Medical Education, Год журнала: 2023, Номер 58(1), С. 17 - 19
Опубликована: Ноя. 20, 2023
Health education's competency models are evolving to balance universal skills with those that job‐ and organization‐specific. These authors argue a three‐layer framework emphasizing person‐organization fit will create better outcomes.
Язык: Английский
Health Research Policy and Systems, Год журнала: 2024, Номер 22(1)
Опубликована: Авг. 5, 2024
Abstract Background Pakistani’s health services delivery system has been rarely evaluated regarding patient satisfaction. This study examined the performance of Pakistani from perspective doctor (DS), digital payment (DPS), nurses’ (NS), laboratory (LS), pharmacy (PHS), registration (RS), physical (environmentally and tangible) doctor-patient communication (DPC) about A random sampling technique was adopted for data collection. Methodology The Social Science Statistical Package (SPSS), analysis moment structures (AMOS), structural equation modeling were used to analyze reliability, validity, correlations, descriptive findings. 879 responses analysis. Results revealed that satisfaction found be significantly affected positively by LS, PHS, DS, NS, DPS, while DPC, RS, PF impacted non-significantly. Consequently, there is a considerable gap in interaction, Pakistan's healthcare confronted with shortage infrastructure challenges system. Conclusion Furthermore, insufficient emphasis on necessitates immediate action improve entire experience Identifying these shortcomings potential result more efficient focused needs patients.
Язык: Английский
Процитировано
2
Medical Teacher, Год журнала: 2024, Номер 46(sup1)
Опубликована: Июнь 4, 2024
The 2022 revision of the Model Core Curriculum (MCC) for Japanese undergraduate medical education aimed to develop a stratified, national-level competency framework. This paper aims explore what innovations emerge during process competency-based (CBME) glocalisation, driven by interplay between global and local language dynamics among multiple stakeholders.
Язык: Английский
Процитировано
2
Indian Pediatrics, Год журнала: 2024, Номер 61(5), С. 463 - 468
Опубликована: Фев. 23, 2024
Язык: Английский
Процитировано
1
The Clinical Teacher, Год журнала: 2024, Номер unknown
Опубликована: Ноя. 6, 2024
Abstract Purpose Entrustable professional activities (EPAs) are used to support clinical skills training by providing a scaffold for practice and feedback. The aim of this study was evaluate how written feedback provided EPAs supports medical students' learning. Materials methods two (admit or consult patient discharge summary) analysed using mixed approach. Content analysis determined the types received. Qualitative identified themes related quality. Hattie Timperley's model that provides framework effective as an interpretive lens our integrated findings. Results Written 89.5% 997 EPAs. proportions learning were follows: what done well (75.6%), areas improvement (27.7%) next steps (17.4%). Only 10% received all three completed independently more likely receive any Feedback supervised include steps. themes: present future performance with detailed description targeted advice, lack specific guidance affirmative statements non‐specific directions. Conclusions most often elicited about is without strategies improvement. Descriptive tailored advice ideal, but uncommon. Students supervisors need on optimise through instruction EPA form design.
Язык: Английский
Процитировано
1
Health care science, Год журнала: 2024, Номер 3(2), С. 73 - 77
Опубликована: Март 18, 2024
A decade ago we asked the question, "Is there something in medicine that is eternal or enduring?" Our aim was to write a manuscript entitled, "That which does not change medicine." The publication begins as follows: "The practice of involves continual change, driven by constant stream developments understanding biological structure and function relevant human diseases, parallel improvements pharmacologic other technological interventions. This also evolving social philosophies, ethical trends, lifestyles." [1] That preamble reverberates strongly now then, perhaps even more so, given velocity change. When deliberated on aspects medical should remain stable, had few premonitions implantable chips, robotic surgery, virtual reality, artificial intelligence (AI) would soon become ubiquitous. needle has clearly moved, propelled extraordinary advances bioengineering, computer data sciences; major shifts governance organization clinical practice; powerful sociocultural trends. As explore current transformative are reminded our earlier conclusions: certain dimensions are, indeed, immutable. Most importantly, relationship between physician patient depends moral obligations, characterized compassionate response best described engagement [2]. requisite virtues affective much