Specialty Roles Research Articles

Engaging Nursing Students in Clinical Research Through a Unique Academic-Clinical Partnership.

A unique partnership between two academic medical centers, one with a college of nursing and the other with a clinical research center (CRC), provided professional development hours focusing on clinical research and the clinical research nurse's role to generalist entry master's nursing students. Students with clinical research interests were invited to apply for the 32-hour professional development program scheduled during 4 sequential days. Didactic, observational, and role-playing experiences offered students a picture of the clinical research nurse role, research regulatory processes, and career opportunities postgraduation. Evaluation of the four cohorts who completed the program demonstrated that most participants highly agreed that the program was educational and valuable. Partnering with academic medical centers who have CRCs provides master's-level students with innovative professional development hours that foster their understanding of practice areas (e.g., clinical research, specialty role of the clinical research nurse) that are not part of their coursework. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Validation of Emergency Nurse Practitioner Competencies: Patient Complexity and Clinical Decision Making

IntroductionOver the past 15 years, the emergency nurse practitioner has been recognized as a nursing specialty role with dedicated scope and standards of practice. However, a paucity of objective data exists to validate the actual practice of emergency nurse practitioners in the emergency care setting. The purpose of this pilot study was to describe the initial acuity of patients assigned to emergency nurse practitioners, actions, decisional complexity, and disposition decisions of advanced practice nurses as they function in emergency departments in a single system. MethodsThis descriptive exploratory study used retrospective chart data to gain understanding. ResultsThe most common Emergency Severity Index level seen by emergency nurse practitioners was Emergency Severity Index 3. Of 8513 encounters with Emergency Severity Index level data, 21% were triaged at Emergency Severity Index 2, 56% at Emergency Severity Index 3, 21% at Emergency Severity Index 4, and only 2% at Emergency Severity Index 5. Half of encounters resulted in a Current Procedural Terminology code of 99825 or higher and 94% were coded at 99824 or higher. There were a high percentage of admissions including intensive care unit admissions. DiscussionAlthough descriptive, this study is highly illustrative of the broad scope of complex skills and clinical decision making required to perform as an advanced practice nurse in the emergency department. Further examination of education and training is warranted.

Modelling a Consultant Workforce for the United Kingdom: needs-based planning for Dental Public Health.

To develop a needs-based workforce planning model to explore specialist workforce capacity and capability for the effective, efficient, and safe provision of services in the United Kingdom (UK); and test the model using Dental Public Health (DPH). Data from a national workforce survey, national audit, and specialty workshops in 2020 and 2021 set the parameters for a safe effective DPH workforce. A working group drawing on external expertise, developed a conceptual workforce model which informed the mathematical modelling, taking a Markovian approach. The latter enabled the consideration of possible scenarios relating to workforce development. It involved exploration of capacity within each career stage in DPH across a time horizon of 15 years. Workforce capacity requirements were calculated, informed by past principles. Currently an estimated 100 whole time equivalent (WTE) specialists are required to provide a realistic basic capacity nationally for DPH across the UK given the range of organisations, population growth, complexity and diversity of specialty roles. In February 2022 the specialty had 53.55 WTE academic/service consultants, thus a significant gap. The modelling evidence suggests a reduction in DPH specialist capacity towards a steady state in line with the current rate of training, recruitment and retention. The scenario involving increasing training numbers and drawing on other sources of public health trained dentists whilst retaining expertise within DPH has the potential to build workforce capacity. Current capacity is below basic requirements and approaching 'steady state'. Retention and innovative capacity building are required to secure and safeguard the provision of specialist DPH services to meet the needs of the UK health and care systems.

Physician interest in hiring pediatric psychologists in specialty care roles.

Physician interest in hiring pediatric psychologists in specialty care roles.

Leadership and Impostor Syndrome in Surgery.

