Improvement Of Training Programs Research Articles

Preparing Military Interprofessional Health Care Teams for Effective Collaboration.

Military Interprofessional Health care Teams (MIHTs) are the backbone of modern military medicine. However, these teams face distinct operational challenges, including frequent personnel rotation, diverse work environments, and the constant possibility of rapid deployment. Serving in dynamic teams that deploy for both military and humanitarian missions, MIHTs face the unique challenge of constant restructuring and reorganization. Consequently, preparing MIHT members to function effectively as a team presents a significant hurdle. This difficulty highlights the limited applicability of existing literature focused on training civilian interprofessional health care teams. To address this gap, we conducted interviews with MIHT members to understand specific training elements that equip MIHT members to effectively collaborate. By gaining a deeper understanding of their needs, we can improve training programs and ultimately optimize MIHT performance, readiness, and patient care. We conducted individual semi-structured interviews with military health care professionals. We employed purposeful sampling to ensure a diverse range of perspectives from individuals with direct experience working in or leading MIHTs. The 30 participants interviewed represented a broad spectrum of MIHT professions. The data used for this study stems from a broader research program on MIHTs conducted between 2017 and 2019. We conducted a secondary analysis focusing specifically on interview data related to education and training. Using Braun and Clarke's 6-step approach to Thematic Analysis, we identified themes from the data to build an understanding of MIHT perspectives on training effectiveness. The participants' insights allowed us to identify 3 critical themes related to the training elements they considered most beneficial for fostering collaboration within MIHTs: (1) MIHT members rely on their own predeployment readiness; (2) MIHT contexts require unique, adaptive communication skills; and (3) MIHT training is an ongoing endeavor. We need our MIHTs to be ready to deploy and effectively collaborate, which involves being clinically, emotionally, physically, and operationally ready. MIHT members describe 3 aspects of specific training elements as having significant potential to equip them to effectively collaborate: (1) MIHT members rely on their own predeployment readiness; (2) MIHT contexts require unique, adaptive communication skills; and (3) MIHT training is an ongoing endeavor at both the individual and team levels. By investing in tailored training programs that address these areas, we can empower MIHTs to continuously adapt, excel, and ultimately, positively impact patient outcomes in diverse military health care settings.

Identification of utilization deficiencies post SAP enterprise resource planning implementation in the Algerian Pharmaceutical Sector.

Enterprise Resource Planning like SAP are software solutions integrating various functional aspects. The study investigates the utilization challenges after the adoption of SAP ERP within a pharmaceutical firm. It is driven by four interrelated objectives: comprehending the operation of the SAP, the motivations behind its implementation, identifying the utilization deficiencies, and examining the relation between deficiencies and implementation challenges. A triangulation approach was adopted. The methods employed are based on batch monitoring, data collection, semi-structured interviews, a literature review, an overview of the software package, a comparison of the SAP with the previous management system, and an in-depth implementation study. 38 challenges were found in the literature, in a causal relationship with 11 identified utilization deficiencies in the study field. This analysis emphasized the significance of the human dimension, particularly the training of users, as a critical element in SAP implementation. The advantages gained from implementing an ERP primarily revolve around the users and the processes. Deployment in itself is not an improvement. By recognizing the importance of the human factor, organizations can focus on improving training programs and enhancing user proficiency to maximize the benefits of SAP implementation.

Інноваційні методологічні підходи до оцінки психофізичних здібностей гандболістів на етапі попередньої базової підготовки

