Professional Obligations Research Articles

Disability Justice and Access on the College Campus: An Uphill Battle Toward Organizational Change

Feeling the exhaustion of multiple disability-related violations occurring in the classroom, staff from the Office of Disability Access at Heneton College have begun to feel isolated and hopeless. When the opportunity for collaborative, college-wide disability-centered training becomes available, it is met with mixed reviews and lots of opinions from across the institution. Some are supportive, many are feeling the pressure of multiple professional development and training obligations, and some question why the institution even needs this kind of training. Leaders in this case are faced with questions around shared governance, organizational change, and equity and inclusion.

Healthcare Workers in Conflict: Challenges and Choices.

'War is definitely hell on earth'. All too often, we hope the hell will be short-lived, over in a few days, and yet, as we know from experience, hell can go on and on and on. For healthcare workers who provide care to victims of conflict, the work raises many ethical dilemmas. The stories showcased in this edition of NIB share the experiences of a handful of brave individuals and how they navigated their professional ethical obligations as well as their personal convictions during times of conflict. Adeptly portrayed are various approaches to ethical dilemmas, such as adhering to the ethical imperative of medical impartiality, the limits of professional and personal responsibility, coping with moral distress, and the power of humanity, evident through the collective efforts of strangers to help others. This commentary reflects on the ethical grey zones of being a healthcare provider in conflict, as there is no single right way of fulfilling professional obligations, each context being different. As several stories highlight, whilst stressful, the solidarity and comradery of working in a healthcare team can provide great support, purpose, and motivation.

Balancing care and responsibility: The role of the general practitioner in specialist referrals.

Referrals are a critical component of the Australian healthcare system, with referrals from general practitioners (GPs) to non-GP specialists making up the majority of medical referrals. Given the key role referrals have in primary healthcare, it is important that GPs understand their legal and professional responsibilities when providing a referral and ensure they refer appropriately and effectively to provide the best healthoutcomes for patients. This article explores GP referrals to other health professionals and aims to describe a doctor's medicolegal obligations and responsibilities when making a referral. The responsibility of GPs in the referral process reflects their central coordinating role as providers of primary care, and the reliance patients place upon them to adviseand recommend treatment and investigations. Understanding the medicolegal obligations and responsibilities when writing a referral can help GPs find the right balance between respecting patient autonomy and the professional obligation to take reasonable steps to ensure referrals and investigations are acted upon appropriately. The key to an effective referral process is clear communication between practitioners and patients, to help align the expectations of all involved so they can agree and implement a shared treatment plan in the interests of the patient.

THE ROLE OF SOCIAL MEDIA IN SCIENCE

Social media platforms provide direct access to a vast amount of information, enabling the promotion of various content. It has become a new way of disseminating news worldwide and often influence social perception and public discourse development. Even scientists are not oblivious to the trend of using social media. Social media allows them to quickly and effectively share their research results with the global audience. Numerous studies indicate that scientists are increasingly participating in public discussions and activities on social media, with nearly half of academic researchers being a part of at least one social network. Media professionals have traditionally been the guardians of scientific information, but new media technologies grant scientists more power than ever to proactively engage in public communication. Many studies also suggest that most scientists consider media visibility important and see responding to journalists as a professional obligation, a stance endorsed by many universities and scientific organizations. Keywords: role, social media, science

Childhood vaccine refusal and what to do about it: a systematic review of the ethical literature

BackgroundParental refusal of routine childhood vaccination remains an ethically contested area. This systematic review sought to explore and characterise the normative arguments made about parental refusal of routine vaccination, with the aim of providing researchers, practitioners, and policymakers with a synthesis of current normative literature.MethodsNine databases covering health and ethics research were searched, and 121 publications identified for the period Jan 1998 to Mar 2022. For articles, source journals were categorised according to Australian Standard Field of Research codes, and normative content was analysed using a framework analytical approach.ResultsMost of the articles were published in biomedical journals (34%), bioethics journals (21%), and journals that carry both classifications (20%). Two central questions dominated the literature: (1) Whether vaccine refusal is justifiable (which we labelled ‘refusal arguments’); and (2) Whether strategies for dealing with those who reject vaccines are justifiable (‘response arguments’). Refusal arguments relied on principlism, religious frameworks, the rights and obligations of parents, the rights of children, the medico-legal best interests of the child standard, and the potential to cause harm to others. Response arguments were broadly divided into arguments about policy, arguments about how individual physicians should practice regarding vaccine rejectors, and both legal precedents and ethical arguments for vaccinating children against a parent’s will. Policy arguments considered the normative significance of coercion, non-medical or conscientious objections, and possible reciprocal social efforts to offset vaccine refusal. Individual physician practice arguments covered nudging and coercive practices, patient dismissal, and the ethical and professional obligations of physicians. Most of the legal precedents discussed were from the American setting, with some from the United Kingdom.ConclusionsThis review provides a comprehensive picture of the scope and substance of normative arguments about vaccine refusal and responses to vaccine refusal. It can serve as a platform for future research to extend the current normative literature, better understand the role of cultural context in normative judgements about vaccination, and more comprehensively translate the nuance of ethical arguments into practice and policy.

