Professional Doctorate Research Articles

Understanding the Second Victim Phenomenon Among Healthcare Workers in an Italian Hospital

Second victim syndrome (SVS) refers to the psychological trauma experienced by healthcare workers (HCWs) as a result of being involved in an adverse event (AE). Research on the prevalence of SVS and the support needed for HCWs who experience it is limited. A cross-sectional study was conducted at the Health Local Unit of Lecce, in Puglia, to identify the phenomenon of SVS among HCWs and recognize the forms of support received and desired. A validated questionnaire, IT-SVEST, was administered to doctors and nurses. The survey received responses from 250 HCWs, and 41% of respondents reported being involved in an AE that could cause SVS. Among the seven dimensions measuring the effects of the SVS and two outcome variables, the highest percentage of agreement was found for psychological distress (23.5%), followed by turnover intentions (19.8%) and physical distress (9.9%); 23.8% of the interviewees declared that they did not receive institutional support, and 9.9% identified help resources mostly in non-work-related support (9.9%), followed by supervisor support (9.3%). The multivariable binary logistic regression analysis showed a positive association between the occurrence of an AE and the medical doctor profession (OR = 4.267, p ≤ 0.0001), and affiliation to intensive care departments (OR = 5.133, p ≤ 0.0001) and male gender (OR = 2.069, p = 0.033). SVS is a serious problem that affects the entire health system, systematic surveys and appropriate institutional responses including formal support programs for affected HCWs are a priority.

A cross-sectional study of satisfaction with life among 1st year students and doctors of a teaching hospital of the national capital region.

With rising work pressure, balancing personal life is not easy for any professional. Aspirations at the time of admission into professional college do not last for long, as we observe doctors who are less satisfied than enthusiastic first-year students at dental college. The present study aimed to determine subjective well-being and comparison of satisfaction with life among first professional dental students and doctors of a teaching hospital in the National Capital Region, India. The current study was conducted for one month among 100 1st year dental students and 100 junior doctors, including the faculty of a teaching hospital in the National Capital Region, India. Satisfaction with Life Scale (SWLS) was used to assess the level of satisfaction in their lives. Associated factors which might affect this satisfaction were also enquired for. The mean age of first professional dental students and doctors was 19.3 ± 1.6 and 27.52 ± 2.54 years, respectively. 76 (76%) 1st professional students and 68 (68%) doctors were found to be satisfied with their lives when assessed over SWLS. Odds of being satisfied were significantly more in the age group of 20-25 years. Those students and doctors who had opted for dental, taking it as a reputed profession or as their ambition, were found to be more satisfied with their lives. Students who were satisfied with the hostel accommodation were significantly more satisfied with their lives. Among doctors, those who were either married or were in a relationship and who were satisfied with their income were more satisfied. A significant proportion of doctors and 1st professional dental students were satisfied with their lives. More students were satisfied with their lives than doctors. Factors like satisfaction with income and reason for joining the dental profession were found to have significant associations.

Risk assessment and automatic identification of autistic children based on appearance

The diagnosis of Autism Spectrum Disorder (ASD) is mainly based on some diagnostic scales and evaluations by professional doctors, which may have limitations such as subjectivity, time, and cost. This research introduces a novel assessment and auto-identification approach for autistic children based on the appearance of children, which is a relatively objective, fast, and cost-effective approach. Initially, a custom social interaction scenario was developed, followed by a facial data set (ACFD) that contained 187 children, including 92 ASD and 95 children typically developing (TD). Using computer vision techniques, some appearance features of children including facial appearing time, eye concentration analysis, response time to name calls, and emotional expression ability were extracted. Subsequently, these features were combined and machine learning methods were used for the classification of children. Notably, the Bayes classifier achieved a remarkable accuracy of 94.1%. The experimental results show that the extracted visual appearance features can reflect the typical symptoms of children, and the automatic recognition method can provide an auxiliary diagnosis or data support for doctors.

Navigating healthcare during a pandemic: what parents of CHD children want healthcare professionals to know.