The article deals with the psychophysical abilities of young handball players at the stage of preliminary basic training. Particular attention is paid to the analysis of the level of formation of such abilities as reaction speed, coordination of movements, concentration of attention and the ability to make decisions in stressful situations. The scientific relevance of the study is due to the need to improve training methods aimed at increasing the effectiveness of athletes' preparation for competitions. The purpose of the study is to analyze and evaluate the psychophysical abilities of young handball players, which will help to determine the effectiveness of the applied training methods and contribute to the development of new approaches to the training of athletes. Material and methods of research. Handball players at the stage of preliminary basic training (103 people) at the age of 15-16 years old, involved in the championship of Ukraine among boys, took part in the pedagogical experiment. To implement the goals and objectives of the study used a set of methods: theoretical analysis, synthesis and generalization; pedagogical observation; pedagogical testing; mathematical and statistical data processing. Research Results. It was found that the psychophysical abilities of young handball players who are at the stage of preliminary basic training correspond to a satisfactory level. However, in order to achieve high results in the future it is necessary to improve training programs taking into account the individual characteristics of each athlete. Analysis of the test results showed that the majority of handball players, both from the experimental and control groups, demonstrate similar results on the complex index of psychophysical abilities, which allowed us to conclude that there were no significant differences in the levels of development of psychophysical abilities between the groups at the beginning of the study. It was revealed that the average characteristics of different psychophysical tests in the majority of athletes correspond to a satisfactory level. For example, the speed of reaction to visual stimuli, reaction speed in game conditions, as well as the results of specialized handball tests showed that the level of formation of these abilities is sufficient for participation in competitions, but requires improvement to achieve high results. It is important to note that the highest average values of complex indicators of psychophysical abilities were observed in point guard players, which corresponds to the average level of formation. Line players also showed the results corresponding to the average level, while half-middle and edge players showed slightly lower values corresponding to the satisfactory level. Conclusions. The conducted study showed that at the stage of preliminary basic training most young handball players have a satisfactory level of development of psychophysical abilities, which indicates that there is a potential to improve their sports training by improving training methods. Given that different players demonstrate different levels of development of psychophysical abilities, especially among midfield and edge players, it is necessary to develop and implement individual training programs, which will optimize the training of each player in accordance with his individual characteristics and increase the overall effectiveness of the team.

Assessing oncology nurses’ knowledge and practices in safe cytotoxic drug handling and waste management in a Moroccan tertiary centre

ABSTRACT Because of the rising burden of cancer worldwide, cytotoxic drugs have become a significant threat to health and the environment. This investigation assessed the level of knowledge of oncology nurses regarding the risks associated with handling cytotoxic drugs and the management of cytotoxic waste and their impact on health and the environment. A qualitative study was conducted among oncology nurses at a Moroccan oncology centre. Most demonstrated a good understanding of cytotoxic drugs and their handling. But, there were notable deficiencies in foundational training. Occasional training sessions were offered, but they were considered insufficient in frequency and depth. The workload was identified as a major obstacle to proper safety protocol implementation. Although all participants recognised the dangers of improper disposal of cytotoxic waste, none had detailed knowledge of the specific environmental impacts. Improved training programmes and a reduced workload are critical to enhancing safety and efficiency in oncology centres.

Challenges in Implementing Early Childhood Care and Education in Anganwadi Centres: A Case Study of Rangia Sub District of Kamrup District of Assam

Early Childhood Care and Education (ECCE) is essential for the cognitive, physical, and socio-emotional development of young children. In India, the National Education Policy (NEP 2020), along with the National Curriculum Framework for Foundational Stage (NCF-FS 2022), emphasizes the importance of providing quality ECCE through Anganwadi Centres to lay a strong foundation for children's overall growth and future learning. The study titled "Challenges in Implementing Early Childhood Care and Education in Anganwadi Centres: A Case Study of Rangia Sub Division of Kamrup District of Assam" examines the obstacles Anganwadi Centres (AWCs) face in delivering ECCE as outlined by NEP 2020. The research identifies key challenges such as inadequate infrastructure, a lack of essential classroom materials, insufficient indoor and outdoor play equipment, and irregular supplies of food and medical resources. Using a survey approach, the findings reveal that most AWCs in the Rangia Sub-Division are under-resourced, limiting their ability to provide the comprehensive educational experiences vital for early childhood development. The study advocates for targeted interventions, including better resource allocation, infrastructure upgrades, and improved training programs, to address these shortcomings and achieve the ECCE objectives set by NEP 2020 in the region.