Healthcare Professionals' Knowledge, Attitude and Perception toward Adverse Drug Reaction Reporting in Saudi Arabia: A Systematic Review

Aims: To systematically evaluate the currently available evidences about the knowledge, attitude and perceptions of healthcare professionals in Saudi Arabia towards reporting adverse drug reactions to the Saudi Food and Drug Authority (Saudi FDA) as the regulatory authority monitoring adverse drug reactions in the country. 
 Study Design: Systematic Review.
 Methodology: A systematic search of the literature was conducted on ScienceDirect, PubMed, OVID databases as well as Google Scholar for all studies published in English up to June 2023. Strengthening the Reporting of Observational Studies in Epidemiology Joanna Briggs Institute (STROBE) checklist was used to appraise the quality of the cross-sectional studies included in this review.
 Results: A total of 27 studies conducted in different healthcare institutions in Saudi Arabia were included in the systematic review. Overall, in the knowledge domain, the awareness of healthcare professionals toward the existence of a national pharmacovigilance adverse drug reaction reporting system ranged from 10% to 95%. In the attitude domain, the belief of the healthcare professionals that reporting adverse drug reaction is a professional obligation ranged from 12.80% to 90.20%. In the perception domain, 46.53% to 100% of healthcare professionals perceive adverse drug reaction reporting has a positive impact on healthcare system and improves patient’s care and quality of life.
 Conclusion: Despite having positive attitude toward reporting adverse drug reaction, the healthcare professionals require more education and training in utilizing the Saudi FDA provided adverse drug reaction form and online system to report on the adverse drug reaction that they encounter during their practice.

Addressing challenges related to the professional practice of abortion post-Roe

The landmark Roe vs Wade Supreme Court decision in 1973 established a constitutional right to abortion. In June 2022, the Dobbs vs Jackson Women's Health Organization Supreme Court decision brought an end to the established professional practice of abortion throughout the United States. Rights-based reductionism and zealotry threaten the professional practice of abortion. Rights-based reductionism is generally the view that moral or ethical issues can be reduced exclusively to matters of rights. In relation to abortion, there are 2 opposing forms of rights-based reductionism, namely fetal rights reductionism, which emphasizes the rights for the fetus while disregarding the rights and autonomy of the pregnant patient, and pregnant patient rights reductionism, which supports unlimited abortion without regards for the fetus. The 2 positions are irreconcilable. This article provides historical examples of the destructive nature of zealotry, which is characterized by extreme devotion to one's beliefs and an intolerant stance to opposing viewpoints, and of the importance of enlightenment to limit zealotry. This article then explores the professional responsibility model as a clinically ethically sound approach to overcome the clashing forms of rights-based reductionism and zealotry and to address the professional practice of abortion. The professional responsibility model refers to the ethical and professional obligations that obstetricians and other healthcare providers have toward pregnant patients, fetuses, and the society at large. It provides a more balanced and nuanced approach to the abortion debate, avoiding the pitfalls of reductionism and zealotry, and allows both the rights of the woman and the obligations to pregnant and fetal patients to be considered alongside broader ethical, medical, and societal implications. Constructive and respectful dialogue is crucial in addressing diverse perspectives and finding common ground. Embracing the professional responsibility model enables professionals to manage abortion responsibly, thereby prioritizing patients' interests and navigating between absolutist viewpoints to find balanced ethical solutions.

ASHP Statement on Leadership as a Professional Obligation.

ASHP Statement on Leadership as a Professional Obligation.