The COVID pandemic has had deleterious effects on the mental health of the global population. Parents of children with CHD were particularly vulnerable to negative mental health outcomes such as depression, anxiety, and perceived stress. A better understanding of the CHD parent experiences, needs, and concerns while navigating the healthcare system during a pandemic is needed. Online survey responses from 71 parents of young children with CHD representing families across the United States of America and Canada were analysed. Qualitative data were collected one year into the COVID pandemic. Thematic analysis was used to examine responses to the open-ended question "What would you like healthcare professionals (doctors, nurses) to know about your experience of being a parent with a child with CHD during the COVID-19 pandemic?." Two major themes with subthemes and an umbrella theme emerged from the parents' responses (1) Pandemic Parenting: The Emotional Toll of Hospital Visitation Restrictions, Dealing with Social Distancing, Feeling Isolated, Decision Making in Uncertainty, and Playing it Safe versus Returning to Normal and (2) Unmet Expectations of Care: Needing Information, Wanting Empathy, Requesting Respect, Questioning Care Quality, and the umbrella theme of: Our Lives were Turned Upside Down. CHD parents describe a negative impact of healthcare-related challenges during the COVID pandemic. These findings may offer insight to how healthcare professionals can better support the mental health and care burden of CHD parents during future pandemics.

Inspanningverbintenis Versus Resultaatsverbintenis: Therapeutic Transactions in Medical Services in Indonesia

The patient's expectations for a cure from their disease takes great demands on the doctor's profession, where patients and families often demand certain positive results for the health services provided, while the therapeutic agreement between the doctor and the patient in health services is inspanningverbintenis where the agreement agreed is the best effort made by doctors regarding therapeutic management without promising definite final results. This concept is supported by amenable laws in Indonesia as stated in the Health Law and the Civil Law. However, the gap in understanding of this concept creates gaps that can give rise to demands. Understanding this concept requires good and intense communication to straighten out differences in the doctor's and patient's perceptions regarding the ongoing therapeutic contract where the doctor adheres to the inspanningverbintenis concept and the patient with their expectations adheres to the concept of resultaatsverbintenis so that confusion of expectations can be minimized.

Do Physician Assistant Professional Doctorate Missions and Learning Outcomes Align With the Physician Assistant Professional Competencies?

Introduction There are little published data about curricula of physician assistant (PA) postprofessional doctoral programs. This study examined current mission statements and learning outcomes for common and emerging themes aligned with the PA professional competencies. Methods This qualitative study examined postprofessional doctoral programs that matriculated PAs as of December 2023. Program web sites were analyzed for mission or purpose statements and learning outcomes. Open coding of the PA professional competencies generated a final code list. Mission and purpose statements and learning outcomes were uploaded into ATLAS.ti and compared with the code list for common and emerging themes. Investigator triangulation confirmed themes. Results Twenty-two programs had mission statements on their websites. The most identified competency theme was the development of leadership skills (64%). Sixteen programs had learning outcomes for 30 concentrations. The most common competency themes in the concentrations' learning outcomes included knowledge/evidence (50%), leadership (40%), and communication (37%). Emerging themes comprised engaging in scholarly activity (29%) and performing research (37%). Discussion Because leadership was the most common theme in mission or purpose statements and learning outcomes, additional leadership training appears to be an area of focus for postprofessional PA programs. Despite common themes across the programs, there appears to be diversity in the areas of content focused on meeting the program's prospective students' needs more than alignment with the competencies. Including research and scholarly activity within postprofessional doctoral programs raises the question of whether this is an emerging area of focus that should be included in the PA professional competencies.

Medical image recognition based on multilayer neural network

As a common accidental injury, accurate identification of burns and scalded injuries is of great significance to the development of treatment programs and prognosis assessment. Traditional identification methods are subjective and inaccurate, this paper proposes a burns and scalds grade identification technique based on multilayer neural network. The three-degree classification standard of burns and scalds is described, and the structure and principle of multilayer neural network are introduced, including the network structure composed of input layer, hidden layer and output layer, forward propagation, back propagation and training process. The implementation steps of burns and scald grade recognition technology based on multi-layer neural network are discussed in detail, such as data acquisition, image pre-processing, feature extraction, classifier design, model training and evaluation. Through experiments, the model is tested using a dataset containing 362 burns and scalds images, and the model achieves more than 90% accuracy on the test set with high accuracy and reliability. The multi-layer neural network model is used to classify the burn and scald data, which improves the diagnostic accuracy, shortens the delay time of the disease, reduces the pressure of professional doctors, and helps patients have a preliminary understanding of the degree of burn.