English Teachers’ Perspectives towards the Implementation of Differentiated Instruction in the Classroom

This study aims to explore the perspectives of junior high school English teachers in Kalimantan Barat on the implementation of differentiated instruction (DI) in culturally and linguistically diverse classrooms. Using a descriptive survey method, data were gathered from 108 teachers through a validated closed-ended questionnaire. The findings reveal that while teachers generally possess a strong understanding of DI and hold positive beliefs about its effectiveness, its application varies, particularly in addressing students' readiness, interests, and learning profiles. Key barriers include limited resources, large class sizes, and insufficient administrative support. The study highlights the need for targeted professional development and resource allocation to support DI implementation. Recommendations include improving training programs and increasing support from school administrations. Limitations of the study include a focus on one geographic region, which may limit the generalizability of the findings. These insights are relevant for enhancing DI practices in similarly diverse educational settings.

Pelatihan Pengukuran Biomotorik bagi Atlet Tinju Tingkat Sekolah Menengah Atas

This community service (PkM) aims to apply effective biomotor measurement techniques for high school-level boxing athletes to improve performance in the ring. The method of implementing this service used lectures, demonstrations, and cognitive tests targeting 9 boxing athletes and 2 coaches at SMAN 6 Gorontalo City. Lecture sessions covered strength, endurance, speed, agility, flexibility, balance, motor skills, body composition, explosive power, and functional tests. Demonstration sessions involved practical measurements using various tests to monitor athlete progress. The cognitive test results showed good understanding from the participants with an average of 83%, indicating increased knowledge about biomotors and their applications. This activity succeeded in improving participants' skills in evaluating and improving boxing performance, facilitating a more effective and highly competitive training program. The application of appropriate biomotor techniques could improve training programs and athlete performance.

Effective Training Programs for Room Attendants in the Hospitality Industry

This study examines the effectiveness of training programs for room attendants in the hospitality industry, focusing on their impact on performance, job satisfaction, and retention. Using a qualitative approach, in-depth interviews were conducted with 20 room attendants and 10 housekeeping managers across various hotel segments. The findings reveal that while initial training typically covers basic cleaning techniques and safety protocols, it often lacks depth in advanced methods and customer service skills. Challenges such as time constraints and reliance on informal learning are common, affecting the consistency and quality of training. Effective training programs were identified as those that provide comprehensive, ongoing instruction and incorporate innovative methods like virtual reality and gamified learning. The study also highlights the importance of mentorship programs and regular feedback to enhance training outcomes. Recommendations for improving training programs include developing detailed curricula, addressing time constraints, and adapting to emerging trends. By implementing these strategies, hotels can enhance room attendants' skills, satisfaction, and overall service quality, leading to improved guest experiences and operational success.

Effectiveness of a virtual quality improvement training program to improve reach of weight management programs within a large health system.

To test effectiveness of the LEAP (Learn Engage Act Process) Program on engaging frontline Veteran Health Administration (VHA) medical center teams in continuous quality improvement (QI), a core capability for learning health systems. Data sources included VHA electronic health record (EHR) data, surveys, and LEAP coaching field notes. A staggered difference-in-differences study was conducted. Fifty-five facilities participated in LEAP across eight randomly assigned clusters of 6-8 facilities per cluster over 2 years. Non-participating facilities were used as controls. A MOVE! weight management program team completed a Plan-Do-Study-Act cycle of change supported by learning curriculum, coaching, and virtual collaboratives in LEAP facilities. Primary outcome was program reach to Veterans. A mixed-effects model compared pre- versus post-LEAP periods for LEAP versus control facilities. LEAP adherence, satisfaction, and cost to deliver LEAP were evaluated. Thirty months of facility-level EHR MOVE! enrollment data were included in analyses. LEAP Satisfaction and QI skills were elicited via surveys at baseline and 6-month post-LEAP. Fifty-five facilities were randomly assigned to eight time-period-based clusters to receive LEAP (71% completed LEAP) and 82 non-participating facilities were randomly assigned as controls. Reach in LEAP and control facilities was comparable in the 12-month pre-LEAP period (p = 0.07). Though LEAP facilities experienced slower decline in reach in the 12-month post-LEAP period compared with controls (p < 0.001), this is likely due to unexplained fluctuations in controls. For LEAP facilities, satisfaction was high (all mean ratings >4 on a 5-point scale), self-reported use of QI methods increased significantly (p-values <0.05) 6 months post-LEAP, and delivery cost was $4024 per facility-based team. Control facilities experienced declining reach in the 12-month post-LEAP period, but LEAP facilities did not, plus they reported higher engagement in QI, an essential capability for learning health systems.