Impostor syndrome is an internalized sense of incompetence and not belonging. We examined associations between impostor syndrome and holding leadership positions in medicine. A cross-sectional survey was distributed to US physicians from June 2021 to December 2021 through medical schools and professional organizations. Differences were tested with the chi-square test and t -test for categorical and continuous variables, respectively. Logistic regression was used to identify factors associated with holding leadership positions and experiencing impostor syndrome. A total of 2,183 attending and retired physicians were included in the analytic cohort; 1,471 (67.4%) were in leadership roles and 712 (32.6%) were not. After adjustment, male physicians were more likely than women to hold leadership positions (odds ratio 1.4; 95% CI 1.16 to 1.69; p < 0.001). Non-US citizens (permanent resident or visa holder) were less likely to hold leadership positions than US citizens (odds ratio 0.3; 95% CI 0.16 to 0.55; p < 0.001). Having a leadership position was associated with lower odds of impostor syndrome (odds ratio 0.54; 95% CI 0.43 to 0.68; p < 0.001). Female surgeons were more likely to report impostor syndrome compared to male surgeons (90.0% vs 67.7%; p < 0.001), an association that persisted even when female surgeons held leadership roles. Similar trends were appreciated for female and male nonsurgeons. Impostor syndrome rates did not differ by race and ethnicity, including among those underrepresented in medicine, even after adjustment for gender and leadership role. Female physicians were more likely to experience impostor syndrome than men, regardless of specialty or leadership role. Although several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.

Online survey and interview evaluation to explore the use of video consulting among Allied Health Professionals during the COVID-19 pandemic

ObjectivesAllied Health Professionals (AHP) consist of 13 different specialty roles in Wales, sharing the responsibility of promoting and supporting the health and well-being of the population. During the COVID-19 pandemic,...

A Review on Michelia Champaca and Flowers

Michelia champaca Linn. Known as Champaca is Belonging to family of Magnoliaceae. It Consists of 12 genera and 220 species of evergreen trees and shrubs. In recent times there are several reports of medical specialty roles and activities of Michelia champaca and its active principles on the circulatory system, antipyretic, diuretic1.The Phytochemical analysis of the leaves and flowers of the plant showed the presence of alkaloids, tannins, glycosides, carbohydrates, amino acids, flavonoids and sterol in different solvent system. The petroleum ether extract of the dried flower contained n-alkane hydrocarbons, unsaturated aliphatic ketones, beta sistosterol and quercetin. The quercetin forms the first report of its occurrence in the genus Michelia(Shalini and Jaggi 2004) Lago et al (2009) reported that volatile oils contained six sesquiterpene hydrocarbons, four oxygenated sesquiterpenes and two aliphatic alcohols from water using dichloromethane solvent in leaves of M. champaca L. This article provides the collective information about the phytochemical constituents isolated from various parts of this plant used in a modern scenario for the treatment of various ailments like β-sitosterol, sesquiterpenes, parthenolide, dihydro parthenolide, gallic acid, quercetin, liriodenine, essential oils, starch, etc. Traditional uses of the plant in the treatment of various disease like rheumatism, gout, diuretic, febrifuge, etc..

Charter for Locally Employed Doctors in the UK Health Service

Locally employed doctors have been described along with their compatriots as 'the lost tribe' compared to their peers who are either in formal training, consultant, or general practitioner posts. Over the lastdecade, considerable progress has been made in improving the recognition, value, and respect given to doctors in Specialty, Staff Grade or Associate Specialist (SAS) roles with harmonised contracts, working conditions and support available. The vast majority of the cohort of over 127,000 doctors in the SAS-LED category as per the UK medical register (GMC 2022 dataset) continue to be lumped with their SAS historicalcounterparts yet have a very different experience. These LEDs are unsung and unheard and remain voiceless in the UK NHS medical staff, yet continue to provide service in delivering high-quality healthcareto the nation.&#x0D; This Charter is ambitious in its aspiration and aims to deliver the 'Gold Standard' for all LEDs. It was developed following a prolonged exercise of listening to the experiences of many LEDs within themembership of BAPIO across its affiliated organisations and social networks. It is unique in being developed and written by LEDs and IMGs early in their careers or by those transitioning to more establishedsenior and autonomous roles. So it is grounded in the reality of lived experiences and ambitious in setting the bar at an equal level with other doctors in the UK NHS.&#x0D; The LED Charter offers ten practical recommendations for implementation by all NHS employing organisations. Most of the principles of equality and inclusion described in this Charter should be embraced by the medical royal colleges, education and training agencies (i.e. Health Education England) in their committees and processes to provide a voice to this 'lost tribe'.