The predictive factors of moral courage among hospital nurses

BackgroundHaving moral courage is a crucial characteristic for nurses to handle ethical quandaries, stay true to their professional obligations towards patients, and uphold ethical principles. This concept can be influenced by various factors including personal, professional, organizational, and leadership considerations. The purpose of this study was to explore the predictors of moral courage among nurses working in hospitals.MethodsIn 2018, an observational cross-sectional study was carried out on 267 nurses employed in six hospitals located in the northern region of Iran. The participants were selected through a simple random sampling technique. To collect data, a demographic information form was used along with two questionnaires. The first questionnaire was a standard survey on moral courage, while the second questionnaire was designed to assess the ethical climate. Linear regression was used to assess the predictors of moral courage.ResultsNurses had an average moral courage score of 87.07 ± 15.52 and an average moral climate score of 96.12 ± 17.17. The study showed that 16% of the variation in moral courage scores among nurses was explained by ethical climate and monthly overtime hours.ConclusionThis study underscores the significance of establishing an ethical work environment and minimizing overtime hours in order to enhance moral courage among nurses. These findings carry weight for both nursing practice and organizational policies focused on fostering ethical conduct within healthcare settings.

ASHP Statement on Precepting as a Professional Obligation.

ASHP Statement on Precepting as a Professional Obligation.

Surgeon Perspectives on Daily Presentation of Ethical Dilemmas: A Qualitative Study.

Surgeons encounter and navigate a unique set of ethical dilemmas. The American College of Surgeons (ACS) previously identified 6 core ethical issues central to the practice of surgery, but there have been no reports of the true range and complexity of ethical dilemmas encountered by surgeons in their daily practice. Qualitative research is well positioned to address this question. We conducted in-depth interviews with attending surgeons across multiple surgical subspecialties at a large, urban, academic medical center asking them to describe the most common ethical dilemmas they encounter in day-to-day practice. Interviews were recorded, transcribed, and coded according to a grounded theory, inductive approach. Thirty attending surgeons were interviewed, representing twelve different general surgery subspecialties. The majority of dilemmas identified pertained to 4 of the 6 ACS identified core ethical issues: professional obligations, competition of interests, truth telling, and end-of-life care. No participants described dilemmas relating to the themes of confidentiality or surrogate decision-making. Approximately one-third of participants identified ethical issues not well characterized by the ACS core principles, most often relating to the pressure to provide care that is not medically indicated. There was strong support for a formalized surgical ethics curriculum. Although the ACS-defined core ethical issues in surgery appropriately captured many ethical dilemmas identified by participants, surgeons described several scenarios not well characterized by these themes. A dedicated surgical ethics curriculum may help to better equip surgeons to navigate the ethical dilemmas they are likely to face in practice.

The role of dental professionals in identifying, reporting, and supporting domestic violence victims.

Domestic violence is a pervasive social issue affecting individuals across all demographics and has severe consequences for both the victims and society. Domestic violence is commonly defined as the exertion of power by one individual over another within a relationship, aiming to establish a sense of fear, control, and authority. The connection between domestic violence and oral health is established, with common oral health issues associated with domestic violence, such as dental trauma, head and neck bruises and injuries as well as facial fractures. Dental professionals play a crucial role in detecting signs of domestic violence by closely examining the head and neck region and the oral cavity during routine examinations. The significance of approaching patients suspected of experiencing domestic violence with sensitivity and empathy is of utmost importance. Recommendations include establishing trust, maintaining confidentiality, using open-ended questions, and providing information about local resources. Legal and ethical considerations are paramount, highlighting the obligations of dental professionals in cases of suspected domestic violence, including mandatory reporting laws and the balance between patient autonomy and safety. Challenges faced by dental professionals in reporting and intervening are discussed as well in this narrative review, emphasizing the importance of collaboration with other healthcare professionals and support services. This review underscores the vital role of dental care providers in recognizing signs of domestic violence, promoting intervention and support, and contributing to the well-being and safety of individuals impacted by domestic violence.

Remote training for strengthening capacity in sexual and reproductive health and rights research: a systematic review

BackgroundTraining has been used to develop research skills among sexual and reproductive health and rights (SRHR) researchers. Remote education may accelerate transfer of skills and reduce barriers to strengthening research capacity. This systematic review aimed to assess the effectiveness of remote training on SRHR research and describe enablers and barriers of effective remote training.MethodsPubMed, Embase, and Scielo were searched up to December 2022 for studies that evaluated in any language online research training programmes either on a SRHR topic or tailored for professionals working in SRHR published since 1990. Characteristics of included studies, the programmes they evaluated, the programme’s effectiveness, and reported barriers and enablers to remote learning were extracted. Three researchers synthesized and described findings on effectiveness, impact and outcomes mapping them against the Kirkpatrick model. Additionally, thematic analysis from qualitative data was conducted to identify themes relating to the barriers and enablers of remote learning.ResultsOf 1,510 articles retrieved, six studies that included 2,058 remote learners met the inclusion criteria. Five out of six studies described empirical improvements in participant research knowledge/skills and three studies reported improvements in attitudes/self-efficacy towards research. Follow-up surveys from four studies revealed frequent application of new research skills and improved opportunities for career advancement and publication following online trainings. Cited barriers to effective online SRHR research training included time management challenges and participants’ competing professional obligations; limited opportunities for interaction; and lack of support from home institutions. Cited enablers included well-structured and clear courses, learning objectives and expectations with participants; ensuring a manageable workload; facilitating interactions with mentors and hands-on experience; and selecting programme topics relevant to participants’ jobs.ConclusionRemote SRHR training can lead to improvements in research knowledge, skills, and attitudes, particularly when course learning objectives, structure, and expectations are outlined clearly, and ongoing mentorship is provided.

