Implementing coaching programmes for healthcare professionals-A review of the barriers and facilitators.

BACKGROUND: The European Union faces severe and worsening personnel shortages in healthcare. Coaching has emerged as a human-centred strategy to enhance sustainable employment and retention. While the number of efficacy studies on coaching continues to grow, knowledge about the barriers and facilitators to implementing coaching interventions among healthcare professionals (HCPs) remains scarce. OBJECTIVES: This systematic review aimed to describe common barriers and facilitators to the implementation of coaching interventions for HCPs. METHODS: In April 2023, five databases were searched for eligible articles. Barriers and facilitators were systematically identified and mapped onto the constructs of the Consolidated Framework for Implementation Research (CFIR). Directed content analysis yielded thematic areas and a reporting frequency. RESULTS: A total of thirty (n = 30) studies were included in this review, representing twenty-five (n = 25) distinct coaching programmes. Implementation determinants were clustered under two CFIR domains: the Inner Setting (8 facilitators, 5 barriers) and Implementation Process (6 facilitators, 1 barrier). Barriers included (i) limited organisational capacity, (ii) lack of psychological safety, (iii) competing work demands, and (iv) insufficient leadership buy-in, while facilitators were the (i) allocation of protected time for participants and coaches, (ii) promotion through opinion leaders, (iii) embeddedness in existing Continuous Professional Development programmes, and (iv) programme co-creation. CONCLUSION: The findings of this study provide practical insights to guide the future implementation of coaching interventions at an organisational level. In particular, the identified barriers and facilitators suggest, for optimal efficacy and sustainment, coaching interventions must be implemented within a safe, supportive organisational climate.

Nonformal education as health promotion method among European youth: the example of transitional Albania.

Nonformal education methodology is promoted by the European Union as a priority. Western Balkan countries are supported in using this methodology via access Community funds (Erasmus +, previously Youth in Action). Nonformal education (proven as the most effective education method for youth) is expected to have the same impact if used in Public Health. We aimed to explore how nonformal education methodology contributes to health promotion through elaborating the example of transitional Albania. An Exploratory Sequential Mixed Methods design was used. We organized two focus groups: one with students of medical sciences and another with none medical students. We randomly selected eight participants per focus group from the Beyond Barriers association database (Contact point for Erasmus+ Programme in Albania). We used conventional content analysis to analyze qualitative data. Exploratory group interviews were conducted previously, using a questionnaire, which was piloted prior to administration. Of a population of 581 youth who participated in nonformal education activities during 2007-2013, 113 youths were interviewed. Ninety percent of interviewees declared that nonformal education activities have influenced improvement of their skills/competences or helped to acquire new ones; 53% declared that they reflected a change into personal behavior/actions/attitudes. Trainees learned through practice. They intended to retain the healthy behavior even when the activity was finished. Nonformal education activities offered equal opportunities to all youth despite their gender or field of study. Nonformal education methodology is recommended to be used in health promotion campaigns targeting young people as a very effective tool.

Promoting rational antibiotic use in Turkey and among Turkish migrants in Europe - implications of a qualitative study in four countries.

BACKGROUND: Antimicrobial resistance is considered one of the major threats to global health. The emergence of resistant microorganisms is a consequence of irrational use of antibiotics. In Turkey, the consumption of antibiotics is relatively high and antibiotics are among the most commonly used drugs. However, Turkey has adopted new, more restrictive policies and regulations on antibiotics. In addition, Turkish migrants to EU countries, such as Germany, the Netherlands and Sweden, may encounter health systems that promote a more restrictive and rational antibiotic use. The objective of this paper was to explore the variation in implemented policies related to rational antibiotic use that citizens in Turkey and Turkish migrants in Germany, the Netherlands and Sweden are subjected to and to discuss the implications for the promotion of rational antibiotic use. Data were collected through focus groups and individual interviews with citizens, physicians and pharmacists in the four countries. In total, 130 respondents were interviewed. Content analysis was used. RESULTS: Three relevant themes were identified: Implementation of regulations and recommendations, Access to antibiotics and Need for health communication. Irrational use of antibiotics was reported mainly in Turkey. While it had become less likely to get antibiotics without a prescription, non-prescribed antibiotics remained a problem in Turkey. In the three EU countries, there were also alternative ways of getting antibiotics. Low levels of knowledge about the rational antibiotic use were reported in Turkey, while there were several sources of information on this in the EU countries. Communication with and trust in physicians were considered to be important. There were also system barriers, such as lacking opportunities for physicians to manage care in accordance with current evidence in Turkey and factors limiting access to care in EU countries. CONCLUSIONS: Several fields of importance for promoting rational antibiotic use were identified. There is a need for harmonisation of health-related regulations and policy programmes. Antibiotics should only be available with a prescription. Programmes for rational antibiotic use should be implemented on a broad scale, in medical care, at pharmacies and in the population. Methods for health communication and patient-centred care should be further developed and implemented in this field.