The Specialty roles in Nursing by Jordanian Nursing Council

The Specialty roles in Nursing by Jordanian Nursing Council

Longitudinal trends of "manels" and gender representation at the ASCO Genitourinary Cancers Symposium.

2 Background: Gender disparity in academic medicine has been a longstanding issue. Efforts have been made to recognize this imbalance and increase inclusivity. Despite this, a recent study examining the prevalence of all-male panels (“manels”) found that female faculty are significantly underrepresented at urology meetings, and nearly two-thirds of the sessions were manels. Therefore, we aimed to investigate the prevalence and longitudinal trends of manels and gender representation across genitourinary oncology disciplines at the ASCO Genitourinary Cancers Symposium (GU ASCO). Methods: GU ASCO online programs from 2018-2021 were used to obtain faculty information. Data collected included perceived gender, medical specialty, and panel role (chair/moderator vs. non-chair/non-moderator). For year 2021, additional data about the panelists, including the number of publications, H-index, citations, and academic rank, was collected. The primary outcomes were the percentage of manels and proportion of female panelists over time. Additionally, female representation among chair/moderators and specialties were evaluated. Results: Among 83 sessions involving 317 faculty members, 227 (71.6%) were males (p&lt;0.001), and 28 panel sessions (33.7%) were manels. Between 2018 and 2020, there was a decrease in the prevalence of manels from 45% to 21.7%, but in 2021, it rose to 32.0%. The proportion of female panel members increased over time from 17.1% in 2018 to 35.7% in 2021 (p=0.012). The role of chair/moderator was predominantly represented by males (67.2%, p&lt;0.001). The proportion of male panelists was particularly high in urology (91.2%, p&lt;0.001) and radiation oncology (81.8%, p=0.002) compared to medical oncology (54.6%). In 2021, male speakers held higher academic rank (i.e. professor, associate, assistant) (p=0.020) and had a greater number of publications (p=0.003), H-index (p=0.009), citations (p=0.014) than females (Table). Conclusions: Over time, the number of female panelists increased with a corresponding decrease in proportion of manels, with the exception of 2021. Future studies that include data on meeting participant demographics will provide insight on whether panelists are over/under-represented in proportion to the audience. While improvements in male and female representation have been made over the years, meeting organizers should strive for representation that reflects a diversity of expertise and perspectives. [Table: see text]

Healthcare Needs and Perceptions of People Living With Inflammatory Bowel Disease in Australia: A Mixed-Methods Study.

Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis are inflammatory bowel diseases (IBDs) that adversely affect the healthcare needs and quality of life (QoL) of people with IBD. The aim of this study was to explore the needs and perceptions of people with IBD in a primary care setting. This sequential explanatory mixed-methods study consisted of a cross-sectional survey (included validated tools), followed by semistructured interviews on participants' perceptions: IBD management, healthcare professionals, IBD care, flare management, and pharmacist's IBD roles. Sixty-seven participants completed the survey, and 8 completed interviews. Quantitative findings: Age at diagnosis had significant association with medication nonadherence (P = .04), QoL (P = .04), and disease control (P = .01) among the respondents. The odds of medication nonadherence were 8 times (adjusted odds ratio [AOR] = 8.04, 95% confidence interval [CI] = 1.08, 60.10) higher among younger participants aged <30 years. Those diagnosed with CD (P = .02) reported more likely to have unfavorable perceptions of pharmacists' role in managing their IBD (AOR = 9.45, 95% CI = 1.57, 56.62) than those with UC and indeterminate colitis. Qualitative findings: General practitioners were considered the most important care provider and the first point of contact for patients in managing all aspects of IBD. Participants identified their key need to be timely access to specialized IBD care and found that other primary healthcare professionals lacked disease-specific knowledge for managing IBD. Primary healthcare professionals are well positioned but need targeted training to influence the needs of IBD patients. The specialty role of an IBD educator could complement existing services to deliver and address patient-specific care.

