Professional Regulation Research Articles

Drivers of regulatory reform in Canadian health professions: Institutional isomorphism in a shifting social context

AbstractResearch has documented how the decline in professional self-regulation in the UK and Australia was led by policy-makers in response to regulatory failures. In Canada, professional self-regulation is currently in decline as well, and while policy-makers have driven some change it is also the case that self-regulating professions have begun to transform themselves from within: altering their structure, make-up, and processes to enhance fairness, public input, and accountability, while reducing professional control. Why would they do so? This paper draws on the concept of institutional isomorphism to understand why professional regulators would invoke changes that, on the surface, might seem to counteract their own interests. Analysing data from 46 interviews with leaders in healthcare profession regulation, this paper examines how coercive, mimetic, and normative processes drive regulatory reform in a changing regulatory field.

The Advanced Clinical Practitioner (ACP) in UK healthcare: Dichotomies in a new ‘multi-professional’ profession

Advanced Clinical Practitioners (ACPs) work in a wide range of settings across the English National Health Service. ACPs come from a wide range of health professional backgrounds. This paper explores the ACP as a multi-professional role, and the implications of these understandings for the sociology of professions. This paper analyses what happens when a new occupational role is created that encompasses several established professions.This qualitative study gathered views and experiences across a range of stakeholders. Fifty-eight semi-structured interviews were undertaken with participants employing ACPs (n ​= ​14) actively working in an ACP role (n ​= ​10), training as an ACP (n ​= ​13) or engaged in the delivery of the ACP education programme in England (n ​= ​21). Findings were analysed into three overarching themes: (i) professional identity, (ii) differing definitions of ACP and (iii) advanced practice, professional regulation and recognition.ACPs hold a unique and emerging professional identity based on their previous professional health background and are themselves clear that they are not doctors. The role is not yet formally regulated, though many ACPs aspire to this. This research is an early look at a new type of professional which challenges existing understandings of what a profession is.

Ukrainian wartime policy and the construction of women's combatant status

This article examines the role of gender in the designation of individuals as civilians and as combatants in the Ukraine conflict (2014–2022). In particular, I explore how gendered decisions by the state have created a conceptual gray zone regarding the combatant status of women through an analysis of three key Ukrainian government policy decisions: the February 2015 military mobilization of women, the December 2021 requirement that professional women register for conscription, and the February 2022 declaration of martial law. I demonstrate that while the Ukrainian state seeks to benefit operationally from women in combatant roles, the need for additional (wo)manpower has come into conflict with gender norms that position women as civilians, even in the context of war. The state's gender ideology simultaneously denies men the status of civilians despite their greater likelihood of being targeted by Russian forces. These gendered policy decisions have forced combatant status on men while making most women's combatant status voluntary.

Welfare practices for anaesthesiology trainees in Europe: A descriptive cross-sectional survey study.

Current regulations of anaesthesiology training programmes may affect gender equity, female representation and leadership. To describe the work regulations of anaesthesiology training programs and working conditions during the early period of child-rearing in European countries. Cross-sectional survey. National Anesthesiologists Societies Committee (NASC) representatives of the European Society of Anesthesiology and Intensive Care. Thirty-eight NASC representatives. Basic specialist training working conditions, gender-related data, return to work after childbirth and workplace policies against discrimination during anaesthesiology specialist training. A 48-item questionnaire to explore the work patterns and conditions for trainees especially for new parents, professional development opportunities and work discrimination regulations in each representative country was distributed to NASC representatives of 44 European countries. We collected the replies of each representative (38 representatives from 44 invited countries' representatives, 86% response rate). The median [IQR] proportion of female trainees was 60% [50 to 68]. There were no reported pay differences between sexes. In eight European countries, pregnant trainees worked fewer hours and were excused from night shifts. Women could not be laid off during pregnancy in all 38 countries (100%). The countries offered a median of 18 weeks of paid (total or partial) maternity leave (range, 13 to 60 weeks). Most countries (89%) accommodate paid paternity leaves. A significant proportion of parental leave was unpaid ( n =18, 42%). Twenty-one (55%) countries allowed part-time work after delivery. The UK was the only country with clear recommendations to formally complain after harassment. European countries have a wide variety of regulations. On paper, numerous countries have various paid maternal, paternal and parental leave; however, it remains to be determined if such leave takes place in practice. The practical consequences of these regulations on female trainees during the child-rearing period need to be explored further. None.