Повышение надежности человеческого фактора как перспектива развития культуры безопасности в производственной деятельности энергетического комплекса ОАО «РЖД»

The criticality of improving the reliability of the human factor in the production safety culture of the JSC RZhD energy complex remains relevant. In order to resolve the issue, the analysis of various acceptable and applied psychological, managerial, and economic measures has been conducted. Measures to reduce the occupational injury rate and develop the occupational safety culture in JSC RZhD have been considered. Specific attention has been paid to the comprehensive approach that covers psychological, managerial, and economic measures. The rapid development of technologies and changing requirements in the sphere of occupational safety prioritize such aspects as professionalism, discipline, motivation for work, and compliance with instruction requirements. Specific methods, including visual information, organizational measures, improving working conditions, and training formats via improving training programs have been provided. Practical examples of the successful use of such measures in the production environment have been considered by using the example of the Power Supply Directorate of the Southeastern Railway where high-risk jobs remain specific. Various measures of encouragement and motivation for employees facilitate the significant improvement of working conditions and the reduction of injury rate. Additionally, the analysis of methods to raise employees’ awareness regarding the importance of compliance with safety rules through regular training and seminars as well as the implementation of a feedback system to ensure prompt identification and elimination of potential threats has been conducted. These measures demonstrate high efficiency and ensure further successful development of the company not only by facilitating the increase of occupational safety level and the reduction of injury rate indices but also by establishing a safety culture among employees, which ultimately affects the total production performance and reputation of JSC RZhD.

Performance of Islamic Teachers in Madrasah: Analysis of Problems and Solutions in the Learning Process

This study investigates the performance achievements of 60 Islamic teachers in madrasahs during the learning process and identifies the problems and solutions needed to ensure all teachers meet the standards set by the Decree of the Minister of Education, Culture, Research, and Technology of the Republic of Indonesia Number 209//P/2021. Utilizing a survey methodology and in-depth interviews, the study found several challenges: 19 teachers struggled with implementing contextual learning; 8 teachers faced issues with process and results assessment; 18 teachers had problems with remedial and enrichment programs; 15 teachers found it difficult to create a pleasant learning environment; 31 teachers encountered obstacles in promoting reading and writing literacy; 10 teachers had trouble ensuring student safety, comfort, and cleanliness; and 17 teachers faced difficulties optimizing school facilities and infrastructure. These challenges were attributed to the lack of active participation in teacher quality improvement training programs such as contextual teaching and learning, assessment instruments, active learning, literacy, and media and learning resource development training. Interviews with teachers who did not face these difficulties indicated that their participation in ongoing professional development programs helped them overcome these issues. Consequently, it is recommended that school stakeholders support teachers' involvement in these professional development programs to enhance their performance.

Archery Analytic Workflow in a Web-Based Application

The integration of sports science and camera sensing technology has recently emerged to be an advanced analytical tool in sportsperson performance enhancement. The use of computing power and a web-based application can provide quick information analysis and data reporting between coaches and athletes. The design of an archery analytic workflow is demonstrated in this paper using the Python Flask framework, video analytic algorithms, a structured video inventory framework, MongoDB database setup and integration of the Keypoint R-CNN machine learning backend. A user-friendly data visualisation interface on the front end is integrated in the software to deliver athletes’ analytical capabilities such as thorough frame-by-frame video analysis, posture consistency estimation and joint kinematic analysis. This web application framework is not limited to archery sports, and can be extended to numerous sports, such as shooting, weightlifting and cycling. The significance of integrating camera sensing technology with the sports science field can offer quantitative and qualitative observations to improve training programs and performance evaluation.