Comparative Perspectives on Geriatrics-Surgery Co-Management Program by Specialty and Staff Role

Co-management programs between geriatrics and surgical specialties have gained popularity in the last few years. Little is known about how these programs are perceived across surgical specialties and staff roles. We conducted a mixed methods study to assess perspectives on a geriatrics-surgery co-management program (GSCP) at a hospital where geriatricians co-manage patients 65 or older admitted to Orthopedic Trauma, General Trauma, and Neurosurgery. We used semi-structured interviews (n=13) and online surveys (n=45) to explore program value, facilitators, use, understanding, and impact by specialty and staff roles (physicians, advanced practice providers, nurses, case managers, social workers). Interview transcripts were analyzed using qualitative thematic analysis, and survey data were analyzed using Kruskal-Wallis, ANOVA, and Fisher’s exact tests. Interviews revealed three themes: 1) GSCP is valued because of geriatricians’ expertise in older adults, relationship with patients and families, and skill in addressing social determinants of health; 2) GSCP facilitators include consistent availability of geriatricians, clear communication, and collaboration via shared data-driven goals; and 3) GSCP use varies by surgical specialty and role depending on expertise and patient complexity. Survey data analysis affirmed interview themes and showed significant differences (p-values<0.05) between perspectives of surgical specialties and roles on GSCP use, understanding, impact, and which specialty should manage specific clinical issues. Findings suggest that while there are similarities across surgical specialties and roles regarding the value of, and facilitators for, a GSCP, specialties and roles differ in use, understanding, and perceived program impact on care. These findings suggest strategies for optimizing this intervention across groups.

UK-based specialist dental professionals' experiences of working with autistic patients.

Previous research has demonstrated that autistic individuals often experience difficulties accessing dental care, both as a result of autism specific difficulties and practitioners' attitudes towards autism. However, very little research exists that explores dental professionals' experiences of providing care to their autistic patients. The aim of this study was to investigate the strategies UK-based dental professionals' use when working with autistic patients METHODS AND RESULTS: In this study, dental professionals (n=16) from a variety of specialty roles (special care, paediatrics, orthodontics) were interviewed. We asked participants to talk through, in depth, specific cases they had encountered in their practice, what sorts of accommodations they had provided, and what concerns had arisen during appointments. Thematic analysis was used to analyses the data and revealed four main themes: the unique dental needs associated with being autistic, effective adaptations to practice, the crucial role of the caregiver, and the importance of specialist knowledge CONCLUSION: Recommendations for how dentists can improve the dental experiences of autistic patients can be drawn from the specialist dentists' responses in this study. These include involving autistic patients in decisions about their treatment and being flexible and willing to work with autistic patients and their caregivers.

The experience of nurses deployed out of their clinical specialty role during the COVID-19 pandemic.

Griffis, Leigh DNP, RN, CPN, NEA-BC; Tanzi, Donna PhD(c), MPS, RN, NE-BC, NPD-BC; Kanner, Kimberly MSN, RN, OCN; Knoepffler, Susan MPA, BSN, RN, NE-BC Author Information

Retention and change in PAs' first years of employment.

Employment analyses demonstrate that physician assistants (PAs) exhibit role flexibility in US medicine. The next step in understanding this labor-shifting observation is to know at what career stage it first occurs. Using matriculate data linked to the American Academy of PAs (AAPA) census survey data, a longitudinal analysis of seven graduate cohorts revealed that one-third of PAs changed specialty roles at least once during their first decade of employment. From this series, it appears that new PAs spend about 3.4 years in their first job, on average, before they decide to move to another medical or surgical field. In examining PAs who changed their clinical role during this time period, 28% shifted from primary care to another medical or specialty role. Overall, the PA career movement to nonprimary care specialties increased substantially. These findings support observations that PAs provide an adaptive role in a dynamic and changing medical workforce.

