on healthcare teams, as well as those of other professions, and explore ways to improve interprofessional education (IPE) courses for health professions students. <h3>Design</h3> Volunteer health professions students participated in online focus group sessions and were asked a series of structured, open-ended questions regarding their profession's roles/responsibilities on a healthcare team, as well as those of other professionals. Responses were transcribed for qualitative analysis by two independent coders who extracted major themes and subthemes. <h3>Setting</h3> Four online Microsoft Teams focus group sessions. <h3>Participants</h3> Undergraduate and graduate health professions students who previously participated in an IPE workshop. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Themes and subthemes obtained from student answers to focus group questions. <h3>Results</h3> Five major themes were constant among focus group sessions: (1) Learning and Roles, (2) Team-based care, (3) Personal voice, (4) Logistics, and (5) Resolutions. Numerous sub-themes emerged, including integration of roles, sharing responsibility, and respect for individual roles, among others. <h3>Conclusions</h3> Rehabilitation medicine is a diverse and integrated field. Integrated care can improve patient outcomes. IPE enables students to understand their professional roles and limits on healthcare teams, as well as respect and appreciate the roles and responsibilities of others on the team. Students enjoy collaborating as a team to provide patient care. Feedback centered on ensuring equal opportunity among professions to share and contribute, standardizing roles of group facilitators, and providing preparatory materials prior to IPE workshops can allow students to maximize their contributions to the group. <h3>Author(s) Disclosures</h3> No disclosures to report.

Systematic Website Review of Diversity Embeddedness in U.S.-Based Graduate Health Professions Education Programs

Systematic Website Review of Diversity Embeddedness in U.S.-Based Graduate Health Professions Education Programs

Reimagining Preparedness of Health Professional Graduates Through Stewardship

Issue: Preparing health professional students for practice matters and is an important objective of health professional education. But although health professional courses grow in number and continue to graduate entry-level practitioners annually, there are signs that health professional education is not quite hitting the “purpose” mark. Preparedness is a term encountered often in health professional education, but it is besieged with challenges. Those challenges relate to whether graduates are prepared for their future careers and how preparedness for practice is understood; understandings of preparedness influence what curriculum, teaching, and learning prepares graduates about and for. Evidence: There is a wealth of the literature that suggests that graduates are not prepared for practice or believe they are not. This literature tends to grow rather than diminish, with arguments about preparedness materializing time and again. Preparedness means different things to students, academics, and practitioners and this creates misunderstanding as well as lessening the construct’s value to research, education, and practice. What it means to be prepared is in fact not a static construct but changes in response to the needs of individuals and communities and broader societal context. When preparedness is defined as competence in skills or knowledge, graduates will be ill equipped to operate in the chaotic, ambiguous times we now face as competencies tend to oversimplify and reduce the demands of practice. Implications: Preparedness is only one purpose that could be attached to the educational formation of university graduates. It is time we expand our thinking about what is valuable and necessary to learn in order to become health professionals equipped to address the health and social care problems now and to come. Furthermore, continuing to address the challenges of preparedness for practice in the same ways as we have done for decades will not result in change; new and different educational approaches are required to meaningfully reimagine health professional education. We need to value education as a scholarly field in its own right, as much as we do evidence-based healthcare. A concept that prompts us to think and act in these reinvigorated ways is stewardship, which I offer as an expansive way to think about the purposes and desired outcomes of health professional education. Stewardship is an idea that sustains and cares for the professions, and therefore is highly relevant to the preparation of healthcare practitioners.

The role of dietetics accreditation standards in supporting practice-ready graduates - a policy analysis.

Despite clear evidence that accreditation has the potential to shape the future of graduate outcomes and health professions, little research has examined accreditation policy within dietetics and whether it achieves its aims. This study aimed to interpret the purpose and positioning of dietetic accreditation standards internationally. This study drew on Yanow's interpretive policy analysis approach. Countries with similar dietetics education and accreditation systems were selected for inclusion in this study, including Australia, Canada, New Zealand, the United Kingdom and the United States. A purposive sample of participants involved in the accreditation process were identified and invited to participate in semistructured interviews. Accreditation standards from all countries were collected. Coding of text for purpose and meaning was undertaken. Codes were then grouped into categories and then themes, in line with the interpretive policy analysis approach that aims to seek meaning from the policy and identify conflicts. A total of 8 interviews and 11 accreditation standard documents were analysed from across the five countries. The analysis of data showed that the purpose of accreditation was protecting public safety by producing safe and effective dietetic graduates and supporting universities to achieve this. Focusing on input- versus outcome-based education was a key conflict. There is a unified purpose of accreditation internationally which may support global mobility of the dietetics workforce. Focusing more on outcome-based standards may support the development of dietetics graduates better equipped to meet future needs.