Outcome Domains of Professional Doctorates in Nursing: An International Three-Phase Exploratory Study.

Professional Doctorate Programmes (PDP) in nursing continue to develop across many countries. However, there is a lack of evidence demonstrating the impact on nurses who graduate from these programmes and the outcomes they deliver. This exploratory study aims to identify graduate outcome domains that can be applied internationally to evaluate professional doctorate programmes in nursing. Underpinned by Kim's theory of knowledge development in nursing, this innovative exploratory study was carried out in three phases: (1) a scoping review of literature published between 1 January 2000 and 1 July 2023, guided by the methodology developed by Arksey and O'Malley; (2) a document analysis of the graduate outcomes of three different universities' Professional Doctorate Programmes in Nursing and (3) a thematic analysis and coalescence of the findings from the initial two study phases. A scoping review revealed three patterns in the literature related to graduate outcomes: personal transformation, critical self-awareness and bridging the theory-practice divide. An analysis of three universities' Professional Doctorate Programmes revealed insights into documented graduate outcomes. The third and final research phase identified five graduate outcome domains: Personal achievement, critical self-awareness and professional identity, professional citizenship, discipline, research and information literacy and community-based academic practice. The impact of Professional Doctorate Programmes in nursing has traditionally lacked consensus and clarity. However, this research has led to the identification of graduate outcome domains that offer valuable insights for establishing new professional doctoral programmes and conducting meaningful evaluations of the outcomes of existing PDP and their graduates globally. This exploratory study establishes five graduate outcome domains for evaluating the effectiveness of PDP in nursing internationally. These domains offer valuable benchmarks for the development and assessment of such nursing programmes globally. Not applicable.

The importance of critical reflexivity in a professional business doctorate

ABSTRACT The focus of this study is to research the importance of critical reflectivity in practice-based management research. To achieve this, this paper seeks to demonstrate how candidates on the Doctor in Business Administration (DBA) programme at the University of Gloucestershire, have managed to integrate the dynamic tensions associated with ‘real life’ practice with their scholarly activities. It contends that rather than applying a Cartesian logic to education, the interplay of theory and practice can provide an essential component for studyat a doctoral level. The proposal here is that it is no longer necessary to maintain the thinking that scholarship and ‘real-life’ practice need to have a critical reflectivity ethos embedded into the candidate’s journey throughout the programme. Adopting a qualitative approach, 12 candidates at various stages of their professional doctorate journey were interviewed, including 5 at the submission or viva stage. To inform the interviews the research drew on Heidegger’s three physical placements of ‘ready to hand’, ‘present to us’ and ‘mitsein’ or ‘being with others’ to contextualise the candidates’ experiences. This was also viewed in terms of anticipatory resoluteness. This study also highlights that the DBA, being a practice-based doctorate, needs to embrace the importance of co-production.

Professional health literacy of health professions in Austria - results of the HLS-PROF-AT study

Abstract Background Health professions play a crucial role in strengthening the health literacy (HL) of the population - provided that they themselves have the necessary professional HL. This encompasses competencies related to information and knowledge management, conveying information and knowledge, patient involvement and shared decision-making, and professional digital HL. In 2022 and 2023, data on professional HL were collected in Austria. Methods Nearly 4,400 healthcare professionals (doctors, nurses, physiotherapists, pharmacists, midwives, dieticians) were asked about their challenges across the four domains of professional HL. A score was calculated for each domain, with five additional subscores for the domain conveying information and knowledge. The relationship between socio-demographic, job-related and organisational characteristics and professional HL were investigated using T-tests, variance analyses and multivariate regression models. Results The greatest challenge for all healthcare professions is supporting patients in dealing with digital information, followed by conveying information and knowledge. Apart from pharmacists, the least difficulties were found in the domain patient involvement and shared decision-making. Furthermore, the results demonstrate that a high level of professional HL is associated with more favourable organisational conditions for HL-promoting patient communication and (very) good preparation in training for the tasks of professional HL. There is no systematic correlation between professional HL and years of professional experience. Conclusions Overall, healthcare professionals rated their professional HL positively. However, the results also highlight areas for improvement. Alongside promoting professional HL in the context of (further) training, it is important to enhance organisational framework conditions for promoting patients’ HL - ideally supported by initiatives to promote the organisational HL in healthcare organisations. Key messages • The greatest challenge for the health professions surveyed is to support patients in dealing with digital information and to convey information and knowledge to their patients. • Good preparation in training for the tasks of professional HL and favourable organisational conditions for HL-promoting patient communication are associated with a higher professional HL.