Feasibility Study Analysis of Mr. Yulianto's Tofu And Tempe Factory In View From Human Resources

This study aims to conduct an in-depth analysis of the operations of the tofu and tempe factory owned by Mr Yulianto, with a focus on the human resources (HR) aspect. The method used is a descriptive method with a qualitative approach, where data is collected through interviews, direct observation and document analysis. The main objective of this research is to evaluate the availability, quality and management of human resources that support the continuity of factory operations. The analysis results show that the factory has an adequate number of workers, but there are weaknesses related to employee skills and training. Lack of optimal HR management also affects factory operational productivity and efficiency. Research recommendations include improving training programs, improving recruitment systems, and implementing more effective performance management to increase employee competency and motivation. It is hoped that improvements in HR management can make Mr Yulianto's tofu and tempeh factory more competitive and sustainable in the future.

The Healthcare Improvement and Innovation in Quality (THINQ) Collaborative: A Novel Quality Improvement Training Program for Undergraduate and Postgraduate Students.

The Healthcare Improvement and Innovation in Quality (THINQ) Collaborative is a uniquely designed program that engages undergraduate and postgraduate students to participate in improving health care and addressing important clinical problems. In 9 years, over 120 THINQ Fellows have been trained in quality improvement (QI) frameworks and methodologies focusing on research skills, social justice, leadership development, and problem-solving. Program evaluation has included surveying current and former THINQ Fellows about their experiences with the program and its subsequent impact on their careers. THINQ's research and outreach initiatives have contributed to improvements in workflows and clinical care on topics such as interdisciplinary team communication, discharge and care transition, sepsis management, and physician burnout. The THINQ Program has equipped future health care leaders to engage with and address QI issues in clinical practice. The structures, processes, and outcomes discussed here can guide other institutions in creating similar QI programs.

Awareness and preparedness level of medical workers for radiation and nuclear emergency response.

Radiological science and nuclear technology have made great strides in the twenty-first century, with wide-ranging applications in various fields, including energy, medicine, and industry. However, those developments have been accompanied by the inherent risks of exposure to nuclear radiation, which is a source of concern owing to its potentially adverse effects on human health and safety and which is of particular relevance to medical personnel who may be exposed to certain cancers associated with low-dose radiation in their working environment. While medical radiation workers have seen a decrease in their occupational exposure since the 1950s thanks to improved measures for radiation protection, a concerning lack of understanding and awareness persists among medical professionals regarding these potential hazards and the required safety precautions. This issue is further compounded by insufficient capabilities in emergency response. This highlights the urgent need to strengthen radiation safety education and training to ensure the well-being of medical staff who play a critical role in radiological and nuclear emergencies. This review examines the health hazards of nuclear radiation to healthcare workers and the awareness and willingness and education of healthcare workers on radiation protection, calling for improved training programs and emergency response skills to mitigate the risks of radiation exposure in the occupational environment, providing a catalyst for future enhancement of radiation safety protocols and fostering of a culture of safety in the medical community.

Evaluation of the Nurses' Understanding of Disease Prevention and Health Promotion in Primary Health Care Centres in Al-Diwaniyah

A descriptive study was undertaken from January 15, 2023 to May 26, 2023 in order to measure the level of knowledge among nurses This text pertains to the improvement of health and the avoidance of illnesses at primary healthcare clinics located in the municipality of Al-Diwaniyah. A precise random population of 150 individuals, evenly distributed among There are eleven primary health care institutions located in the city of Al Diwaniyah. The numbers were obtained from the health promotion and disease prevention tool that has been authorized by the Iraqi Ministry of Health. Data was gathered by conducting a questionnaire for each variable, employing a research instrument and the personal interview method. Each survey necessitated roughly 10 minutes to complete. The questionnaire comprised four axes, with the initial axis explicitly focusing on community partnership and mobilization. The second axis relates to the local council of the primary health care centre. The third level of communication focuses on modifying behaviour, while the fourth dimension revolves around promoting health and preventing sickness. The data was evaluated using the weighted average method, renowned for its ability to generate accurate outcomes by using the principle of weight ratios. The study found that the research sample had outstanding expertise in the field of health promotion and illness prevention. The study proposes improving training programs in primary health care, with a specific emphasis on boosting communication skills and promoting changes in health behaviours. Additionally, it suggests prioritizing community involvement and activation, while also strengthening the local governing bodies of basic healthcare facilities. In addition, the study cautions against indiscriminately replacing experienced nurses with new workers.