Quality and Safety Considerations in Intensity Modulated Radiation Therapy: An ASTRO Safety White Paper Update

This updated report on intensity modulated radiation therapy (IMRT) is part of a series of consensus-based white papers previously published by the American Society for Radiation Oncology (ASTRO) addressing patient safety. Since the first white papers were published, IMRT went from widespread use to now being the main delivery technique for many treatment sites. IMRT enables higher radiation doses to be delivered to more precise targets while minimizing the dose to uninvolved normal tissue. Due to the associated complexity, IMRT requires additional planning and safety checks before treatment begins and, therefore, quality and safety considerations for this technique remain important areas of focus. ASTRO convened an interdisciplinary task force to assess the original IMRT white paper and update content where appropriate. Recommendations were created using a consensus-building methodology, and task force members indicated their level of agreement based on a 5-point Likert scale, from "strongly agree" to "strongly disagree." A prespecified threshold of ≥75% of raters who select "strongly agree" or "agree" indicated consensus. This IMRT white paper primarily focuses on quality and safety processes in planning and delivery. Building on the prior version, this consensus paper incorporates revised and new guidance documents and technology updates. IMRT requires an interdisciplinary team-based approach, staffed by appropriately trained individuals as well as significant personnel resources, specialized technology, and implementation time. A comprehensive quality assurance program must be developed, using established guidance, to ensure IMRT is performed in a safe and effective manner. Patient safety in the delivery of IMRT is everyone's responsibility, and professional organizations, regulators, vendors, and end-users must work together to ensure the highest levels of safety.

Proposal for a professional qualification course in radiation protection to obtain the registration of Radiation Protection Supervisor to work at teaching and research laboratories

According to the CNEN Standard NN 6.01, aiming at professional registration for the preparation, use and handling of radioactive sources in teaching and research (T&R), the candidate must submit to the National Nuclear Energy Commission (CNEN), in addition to the registration professional or diploma recognized by the Ministry of Education (MEC) and the application for registration, proof of radiation protection course, with a minimum load of forty (40) hours. In this sense, the present paper aims to present a proposal and an experience report of a training course. The course, developed in conjunction with the rectory of the State University of West Paraná (UNIOESTE) / Cascavel campus, was directed to 12 professionals (teachers and technicians of the Chemistry and Biology courses), and carried out at the Fine Equipment Laboratory, in 2020. After the training, individuals were registered for the preparation, use and handling of radioactive sources with all the documentation proposed in Standard NN6.01 to obtain the registration and title of Radiation Protection Supervisor at T&R institutions issued by CNEN . With this certification, the professional will have a record valid for 05 years in low-risk installations, classified according to Standard NN 6.02. It is understood that the professional qualification course, with the objective of being certified by CNEN, is of great importance for T&R institutions that use radioactive material, in view of the lack of qualified professionals, and can be applied in other T&R institutions.

Teaching students to mentor: Near-peer mentoring in undergraduate medical radiation science education

Mentoring is emphasised as a professional requirement by national bodies which administer the registration of new graduate medical radiation professionals. ‘Near-peer’ mentoring, where the mentor and mentee are similar in social or professional status, has the potential to develop necessary mentoring skills and attitudes in the undergraduate setting. This is in addition to the positive benefits experienced by the mentee, who is beginning to navigate the university environment. In this educational perspective, the concept and value of near-peer mentorship within undergraduate medical radiation curriculum is discussed. Based on the literature, recommendations and strategies are described for educators looking to implement near-peer mentoring programs within their universities or healthcare institutions.

Assessing Capture Risks in the Regulatory Mechanism: Insights from Kenya’s Regulation of Professionals in the Construction Labour Market

The article draws academic attention to capture risks in the regulatory statutes that may lead to capture by regulators. It takes a practical outlook of Kenya for empirical demonstration of the statute-based capture risks. The article uses the Regulatory Impact Assessment (RIA) framework to identify the risk factors in the regulatory environment for professions involved in real estate development, that is, architects, engineers and quantity surveyors. The OECD Reference Checklist for Regulatory Decision-making is used as a reference point in identifying risk analysis as a candidate of inclusion in the checklist for purposes of improvement in regulatory outcomes. Document analysis is used to make observations on the statutes and generate data for qualitative analysis and interpretation. Capture risks are identified in terms of composition of regulatory boards that include powerful public servants. Exclusion of relevant stakeholders in the regulation of professions, inclusion of extraprofessional regulations and uncontrolled legislative powers are other sources of risk of regulatory capture. The article gives central focus to the capture by regulators. Existing regulatory capture literature predominantly consider regulatory capture by private or special interest groups.