Improving vaccination uptake with the implementation of an immunisation Nurse Practitioner

Patients at increased risk of vaccine preventable diseases require additional vaccines that are not licensed for Nurse Immunisers to administer without a prescription. An Immunisation Nurse Practitioner (NP) at the Royal Children’s Hospital (RCH) Melbourne was introduced to address deficiencies in the current management of these patients. NP endorsement requires successful completion of a Masters level study program, plus the equivalent of three years (5,000) hours full-time experience in advanced clinical nursing. The Immunisation NP was endorsed in May 2017 and since then, the Immunisation service at RCH has recorded a 140% increase in uptake of Meningococcal B vaccine as well as improved delivery of immunisations to special-risk patients. In addition, there was improved access to specialist immunisation advice as well as improved opportunistic immunisation of inpatients. New initiatives were implemented including immunisation of needle phobic patients using nitrous oxide sedation. This paper describes the outcomes of employing an Immunisation NP at the RCH, Melbourne. What is currently known about the topic? Nurse Practitioners provide excellent, patient-centred care whilst also contributing to research, education, leadership and management. There is much literature on describing Nurse Practitioner specialty roles however, none in the area of Immunisation. What this paper adds: A Nurse Practitioner (NP) role in the specialty field of immunisation can contribute to improving hospital inpatient rates of immunisation, facilitate uptake of non-scheduled vaccines and decrease pressure on wait times for a specialist clinic appointment. The Immunisation NP reflects the full diversity of nursing practice and addresses the many service gaps in the previous delivery model, that can be emulated by paediatric nurses in other specialist areas.

Specialty representation on national comprehensive cancer network guideline committees.

11041 Background: Among the National Comprehensive Cancer Network (NCCN) guidelines, the existence of Category 1 evidence for cancer management decisions remains low, resulting in the reliance on multispecialty perspective to determine optimal treatment approach. Multiple studies suggest that the specialty composition of oncological teams is important in the trajectory of decision-making. Consequently, we sought to determine if there was adequate representation of radiation oncologists (ROs) on NCCN committees (NCMs). Methods: NCMs with Category 1 or 2A recommendations for radiotherapy use were identified. Committee members were documented including specialty, academic rank, and committee role. H-index and gender was assessed for each member. A minimum arbitrary threshold of &lt; 10% was used to define underrepresentation of ROs. Univariate and multivariate (MVA) logistic regression identified factors predictive of underrepresentation. Results: Of 57 assessed guidelines, 38 (66.7%) NCMs recommended radiation as Category 1 or 2A from which a total of 1284 committee members were identified. Median committee size was 33 (range 29-38). Overall, 42.2% were Medical Oncologists (MOs), 23.9% were Surgical Oncologists (SOs), and 11.5% were ROs [22.4% were a mix of Radiologists, Pathologists, other specialty physicians, and non-physician members like Patient Advocates]. ROs constituted 4.4% of NCM Chairs (MOs: 68.9%, SOs: 13.3%, Other: 13.3%); 29% of Vice Chairs (MOs: 35.5%, SOs: 35.5%); and 5.9% of the discussion writing committee (MOs: 70.6%, SOs: 23.5%). The representation of ROs was highest for Head/ Neck Cancer NCM (38.8%) and Prostate Cancer NCM (25.8%). 42% of the NCMs recommending radiation had &lt; 10% representation of ROs; 17% of guidelines recommending radiation had 1 or less RO including 4 NCMs which did not have a single RO committee member. On univariate analysis, factors predictive of RO underrepresentation were low SO representation (p = 0.038) and low median H-index of the NCM (p = 0.013); low proportion of full professors trended towards significance (p = 0.060). On MVA, median H-index had a negative association with RO underrepresentation (p = 0.038) —no association was found to rank, gender or specialty. Conclusions: Our study shows alarmingly low representation of ROs among NCCN committees which include radiation as a Category 1 or 2A recommendation. This can both limit the discussion during guideline development and negatively impact the diversity of perspectives in management recommendations. Efforts to ensure more proportional representation of ROs on NCCN guideline committees are warranted including exploring potential barriers to committee leadership.