The Regulation of Apology In Healthcare: Learning from GMC V Dr Pandian 2023

"The MTPS case involving Dr Pandian has sparked significant debate within the medical profession, particularly regarding the disciplinary process and its implications for international medical graduates, gender dynamics, and attitudes towards complaints. A noteworthy factor contributing to the strong reactions in GMC v Pandian is the 2014 implementation of a statutory duty on healthcare providers to be open and honest when medical harm occurs. This legal duty of candour complements existing ethical and professional obligations to maintain transparency and openness with colleagues and patients. This article reflects on the intriguing role of apologies, both inside and outside legal and disciplinary proceedings. It is acknowledged that healthcare professionals often hesitate to issue apologies due to concerns about potential legal liabilities or substantial claims. In response to this challenge, legislators have introduced apology laws, creating 'safe spaces' where healthcare providers can apologise without necessarily admitting liability. Paradoxically, however, research suggests that these regulatory measures may discourage apologies and hinder honest communication regarding medical harm. Furthermore, incorporating apologies into legal frameworks may unintentionally strip apologies of their inherently humane and uncertain nature."

How Work Culture Contributes to Client Harm in Social Care: An Analysis of Reports from the Client Safety Reporting System in Finland

ABSTRACT The ethical obligation of social services professionals is to ensure that clients are not repeatedly harmed by the same risks. This study examines reports classified as actions harmful to clients due to work culture and the measures taken by managers in Finnish social services. The data used were the reports submitted by social services professionals based on reporting obligations to the SPro client-safety-reporting system and managers’ measures documented in the reports. The reports (n = 1,433) were submitted from October 11, 2016, to December 31, 2020; those related to harmful work culture (n = 95) were selected and analyzed using inductive content analysis and quantification. The results showed that, based on professionals’ perceptions, harmful work culture was linked to cooperation, information flow, resources, service or care implementation, and individuals’ actions. Managers often decided to discuss reported events within the unit. More research is needed on harmful work culture from clients’ perspectives and the effectiveness of measures to eliminate observed risks.

Kepala sekolah sebagai Power Peningkatan Loyalitas Guru di SMP Negeri 1 Mojoagung Jombang

Loyalty is an extremely important quality in a leader, and its presence guarantees the growth of a dedicated following. A competent instructor will carry out the required actions. Therefore, it is necessary to increase teacher loyalty to their jobs, as teachers play a crucial role in the educational process. Teachers who are not committed to their institutions typically display low levels of motivation and professionalism in the classroom. The purpose of this study is to de-emphasize teacher loyalty and instead learn how the school's administration plans to increase teacher loyalty at SMP Negeri 1 Mojoagung Jombang. This type of study is a descriptive quantitative study. Instead, observation, interviews, and paperwork are used as data collection methods. Meanwhile, common data analysis techniques include data reduction, data presentation, and data verification. However, the study's findings pertain to teachers' loyalty at SMP Negeri 1 Mojoagung Jombang, and they are as follows: strict adherence to established rules and regulations, acceptance of responsibility for the responsibilities placed on him as a teacher and the tasks assigned to him, and a commitment to communicating truthfully and in accordance with Islamic principles. In contrast, the school's administration can boost teacher loyalty by measures such as increased surveillance, providing teachers with feedback and coaching opportunities, conducting regular classroom observations, reminding teachers of their professional obligations, reminding teachers that the school is their own, providing uswatun khasanah.