Relevansi Konsep Pemikiran Ekonomi Islam Yusuf Qardhawi dan Penerapannya di Indonesia

The low level of public literacy related to Islamic economics causes errors and mistakes in the practice of Islamic economics, so that if it is ignored it can have a negative impact on the development and progress of Islamic economics itself. So it is important for various parties to know and study various models of economic thought concepts from Islamic economists such as Yusuf Qardhawi. Because the concept of Islamic economic thought can be used as a reference in dealing with economic problems. Yusuf Qardhawi's phenomenal economic thought is related to professional zakat, ethics and economic norms which include the ethical concepts of production, distribution, and consumption. Not only that, but Yusuf Qardhawi also expressed his phenomenal thoughts related to the concept of property which includes zakat, taxes, interest and usury, the concept of working in Islam, government involvement in economic ethics, and also the concept of equitable distribution of welfare for all people. Although it contains various pros and cons, the journey of professional zakat in Indonesia has attracted a lot of attention from various groups ranging from academics, scholars and the government who are also serious about responding to this phenomenon, especially MUI with the issuance of Law No. 3 of 2003 concerning Income Zakat, Law No. 23 of 2011 concerning Zakat Collection, PMA and BAZNAS also participate to strengthen regulations and policies on professional zakat regulation.
 Keywords: Relevance, Islamic Economics, Yusuf Qardhawi, Indonesia.

Delaware Division of Professional Regulation

Delaware Division of Professional Regulation

Delaware Division of Professional Regulation.

Delaware Division of Professional Regulation.

Emotion regulation and mental health among professionals of long-term care institutions for older adults: The mediating role of work engagement

BackgroundThis study examined whether work engagement mediated the association between emotion regulation and mental health of professionals working in long-term care institutions for older adults in Brazil.Participants and procedureA cross-sectional study with a total of 104 professionals working in 13 long-term care facilities for the elderly in Brazil was conducted. Emotion regulation (expressive suppression and cognitive reappraisal), work engagement (vigor, dedication, and absorption), and mental health (depression, anxiety, and stress) were measured using self-report scales. Multiple me-diation models were used to test the mediating role of engagement.ResultsExpressive suppression was associated with more vigor, which in turn was associated with less anxiety and stress; cognitive reappraisal was associated with more vigor, which in turn was associated with less anxiety and stress. No indirect effects were found for depression.ConclusionsExpressive suppression and cognitive reappraisal strategies to regulate emotions seem to be associated with more vigor in terms of resilience and persistence to deal with work demands in these professionals. These results seem to suggest that workers who are more capable of regulating their emotions (using both expressive suppression and cognitive reappraisal in a flexible way according to work demands) are more likely to be resilient, invest in their profession, and be persistent in the face of difficulties. This, in turn, contributes to protecting them from experiencing anxiety and stress.

Midwives' perspectives of intravenous fluid management and fluid balance documentation in labour: A qualitative reflexive thematic analysis study.

To describe current practice, examine the influences and explore barriers and facilitators to accurate documentation, for the administration of intravenous fluids during labour. A descriptive qualitative study was performed. Qualitative semi-structured interviews were conducted with Registered Midwives working across Australia. Midwives were recruited via email and social media advertisements. A maximum variation sampling strategy was used to identify potential participants. Interview questions explored four main areas: (i) understanding of indications for IV fluids in labour; (ii) identification of current practice; (iii) barriers to documentation and (iv) benefits and complications of IV fluid administration. Reflexive thematic analysis of recorded-transcribed interviews was conducted. Eleven midwives were interviewed. Clinical practice variation across Australia was recognized. Midwives reported a potential risk of harm for women and babies and a current lack of evidence, education and clinical guidance contributing to uncertainty around the use of IV fluids in labour. Overall, eight major themes were identified: (i) A variable clinical practice; (ii) Triggers and habits; (iii) Workplace and professional culture; (iv) Foundational knowledge; (v) Perception of risk; (vi) Professional standards and regulations; (vii) The importance of monitoring maternal fluid balance and (viii) barriers and facilitators to fluid balance documentation. There was widespread clinical variation identified and midwives reported a potential risk of harm. The major themes identified will inform future quantitative research examining the impact of IV fluids in labour. The implications of this research are important and potentially far-reaching. The administration of IV fluids to women in labour is a common clinical intervention. However, there is limited evidence available to guide practice. This study highlights the need for greater education and evidence examining maternal and neonatal outcomes to provide improved clinical guidance.