The Effect of Specific Training Programs to Improve Agility and Flexibility of Wushu Taolu Athletes

Background and Aim: In the realm of Wushu sports, the essential professional attributes of a Wushu Taolu athlete encompass flexibility and agility. In contemporary Wushu Taolu training, there is a prevailing emphasis on achieving the intricacies of captivating aesthetics, often neglecting the foundational skills of Wushu Taolu. Consequently, many Wushu athletes encounter a range of issues. The absence of fundamental skills can result in a deficiency in the physical aptitude of Wushu Taolu athletes, leading to inadequate execution of movements, a lack of fluidity, and subpar completion quality. These shortcomings can adversely impact the overall sports proficiency of athletes. This study aims to address this by concentrating on the development and implementation of a training program specifically targeting the basic skills of Wushu Taolu, to significantly enhance the agility and flexibility of Wushu Taolu athletes. Materials and Methods: This study is an experimental study. The participants of this study are 30 Wushu Taolu athletes from Northwest Normal University, 8 professional Wushu coaches, 4 teachers of Wushu direction in professional sports colleges and universities, and 3 professors in the direction of physical training, which makes a total of 15 experts. This study used focus groups to develop and improve training programs through expert interviews and experimental analysis with an IOC value of 0.82. This study mainly used ANOVA to analyze the results of the pre-test, 4 weeks post-test, and post-test. Results: The results showed that the flexibility and agility of Wushu Taolu athletes were effectively improved by seated forward body flexion and T-word agility test after specific Wushu basic training, and the improvement of flexibility and agility can help athletes to improve their sports level and get better performance in the competition. Conclusion: After 8 weeks of Wushu training, these 30 Wushu Taolu athletes were tested again for agility and flexibility. The study analyzed the differences and effects of agility and flexibility before and after training. The comparison between before and after training fully proved that basic Wushu training can effectively improve the agility and flexibility of Wushu sparring athletes.

Effect of Healthcare Professionals’ Knowledge and Attitude Towards Reporting Adverse Drug Reaction (ADR) in Military and Paramilitary Hospitals in Enugu, Nigeria

The study evaluated the effect of healthcare professionals (HCPs) on knowledge and attitude towards reporting adverse drug reactions (ADRs) in military and paramilitary hospitals in Enugu, Nigeria. The purpose of the study was to determine if the level of knowledge and attitude has any significant effect on reporting ADRs. Data were collected through the use of questionnaires from the healthcare professionals (Doctors, Pharmacists, and Nurses) because of the position they occupy in the implementation of pharmacovigilance procedures. The technique employed in the data analysis is regression and the following results were obtained: the level of knowledge of HCPs on pharmacovigilance had a P- value of 0.027 &lt; 0.05 while HCPs attitude had p-value of 0.010 &lt; 0.05. Hence, the study concludes that knowledge level and attitude significantly affect ADR reporting. The following recommendations were made in line the findings: the need to improve training programs across all strata of HCPs as a means of updating their knowledge of pharmacovigilance and ADR reporting procedures. Similarly, it is important to develop a culture of ADR Reporting amongst healthcare professionals in these hospitals; by raising the recognition of the importance of reporting both tolerable and moderate ADRs as well as previously unknown or severe ADRs, this strategy aims to promote a culture of ADR reporting.