The impact of community engagement on undergraduate social responsibility attitudes

ABSTRACT The literature on student development cautions that social responsibility attitudes may stagnate or decline as students proceed through college. Given the importance of students’ future professional obligations to society, identifying ways to reverse this trend is crucial. In turn, an important aim of this study, situated at a large public university, is to evaluate the prospects of community engagement as a strategy to foster professional social responsibility development. The study uses longitudinal results from an instrument known as the Generalized Professional Responsibility Assessment (GPRA) to assess personal and professional social responsibility attitudes. The study’s sample includes 128 students who completed a survey both in 2017, when entering college, and in 2019, when near the midpoint of college. Findings indicate that social responsibility attitudes remain stagnant, and that students over that time period attach more importance to salary as compared to helping people when considering job priorities. Yet, results reveal that increased community engagement predicts growth in social responsibility attitudes, even when controlling for students’ pre-college social responsibility attitudes and demographic characteristics. Further, a novel contribution of this study is a focus on two sub-categories of community engagement: discipline-based and peer-based. Discipline-based community engagement appears to foster professional aspects of social responsibility, while community engagement experiences tied to peer interaction appear to exert greater impacts for non-White students. An observation derived from the study is that community engagement, particularly when it connects to a student’s discipline or draws on peer influences, could be an effective strategy to promote social responsibility development.

Understanding socialization in interprofessional practice: health science perspectives

According to a study of the research, there is a lack of understanding about how students see the professional obligations and functions of other professions. This research aimed to investigate how health professional students (HPS) perceived Inter professional socialization (IPS). Participants came from eight different health-related academic fields, including nursing, radiological science, occupational therapy, clinical lab science, social work, nutritional science, and physical therapy. In all, 300 undergraduate (UG) and 114 graduate students participated. The Interprofessional socialization and Valuing Scale (ISVS-21) was used to gather the data. On a Likert scale with 1 being not at all and 7 being to a very large amount, the participants were asked to score 21 questions concerning their beliefs, practices, and perspectives towards IPS. To examine variations across the health fields, descriptive statistics and analysis of variance were used to analyze the information. According to a descriptive study, 95.2% of students believed IPS was happening to a rather considerable level, with a mean of 5.12 or higher on a scale from 1 to 7. The health fields didn't vary all that much from one another. The results indicate that pupils are prepared to comprehend one another's professional duties and obligations. There are several things to keep in mind for future Interprofessional collaborative activities even if there are no standardized educational methodologies to encourage student cooperation across disciplines.

The Role of Psychological Empowerment Mediation and Organizational Commitment to Influence Transformational Leadership on Nurse Performance (Study at The Countermeasures Referral Hospital Certain Emerging Infectious Diseases in Bali)

Nurses who work during the pandemic have a high risk of exposure to the Covid-19 disease. The professional obligations of nurses that must be carried out during the pandemic have caused many nurses to have concerns about work and have an impact on their performance. This study aims to be able to analyze the role of psychological empowerment mediation and organizational commitment on the influence of transformational leadership on the performance of nurses in the isolation room of a referral hospital for the management of certain emerging infectious diseases in Bali. The sample of this study was 199 respondents from 396 nurses who worked in the isolation treatment room of a referral hospital to manage certain emerging infectious diseases in Bali. The sampling technique used is incidental sampling. This study uses a quantitative approach associative of causality with the dissemination of google form questionnaires analyzed using SmartPLS. The results of the study prove that (1) transformational leadership does not have a direct effect on nurse performance, (2) transformational leadership has a positive and significant effect on psychological empowerment, (3) transformational leadership has a positive and significant effect on organizational commitment, (4) psychological empowerment has a positive effect. and significant effect on nurse performance, (5) organizational commitment has a positive and significant effect on nurse performance, (6) psychological empowerment fully mediates positively and significantly influences transformational leadership on nurse performance, (7) organizational commitment fully mediates positively and significantly influences transformational leadership on nurse performance. Organizational commitment has a stronger mediating role than psychological empowerment on the influence of transformational leadership on nurse performance. This research implies that nurses' performance improvement can be done with transformational leadership which is able to make nurses have high organizational commitment and psychological empowerment.

Zen and the art of advising student organizations

Advisors of student organizations face many challenges, including holding students accountable while respecting their autonomy, dealing with challenges of diversity, equity, and inclusion, and navigating their lack of training. Coupled with other professional obligations, it is common for advisors to feel stressed and under-prepared in their advising role. Given the increased interest in mindfulness, this article provides context on the practice of mindfulness meditation and explores how advisors can apply mindfulness principles in handling the challenges they face in their student organization advising role. Mindfulness meditation offers an opportunity for advisors of student organizations to incorporate best practices in reflection, emotional regulation, and handling uncertainty. Since the practice of mindfulness meditation requires no additional tools, costs, or formal training, it is a suitable option for busy professionals.