Growing Indigenous graduates in the health professions: a case study in decentralised student selection and engagement

ABSTRACT This case study research, informed by an Indigenous Research Paradigm, sought to ascertain the impact of a university’s decentralised health faculty Aboriginal engagement program. It involved analysis of health faculty and other faculties’ 2016–2020 student commencement, enrolment, completion, and retention data. The health faculty was more likely to have Aboriginal commencements in 2017 and 2018 due to a more equitable student selection process focused on applicant success factors and inclusive of Aboriginal epistemology. Other faculties’ Aboriginal commencement improved when a similar process was adopted. Excepting 2018, the health faculty was more likely to have Aboriginal completions and from 2017 onwards, Aboriginal enrolments. An increasing faculty retention pattern existed likely relating to earlier student engagement and planning. The decentralised model, led by Aboriginal people and supported by faculty and university, also provided processes for Aboriginal students, to crucially be, belong, and further grow as, Aboriginal people. With this presumably better positioning of graduates’ standpoints as Aboriginal health professionals to engage with healthcare cultural safety. This is important as health professions education is predominantly conceived by colonial paradigms which can promote assimilation. Despite improvements, inequities remained. Higher education should aim to graduate as many Aboriginal health professional graduates as possible to address healthcare inequities.

Impact of Research Training on Newly Graduated Health Professionals' Motivation to Undertake Research.

BackgroundClinical research is vital for improved patient health outcomes. However, there has been a decline in the number of new researchers replacing an aging workforce. This is because multiple factors impact on newly graduated health professionals’ (HPs) readiness and motivation to engage with research training and undertake research when taking up hospital clinical roles.MethodsDrawing on the Expectancy-Value-Cost (EVC) theory, a sequential explanatory mixed methods design involving cross-sectional survey and purposely sampled participant interview data was utilised to investigate the factors that impact on motivation to undertake research for three newly graduated HP groups (allied health, medical and nursing and midwifery). Survey data were subjected to descriptive and inferential statistical analysis, while interview data were thematically analysed to identify recurring themes. Framework analysis was utilised for triangulation of findings.ResultsParticipants’ previous exposure to research training influenced their expectancy to undertake research. Participants who had previous research training reported significantly higher (P < 0.001) research confidence (Median (IQR) 3.0 (3.0–3.0)) compared to those who had no previous research training (Median (IQR) 0.0 (0.0–1.0)). However, in relation to types of values attached to research, participants who demonstrated intrinsic and attainment values were more engaged and motivated to undertake research despite a myriad of barriers compared to those who demonstrated utility value (P < 0.001). The qualitative data revealed six overarching themes in terms of factors that influence motivation (i) Importance of early immersion into formal research training (ii) Attitude to research (iii) Time constraints (iv) Poor visibility of research training opportunities (v) Lack of organisational support (vi) Low returns on effort.ConclusionResearch training builds confidence, however, to foster motivation for the uptake and continued engagement with research, educators would need to help new HPs see the intrinsic and attainment values of research as they move through the career pipeline.

Research utilisation in older people care: Translation, cross-cultural adaptation and validation of instruments into Brazilian Portuguese.

To translate and culturally validate the Estabrooks' Kinds of Research Utilization (RU) and the Conceptual Research Utilization Scale (CRU) into Brazilian Portuguese; and to describe the research use by health professionals working on Long Term Care Institutions (LTCI) for older people. Research utilisation ensures greater quality and effectiveness in the care provided by health professionals. However, there are no instruments to evaluate research utilisation in Latin America countries, like Brazil. A methodological cross-sectional questionnaire validity and descriptive study. The translation and adaptation of the instruments was performed in seven steps following psychometric guidelines. The instruments evaluate research utilisation by health professionals in clinical practice. The RU is composed of single-items of instrumental, persuasive, conceptual and overall forms; and the CRU the conceptual form through a 5-item scale. Professionals of technical level and graduated working in nine LTCI were evaluated from August to December 2018. Descriptive and inferential (reliability, correlation, internal consistency and structure of CRU) analyses were conducted. Sample composed of 117 professionals, 67.5% of healthcare aides and 32.5% of graduated health professionals. All forms of research utilisation showed high implementation in practice (about 75% of the time, or frequently). CRU internal consistency (α=0.885) and structure were adequate. There were significant correlations between RU and CRU (from very low r=0.187 to high r=0.712). Intra-rater, inter-rater and alternate forms reliability ranged from moderate to substantial. The Brazilian versions of the RU and the CRU are valid, reliable and acceptable for evaluating research utilisation by professionals working on LTCI. It is of great relevance to introduce these instruments in low- and middle-income countries to have future data on how much older people care is influenced by the best evidence available. These instruments can be adapted to different healthcare settings and populations.