An international exploration of blended learning use in pre-registration nursing and midwifery education

AimTo explore international experiences of using blended learning in preparing nursing and midwifery students for initial professional registration to inform future education policy. BackgroundThe global nursing and midwifery skills shortage and need for an expanded nursing workforce that is fit for contemporary care delivery is widely acknowledged. The immense pressure the profession was already under because of austerity, staff shortages and increasingly complex healthcare needs has been worsened by the Covid-19 pandemic. The UK is extending and evaluating the use of blended learning programmes for pre-registration nursing and midwifery students to help address these issues. This study sought to explore relevant nursing and midwifery experiences from outside the UK to help inform future health professional education policy here and elsewhere. DesignCross-sectional, sequential, mixed methods study Participants/settingsNursing/nurse education leaders from across International Council of Nurses regions MethodsExploratory online survey (n = 32) and three follow-up case studies (March-May 2021). Participants’ knowledge and experiences of blended learning were examined along with any perceived benefits for workforce development and successful strategies for addressing the challenges blended learning presents in this context. Case studies were developed inductively from survey responses and follow up telephone calls to provide more detailed information about reported successes. ResultsParticipants reported flexibility, cost effectiveness, increased student/tutor and student/student communication and interaction as benefits of blended learning. Challenges included the design and use of interactive learning resources, appropriate preparation and support for staff and students, the potential of blended learning to exacerbate otherwise hidden disadvantage and the need for multi-stakeholder cost/benefit evaluation. ConclusionsBlended learning is used globally in the pre-registration education of nurses, midwives and other healthcare professionals. These results broadly mirror the literature regarding the benefits blended learning offers healthcare students, staff and organisations and the strategies employed to mitigate risk. As the deployment of blended learning nursing and midwifery programmes expands, further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach. These concern adequate preparation and support of students and staff, ensuring access to appropriate equipment and connectivity, exploration of student perceptions that online learning is of lesser value and comprehensive multi-stakeholder, exploratory evaluation to uncover any hidden factors and impact. Tweetable abstractBlended learning plays an effective part in the education of pre-registration nursing and midwifery students to help tackle global workforce shortages, but further work is needed to address gaps in the current evidence base regarding the practice and impact of this approach.

Regulating for-profit virtual care in Canada: Implications for medical profession regulators and policy-makers.

For-profit virtual medical care has been expanding rapidly in Canada, creating new societal and practical challenges requiring policy and regulatory reform. We mapped the current state of regulatory policy across 10 Canadian provinces by analyzing practice standards and guidelines for virtual care from medical profession regulators. Through a comparative framework, we assessed the extent to which virtual practice policies addressed issues around mobility and licensure, equitable access, privacy, complaints, and continuity of care. We also compared these regulatory documents to the model standards from the Canadian medical regulatory consortium and considered implications for practicing in for-profit virtual environments. We found considerable variation across provincial regulatory bodies, with most existing frameworks not adequately addressing equity, access, and practitioner competency and not providing flexible, nuanced, or risk-based approaches to virtual care provision. As we compared jurisdictions, we identified gaps and leading practices to inform recommendations for professional regulators and policy-makers.

Veterinary nursing in the United Kingdom: Identifying the factors that influence retention within the profession.