Enhancing digital health competencies: insights from european human resources for health

Abstract Background Mixed-skills for digital health transformation are critical for human resources for health (HRH). This study aimed to inform the design of new training programmes that address soft, hard and digital health skills. Methods Using a mixed-methods design science approach, focus groups were conducted by invitation and with informed consent, online or in-person. A script was prepared with key questions for orientation and facilitation, addressing the topics of current situation, desired situation, desired skills, practical and organisational needs to implement continuous training in healthcare. The collected data were analysed using Nvivo. Results Focus groups (14) had 87 participants (Norway, Latvia, Belgium, Italy and Portugal): 26 healthcare professionals (nurses, midwives, nutritionists, pharmacists, assistants and doctors); 27 managers or directors of hospitals and care centres; 34 experts (digital health specialists, researchers, technical officers, members of professional societies and national authorities). Real needs were identified, with 2 direct sub-themes that were best related to each other (Pearson coefficient, p > 0.40 - cluster analysis): 1. ‘Current situation’: Cybersecurity (eg. privacy, law and ethics); Time (work time versus private time, p = 0.69); Type (informal versus formal training, p = 0.32); Programmes (graduation, continuing education and post-graduation levels). 2. ‘Desired situation: Desired skills (eg. digital - basic ICT, data analysis, soft - communication, emotional intelligence, and hard skills - medication administration, catheters, ECG, vital signs, telehealth - digital stethoscope); Learning design and objectives (eg. collective learning, simulations, location - peer-to-peer and hybrid); Emergency care and the link between primary and secondary levels of care were considered important. Conclusions These findings of convergence among HRH inform Program design process to support the training programs and course syllabus design. Key messages • The identified needs and priorities inform Program design further to support Digital Health Transformation training programs and course syllabus design. • Real needs points to Current and Desired situation, where HRH give important insights that need to be considered to engage people to perform training courses.

Knowledge and Consequences of Violence Against Health Professionals in Southern Portugal.

Violence against health professionals is a global and growing problem, with significant impacts on the quality of care and the mental health of workers. To analyze the level of knowledge, reporting practices and consequences of violence against health professionals in the Alentejo region (southern Portugal). This was an observational, cross-sectional study involving 440 health professionals (doctors and nurses). Data were collected using an online platform and a structured questionnaire created specifically for this study. In the statistical analysis, the data were described as counts and proportions and the X2 test was used considering a significance level of 0.05. This study reveals that violence against health professionals in the southern region of Portugal is a frequent problem (40%), with a higher incidence among nurses (80%). Despite awareness of the existence and functioning of reporting channels, reporting is low (52%). The main causes are related to the health system, professionals and users. The consequences include mental health problems and a reduction in the quality of care provided. Suggested measures to combat violence include improving security, training and punishing aggressors. This study reveals that violence against health professionals in the southern region of Portugal is a frequent, under-reported problem with serious consequences for professionals and the quality of care.

Assessment of the research potential of healthcare specialists in the Republic of Kazakhstan in the implementation of clinical research: results of online questionnaires and self-assessments. Global crisis of clinical researcher shortage

The study aimed to identify and analyze the potential of practical healthcare professionals in terms of skills and knowledge for conducting clinical research in Kazakhstan, as well as to identify obstacles that may arise and cause the low involvement of specialists in research activities.Materials and methods. A specially developed questionnaire was conducted online. Various healthcare professionals (doctors, nurses, teachers of medical educational organizations) from all regions of Kazakhstan participated. By random sampling, 337 respondents answered the questions. Data was collected anonymously through Google Forms.Results and discussion. 29,7% respondents had participated in clinical research. Most respondents do not have sufficient knowledge in conducting clinical research; on average, 35% of respondents answered correctly. On average, respondents' self-assessment of knowledge and skills in choosing a study design, forming groups of study objects, collecting, analyzing, and interpreting data obtained during clinical trials, and performing statistical processing of results was 3 points (max = 5 points). A majority expressed a need for further training in clinical research. The main barriers to conducting clinical research were identified as lack of working time (44%), insufficient knowledge in conducting clinical research (34%), inaccessibility of educational programs (28%), lack of personal interest (27%), non-compliance of clinical base infrastructure (23%), difficulties in patient recruitment (20%), and the risk of losing professional autonomy (13%).Conclusions: The survey results show an unsatisfactory level of existing research potential of healthcare professionals in the organization and conduct of clinical research. the findings reveal a significant gap in the research potential of healthcare professionals in Kazakhstan. There is a lack of understanding of clinical research concepts, international standards, and local legislative requirements. The main obstacles are inadequate time for research, insufficient knowledge and experience, limited access to training, and low interest among professionals.