cognitive. challenge for educators, physicians, policymakers accommodate benefits transformational both conceptual, whilst remaining true fundamental, dyadic relationship. Thus, pedagogic welcome innovations but do so with restraint is, an attitudinal disposition neither cynical nor inhibitory rather alert mindful, especially when faced announcements innovation will solve problems overburdened hospital system. By insisting cautious approach may avoid pendulum swings too far, resulting unintended consequences costly backtracking undo damage untrammeled enthusiasms. We consider two illustrative germane healthcare delivery: one education technology. try anticipate understand impacts conclude posing set questions be useful those who manage systemic changes. An innovation, unfolding schools world-wide often regarded "transformative," competency-based (CBME). analyze this trend, relying hierarchy knowledge frame reference. historian Jill Lepore, using metaphor filing cabinet four drawers, proposed categorization [3]. Each drawer contains different kind. top "mysteries"; second "facts"; third "numbers"; lowest "data". With respect their epistemologies, she suggests mysteries accessible revelation (thus, discernable "God"); facts derived way experimental scientific methods observations (i.e., product natural sciences humanities); numbers entities can counted (e.g., measured statisticians epidemiologists); and, generated computers science). these categories potentially valuable practice. CBME lives, metaphorically speaking, Lepore's drawer. Its ontology reductionist; it views professional development accumulation small quanta knowledge, accompanied accretion discrete psychomotor skills, then presented stepwise progress personal abilities. epistemology, tenacity defines educational outcomes behaviorally measurable ways, aligned psychometrics. model been able mitigate well-documented deficiencies assessments performance; however, its implementation, theoretical coherence, axiological foundations have criticized. Numerous commentators bemoaned monopolized resources, distracted leaders, undermined loco parentis nature teaching, most distressingly, failed provide holistic picture students' capabilities [4]. fraught controversy. It apparent tensions exist obligation attend identity formation [5]. recent commentary attempts rescue concept "competencies" distinguishing from "competence" foregrounding latter; argues competence multilayered visualizes continuum existing three separate levels [6]. first layer, considered develop primarily undergraduate (UGME) labeled "canonical competence," represents amalgam foundational declarative sprinkling basic skills. Higher order capabilities, such creativity, curiosity, adaptability, humility, leadership, postponed later phases training, layers encapsulated hackneyed phrase, "the art "art" supposedly acquired preferentially during residency independent curricular edifice reinforces reductionist suggesting needs focus rote undermines arguments appropriateness UGME. There striking disconnect wholesale adoption paucity compelling evidence superiority. In Canada, country long promoted CBME, report Royal College Physicians Surgeons confirmed only minority resident physicians supportive [7]. Understandably, many jurisdictions decided slacken transition adopting competency-compatible lieu model. experience serve note caution leaders health professions. changes presumed salutary, recommend following reflections: Might represented transformation risk overwhelming alternative ways indispensable institutional values? Could deforming transforming? To what extent new innovative tool result advantages adopter (in illustration, managers) culminate improved client teachers learners)? Perhaps time make haste slowly! introduction AI illustrates how ideas received, adopted, translated strategically pragmatically medicine. heralded exciting yet disruptive. technology unfolded pari passu domains. promises pitfalls former summarized [8] avalanche studies, reviews, commentaries scope, risks introducing various types clinically related tasks diagnosis, documentation, scheduling, workflow, simple surgery) diverse specialities [9]. For purposes analysis, put aside specific modes domains application essences technology, writ large. turn Aristotelian philosophical constructs. etymology word Greek technē (or ars, Latin)—commonly craft. ancient Greeks viewed antithesis tuchē (luck). Tuchē refers happenstance events occur chance controlled humans. Technē aims introduce predictability. Philosopher Martha Nussbaum notes, "Technē …. deliberate some part world, yielding control over tuchē; concerned management need prediction concerning future contingencies" [10]. Control contingencies cardinal feature. highly awash contingencies. Clinical defined as: "a science-using must diagnose treat illnesses