Exploring Women Healthcare Leaders' Perceptions on Barriers to Leadership in Greek Context.

Background: Gender inequalities have been identified as important derailment factors for health workforce and health system sustainability. Literature holds responsible a list of gendered barriers faced by female health workforce. However, there is a gap in the evidence based research on women leaders' own perceptions of barriers to leading positions advancement. This study aims to explore leadership barriers perceived by women healthcare leaders within country's context; research focused on Greece due to country's poor performance on gender equality index and current economic turbulence. Study supplements survey data and provides orientation for further gender sensitive research in health workforce development through country's specificity lens to better inform education and policy makers. Methods: The best-worst object case survey method was used, applying an online questionnaire designed in Qualtrics. The online questionnaire was sent to 30 purposively invited participants. Respondents were asked to tick the most and the least important barriers to women's leadership in provided choice scenarios. Descriptive data analysis was used to understand and interpret the results. Results: Women leaders perceived stereotypes, work/life balance, lack of equal career advancement, lack of confidence, gender gap and gender bias to be the barriers with the greatest relative importance in constraining opportunities for pursuing leading positions in Greek healthcare setting. Twenty more barriers were identified and ranked lower in relative importance. The results are considered exploratory and not to obtain population based outcomes. Conclusion: This exploratory study reports the perceived barriers of women leaders in pursuing leading positions within Greek healthcare context. The findings point mainly to organizational and socio-cultural related barriers potentially aggravated by country's unfortunate current economic turbulence. Further extensive research is required to establish grounded conclusions and better inform education and policy makers in developing gender sensitive strategies to sustainable health workforce development.

Teaching Ethics to Pediatric Residents: A Literature Analysis and Synthesis.

BACKGROUND: Ethics education rarely exists in pediatric resident curricula, although ethical conflicts are common in the clinical practice. Ethics education can prepare residents to successfully handle these conflicts. AIM: We searched for methods in teaching ethics to clinical and especially pediatric residents, and identified recurring barriers to ethics teaching and solutions to overcome them. DESIGN: Literature from 4 electronic databases with peer-reviewed articles was screened in 3 phases and analyzed. The literature included papers referring to applied methods or recommendations to teaching ethics to clinical residents, and on a second level focusing especially on pediatrics. An analysis and critical appraisal was conducted. RESULTS: 3 231 articles were identified. 96 papers were included. The applied learning theory, the reported teaching approaches, the barriers to teaching ethics and the provided solutions were studied and analyzed. CONCLUSIONS: We recommend case-based ethics education, including lectures, discussion, individual study; regular teaching sessions in groups, under supervision; affiliation to an ethics department, institutional and departmental support; ethics rounds and consultations not as core teaching activity; recurring problems to teaching ethics, primarily deriving from the complexity of residential duties to be addressed in advance; teaching ethics preferably in the first years of residency. We may be cautious generalizing the implementation of results on populations with different cultural backgrounds.

Policy summary 10: addressing needs in the public health workforce in Europe

Health systems in Europe face a number of increasingly complex challenges. Globalization, evolving health threats, an ageing society, fi nancial constraints on government spending, and social and health inequalities are some of the most pressing. Such challenges require not only different funding and organizational approaches to health services, but also demand a multidisciplinary public health workforce supported by new skills and expertise. This policy summary aims to outline these needs and to consider measures and options towards meeting them. First, the aims of the public health workforce in Europe (noting that many elements of this discussion should not be seen as unique to Europe) and the importance of public health are described. The importance of public health professionals who can fi ll information, prevention, social and regulatory defi cits is explained. This is followed by a picture of the current workforce and training provisions. Although the Bologna Process and the WHO Regional Offi ce for Europe's Health 2020 policy provide a conducive backdrop for change and promote positive developments, public health training and education lag behind. Large gaps are apparent in both the numbers of professionals trained and the kind of training that exists. Education is still largely characterized by a traditional and limited public health focus.