Using U-Net models in deep learning for brain tumor detection from MRI scans

Tumor diseases in the nervous system are both dangerous and complex. Magnetic Resonance Imaging (MRI) is crucial for detecting brain disease; however, identifying the presence of tumors from these is time-consuming and requires a professional doctor. Utilizing deep learning for tumor detection in MRI images can reduce waiting times and enhance detection accuracy. We propose a method employing two U-Net models: ResNeXt-50 and EfficientNet architectures, integrated with a Feature Pyramid Network (FPN) for segmenting brain tumor. The models were trained on the BraTS 2021 dataset, consisting of 3,929 MRI scan images with 3,929 corresponding masks, divided into training, testing, and evaluation sets in a 70:15:15 ratio. The results indicate that the hybrid model, which combines EfficientNet and FPN, delivers superior performance, with an average Intersection over Union (IoU) accuracy of 0.90 on the test set compared to 0.50 for ResNeXt-50, and Dice accuracy of 0.92 compared to 0.66 for ResNeXt-50. Furthermore, we developed a web application that implements the EfficientNet with FPN model, facilitating convenient tumor detection from uploaded MRI images for doctors.

Protocol: Assessing the outcomes and impact of professional doctorate programmes in health and social care on the individual, their profession, their employing organisation and wider society: A comprehensive systematic review.

This is the protocol for a Campbell systematic review. This review's objectives are to find out (in relation to health and/or social care): (1) What is known about the outcomes and impact of completing (or not completing) a professional doctorate in health and/or social care on the individual professional? (2) What is known about the outcome and impact of completing (or not completing) a professional doctorate in health and/or social care on the employing organisation? (3) What is known about the outcome and impact of completing (or not completing) a professional doctorate in health and/or social care on the profession? (4) What is known about the outcome and impact of completing (or not completing) a professional doctorate in health and/or social care on service users and the wider society? (5) How do we use the findings from this review to inform educators, higher education institutions, professionals, investors in employing organisations and policymakers? (6) What further research will be needed to answer any knowledge gaps or recommendations? (7) Where possible, we will identify and report on any demographic data and discuss their relevance to the impact and outcomes from professional doctorates.

Doctoral rhythms within an EdD: the case of group supervision

ABSTRACT This paper explores the application and use of group supervision with doctoral candidates studying a professional doctorate, the EdD, at a teaching intensive university. Group supervision is applied as a pedagogical strategy during the module stage of the award with candidates who were advanced practitioners in their fields with several working at the Post’92 university in question. Group supervision is an emergent idea has not been well described in the literature either as a concept or a practice. This paper aims to contribute to understandings of group supervision and its potential value as a doctoral learning approach. Rhythmanalysis is used to explore students’ experiences of group supervision particularly the advantages for advanced professionals from education who are at an early stage in their research career. The paper highlights the importance of the exploration and production of ideas within the group supervision process such as the containing of anxiety, development of identities, grappling with theories and methodologies and the value of peer learning and mattering. Group supervision itself could also be described as a meta-supervision approach with the supervisor stepping in and out of the doctoral learning to articulate and justify what was happening in relation to future learning demands.