Unlocking Innovation from Within: The Power of Tacit Knowledge and Change Adaptability in Indonesian Internal Organisational Innovation Processes

Abstract Research purpose. The study examines how tacit knowledge sharing affects internal organisational innovation by exploring change adaptability as a mediator. Hence, it tries to fill this gap and further explain the role played by tacit knowledge sharing in the entire knowledge management process. Given the mediating effect of change adaptability, this study aims to provide new insight into effective management and sharing tacit knowledge among organisations to improve their innovation processes. Design / Methodology / Approach. This study adopted a quantitative cross-sectional survey design, with Partial Least Squares Structural Equation Modeling (PLS-SEM) as the main statistical technique. Such a method is best applied in this research, where one confirms hypotheses and the relationship between observed and latent variables. The samples were selected based on judgmental non-probability and purposive sampling approaches. The SEM was used in data analysis. It contributed to understanding the relationship of the variables, such as sharing tacit knowledge, change adaptability, and internal organisational innovation. Findings. The study proved that tacit knowledge sharing is highly significant in internal organisational innovation, mediated by change adaptability. Direct effect: Tacit knowledge sharing directly affects the organisational ability to adapt to change and internal innovativeness, thus underpinning its basis. Change adaptability mediates the effect of tacit knowledge sharing on internal organisational innovation, which influences innovation outcomes. Path coefficient analysis confirms the positive influence of tacit knowledge sharing on adaptability to change and innovation. Indirect Effects: Empirical examination has proved the significant mediating effect of change adaptability in leveraging tacit knowledge for innovation. These results suggest that the strategic value of tacit knowledge and adaptability, which will drive sustainable innovation within organisations and support their integration within strategic frameworks, is fully justified. Originality / Value / Practical implications. This is a new model used for the first time to suggest novel contributions and usefulness in understanding the relationship among sharing of tacit knowledge, change adaptability, and innovation at the internal level of the organisation. Tacit knowledge sharing, combined with change adaptability, is a model for internal organisational innovation. Therefore, it fills an important gap in the existing literature: the quantification of adaptability in mediating the effect of tacit knowledge on innovation. The results of this study will provide empirical validation of these relationships and further contribute to the knowledge in practice, particularly by emphasising the mediating role of change adaptability, which has been relatively underexplored. Practically, tacit knowledge sharing within adaptive organisational environments is thus an important call towards effective adaptation to change. The level of enhancement of these dimensions as core competencies through strategies could make a difference in the success of businesses. The importance of adaptability has to be emphasised by training programs and management practices that would provide the same skills. Other important avenues include those that work towards cultivating supportive organisational cultures that would facilitate tacit knowledge exchange, support employee interaction and informal knowledge exchange, and measures to reward innovation efforts. Investment in human resources practices that encourage learning and adaptability will continue to encourage knowledge sharing and innovation, including improving training programs, offering mentorship opportunities, and developing performance management systems that support and reward behaviours around innovation. This study contributes to the literature with a developed framework and empirical examination of the interrelations between tacit knowledge sharing, change adaptability, and innovation. It provides practical strategies that can be of value to the organisation in enhancing innovation capabilities through knowledge management.

Changes in attitudes, beliefs, and experiences related to pregnancy during graduate medical education training from 2005 to 2021.

Today, 50% of medical students are women, and residency and fellowship training years overlap with peak times for starting families. The authors describe attitudes toward pregnancy during residency and fellowship and report pregnancy rates and complications for female residents and resident partners across several decades. A web-based survey was emailed to 1,057 residents in 2005 (period 1) and 1,860 residents in 2021 (period 2). Anonymous surveys were sent to all trainees including pregnant trainees, affected co-trainees and trainee partners. Resident attitudes and pregnancy characteristics were compared between groups using the chi-square (χ2) test for categorical variables and the Kruskal-Wallis test for ordinal variables. A total of 442 residents (41.8%) responded to the 2005 survey, and 525 (28.2%) responded to the 2021 survey. Most residents who covered for a pregnant resident had positive feelings about covering for their colleagues during both time periods, although more positive attitudes were present during the period 2. Only about 10% of residents received compensation for their coverage during both time periods. Among residents with a pregnancy during training (i.e., themselves or partners), most characterized having a baby in training as "somewhat difficult" or "very difficult" at both time periods. Pregnancy complication rates were 33% and 44% for training years 2005 and 2021. As medical education evolves, training programs should be proactive in creating structured support systems for pregnant residents and resident partners to minimize adverse maternal and fetal outcomes and to improve training programs. Future studies are needed to elucidate the causality of higher-than-expected pregnancy complication rates.