The UK regulatory body for registered veterinary nurses (RVNs), the Royal College of Veterinary Surgeons (RCVS), maintains the professional register of RVNs. Every year, a proportion fail to re-join the register. This research aimed to identify the factors that predict retention and to make recommendations to inform the Royal College of Veterinary Surgeons as the regulator as well as both the veterinary nursing and veterinary professions. An analysis of the raw quantitative data generated by the 2014 and 2019 RCVS surveys of the veterinary nurse profession was undertaken using multivariable logistic regression analysis. First, bivariable associations were estimated using unadjusted odds ratios to explore whether there are any (unconditional) associations between each predictor and the outcome. Predictors that were significant unconditional predictors of intention to leave were then entered into a multivariable logistic regression, yielding adjusted odds ratios. Quantitative analysis found significant relationships between intention to leave and the following factors in both the 2014 and 2019 survey data: job satisfaction; believing that veterinary nursing offers good opportunities for career progression; satisfaction with employer support; and having a second job. The following factors were significant in 2014, but not in 2019: undertaking nurse clinics, feeling valued, and being respected by veterinary surgeons. The factors that influence the retention of registered veterinary nurses (RVNs) within the profession are multifactorial and individual. Nurses are responsible for ensuring that those they work with are aware of their skill set and that they themselves are accountable for utilisation of those skills. When veterinary nurses are supported by their employers, they are more likely to stay in the profession. Having a clearly defined career structure and mapped routes for progression will be helpful with retention. A sense of job satisfaction was another important factor in retention. A pay structure linked to a career pathway framework, such as in human-centred nursing, is an area for further work.

What is the Public Interest in Professional Regulation? Canadian Regulatory Leaders’ Views in a Context of Change

Professions are regulated in the public interest, but precisely what the term “public interest” means can vary across time and place. Research exploring changes to professional regulation in the West has begun to identify such shifts: for instance, highlighting the emphasis on consumer satisfaction and public protection over other potential meanings of the public interest. To understand these societal shifts and their implications for professional regulation, this article first reviews neo-Weberian theories of rationalization, and empirical literature. Subsequently, it presents findings from interviews with regulatory leaders across six Canadian provinces to determine if the trends in rationalization identified are reflected in leaders’ accounts of professional regulation in the public interest. Interviews reveal that many leaders define the public interest in ways consistent with technical rationality, including a safety lens and consumer orientation; however, there is also evidence of broader meanings and values. The implications of these findings are discussed.

Harnessing the nursing and midwifery workforce to boost Australia's clinical research impact.

Harnessing the nursing and midwifery workforce to boost Australia's clinical research impact.

Health Workforce Planning: an urgent need to link islands of expertise

This article provides a snapshot of the legislative framework for, and ministries and agencies involved in or with influence over, theeducation of the health and disability workforce, including examples of disconnection between the wider health and education sectors.Particular challenges occur between health professional regulators, education providers and clinical (placement) providers because their respective areas of expertise tend to be siloed, thus reducing the capacity for a coordinated and holistic perspective. Four potential ‘bridges’ for linking these ‘islands’ of expertise are suggested. The current period of institutional reforms in the health and education sectors presents an opportunity to refine the structures and systems for workforce education and planning, thereby facilitating a more flexible, responsive and resilient workforce which is better equipped to engage with, and improve outcomes for, the wider community.

Admission Criteria as Predictors of Licensure Performances among Graduates of a State University in the Philippine Cordillera Administrative Region

Proficiency in licensure examinations has emerged as a foundation of pride for graduates and an attraction for potential students to higher education institutions (HEIs). Therefore, the purpose of this study was to uncover the admission criteria that confidently predicted the licensure performance of graduates of a state institution in the Philippine Cordillera Administrative Region. This study used correlation research and 654 randomly selected graduates of Ifugao State University (IFSU) who took and eventually passed their licensure tests. The records of the university registrar and the Professional Regulations Commission (PRC) were the primary sources of data. To comply with research ethics and standards, written permission from university officials was obtained. The mean, standard deviation, and frequency were used to describe the descriptive variables. Multiple regression analysis was utilized to identify the significant set of predictors of license performance per licensure examination. A stepwise procedure was used to select the best model. The study concludes that the performance of graduates in the fields of agriculture, criminology, and teacher education in their respective licensure examinations can best be predicted by their high school grade point average and admission test scores, whereas the performance of graduates in the field of forestry in their licensing exam is best explained by their performance in their secondary education curriculum.
 
 Received: 25 August 2022 / Accepted: 20 October 2022 / Published: 5 November 2022