A Deep Learning-Based Method for Rapid 3D Whole-Heart Modeling in Congenital Heart Disease

Introduction: This study aimed to develop a deep learning-based method for generating three-dimensional heart mesh models for patients with congenital heart disease by integrating medical imaging and clinical diagnostic information. Methods: A deep learning model was trained using CT and cardiac MRI, along with clinical data from 110 patients. The Web-based platform automatically outputs STL files for 3D printing and Unity 3D OBJ files for virtual reality (VR) applications upon uploading the medical images and diagnostic information. The models were tested on three congenital heart disease cases, with corresponding 3D-printed and VR heart models generated. Results: The 3D-printed and VR heart models received high praise from professional doctors for their anatomical accuracy and clarity. Evaluations indicated that the proposed method effectively and rapidly reconstructs complex congenital heart disease structures, proving useful for preoperative planning and diagnostic support. Conclusion: The 3D modeling approach has the potential to enhance the precision of surgical planning and diagnosis for congenital heart disease. Future studies should explore larger datasets and training models for different types of congenital heart disease to validate the model’s broad applicability.

Knowledge, competence and educational needs of mental health staff on palliative care for the elderly with dementia.

Dementia is a clinical syndrome for which the benefits of palliative care have been recognized. The aim of this study was to investigate the knowledge and educational needs of mental health physicians and nurses and also their perceptions of their competence regarding palliative care for the elderly with dementia. A total of 96 mental health professionals (doctors, nurses) working in a public psychiatric hospital and its allied community mental health settings participated in the study. The Palliative Care Quiz for Nursing (PCQN) was used to detect their knowledge on palliative care as well as a questionnaire to collect participants' demographics, their perceptions about their competence on palliative care provision and their educational needs on the basics domains of palliative care for the elderly with dementia. Results revealed participants' significant lack of knowledge (PCQN =7.79/20) and low perception of competence regarding palliative care for aged persons with dementia. Participants who were psychiatrists, who had work experience between 16-20 years and provided care to more than ten patients with terminal dementia per year, showed higher PCQN scores in statistically significant level (p=0.001). The majority (93.6%) of participants considered training in palliative care for dementia patients as necessary, particularly in providing information to family/carers, relieving the psychosocial burden of family/carers, managing the terminal stage of dementia, providing information to dementia patients and planning their advanced care. Findings of this study could inform the design of training programs on palliative care for the elderly with dementia in Greece.

Developing a Supportive Community of Practice

This paper employs a qualitative case study to suggest how the research journey of doctoral students can be improved in educational institutions by encouraging the formation of small and informal Communities of Practice (CoP). It examines themes emerging from the feelings and opinions of four part-time professional doctorate students about their study experience and participation in their emergent CoP. A peer group developed where the students share their experience, expertise, insight, and knowledge in a caring and supportive, but informal, forum. CoP could become an effective tool to aid retention, identity development and wellbeing of postgraduate level students, factors which have been previously identified as key areas of risk. An autoethnographic approach was used to review the feelings, perceptions, and opinions of the four case study group members about their experiences of the informal CoP to date. Thematic analysis of transcripts and WhatsApp communications was used to reveal the perceived common benefits and gains from participation in the informal CoP such as joy, safe spaces, and identity development, aligning members experiences to a CoP lifecycle. The study found small group formation at doctoral programme induction, and encouragement for students to organise their own regular study days using of social channels, may impact overall success. Application and adaptation of this doctoral CoP model could form the basis for future research and a model for academic institutions to suggest to new and existing students

Use of Social Media and Artificial Intelligence Tools by Online Doctoral Students

Our paper aims to explore how doctoral EdD students in their thesis stage made use of digital technologies, social media (SM), and artificial intelligence (AI) tools. In this study, AI does not involve data on the use of the new generation of AI, which has been introduced in more recent years after this study took place. This paper refers to a 2nd stage qualitative analysis of semi-structured interviews collected from research undertaken in 2018 into student use of digital technologies in an online professional doctorate programme. The original study utilised an exploratory case study approach, an online survey (n = 28), and a series of semi-structured interviews (n = 9). This study will add further qualitative findings and perspectives to those that emerged in the previous study. This study will help to provide new insights into the interview data that was used to inform the initial paper resulting from the research in 2018. We argue that the unique characteristics of online doctoral students as both individuals and learners determine the popularity of some digital tools and that, in order to make the best use of the full range available they need to develop new skills and a better understanding of the pedagogy associated with those digital tools and the value they can add to an educational context. This can be achieved through the provision of more systematic coaching and support systems. This in turn will contribute to enhancing students’ feelings of belonging to a real academic learning community and their self-confidence and autonomy as online learners in general and in their performance in a Viva in particular.