one" [11]. definition helps situate context practices. notion "science-using." support physicians' abilities diagnosing, treating, prognosticating reducing inherent responsibilities. Although founded databases "N" gigabytes, resolutely mode "one one." Aristotle distinguished branches thought pertinent activities practical domains: fabricating forging porcelain plate) versus performing navigating ship). activity requires distinct cognitive disposition. technē—a productive characteristics: identifies features common group cases generalizable); culminates definable external agent involved making; explains phenomena through cause effect; directly teachable; succeeds creating artifacts canonical methods. These characteristics normative aspects, hearken back layer competence, retrofit noted earlier. contrast pursuit, corresponds phronēsis. Phronēsis prudence wisdom. analogous virtue Confucianism ren (humanness), moderated yi (justice), guides person "to localized factors" [12]. Practical wisdom allows apprehend singular contextual factors particular case). less formulaic than technē; deliberation about worthwhileness thus tied judgment; dependent excellence character; results inextricable agent; nurtured transmitted experiential learning. argued practices focused N 1, endeavors understood lens phronēsis [13, 14]. important underline above concepts crystalline terms open debate. discussion controversies beyond remit article. point wish pedagogical reasoning involve choreography generalization particularization. integrate nomothetic idiographic approaches, philosopher Wilhelm Windelband [15]. AI, like all cannot escape dance. will, undoubtedly, help formulate generalizations precepts routinely used outputs improve decision making rendering diagnostic evaluations, notably rely visual interpretations dermatology radiology), prognostications increasingly accurate. Time-honored heuristics served well generations fine-tuned rendered obsolete AI. If trials confirm overall good. However, nameless "generic" counts. individual matters greatly. Would robot engage suffering manners wise clinician? see patient, personhood, accompany them healing journey comparable three-dimensional space fellow being? Randomized studies demonstrated large language model-based systems generate responses empathic tone provided clinicians [16]. Some interpreted findings proof Chatbot displays "bedside manners" equivalent superior [17]. Such conclusions unwarranted. Interpersonal connections empathy complex multifaceted constructs reduced question-and-answer duet. Considering sharpen distinctions machine encounter. Two empirical revealed characteristics; include having capacity sustaining hope, rule breaking, bubble undivided attention, encountering patients reveal centrality care, decisions influenced embodied perceptions gut feelings intuitions [2, 18]. These, agency, unlikely achievable robots. destined desirable assistive functions, particularly generalizations, computations, pattern recognition. particularization approaches within domains, decision-making engagement, contend never pass muster. reason … "Data, Information, Knowledge, Wisdom" pyramid represent intellectual progression possession unprocessed insight. origins uncertain [19]. find useful, least because positions "wisdom" at pinnacle. perhaps, "mysteries" visualized Lepore her propose aspirational goal. magic recipe acquisition. Practiced discernment, guided reflection, longitudinal learning, preferably sage mentors, candidate ingredients. Benjamin Chin-Yee, direct necessary reflections. He "… refer simply material describes thinking interacting world; …(it) value-neutral reflects range choices values; pure ends fixed means instead exists ends" [20]. framing warranted models. Critical posed: (i) Whose interests anyone overlooked? (ii) Will any tradition threatened if loss acceptable? (iii) Does deployment suggest realignment core values beliefs (intentionally inadvertently) promotion demotion? guiding principles ethos telos physician, we, professionals, obliged recall students focal duties. must, therefore, assure entrusted us care benefit harmed creativity. Both authors participated conception design written perspective. worked revisions contributed final version. None. declare no conflict interest. Not applicable. Informed consent applicable article subjects were involved. Data sharing datasets analyzed formulation commentary.
Язык: Английский
Процитировано
0
Medical Teacher, Год журнала: 2024, Номер unknown, С. 1 - 11
Опубликована: Авг. 3, 2024
Purpose With limited means, resource-deprived countries must find ways to organize education meet standards. Few reports exist about anatomical in LLMICs. This study explores how anatomy teaching is sustained with few resources and which affordable educational strategies are applied uphold quality.