P55 FutureCOVID: Exploring the perspectives of doctors &amp; nurses of student response during the COVID-19 pandemic

IntroductionThe training medical students receive means they can be used as auxiliary healthcare staff during pandemics and disasters. During COVID-10, many medical students volunteered in healthcare settings in clinical and non-clinical capacities. While there has been research into students’ perceptions of the pandemic and their role within the NHS, the perceptions of healthcare staff perceive this student response has not been explored.MethodsCOVIDAssist is a survey based cross sectional observational study of medical student volunteering during COVID-19. The study consists of a cross sectional survey of doctors & nurses who worked alongside medical students in the NHS during the pandemic. We will use qualitative and quantitative methods to analyze responses.ResultsThe primary objective of the study is to assess how effective student response was in reducing the burden on healthcare teams during the pandemic. Secondary objectives are: to identify the broad specialty (e.g. medicine, surgery, primary care) and healthcare roles medical students were most beneficial) ; the GMC outcome-based skills students exhibited; the training provided to students before volunteering and what additional training could have been provided to students.ConclusionThe outcomes of this study will help inform current and future guidance on effective student deployment during pandemics and disasters. The results are also expected to provide insight into necessary training adaptations.

Defining the urology nurse practitioner role in the United States: A Delphi study.

Nurse practitioners (NPs) achieve expertise in urology environments due to on-the-job training and independent study, coupled with mentoring. This creates a wide variety of preparation and role descriptions, and despite the availability of sought NP certification in urology, there is not a current definition for a "urology NP." This project sough to develop a contemporary definition of the urology NP role, based on expert opinion. Study design was the Delphi method, which evaluates consensus and opinion when there is incomplete knowledge or lack of evidence. Participants were a nonrandom panel of experts on the urology NP role with at least 2 years as a full-time urology NP. This exempted study collected data via an online platform that ensured anonymity, and was completed in two rounds. The following definition is proposed after the study results: "The Urology NP provides acute and chronic care to individuals experiencing urological health care needs across the lifespan, engages in office-based urology procedures in accordance with the state Board of Nursing, maintains membership in professional organizations and acts as preceptor to all health care disciplines." Certification in the specialty role was deemed important. Results demonstrated the very patient-care centered nature of this specialty NP role, as professional roles of the NP were given less weight. The project offers a definition of the urology NP role that can be offered to educators and other stakeholders.

A scholarly concentration program to promote public health nursing for generalist Clinical Nurse Leader students.

The number of public health nurses has decreased consistently and significantly since the 1920's. The recent COVID-19 pandemic has put a spotlight on the need for more public health nurses in the workforce. The number of novice nurses entering into public health roles is declining, demonstrating a clear need to mentor pre-licensure nursing students into the public health nursing workforce. Scholarly concentration (SC) programs are a method to explore specialty roles through in-depth scholarly activities, outside of core curriculum. However, SC programs have not been described in the nursing literature. The purpose of this paper is to describe the development of a SC program to engage pre-licensure Clinical Nurse Leader (CNL) students in scholarly activities related to public health nursing. This Public Health Nurse Scholars program was developed in 2014 with the goal of developing a cadre of generalist CNL students with experiences in public health nursing scholarly activities. The program aimed to increase awareness of career and scholarship opportunities through mentorship with public health nursing faculty. Students were encouraged to attend and present at professional conferences, participate in active scholarly projects and conduct quality improvement projects from a public health nursing perspective. The program was designed to foster students' public health nursing leadership and presentation skills and enhance their self-directed learning. To date, 46 pre-licensure nursing students were selected as Public Health Nurse Scholars. Sixty-seven percent (n=31) have graduated as Public Health Nurse Scholars; 33% (n=15) are current Public Health Nurse Scholars. Twelve public health nursing faculty have served as mentors. As a result of the program 15 scholars attended and 3 scholars presented respectively at community/public health nursing conferences, and several scholars had related professional development opportunities. A majority of Public Health Nurse Scholars have designed and implemented a capstone quality improvement project with a public health nursing perspective, 15 of which were completed at community-based sites. In the face of our current global, public health crisis, there is a clear need to develop a cadre of novice nurses prepared to enter the public health nursing workforce. The Public Health Nurse Scholars program shows promise towards encouraging an interest in public health nursing scholarship. Schools of nursing may consider the implementation of similar SC programs as an approach to mentor pre-licensure nurses in other specialty areas such as gerontological and neonatal nursing.