Язык: Английский
Процитировано
0
International Journal of Pharmacy Practice, Год журнала: 2024, Номер 33(1), С. 88 - 94
Опубликована: Дек. 3, 2024
The aim of this work was to evaluate the performance UK MPharm graduates on General Pharmaceutical Council's (GPhC) registration assessment, between years 2011-2024, explore factors that impact student in examination. Student GPhC assessment contextualized with like alma mater, Foundation Training placement, NSS, and HESA data. Relationships these weighted average passing rates raw scores were analysed using a range statistical methods including correlation analysis, ANOM, Tukey-Kramer, t-tests. Year year, students from top performing Schools Pharmacy consistently perform well becomes less consistent as rate decreases (R2 = 0.89; Prob > F < 0.0001). To best discriminate programmes placement type, can be grouped by their score. We also find are more likely pass hospital compared community placements, independent institution. These relationships hold true for best- worst-performing students. Our analysis highlights substantial differences levels highest lowest-performing schools types. While not always case, it appears pharmacy should seek obtain pre-registration environment maximise chances success exam. Moving forward, we advocate better quality data which could link each individual (and demographic characteristics) they move through university right question
Язык: Английский
Процитировано
0
BMC Medical Education, Год журнала: 2024, Номер 24(1)
Опубликована: Дек. 18, 2024
Abstract Introduction Effective chronic disease management (CDM) is vital for addressing challenges. Given the importance of ensuring pharmacists’ competence in CDM, interventions targeting knowledge, skills, and attitudes are essential. Therefore, a comprehensive up-to-date study needed to analyze these interventions’ effect potential development. Categorizing based on Practice Organization Care (EPOC) taxonomy essential better informing policymakers. The objectives this systematic review were identify improve competency EPOC summarize their effectiveness. Methods Following methods Cochrane Handbook, search was conducted up April 2024 MEDLINE Scopus. inclusion criteria an intervention with randomized controlled trial (RCT) design published English, pharmacists, measuring aspects CDM. risk bias assessed using Cochrane’s RoB 2 tool either or cluster-randomized trials. Findings reported narratively align Preferred Reporting Items Systematic Reviews Meta-Analyses (PRISMA) statement. Results We included 11 RCT studies that focused various CDM among community hospital pharmacists. Implementation strategies combined implementation strategies–delivery arrangements identified. Six consistently yielded effective results, scores ranging from 0.99 9.17 ( p < 0.05). However, other two mixed no significant improvements knowledge skills. Two strategies-delivery showed improvements, score differences 4.5% (95% CI: 1.6%-7.4%) 30% 29%-40%). Conversely, one improvement. assessment revealed varying levels across studies. Conclusions improved pharmacists' Most resulted attitudes. These findings underscore tailored, competency-based pharmacist competencies Policymakers can use insights create guidelines policies promote ongoing professional development
Язык: Английский
Процитировано
0
Academic Medicine, Год журнала: 2024, Номер 99(10), С. 1083 - 1087
Опубликована: Июнь 26, 2024
Abstract In the United States, initial board certification remains focused on a high-stakes knowledge examination after completion of training. A more contemporary view supports program assessment that includes multiple types and sources data with an emphasis direct workplace observation to get best picture individual’s performance. this article, authors reimagine as continuous for learning begins in residency, focuses both acquisition its application, interdigitates intentionally first cycle maintenance advance smooth transition from training practice. expanded competence, 3-layered construct (canonical, contextual, personalized), proposal. Canonical competence (context-independent knowledge)—best assessed through examinations knowledge—is most heavily weighted during medical school but critical throughout one’s career. Contextual (context-dependent knowledge) is key residency fellowship trainees navigate myriad clinical work environments. Personalized representing totality unique areas expertise, demonstrated practice years when deliberate experience growth personalized expertise discoveries field. Shifting relying anxiety-provoking, high-stakes, often single moment time-standardized nuanced approach part individual trainee’s offers just robust decision about readiness unsupervised Such model would also sow seeds meaningful individualization needs training, continues practice, lays foundation improving quality care patients within given well shifting current contiguous phases into true continuum.
Язык: Английский
Процитировано
0
ATS Scholar, Год журнала: 2024, Номер 5(4), С. 599 - 606
Опубликована: Июль 22, 2024
Background: Physicians practicing in pediatric critical care medicine (PCCM) should maintain procedural skills competency. Faculty academic centers face challenges that may affect their maintenance. The overall clinical opportunities are decreasing PCCM. also have the dual role of supervising and supporting achievement trainee competence. Mental practice (MP) does not need direct involvement could be a helpful strategy for faculty. Objectives: This study's objective was to explore how faculty an center use MP competency when faced with decreased opportunities. Methods: study conducted tertiary 2023. We used qualitative methodology using semistructured interviews as our data source. Participants were Interviews transcribed verbatim then analyzed coded inductively deductively Guillot Collet's Motor Imagery Integrative Model. A member performed analysis. Differences resolved through discussion. Triangulation done checking. Results: Thirteen PCCM Thematic saturation achieved. All rehearse strategies anticipate troubleshoot problems. Fewer members steps. consequently increased self-confidence reduced anxiety. Conclusions: is by performing maintaining low-resource nature make it useful adjunct maintenance
Язык: Английский
Процитировано
0